@article {pmid40462425, year = {2025}, author = {Feng, Y and Wang, F}, title = {[Meta analysis of the prevalence of depressive symptoms among children and adolescents in China from 2015 to 2024].}, journal = {Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics}, volume = {27}, number = {5}, pages = {529-539}, pmid = {40462425}, issn = {1008-8830}, mesh = {Humans ; Adolescent ; Child ; China/epidemiology ; Prevalence ; *Depression/epidemiology ; Female ; Male ; COVID-19 ; }, abstract = {OBJECTIVES: To systematically evaluate the prevalence of depressive symptoms among children and adolescents in China.<br><br>METHODS: A comprehensive search was conducted in PubMed, Embase, Cochrane Library, Web of Science, Wanfang Data, China Biomedical Literature Database, China National Knowledge Infrastructure, and VIP Database for literature published from January 2015 to May 2024 regarding the prevalence of depressive symptoms among Chinese children and adolescents. Stata 16.0 software was used for Meta analysis, and Egger's test and funnel plot analysis were performed to assess publication bias.<br><br>RESULTS: A total of 53 studies were included, encompassing 314 867 children and adolescents, with 65 324 exhibiting depressive symptoms, resulting in a prevalence rate of 23.3% (95%CI: 21.4%-25.1%). Subgroup analysis revealed higher prevalence rates among females, those in rural areas, vocational high school students, individuals from the eastern region, those assessed using the Depression Self-Rating Scale for Children, and during the COVID-19 pandemic, with rates of 24.9%, 29.5%, 28.1%, 25.6%, 27.2%, and 27.7%, respectively. The distribution of studies in the funnel plot was roughly symmetrical, but Egger's test indicated potential publication bias (P<0.001).<br><br>CONCLUSIONS: The prevalence of depressive symptoms among children and adolescents in China is relatively high, particularly among females, those in rural areas, vocational high school students, and those in the eastern regions. Additionally, the COVID-19 pandemic may have impacted the incidence of depressive symptoms in this population.}, }
@article {pmid41521363, year = {2026}, author = {Singh, D}, title = {mRNA-Encoded antibodies as a next-generation therapeutic paradigm: a rapid and adaptive platform for the prevention and treatment of emerging and re-emerging infectious diseases - A critical review.}, journal = {Immunologic research}, volume = {74}, number = {1}, pages = {7}, pmid = {41521363}, issn = {1559-0755}, mesh = {Humans ; *COVID-19/immunology/prevention &amp; control/therapy ; *SARS-CoV-2/immunology ; *Antibodies, Neutralizing/genetics/therapeutic use/immunology ; Animals ; *RNA, Messenger/genetics ; Spike Glycoprotein, Coronavirus/immunology ; *Antibodies, Viral/genetics/therapeutic use/immunology ; *Communicable Diseases, Emerging/therapy/immunology/prevention &amp; control ; }, abstract = {Messenger RNA (mRNA)-encoded antibodies represent a transformative therapeutic platform with the potential to rapidly combat emerging infectious diseases by enabling in situ expression of potent neutralizing antibodies directly in the patient's body. Unlike conventional monoclonal antibody (mAb) therapies, which rely on labor-intensive and time-consuming cell culture production, mRNA-encoded antibodies offer a faster, scalable, and cell-free approach that bypasses protein purification and cold-chain constraints. This strategy has demonstrated considerable promise during the COVID-19 pandemic, where Moderna's mRNA-1940, an mRNA-based neutralizing antibody targeting the SARS-CoV-2 spike protein, entered preclinical and early-phase trials within months of viral emergence, underscoring the potential for rapid response in outbreak settings. The platform leverages advances in nucleoside-modified mRNA, codon optimization, and lipid nanoparticle (LNP) delivery systems to achieve transient, high-level expression of functional antibodies with reduced innate immune activation. Beyond COVID-19, mRNA-encoded antibody approaches have been explored in preclinical models of Zika virus, Ebola virus, and rabies, where a single intramuscular dose provided prophylactic and therapeutic benefits in animal models. As the world faces recurrent viral threats, the development of mRNA-encoded antibodies as a plug-and-play system offers a compelling, adaptable, and clinically feasible strategy for infectious disease preparedness. This review explores the mechanistic foundation, delivery technologies, translational progress, case studies, safety considerations, and future clinical potential of mRNA-encoded antibodies in combating both pandemic and endemic infections.}, }
@article {pmid41521058, year = {2026}, author = {Keefer, S and Lorenzo-Leal, AC and Bach, H}, title = {Advancements in nanotrap technology for the prevention, diagnosis and treatment of infectious diseases.}, journal = {Nanomedicine (London, England)}, volume = {}, number = {}, pages = {1-11}, doi = {10.1080/17435889.2026.2614545}, pmid = {41521058}, issn = {1748-6963}, abstract = {Nanotraps are particles designed to capture and concentrate target molecules and have numerous applications in infectious diseases. This review outlines how nanotrap technologies may improve the detection and treatment of bacterial and viral pathogens, including Mycobacterium tuberculosis, Borrelia burgdorferi, Yersinia pestis, HIV, SARS-CoV-2, and others. Nanotraps can enhance the sensitivity of diagnostic tools and support treatment by neutralizing bacterial toxins, capturing inflammatory mediators, and preserving viral proteins for detection. Nanotraps have also been investigated for vaccine development. While results from in vitro and in vivo models are encouraging, there is significant room for further research regarding safety and other unexplored applications of these technologies. Nanotraps offer a flexible platform with the potential to improve how we diagnose and manage a multitude of infectious diseases.}, }
@article {pmid41519993, year = {2026}, author = {Azhar, LE and Samkari, DA and Hassan, AM and Alsayed, SM and Azhar, EI}, title = {The Emergence and Characterization of SARS-CoV-2 Variant XFG ("Stratus"): Comparative Virological, Epidemiological, and Public-Health Perspectives.}, journal = {Journal of epidemiology and global health}, volume = {}, number = {}, pages = {}, doi = {10.1007/s44197-025-00510-x}, pmid = {41519993}, issn = {2210-6014}, }
@article {pmid41517681, year = {2026}, author = {Escobar-Segovia, K and Domínguez-Salas, S and García-Iglesias, JJ and López-López, D and Allande-Cussó, R and Ruiz-Frutos, C and Artero-García, A and Gómez-Salgado, J}, title = {Psychological distress in Spanish-speaking countries during the COVID-19 pandemic: A systematic review and meta-analysis.}, journal = {Medicine}, volume = {105}, number = {2}, pages = {e47062}, pmid = {41517681}, issn = {1536-5964}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Psychological Distress ; *Stress, Psychological/epidemiology ; Prevalence ; SARS-CoV-2 ; Female ; Pandemics ; Spain/epidemiology ; }, abstract = {BACKGROUND: Psychological distress (PD) has increased significantly during the coronavirus disease 2019 (COVID-19) pandemic. In Spanish-speaking countries, with their cultural, social, and economic diversity, this phenomenon has become particularly relevant and has been aggravated by factors such as socioeconomic inequalities and unequal access to mental health services. The aim of this systematic review was to consolidate the available knowledge on PD in Spanish-speaking population groups by assessing both the prevalence of symptoms and the associated factors in different demographic groups and geographic contexts, during the COVID-19 pandemic.<br><br>METHODS: A systematic review following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement was conducted in the Web of Science, PubMed, and Scopus electronic databases in January 2025. The search included studies published from the beginning of the pandemic until May 2023. The Joanna Briggs Institute's critical assessment tool was used to evaluate the chosen studies' methodological quality.<br><br>RESULTS: A total of 53 studies were included in the review, which involved research conducted in Spain, Peru, Chile, Ecuador, Argentina, and Colombia. The results revealed a high prevalence of PD in these countries, especially among healthcare workers, women, and young people. The assessment methods used included the General Health Questionnaire (GHQ, GHQ-12, and GHQ-28 versions), the Kessler scale (K-6 and K-10 versions), and the 90-symptom checklist questionnaire (SCL-90-R), that allowed obtaining various dimensions of PD. The studies also highlighted the importance of the sense of coherence and work engagement as protective factors.<br><br>CONCLUSIONS: In the COVID-19 pandemic, PD was analyzed to be severe in Spanish-speaking countries, pointing to the need for specific and culturally adapted interventions to address this public mental health crisis. This is why public health policies must focus on the prevention and treatment of PD, with special attention to the most vulnerable groups.}, }
@article {pmid41517591, year = {2026}, author = {Cotet, IG and Mateescu, DM and Gavrilescu, DM and Marginean, A and Serban, S and Ilie, AC and Guse, C and Pah, AM and Badalica-Petrescu, M and Iurciuc, S and Craciun, ML and Avram, A and Tudoran, C}, title = {Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies.}, journal = {Journal of clinical medicine}, volume = {15}, number = {1}, pages = {}, pmid = {41517591}, issn = {2077-0383}, support = {Victor Babe&#x219; University of Medicine and Pharmacy Timi&#x219;oara//Victor Babe&#x219; University of Medicine and Pharmacy Timi&#x219;oara/ ; }, abstract = {Background: The COVID-19 pandemic raised uncertainties regarding the safe timing of breast cancer surgery after SARS-CoV-2 infection, and robust prospective evidence has remained limited. Methods: We conducted a systematic review and meta-analysis of prospective cohort studies (2020-2024) investigating postoperative outcomes in breast cancer patients with confirmed SARS-CoV-2 infection ≤90 days before surgery versus contemporaneous non-infected controls treated at the same institutions and in the same period. PROSPERO CRD420251174613. Random-effects models (DerSimonian-Laird with Hartung-Knapp adjustment) were used to pool odds ratios (ORs) and 95% confidence intervals (CIs). Study quality was assessed with the Newcastle-Ottawa Scale, and certainty of evidence was rated using GRADE. Results: Twelve prospective cohort studies, including 7812 patients, compared breast cancer surgery after recent confirmed SARS-CoV-2 infection over 90 days with contemporaneous non-infected controls treated at the same centres. Overall, recent infection was associated with higher 30-day postoperative complications (Clavien-Dindo ≥ II) compared to. non-infected patients (OR 2.01, 95% CI 1.44-2.81) and increased venous thromboembolism (3.6%vs. 1.2%; OR 3.12, 95% CI 1.29-7.55). Early surgery 14 days after infection carried the highest risk of complications (OR 4.38, 95 CI 2.31-8.30), whereas operations performed ≥6 weeks yielded outcomes comparable to non-infected controls (OR 1.03, 95 CI 0.81-1.31); 30-day mortality remained very low (0.3). Conclusions: Breast cancer surgery after SARS-CoV-2 infection is associated with excess perioperative risk only when performed within the first two weeks. Delaying surgery to approximately six weeks minimises complications and VTE without compromising short-term safety.}, }
@article {pmid41517347, year = {2025}, author = {Boccatonda, A and Brighenti, A and D'Ardes, D and Vetrugno, L}, title = {High-Flow Nasal Cannula Outside the ICU: A Systematic Review and Meta-Analysis.}, journal = {Journal of clinical medicine}, volume = {15}, number = {1}, pages = {}, pmid = {41517347}, issn = {2077-0383}, abstract = {Background: Use of high-flow nasal cannula (HFNC) expanded from ICUs to internal medicine/respiratory wards during and after the COVID-19 pandemic, but safety and effectiveness in non-ICU settings remain uncertain. Methods: We performed a systematic review and meta-analysis of adults (≥18 years) initiated on HFNC in non-ICU wards. Primary outcomes were in-hospital (or 28-day) mortality and ICU transfer; where available, we compared mortality for HFNC vs. conventional oxygen therapy (COT) in do-not-intubate (DNI) cohorts. Observational studies and trials were eligible. Random-effects models synthesized proportions and risk ratios; risk of bias (ROBINS-I/RoB 2) and certainty (GRADE) were assessed. Results: Ten studies met the inclusion criteria for any-ward HFNC; subsets contributed data to pooled analyses. Across all non-ICU wards (general wards plus step-up IMCU/HDU), pooled mortality was 14.0% (95% CI 4.6-35.5; I[2] ≈ 92%). Pooled ICU transfer after ward/step-up HFNC start was 20.0% (95% CI 6.3-48.1; I[2] ≈ 97%). Restricted to internal medicine/respiratory wards, pooled mortality was 19.8% (95% CI 7.1-44.2; I[2] ≈ 95%) and ICU transfer 31.2% (95% CI 9.9-65.0; I[2] ≈ 97%). In step-up units (IMCU/HDU), ICU transfer appeared lower and less variable (22.0% [95% CI 16.5-28.8]; I[2] ≈ 10%), suggesting environment-dependent outcomes. In a multicenter DNI COVID-19 cohort, HFNC vs. COT showed no clear mortality difference (RR ≈ 0.90, 95% CI 0.75-1.08; adjusted OR ≈ 0.72, 95% CI 0.34-1.54). Certainty of evidence for all critical outcomes was very low due to observational design, high inconsistency, and imprecision. Conclusions: HFNC outside the ICU is feasible, but it is related to nontrivial mortality and frequent escalation-particularly on general wards-while step-up units demonstrate more reproducible trajectories. Outcomes appear strongly conditioned by care environment, staffing, monitoring, and escalation pathways. Given very low certainty and substantial heterogeneity, institutions should pair ward HFNC with protocolized reassessment and rapid response/ICU outreach, and future research should prospectively compare ward HFNC pathways against optimized COT/NIV using standardized outcomes.}, }
@article {pmid41516981, year = {2025}, author = {Huang, WH and Ho, YF and Yeh, JY and Liu, PY and Huang, PH}, title = {Hospital Influenza Outbreak Management in the Post-COVID Era: A Narrative Review of Evolving Practices and Feasibility Considerations.}, journal = {Healthcare (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, pmid = {41516981}, issn = {2227-9032}, abstract = {Background: Hospital-acquired influenza remains a persistent threat that amplifies morbidity, mortality, length of stay, and operational strain, particularly among older and immunocompromised inpatients. The COVID-19 era reshaped control norms-normalizing N95 use during surges, ventilation improvements, and routine multiplex PCR-creating an opportunity to strengthen hospital outbreak management. Methods: We conducted a targeted narrative review of WHO/CDC/Infectious Diseases Society of America (IDSA) guidance and peer-reviewed studies (January 2015-August 2025), emphasizing adult inpatient care. This narrative review synthesizes recent evidence and discusses theoretical implications for practice, rather than establishing formal guidelines. Evidence was synthesized into pragmatic practice statements on detection, diagnostics, isolation/cohorting, antivirals, chemoprophylaxis, vaccination, surveillance, and communication. Results: Early recognition and test-based confirmation are pivotal. For inpatients, nucleic-acid amplification tests are preferred; negative antigen tests warrant PCR confirmation, and lower-respiratory specimens improve yield in severe disease. A practical outbreak threshold is ≥2 epidemiologically linked, laboratory-confirmed cases within 72 h on the same ward. Effective control may require immediate isolation or cohorting with dedicated staff, strict droplet/respiratory protection, and daily active surveillance. Early oseltamivir (≤48 h from onset or on admission) reduces mortality and length of stay; short-course post-exposure prophylaxis for exposed patients or staff lowers secondary attack rates. Integrated vaccination efforts for healthcare personnel and high-risk patients reinforce workforce resilience and reduce transmission. Conclusions: A standardized, clinician-led bundle-early molecular testing, do-not-delay antivirals, decisive cohorting and Personal protective equipment (PPE), targeted chemoprophylaxis, vaccination, and disciplined communication- could help curb transmission, protect vulnerable patients and staff, and preserve capacity. Hospitals should codify COVID-era layered controls for seasonal influenza and rehearse unit-level outbreak playbooks to accelerate response and recovery. These recommendations target clinicians and infection-prevention leaders in acute-care hospitals.}, }
@article {pmid41516418, year = {2026}, author = {Barajas, A and Riquelme-Alacid, G and Vera-Montecinos, A and Ramos, B}, title = {Cognition, Cytokines, Blood-Brain Barrier, and Beyond in COVID-19: A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516418}, issn = {1422-0067}, support = {PI21/00059//Instituto de Salud Carlos III/ ; }, mesh = {Humans ; *Blood-Brain Barrier/metabolism ; *COVID-19/complications/psychology/metabolism/immunology ; *Cytokines/metabolism/blood ; *Cognitive Dysfunction/etiology ; SARS-CoV-2 ; *Cognition/physiology ; }, abstract = {Numerous studies report cognitive impairment in COVID-19 patients from the acute to post-acute phases, linked to blood inflammation affecting blood-brain barrier (BBB) permeability and causing leakage of glial and neuronal proteins. However, a clear classification of these cognitive deficits and molecular blood events over time is still lacking. This narrative review summarizes the neuropsychological consequences of COVID-19 and evidence of altered cytokines and BBB disruption as potential mediators of cognitive impairment across post-infection phases. Post-COVID-19 cognitive dysfunction appears to follow a temporal course, evolving from acute focal deficits in attention, working memory, and executive function to more persistent multidomain impairments. We reviewed key cytokines released into the blood during COVID-19 infection, including antiviral (IFNγ, CXCL1, CXCL10), inflammatory (IL-1β, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, GM-CSF, TNFα), and monocyte chemoattractants (MCP1/CCL2, MCP3/CCL7, MIP-1α/CCL3, GM-CSF, G-CSF). This analysis shows that several inflammatory and viral cytokines remain elevated beyond the acute phase and are associated with cognitive deficits, including IL-6, IL-13, IL-8, IL-1β, TNFα, and MCP1 in long-term post-COVID-19 patients. In addition, we examined studies analyzing changes over time in neurovascular unit proteins as biomarkers of BBB disruption, including extracellular matrix proteins (PPIA, MMP-9), astrocytes (S100β, GFAP), and neurons (NFL). These proteins are elevated in acute COVID-19 but generally return to control levels within six months, suggesting BBB restoration. However, in patients followed for over a year, BBB disruption persists only in those with cognitive impairment and is associated with systemic inflammation, with TGFβ as a related biomarker. Although cognitive sequelae can persist for over 12 months after SARS-CoV-2 infection, further studies are needed to investigate long-term neurocognitive outcomes and their link to sustained proinflammatory cytokine elevation and brain impact.}, }
@article {pmid41456509, year = {2026}, author = {Lopez-Villalba, B and Tortosa, F and Castrodeza-Sanz, J and Prada, C and Sued, O}, title = {Systematic review and meta-analysis of respiratory virus infections in HIV-positive and HIV-negative patients.}, journal = {Diagnostic microbiology and infectious disease}, volume = {114}, number = {3}, pages = {117238}, doi = {10.1016/j.diagmicrobio.2025.117238}, pmid = {41456509}, issn = {1879-0070}, mesh = {Humans ; *HIV Infections/complications/virology ; *Respiratory Tract Infections/virology/mortality/epidemiology/complications ; Hospitalization/statistics &amp; numerical data ; Hospital Mortality ; Coinfection/virology ; *Virus Diseases/mortality/virology/epidemiology ; }, abstract = {BACKGROUND: Respiratory virus infections are a major cause of morbidity and mortality globally, particularly among people living with HIV.<br><br>OBJECTIVES: To evaluate the impact of respiratory virus infections on clinical outcomes in HIV-positive individuals compared with HIV-negative individuals.<br><br>STUDY DESIGN: We conducted a systematic review and meta-analysis of 19 studies comparing HIV-positive and HIV-negative individuals infected with common respiratory viruses (excluding SARS-CoV-2).<br><br>RESULTS: HIV-positive individuals had significantly higher odds of in-hospital mortality, prolonged hospitalization, and antibiotic use at admission. No significant differences were observed in intensive care unit admission, initial hospitalization, mechanical ventilation, or oxygen therapy. The most severe outcomes were associated with adenovirus, respiratory syncytial virus, and influenza. The certainty of evidence was moderate but limited by study heterogeneity and risk of bias.<br><br>CONCLUSIONS: These findings underscore the need for improved diagnostic tools, infection control strategies, and tailored clinical management for HIV-positive populations. Further prospective, multicenter studies are essential to inform evidence-based guidelines in both high- and low-resource settings.}, }
@article {pmid41421320, year = {2026}, author = {Soares, L and Davis, H and Spier, E and Walker, T and Davenport, T and Putrino, D and Peluso, M and Vogel, JM}, title = {Recommended long COVID outcome measures and their implications for clinical trial design, with a focus on post-exertional malaise.}, journal = {EBioMedicine}, volume = {123}, number = {}, pages = {106083}, pmid = {41421320}, issn = {2352-3964}, mesh = {Humans ; *COVID-19/complications/therapy ; *Clinical Trials as Topic ; SARS-CoV-2 ; *Research Design ; COVID-19 Drug Treatment ; Treatment Outcome ; Outcome Assessment, Health Care ; }, abstract = {Long COVID has created a worldwide public health crisis and has no approved treatments or validated biomarkers. We summarize the current challenges and considerations of outcome selection in Long COVID trials, along with recommendations for current trial design and future endpoint validation, with a focus on post-exertional malaise (PEM). We make five overarching recommendations for Long COVID clinical trials: 1) thorough characterisation of baseline disease; 2) collection of longitudinal data; 3) design of a placebo arm to enable comparison of treatment effect relative to the disease natural history; 4) accounting for, and when feasible, measuring PEM; 5) balancing severity, duration, and relevant phenotypes across trial arms and within subgroups to be analysed. We present a list of outcomes that may be considered for Long COVID clinical trials, with a focus on PEM. Crucially, the field of Long COVID clinical trials urgently needs funding and research effort investment to develop and validate outcomes concomitantly with clinical trial research.}, }
@article {pmid41366804, year = {2025}, author = {Fan, J and Jiao, J and Chang, HQ and Zhong, DL and Liu, XB and Li, J and Chen, LM and Jin, RJ and Wu, X}, title = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS): diagnosis and management.}, journal = {Journal of translational medicine}, volume = {24}, number = {1}, pages = {62}, pmid = {41366804}, issn = {1479-5876}, support = {2024NSFSC2123//Natural Science Foundation of Sichuan Province/ ; 2025M771949//China Postdoctoral Science Foundation/ ; 2025ZNSFSC1646//Sichuan Science and Technology Program/ ; 2024HXBH065//Clinical Trial Center, China Medical University Hospital/ ; }, abstract = {BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) has garnered substantial scientific and clinical interest, due to its rising global prevalence and significant pathophysiological overlap with post-acute COVID-19 syndrome (PACS). This review systematically elucidates the prevailing diagnostic criteria, summarizes recent advances in understanding the potential pathophysiological mechanisms, and evaluates pharmacological and non-pharmacological interventions, and symptom-based assessment and management strategies.<br><br>METHODS: A comprehensive literature search was conducted across PubMed, Web of Science, Embase, and the Cochrane Library for articles published from inception to August 2025.<br><br>RESULTS: Current diagnostic frameworks for ME/CFS rely primarily on clinical symptomatology and lack definitive biomarkers. Immune dysregulation, oxidative stress, mitochondrial dysfunction, and neuroinflammation are central to its pathology. Pharmacological management includes immunomodulatory treatments, antioxidant therapies, mitochondrial support, and neuroinflammation intervention. Non-pharmacological strategies such as cognitive behavioral therapy (CBT), graded exercise therapy (GET), activity pacing, and traditional Chinese medicine (TCM) complement biomedical approaches by alleviating symptom severity and promoting energy conservation.<br><br>CONCLUSION: Among these approaches, CBT serves as an adjunctive therapy for symptom management rather than a curative one, whereas GET is contraindicated due to its potential for harm. Comprehensive clinical assessment and management of ME/CFS requires being symptom oriented and the recognition of individual differences. Recommended directions for future research include developing biomarker-based diagnostic tools, optimizing combination therapies that target multiple pathophysiological pathways simultaneously, and integrating real-world data and digital health technologies for precise monitoring and management of ME/CFS.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12967-025-07506-y.}, }
@article {pmid41354839, year = {2025}, author = {Aryeetey, S and El-Duah, P and Gmanyami, JM and Agyei, G and Sylverken, AA and Dumevi, RM and Tasiame, W and Adu-Sarkodie, Y and Phillips, RO and Drosten, C and Owusu, M}, title = {Viral zoonotic disease outbreaks and response strategies in Sub-Saharan Africa: a scoping review.}, journal = {One health outlook}, volume = {8}, number = {1}, pages = {3}, pmid = {41354839}, issn = {2524-4655}, abstract = {BACKGROUND: Viral zoonoses, particularly RNA viruses, pose a growing public health threat in Sub-Saharan Africa (SSA) due to ecological disruption, rapid urbanization, and weak health systems. This scoping review synthesizes the available evidence on viral zoonotic outbreaks in SSA, focusing on documented public health and medical response strategies and the extent to which the One Health approach has been applied.<br><br>METHODS: We conducted searches of peer-reviewed and grey literature published between January 2005 and March 2025 in PubMed, Scopus, Google Scholar, Google, and website searches including WHO-AFRO and Africa CDC. The search strategy combined Medical Subject Headings (MeSH) and keywords related to &#x201c;zoonotic viruses,&#x201d; &#x201c;outbreaks,&#x201d; &#x201c;response,&#x201d; and &#x201c;Sub-Saharan Africa.&#x201d; Eligible studies included outbreak reports, surveillance summaries, case reports, and epidemiological investigations involving human and/or animal viral zoonotic disease outbreaks in SSA. Data on outbreak characteristics, transmission patterns, response strategies, and One Health implementation were extracted.<br><br>RESULTS: From an initial pool of 4,534 studies, fifty-two met the inclusion criteria. Rift Valley Fever virus (RVFV), Ebola virus, Marburg virus, Monkeypox, and Lassa virus were the most frequently reported viruses. A notable case of Lassa fever and SARS-CoV-2 co-infection was reported in Guinea. Transmission routes varied: direct contact, vector-borne, sexual, and nosocomial transmission. Reported public health responses included case isolation, contact tracing, community sensitization, vector control, and livestock surveillance, though there was limited formal assessment of their effectiveness. Integration of the One Health approach was inconsistently applied and explicitly documented in only a few studies.<br><br>CONCLUSION: Zoonotic viral outbreaks in Sub-Saharan Africa remain a recurrent and evolving public health challenge due to persistent gaps in surveillance, preparedness, and cross-sector coordination. Strengthening community-based detection, rapid laboratory confirmation, health system capacity for diagnostics and response, and fully operationalizing One Health frameworks is essential to enhance early warning and outbreak control.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s42522-025-00186-0.}, }
@article {pmid41311305, year = {2025}, author = {Lamoth, F and Albrich, WC and Ragozzino, S and Bosetti, D and Delaloye, J and El Khoury, C and Munting, A and Portillo, V and Reinhold, I and Sumer, J and Zbinden, A and Bättig, V and Beigelman-Aubry, C and Boggian, K and Conen, A and Fischer, TS and Garzoni, C and Goldenberger, D and Hofmann, E and Khafagy, P and Kern, L and Kleger, GR and Le Terrier, C and Marchetti, O and Pagani, JL and Rupp, NJ and Schreiber, PW and Siegemund, M and Kadgien, F and Neofytos, D and Khanna, N and , }, title = {Management of Invasive Pulmonary Aspergillosis in Intensive Care Units: Guidelines From the Fungal Infection Network of Switzerland (FUNGINOS).}, journal = {Mycoses}, volume = {68}, number = {11}, pages = {e70132}, pmid = {41311305}, issn = {1439-0507}, support = {//Mundipharma Medical Company, Basel/ ; //Gilead Foundation/ ; //Pfizer/ ; }, mesh = {Humans ; *Invasive Pulmonary Aspergillosis/diagnosis/drug therapy/epidemiology ; *Intensive Care Units ; *Antifungal Agents/therapeutic use ; Switzerland/epidemiology ; }, abstract = {Invasive pulmonary aspergillosis (IPA) is increasingly recognised in intensive care units (ICU) affecting not only patients with classical immunosuppressive conditions but also other severely ill patients, including those with respiratory viral infections (influenza, COVID-19), advanced chronic obstructive pulmonary disease or acute and chronic liver diseases. Several expert panels have proposed definitions of IPA in different ICU settings. However, practical recommendations for its diagnostic and therapeutic approaches are scarce. Moreover, these approaches can be influenced by different parameters that may vary across countries including the case mix of ICU patients, the incidence of IPA, the prevalence of azole resistance and the availability of diagnostic tests and antifungal drugs. For these reasons, the Fungal Infection Network of Switzerland (FUNGINOS) has appointed a panel of different specialists to develop a practical guideline for the management of IPA in ICU. This article provides the executive summary of the panel conclusions and recommendations regarding the epidemiology, diagnosis, definitions and therapy of IPA in ICU.}, }
@article {pmid41108326, year = {2026}, author = {Hwang, EC and Hwang, JE and Kim, K and Kim, SJ and Jung, JH and Lee, H and Sun, KH and Han, MA}, title = {Prognostic factors of mortality in patients with cancer infected with COVID-19: A systematic review and meta-analysis using the GRADE approach.}, journal = {International journal of cancer}, volume = {158}, number = {6}, pages = {1640-1653}, doi = {10.1002/ijc.70202}, pmid = {41108326}, issn = {1097-0215}, support = {RS-2022-NR070848//Ministry of Science and ICT, South Korea/ ; RS-2021-NR065884//National Research Foundation of Korea/ ; }, mesh = {Humans ; *COVID-19/mortality/complications/virology ; *Neoplasms/mortality/complications ; Prognosis ; SARS-CoV-2/isolation &amp; purification ; Comorbidity ; Risk Factors ; Male ; Female ; }, abstract = {This study aimed to systematically synthesize the available evidence on prognostic factors affecting mortality in these patients. This review included cohort studies of adult patients with cancer diagnosed with Coronavirus disease 2019 (COVID-19). We searched MEDLINE and Embase for data from December 2019 to June 2025, and Cochrane Central Libraries and other databases for data to July 2023. Two independent reviewers screened references, extracted data, and assessed bias risk. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to evaluate the certainty of the evidence and present the relative and absolute effect sizes. Fifty-two prognostic factors were identified from 92 included studies. These included sociodemographic variables, comorbidities, cancer-related characteristics, COVID-19-related clinical features, and laboratory results. We found high certainty associations between an increased risk of death and male sex (absolute risk [AR] = 3.7%, 95% confidence interval [CI] = 2.1% to 5.8%), high Charlson Comorbidity Index (AR = 8.8%, 95% CI = 7.2%-10.6%), low performance status (AR = 14.7%, 95% CI = 11.2%-18.7%), immunosuppression (AR = 14.5%, 95% CI = 7.3%-24.6%), kidney disease (AR = 9.2%, 95% CI = 4.9%-14.7%), and lung cancer (AR = 7.2%, 95% CI = 3.5%-12.0%). Hypoxia, high creatinine, high C-reactive protein, high D-dimer, low hemoglobin, low lymphocytes, high procalcitonin, and high white blood cell counts were also associated with increased mortality with high certainty. This comprehensive GRADE-based systematic review provides healthcare providers with evidence-based prognostic factors to predict outcomes, counsel patients, and guide treatment decisions for cancer patients with COVID-19. The findings offer crucial insights for managing this vulnerable population during the pandemic.}, }
@article {pmid40974632, year = {2025}, author = {Macedo, PLG and Taborda, M and Oliveira, VF and Magri, ASGK and Frutuoso, LL and Oliveira, GM and Martins, ST and Santos, DWCL and Carlesse, FAMC and Cavassin, FB and Eulálio, KD and Andréa, ML and Freitas, AD and Vidal, JE and Freitas, DFS and Garnica, M and Leitão, TDMJS and Zancopé-Oliveira, RM and Melhem, MSC and Telles, FQ and Shikanai-Yasuda, MA and Costa, FD and Millington, MA and Magri, MMC}, title = {Brazilian task force for the management of mucormycosis.}, journal = {The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases}, volume = {29}, number = {6}, pages = {104579}, pmid = {40974632}, issn = {1678-4391}, mesh = {Humans ; *Antifungal Agents/therapeutic use ; Brazil/epidemiology ; COVID-19/epidemiology ; *Mucormycosis/diagnosis/drug therapy/epidemiology/surgery ; }, abstract = {BACKGROUND: Mucormycosis is a rare but life‑threatening fungal infection that has shown an increased incidence in Brazil, especially during the COVID‑19 pandemic.<br><br>OBJECTIVE: To provide an evidence&#x2011;based, context&#x2011;specific guideline for the diagnosis and management of mucormycosis within the Brazilian healthcare system.<br><br>CLINICAL FEATURES: Rhino&#x2011;orbito&#x2011;cerebral disease predominates, followed by pulmonary, cutaneous, gastrointestinal and disseminated forms; delayed recognition dramatically increases mortality.<br><br>EPIDEMIOLOGY: The global incidence of mucormycosis is increasing, particularly among patients with diabetes mellitus, hematologic malignancies, transplantation, and corticosteroid exposure. The most frequently isolated species is Rhizopus arrhizus, and regional variations in species distribution may be present. In Brazil, comprehensive epidemiological data remain scarce.<br><br>TREATMENT: Early, aggressive surgical debridement plus induction with liposomal amphotericin B (5-10 mg/kg/day) followed by isavuconazole or posaconazole is recommended; strict control of hyperglycemia and immunosuppression is essential.<br><br>CONCLUSION: Standardized national guidance, improved rapid diagnostics, systematic surveillance and equitable drug availability are critical to reduce Brazil's mucormycosis burden.}, }
@article {pmid40923137, year = {2026}, author = {Nadig, N and Bhimraj, A and Cawcutt, K and Chiotos, K and Dzierba, AL and Kim, AY and Martin, GS and Pearson, JC and Shumaker, AH and Baden, LR and Bedimo, R and Cheng, VC and Chew, KW and Daar, ES and Glidden, DV and Hardy, EJ and Johnson, S and Li, JZ and MacBrayne, C and Nakamura, MM and Riley, L and Shafer, RW and Shoham, S and Tebas, P and Tien, PC and Loveless, J and Falck-Ytter, Y and Morgan, RL and Gandhi, RT}, title = {2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Abatacept.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_3}, pages = {i17-i21}, doi = {10.1093/cid/ciaf354}, pmid = {40923137}, issn = {1537-6591}, support = {//IDSA/ ; 75N91019D00024/CA/NCI NIH HHS/United States ; 75N91019D00024/CA/NCI NIH HHS/United States ; }, mesh = {Humans ; *Abatacept/therapeutic use ; COVID-19 ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of abatacept in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.}, }
@article {pmid40831386, year = {2026}, author = {Nadig, N and Bhimraj, A and Cawcutt, K and Chiotos, K and Dzierba, AL and Kim, AY and Martin, GS and Pearson, JC and Shumaker, AH and Baden, LR and Bedimo, R and Cheng, VC and Chew, KW and Daar, ES and Glidden, DV and Hardy, EJ and Johnson, S and Li, JZ and MacBrayne, C and Nakamura, MM and Riley, L and Shafer, RW and Shoham, S and Tebas, P and Tien, PC and Loveless, J and Falck-Ytter, Y and Morgan, RL and Gandhi, RT}, title = {2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Infliximab.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_3}, pages = {i22-i26}, doi = {10.1093/cid/ciaf355}, pmid = {40831386}, issn = {1537-6591}, support = {//Infectious Diseases Society of America/ ; /CA/NCI NIH HHS/United States ; 75N91019D00024)/NH/NIH HHS/United States ; /CA/NCI NIH HHS/United States ; 75N91019D00024)/NH/NIH HHS/United States ; }, mesh = {Humans ; *Infliximab/therapeutic use ; *COVID-19 Drug Treatment ; COVID-19 ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of infliximab in hospitalized adults with severe or critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.}, }
@article {pmid40757658, year = {2026}, author = {Bhimraj, A and Falck-Ytter, Y and Baden, LR and Bedimo, R and Cawcutt, K and Cheng, VC and Chew, KW and Chiotos, K and Daar, ES and Dzierba, AL and Glidden, DV and Hardy, EJ and Johnson, S and Kim, AY and Li, JZ and MacBrayne, C and Martin, GS and Nadig, N and Nakamura, MM and Pearson, JC and Riley, L and Shafer, RW and Shoham, S and Shumaker, AH and Tebas, P and Tien, PC and Loveless, J and Morgan, RL and Gandhi, RT}, title = {2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Pemivibart for Pre-exposure Prophylaxis, Vilobelimab for Critical Illness, and Abatacept or Infliximab for Severe or Critical Illness.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_3}, pages = {i1-i5}, doi = {10.1093/cid/ciaf424}, pmid = {40757658}, issn = {1537-6591}, support = {//Infectious Diseases Society of America/ ; /CA/NCI NIH HHS/United States ; 75N91019D00024/NH/NIH HHS/United States ; /HH/HHS/United States ; //U.S. Government/ ; }, mesh = {Humans ; *COVID-19/prevention &amp; control/therapy ; *Pre-Exposure Prophylaxis ; SARS-CoV-2 ; Critical Illness ; *Infliximab/therapeutic use ; *COVID-19 Drug Treatment ; Pregnancy ; Female ; Immunocompromised Host ; Adult ; Societies, Medical ; }, abstract = {As the first part of several focused updates to the clinical practice guideline on the treatment and management of COVID-19 in adults, children, and pregnant people, developed by the Infectious Diseases Society of America, the panel presents four new recommendations. These recommendations include pre-exposure prophylaxis for immunocompromised persons and treatment of severe or critical COVID-19. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.}, }
@article {pmid40402009, year = {2026}, author = {Nadig, N and Bhimraj, A and Cawcutt, K and Chiotos, K and Dzierba, AL and Kim, AY and Martin, GS and Pearson, JC and Shumaker, AH and Baden, LR and Bedimo, R and Cheng, VC and Chew, KW and Daar, ES and Glidden, DV and Hardy, EJ and Johnson, S and Li, JZ and MacBrayne, C and Nakamura, MM and Riley, L and Shafer, RW and Shoham, S and Tebas, P and Tien, PC and Loveless, J and Falck-Ytter, Y and Morgan, RL and Gandhi, RT}, title = {2025 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Treatment and Management of COVID-19: Vilobelimab.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_3}, pages = {i13-i16}, doi = {10.1093/cid/ciaf235}, pmid = {40402009}, issn = {1537-6591}, support = {//Infectious Diseases Society of America (IDSA)/ ; /CA/NCI NIH HHS/United States ; 75N91019D00024/NH/NIH HHS/United States ; }, mesh = {Humans ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use ; *Antibodies, Monoclonal, Humanized/therapeutic use ; SARS-CoV-2 ; COVID-19 ; United States ; Antibodies, Neutralizing ; }, abstract = {This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019 (COVID-19), developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of vilobelimab in hospitalized adults with critical COVID-19. The recommendation is based on evidence derived from a systematic literature review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.}, }
@article {pmid40105496, year = {2025}, author = {Dobson, KS and Lindsay, B and Termeer, J and Mineva, E and Szeto, A}, title = {Reducing Mental Health Stigma in the Workplace: A Meta-Analysis of The Working Mind Program in Virtual Delivery Format: Réduire la stigmatisation en milieu de travail : Une méta-analyse du programme L'esprit au travail en format virtuel.}, journal = {Canadian journal of psychiatry. Revue canadienne de psychiatrie}, volume = {70}, number = {4}, pages = {278-288}, doi = {10.1177/07067437251328366}, pmid = {40105496}, issn = {1497-0015}, mesh = {Humans ; *Social Stigma ; *Workplace/psychology ; *COVID-19/psychology ; Female ; Male ; Resilience, Psychological ; Adult ; Mental Health ; *Mental Disorders/psychology ; Telemedicine ; }, abstract = {BackgroundMental health stigma in the workplace has been widely recognized, and workplace programs have been created to improve self-awareness and resiliency, while decreasing stigma. Prior meta-analyses of The Working Mind (TWM) program suggest positive benefits. The current meta-analysis was based on the shift to online delivery of TWM during the COVID-19 pandemic. It was predicted that program outcomes would be approximately the same as in prior analyses of in person delivery of the TWM program.MethodTWM program was delivered by expert trainers to a total of 1,159 participants across six workplace settings. Participants provided informed consent and survey data, prior to, just after and 3 months after the program. Outcomes included stigma, resiliency and readiness for change. Standardized assessments were employed, consistent with prior program analyses.ResultsSignificant reductions in stigma and increases in self-reported resiliency occurred, with immediate overall effect sizes of 0.33 and 0.40, respectively. Some variability among workplace settings was observed. Males had a somewhat better result than females and people who reported worse mental health at program initiation had somewhat better results than others, but these were modest effects. The results were largely stable until the 3-month follow-up assessment period. Attrition across the study interval was considerable.ConclusionsThe virtual delivery of TWM yielded meta-analytic results that were comparable to previous in person outcomes, both in terms of immediate and 3-month assessment intervals. Some variability in outcomes was noted, and some return towards baseline was observed at the 3-month follow-up period. The issue of attrition was also noted, possibility due to effects of online fatigue and the voluntary nature of the study. Suggestions for further study of program effects are given, and workplace wellness programs are encouraged.Plain Language Summary TitleOutcomes of a virtual program to address mental Health Stigma in the workplace.}, }
@article {pmid39471458, year = {2026}, author = {Bhimraj, A and Falck-Ytter, Y and Kim, AY and Li, JZ and Baden, LR and Johnson, S and Shafer, RW and Shoham, S and Tebas, P and Bedimo, R and Cheng, VC and Chew, KW and Chiotos, K and Daar, ES and Dzierba, AL and Glidden, DV and Hardy, EJ and Martin, GS and MacBrayne, C and Nadig, N and Nakamura, MM and Shumaker, AH and Tien, P and Loveless, J and Morgan, RL and Gandhi, RT}, title = {2024 Clinical Practice Guideline Update by the Infectious Diseases Society of America on the Management of COVID-19: Anti-SARS-CoV-2 Neutralizing Antibody Pemivibart for Pre-exposure Prophylaxis.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_3}, pages = {i6-i12}, doi = {10.1093/cid/ciae435}, pmid = {39471458}, issn = {1537-6591}, support = {//Infectious Diseases Society of America/ ; 6 NU50CK000477-04-01/CC/CDC HHS/United States ; 6 NU50CK000477-04-01/CC/CDC HHS/United States ; }, mesh = {Humans ; *Pre-Exposure Prophylaxis/methods ; *COVID-19/prevention &amp; control ; *Antibodies, Neutralizing/therapeutic use ; *SARS-CoV-2/immunology ; *COVID-19 Drug Treatment ; United States ; *Antiviral Agents/therapeutic use ; }, abstract = {This article provides a focused update to the clinical practice guideline on the treatment and management of patients with coronavirus disease 2019, developed by the Infectious Diseases Society of America. The guideline panel presents a recommendation on the use of the anti-severe acute respiratory syndrome coronavirus 2 neutralizing antibody pemivibart as pre-exposure prophylaxis. The recommendation is based on evidence derived from a systematic review and adheres to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Information on pemivibart is included in the U.S. Food and Drug Administration Emergency Use Authorization for this agent.}, }
@article {pmid38980578, year = {2024}, author = {Kori, M and Kasavi, C and Arga, KY}, title = {Exploring COVID-19 Pandemic Disparities with Transcriptomic Meta-analysis from the Perspective of Personalized Medicine.}, journal = {Journal of microbiology (Seoul, Korea)}, volume = {62}, number = {9}, pages = {785-798}, pmid = {38980578}, issn = {1976-3794}, mesh = {Female ; Humans ; Male ; Antiviral Agents/therapeutic use ; Computational Biology/methods ; *COVID-19/genetics/prevention &amp; control/therapy/virology ; Drug Repositioning ; Gene Expression Profiling ; Pandemics ; *Precision Medicine/methods ; *SARS-CoV-2/isolation &amp; purification ; *Transcriptome ; Viral Load ; }, abstract = {Infection with SARS-CoV2, which is responsible for COVID-19, can lead to differences in disease development, severity and mortality rates depending on gender, age or the presence of certain diseases. Considering that existing studies ignore these differences, this study aims to uncover potential differences attributable to gender, age and source of sampling as well as viral load using bioinformatics and multi-omics approaches. Differential gene expression analyses were used to analyse the phenotypic differences between SARS-CoV-2 patients and controls at the mRNA level. Pathway enrichment analyses were performed at the gene set level to identify the activated pathways corresponding to the differences in the samples. Drug repurposing analysis was performed at the protein level, focusing on host-mediated drug candidates to uncover potential therapeutic differences. Significant differences (i.e. the number of differentially expressed genes and their characteristics) were observed for COVID-19 at the mRNA level depending on the sample source, gender and age of the samples. The results of the pathway enrichment show that SARS-CoV-2 can be combated more effectively in the respiratory tract than in the blood samples. Taking into account the different sample sources and their characteristics, different drug candidates were identified. Evaluating disease prediction, prevention and/or treatment strategies from a personalised perspective is crucial. In this study, we not only evaluated the differences in COVID-19 from a personalised perspective, but also provided valuable data for further experimental and clinical efforts. Our findings could shed light on potential pandemics.}, }
@article {pmid37259108, year = {2023}, author = {Chen, C and Wang, J and Liu, YM and Hu, J}, title = {Single-cell analysis of adult human heart across healthy and cardiovascular disease patients reveals the cellular landscape underlying SARS-CoV-2 invasion of myocardial tissue through ACE2.}, journal = {Journal of translational medicine}, volume = {21}, number = {1}, pages = {358}, pmid = {37259108}, issn = {1479-5876}, mesh = {Humans ; Male ; Adult ; SARS-CoV-2 ; *COVID-19 ; Angiotensin-Converting Enzyme 2/metabolism ; *Cardiovascular Diseases ; Myocardium/metabolism ; Single-Cell Analysis ; Peptidyl-Dipeptidase A/genetics ; Membrane Proteins/metabolism ; RNA-Binding Proteins ; }, abstract = {BACKGROUND: The distribution of ACE2 and accessory proteases (ANAD17 and CTSL) in cardiovascular tissue and the host cell receptor binding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are crucial to understanding the virus's cell invasion, which may play a significant role in determining the viral tropism and its clinical manifestations.<br><br>METHODS: We conducted a comprehensive analysis of the cell type-specific expression of ACE2, ADAM17, and CTSL in myocardial tissue from 10 patients using RNA sequencing. Our study included a meta-analysis of 2 heart single-cell RNA-sequencing studies with a total of 90,024 cells from 250 heart samples of 10 individuals. We used co-expression analysis to locate specific cell types that SARS-CoV-2 may invade.<br><br>RESULTS: Our results revealed cell-type specific associations between male gender and the expression levels of ACE2, ADAM17, and CTSL, including pericytes and fibroblasts. AGT, CALM3, PCSK5, NRP1, and LMAN were identified as potential accessory proteases that might facilitate viral invasion. Enrichment analysis highlighted the extracellular matrix interaction pathway, adherent plaque pathway, vascular smooth muscle contraction inflammatory response, and oxidative stress as potential immune pathways involved in viral infection, providing potential molecular targets for therapeutic intervention. We also found specific high expression of IFITM3 and AGT in pericytes and differences in the IFN-II signaling pathway and PAR signaling pathway in fibroblasts from different cardiovascular comorbidities.<br><br>CONCLUSIONS: Our data indicated possible high-risk groups for COVID-19 and provided emerging avenues for future investigations of its pathogenesis.<br><br>TRIAL REGISTRATION: (Not applicable).}, }
@article {pmid37194007, year = {2023}, author = {Hennessey, K and Pezzoli, L and Mantel, C}, title = {A framework for seroepidemiologic investigations in future pandemics: insights from an evaluation of WHO's Unity Studies initiative.}, journal = {Health research policy and systems}, volume = {21}, number = {1}, pages = {34}, pmid = {37194007}, issn = {1478-4505}, support = {APW 111261534//WHO/ ; }, mesh = {Humans ; *COVID-19 ; Pandemics ; Seroepidemiologic Studies ; Public Health ; World Health Organization ; }, abstract = {BACKGROUND: The WHO Unity Studies initiative supports countries, especially low- and middle-income countries (LMICs), in conducting seroepidemiologic studies for rapidly informing responses to the COVID-19 pandemic. Ten generic study protocols were developed which standardized epidemiologic and laboratory methods. WHO provided technical support, serological assays and funding for study implementation. An external evaluation was conducted to assess (1) the usefulness of study findings in guiding response strategies, (2) management and support to conduct studies and (3) capacity built from engagement with the initiative.<br><br>METHODS: The evaluation focused on the three most frequently used protocols, namely first few cases, household transmission and population-based serosurvey, 66% of 339 studies tracked by WHO. All 158 principal investigators (PIs) with contact information were invited to complete an online survey. A total of 19 PIs (randomly selected within WHO regions), 14 WHO Unity focal points at the country, regional and global levels, 12 WHO global-level stakeholders and eight external partners were invited to be interviewed. Interviews were coded in MAXQDA&#x2122;, synthesized into findings and cross-verified by a second reviewer.<br><br>RESULTS: Among 69 (44%) survey respondents, 61 (88%) were from LMICs. Ninety-five percent gave positive feedback on technical support, 87% reported that findings contributed to COVID-19 understanding, 65% to guiding public health and social measures, and 58% to guiding vaccination policy. Survey and interview group responses showed that the main technical barriers to using study findings were study quality, variations in study methods (challenge for meta-analysis), completeness of reporting study details and clarity of communicating findings. Untimely study findings were another barrier, caused by delays in ethical clearance, receipt of serological assays and approval to share findings. There was strong agreement that the initiative created equitable research opportunities, connected expertise and facilitated study implementation. Around 90% of respondents agreed the initiative should continue in the future.<br><br>CONCLUSIONS: The Unity Studies initiative created a highly valued community of practice, contributed to study implementation and research equity, and serves as a valuable framework for future pandemics. To strengthen this platform, WHO should establish emergency-mode procedures to facilitate timeliness and continue to build capacity to rapidly conduct high-quality studies and communicate findings in a format friendly to decision-makers.}, }
@article {pmid37148586, year = {2023}, author = {Wouters, E and Verbrugghe, C and Abdelnabi, R and Devloo, R and De Clippel, D and Jochmans, D and De Bleser, D and Weynand, B and Compernolle, V and Neyts, J and Feys, HB}, title = {Intranasal administration of convalescent plasma protects against SARS-CoV-2 infection in hamsters.}, journal = {EBioMedicine}, volume = {92}, number = {}, pages = {104597}, pmid = {37148586}, issn = {2352-3964}, mesh = {Animals ; Cricetinae ; Humans ; Administration, Intranasal ; *COVID-19 ; COVID-19 Serotherapy ; SARS-CoV-2 ; Antiviral Agents ; Antibodies, Viral ; }, abstract = {BACKGROUND: Convalescent plasma (CP) transfusion is an early option for treating infections with pandemic potential, often preceding vaccine or antiviral drug rollout. Heterogenous findings from randomized clinical trials on transfusion of COVID-19 CP (CCP) have been reported. However, meta-analysis suggests that transfusion of high titer CCP is associated with a mortality benefit for COVID-19 outpatients or inpatients treated within 5 days after symptom onset, indicating the importance of early administration.<br><br>METHODS: We tested if CCP is an effective prophylactic against SARS-CoV-2 infection by the intranasal administration of 25&#xa0;&#x3bc;L CCP/nostril (i.e. 0.01-0.06&#xa0;mg anti-RBD antibodies/kg) in hamsters exposed to infected littermates.<br><br>FINDINGS: In this model, 40% of CCP treated hamsters were fully protected and 40% had significantly reduced viral loads, the remaining 20% was not protected. The effect seems dose-dependent because high-titer CCP from a vaccinated donor was more effective than low-titer CCP from a donation prior to vaccine rollout. Intranasal administration of human CCP resulted in a reactive (immune) response in hamster lungs, however this was not observed upon administration of hamster CCP.<br><br>INTERPRETATION: We conclude that CCP is an effective prophylactic when used directly at the site of primary infection. This option should be considered in future prepandemic preparedness plans.<br><br>FUNDING: Flanders Innovation &amp; Entrepreneurship (VLAIO) and the Foundation for Scientific Research of the Belgian Red Cross Flanders.}, }
@article {pmid36759670, year = {2023}, author = {Popov, IV and Ohlopkova, OV and Donnik, IM and Zolotukhin, PV and Umanets, A and Golovin, SN and Malinovkin, AV and Belanova, AA and Lipilkin, PV and Lipilkina, TA and Popov, IV and Logvinov, AK and Dubovitsky, NA and Stolbunova, KA and Sobolev, IA and Alekseev, AY and Shestopalov, AM and Burkova, VN and Chikindas, ML and Venema, K and Ermakov, AM}, title = {Detection of coronaviruses in insectivorous bats of Fore-Caucasus, 2021.}, journal = {Scientific reports}, volume = {13}, number = {1}, pages = {2306}, pmid = {36759670}, issn = {2045-2322}, mesh = {Animals ; *Chiroptera ; *Coronavirus/genetics ; *Coronavirus Infections/epidemiology/veterinary/genetics ; Genome, Viral ; Phylogeny ; RNA ; }, abstract = {Coronaviruses (CoVs) pose a huge threat to public health as emerging viruses. Bat-borne CoVs are especially unpredictable in their evolution due to some unique features of bat physiology boosting the rate of mutations in CoVs, which is already high by itself compared to other viruses. Among bats, a meta-analysis of overall CoVs epizootiology identified a nucleic acid observed prevalence of 9.8% (95% CI 8.7-10.9%). The main objectives of our study were to conduct a qPCR screening of CoVs' prevalence in the insectivorous bat population of Fore-Caucasus and perform their characterization based on the metagenomic NGS of samples with detected CoV RNA. According to the qPCR screening, CoV RNA was detected in 5 samples, resulting in a 3.33% (95% CI 1.1-7.6%) prevalence of CoVs in bats from these studied locations. BetaCoVs reads were identified in raw metagenomic NGS data, however, detailed characterization was not possible due to relatively low RNA concentration in samples. Our results correspond to other studies, although a lower prevalence in qPCR studies was observed compared to other regions and countries. Further studies should require deeper metagenomic NGS investigation, as a supplementary method, which will allow detailed CoV characterization.}, }
@article {pmid36698073, year = {2023}, author = {Wu, D and Goldfeld, KS and Petkova, E}, title = {Developing a Bayesian hierarchical model for a prospective individual patient data meta-analysis with continuous monitoring.}, journal = {BMC medical research methodology}, volume = {23}, number = {1}, pages = {25}, pmid = {36698073}, issn = {1471-2288}, support = {UL1 TR001445/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; Bayes Theorem ; Computer Simulation ; *COVID-19/epidemiology ; Research Design ; Sample Size ; Adaptive Clinical Trials as Topic ; }, abstract = {BACKGROUND: Numerous clinical trials have been initiated to find effective treatments for COVID-19. These trials have often been initiated in regions where the pandemic has already peaked. Consequently, achieving full enrollment in a single trial might require additional COVID-19 surges in the same location over several years. This has inspired us to pool individual patient data (IPD) from ongoing, paused, prematurely-terminated, or completed randomized controlled trials (RCTs) in real-time, to find an effective treatment as quickly as possible in light of the pandemic crisis. However, pooling across trials introduces enormous uncertainties in study design (e.g., the number of RCTs and sample sizes might be unknown in advance). We sought to develop a versatile treatment efficacy assessment model that accounts for these uncertainties while allowing for continuous monitoring throughout the study using Bayesian monitoring techniques.<br><br>METHODS: We provide a detailed look at the challenges and solutions for model development, describing the process that used extensive simulations to enable us to finalize the analysis plan. This includes establishing prior distribution assumptions, assessing and improving model convergence under different study composition scenarios, and assessing whether we can extend the model to accommodate multi-site RCTs and evaluate heterogeneous treatment effects. In addition, we recognized that we would need to assess our model for goodness-of-fit, so we explored an approach that used posterior predictive checking. Lastly, given the urgency of the research in the context of evolving pandemic, we were committed to frequent monitoring of the data to assess efficacy, and we set Bayesian monitoring rules calibrated for type 1 error rate and power.<br><br>RESULTS: The primary outcome is an 11-point ordinal scale. We present the operating characteristics of the proposed cumulative proportional odds model for estimating treatment effectiveness. The model can estimate the treatment's effect under enormous uncertainties in study design. We investigate to what degree the proportional odds assumption has to be violated to render the model inaccurate. We demonstrate the flexibility of a Bayesian monitoring approach by performing frequent interim analyses without increasing the probability of erroneous conclusions.<br><br>CONCLUSION: This paper describes a translatable framework using simulation to support the design of prospective IPD meta-analyses.}, }
@article {pmid36183027, year = {2022}, author = {de Saint Laurent, C and Murphy, G and Hegarty, K and Greene, CM}, title = {Measuring the effects of misinformation exposure and beliefs on behavioural intentions: a COVID-19 vaccination study.}, journal = {Cognitive research: principles and implications}, volume = {7}, number = {1}, pages = {87}, pmid = {36183027}, issn = {2365-7464}, mesh = {*COVID-19/prevention &amp; control ; COVID-19 Vaccines ; Communication ; Humans ; Intention ; Pandemics ; Vaccination ; *Vaccines ; }, abstract = {Misinformation has been a pressing issue since the beginning of the COVID-19 pandemic, threatening our ability to effectively act on the crisis. Nevertheless, little is known about the actual effects of fake news on behavioural intentions. Does exposure to or belief in misinformation about COVID-19 vaccines affect people's intentions to receive such a vaccine? This paper attempts to address this question via three preregistered experiments (N = 3463). In Study 1, participants (n = 1269) were exposed to fabricated pro- or anti-vaccine information or to neutral true information, and then asked about their intentions to get vaccinated. In Study 2, participants (n = 646) were exposed to true pro- and anti-vaccine information, while Study 3 (n = 1548) experimentally manipulated beliefs in novel misinformation about COVID-19 vaccines by increasing exposure to the information. The results of these three studies showed that exposure to false information about the vaccines had little effect on participants' intentions to get vaccinated, even when multiple exposures led them to believe the headlines to be more accurate. An exploratory meta-analysis of studies 1 and 3, with a combined sample size of 2683, showed that exposure to false information both supporting and opposing COVID-19 vaccines actually increased vaccination intentions, though the effect size was very small. We conclude by cautioning researchers against equating exposure to misinformation or perceived accuracy of false news with actual behaviours.}, }
@article {pmid36123623, year = {2022}, author = {Gan, L and Chen, Y and Tan, J and Wang, X and Zhang, D}, title = {Does potential antibody-dependent enhancement occur during SARS-CoV-2 infection after natural infection or vaccination? A meta-analysis.}, journal = {BMC infectious diseases}, volume = {22}, number = {1}, pages = {742}, pmid = {36123623}, issn = {1471-2334}, support = {2020001000430//Foshan Scientific and Technological Key Project for COVID-19/ ; ZH22036302200008PWC//Zhuhai Scientific and Technological Key Project for COVID-19/ ; }, mesh = {Antibodies, Viral ; Antibody-Dependent Enhancement ; *COVID-19/prevention &amp; control ; Humans ; SARS-CoV-2 ; Vaccination ; *Vaccines ; }, abstract = {Coronavirus disease 2019 (COVID-19) continues to constitute an international public health emergency. Vaccination is a prospective approach to control this pandemic. However, apprehension about the safety of vaccines is a major obstacle to vaccination. Amongst health professionals, one evident concern is the risk of antibody-dependent enhancement (ADE), which may increase the severity of COVID-19. To explore whether ADE occurs in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and increase confidence in the safety of vaccination, we conducted a meta-analysis to investigate the relationship between post-immune infection and disease severity from a population perspective. Databases, including PubMed, EMBASE, Chinese National Knowledge Infrastructure, SinoMed, Scopus, Science Direct, and Cochrane Library, were searched for articles on SARS-CoV-2 reinfection published until 25 October 2021. The papers were reviewed for methodological quality, and a random effects model was used to analyse the results. Heterogeneity was assessed using the I[2] statistic. Publication bias was evaluated using a funnel plot and Egger's test. Eleven studies were included in the final meta-analysis. The pooled results indicated that initial infection and vaccination were protective factors against severe COVID-19 during post-immune infection (OR = 0.55, 95%CI = 0.31-0.98). A subgroup (post-immune infection after natural infection or vaccination) analysis showed similar results. Primary SARS-CoV-2 infection and vaccination provide adequate protection against severe clinical symptoms after post-immune infection. This finding demonstrates that SARS-CoV-2 may not trigger ADE at the population level.}, }
@article {pmid35841887, year = {2022}, author = {Pogorelyy, MV and Rosati, E and Minervina, AA and Mettelman, RC and Scheffold, A and Franke, A and Bacher, P and Thomas, PG}, title = {Resolving SARS-CoV-2 CD4[+] T cell specificity via reverse epitope discovery.}, journal = {Cell reports. Medicine}, volume = {3}, number = {8}, pages = {100697}, pmid = {35841887}, issn = {2666-3791}, support = {F32 AI157296/AI/NIAID NIH HHS/United States ; R01 AI136514/AI/NIAID NIH HHS/United States ; }, mesh = {CD4-Positive T-Lymphocytes/chemistry ; *COVID-19 ; Epitopes/analysis ; Humans ; Receptors, Antigen, T-Cell/genetics ; *SARS-CoV-2 ; T-Cell Antigen Receptor Specificity ; }, abstract = {The current strategy to detect immunodominant T cell responses focuses on the antigen, employing large peptide pools to screen for functional cell activation. However, these approaches are labor and sample intensive and scale poorly with increasing size of the pathogen peptidome. T cell receptors (TCRs) recognizing the same epitope frequently have highly similar sequences, and thus, the presence of large sequence similarity clusters in the TCR repertoire likely identify the most public and immunodominant responses. Here, we perform a meta-analysis of large, publicly available single-cell and bulk TCR datasets from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected individuals to identify public CD4[+] responses. We report more than 1,200 αβTCRs forming six prominent similarity clusters and validate histocompatibility leukocyte antigen (HLA) restriction and epitope specificity predictions for five clusters using transgenic T cell lines. Collectively, these data provide information on immunodominant CD4[+] T cell responses to SARS-CoV-2 and demonstrate the utility of the reverse epitope discovery approach.}, }
@article {pmid35589964, year = {2022}, author = {El-Sayed Moustafa, JS and Jackson, AU and Brotman, SM and Guan, L and Villicaña, S and Roberts, AL and Zito, A and Bonnycastle, L and Erdos, MR and Narisu, N and Stringham, HM and Welch, R and Yan, T and Lakka, T and Parker, S and Tuomilehto, J and Seow, J and Graham, C and Huettner, I and Acors, S and Kouphou, N and Wadge, S and Duncan, EL and Steves, CJ and Doores, KJ and Malim, MH and Collins, FS and Pajukanta, P and Boehnke, M and Koistinen, HA and Laakso, M and Falchi, M and Bell, JT and Scott, LJ and Mohlke, KL and Small, KS}, title = {ACE2 expression in adipose tissue is associated with cardio-metabolic risk factors and cell type composition-implications for COVID-19.}, journal = {International journal of obesity (2005)}, volume = {46}, number = {8}, pages = {1478-1486}, pmid = {35589964}, issn = {1476-5497}, support = {R01 DK072193/DK/NIDDK NIH HHS/United States ; P01 HL028481/HL/NHLBI NIH HHS/United States ; R01 DK062370/DK/NIDDK NIH HHS/United States ; MR/M004422/1/MRC_/Medical Research Council/United Kingdom ; P30 DK020572/DK/NIDDK NIH HHS/United States ; R01 DK093757/DK/NIDDK NIH HHS/United States ; 221574/WT_/Wellcome Trust/United Kingdom ; ZIA HG000024/ImNIH/Intramural NIH HHS/United States ; MR/L01999X/1/MRC_/Medical Research Council/United Kingdom ; MR/R023131/1/MRC_/Medical Research Council/United Kingdom ; U01 DK062370/DK/NIDDK NIH HHS/United States ; T32 GM007092/GM/NIGMS NIH HHS/United States ; }, mesh = {*Adipose Tissue/metabolism ; *Angiotensin-Converting Enzyme 2/genetics/metabolism ; *COVID-19/complications/genetics ; Cardiometabolic Risk Factors ; Diabetes Mellitus, Type 2/genetics ; Endothelial Cells/metabolism ; Humans ; Obesity ; SARS-CoV-2 ; }, abstract = {BACKGROUND: COVID-19 severity varies widely. Although some demographic and cardio-metabolic factors, including age and obesity, are associated with increasing risk of severe illness, the underlying mechanism(s) are uncertain.<br><br>SUBJECTS/METHODS: In a meta-analysis of three independent studies of 1471 participants in total, we investigated phenotypic and genetic factors associated with subcutaneous adipose tissue expression of Angiotensin I Converting Enzyme 2 (ACE2), measured by RNA-Seq, which acts as a receptor for SARS-CoV-2 cellular entry.<br><br>RESULTS: Lower adipose tissue ACE2 expression was associated with multiple adverse cardio-metabolic health indices, including type 2 diabetes (T2D) (P&#x2009;=&#x2009;9.14 &#xd7; 10[-6]), obesity status (P&#x2009;=&#x2009;4.81&#x2009;&#xd7;&#x2009;10[-5]), higher serum fasting insulin (P&#x2009;=&#x2009;5.32&#x2009;&#xd7;&#x2009;10[-4]), BMI (P&#x2009;=&#x2009;3.94&#x2009;&#xd7;&#x2009;10[-4]), and lower serum HDL levels (P&#x2009;=&#x2009;1.92&#x2009;&#xd7;&#x2009;10[-7]). ACE2 expression was also associated with estimated proportions of cell types in adipose tissue: lower expression was associated with a lower proportion of microvascular endothelial cells (P&#x2009;=&#x2009;4.25&#x2009;&#xd7;&#x2009;10[-4]) and higher proportion of macrophages (P&#x2009;=&#x2009;2.74&#x2009;&#xd7;&#x2009;10[-5]). Despite an estimated heritability of 32%, we did not identify any proximal or distal expression quantitative trait loci (eQTLs) associated with adipose tissue ACE2 expression.<br><br>CONCLUSIONS: Our results demonstrate that individuals with cardio-metabolic features known to increase risk of severe COVID-19 have lower background ACE2 levels in this highly relevant tissue. Reduced adipose tissue ACE2 expression may contribute to the pathophysiology of cardio-metabolic diseases, as well as the associated increased risk of severe COVID-19.}, }
@article {pmid35512728, year = {2022}, author = {, }, title = {Remdesivir and three other drugs for hospitalised patients with COVID-19: final results of the WHO Solidarity randomised trial and updated meta-analyses.}, journal = {Lancet (London, England)}, volume = {399}, number = {10339}, pages = {1941-1953}, pmid = {35512728}, issn = {1474-547X}, mesh = {Adenosine Monophosphate/analogs &amp; derivatives/therapeutic use ; Adult ; Alanine/analogs &amp; derivatives/therapeutic use ; *Antiviral Agents/therapeutic use ; Humans ; Hydroxychloroquine/therapeutic use ; Interferon beta-1a/therapeutic use ; Lopinavir/therapeutic use ; Oxygen/administration &amp; dosage ; Randomized Controlled Trials as Topic ; Treatment Outcome ; World Health Organization ; *COVID-19 Drug Treatment ; }, abstract = {BACKGROUND: The Solidarity trial among COVID-19 inpatients has previously reported interim mortality analyses for four repurposed antiviral drugs. Lopinavir, hydroxychloroquine, and interferon (IFN)-β1a were discontinued for futility but randomisation to remdesivir continued. Here, we report the final results of Solidarity and meta-analyses of mortality in all relevant trials to date.<br><br>METHODS: Solidarity enrolled consenting adults (aged &#x2265;18 years) recently hospitalised with, in the view of their doctor, definite COVID-19 and no contraindication to any of the study drugs, regardless of any other patient characteristics. Participants were randomly allocated, in equal proportions between the locally available options, to receive whichever of the four study drugs (lopinavir, hydroxychloroquine, IFN-&#x3b2;1a, or remdesivir) were locally available at that time or no study drug (controls). All patients also received the local standard of care. No placebos were given. The protocol-specified primary endpoint was in-hospital mortality, subdivided by disease severity. Secondary endpoints were progression to ventilation if not already ventilated, and time-to-discharge from hospital. Final log-rank and Kaplan-Meier analyses are presented for remdesivir, and are appended for all four study drugs. Meta-analyses give weighted averages of the mortality findings in this and all other randomised trials of these drugs among hospital inpatients. Solidarity is registered with ISRCTN, ISRCTN83971151, and ClinicalTrials.gov, NCT04315948.<br><br>FINDINGS: Between March 22, 2020, and Jan 29, 2021, 14&#x2009;304 potentially eligible patients were recruited from 454 hospitals in 35 countries in all six WHO regions. After the exclusion of 83 (0&#xb7;6%) patients with a refuted COVID-19 diagnosis or encrypted consent not entered into the database, Solidarity enrolled 14&#x2009;221 patients, including 8275 randomly allocated (1:1) either to remdesivir (ten daily infusions, unless discharged earlier) or to its control (allocated no study drug although remdesivir was locally available). Compliance was high in both groups. Overall, 602 (14&#xb7;5%) of 4146 patients assigned to remdesivir died versus 643 (15&#xb7;6%) of 4129 assigned to control (mortality rate ratio [RR] 0&#xb7;91 [95% CI 0&#xb7;82-1&#xb7;02], p=0&#xb7;12). Of those already ventilated, 151 (42&#xb7;1%) of 359 assigned to remdesivir died versus 134 (38&#xb7;6%) of 347 assigned to control (RR 1&#xb7;13 [0&#xb7;89-1&#xb7;42], p=0&#xb7;32). Of those not ventilated but on oxygen, 14&#xb7;6% assigned to remdesivir died versus 16&#xb7;3% assigned to control (RR 0&#xb7;87 [0&#xb7;76-0&#xb7;99], p=0&#xb7;03). Of 1730 not on oxygen initially, 2&#xb7;9% assigned to remdesivir died versus 3&#xb7;8% assigned to control (RR 0&#xb7;76 [0&#xb7;46-1&#xb7;28], p=0&#xb7;30). Combining all those not ventilated initially, 11&#xb7;9% assigned to remdesivir died versus 13&#xb7;5% assigned to control (RR 0&#xb7;86 [0&#xb7;76-0&#xb7;98], p=0&#xb7;02) and 14&#xb7;1% versus 15&#xb7;7% progressed to ventilation (RR 0&#xb7;88 [0&#xb7;77-1&#xb7;00], p=0&#xb7;04). The non-prespecified composite outcome of death or progression to ventilation occurred in 19&#xb7;6% assigned to remdesivir versus 22&#xb7;5% assigned to control (RR 0&#xb7;84 [0&#xb7;75-0&#xb7;93], p=0&#xb7;001). Allocation to daily remdesivir infusions (vs open-label control) delayed discharge by about 1 day during the 10-day treatment period. A meta-analysis of mortality in all randomised trials of remdesivir versus no remdesivir yielded similar findings.<br><br>INTERPRETATION: Remdesivir has no significant effect on patients with COVID-19 who are already being ventilated. Among other hospitalised patients, it has a small effect against death or progression to ventilation (or both).<br><br>FUNDING: WHO.}, }
@article {pmid35279232, year = {2022}, author = {, }, title = {Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020-21.}, journal = {Lancet (London, England)}, volume = {399}, number = {10334}, pages = {1513-1536}, pmid = {35279232}, issn = {1474-547X}, mesh = {*COVID-19 ; Global Health ; Humans ; Mortality ; Pandemics ; SARS-CoV-2 ; Seroepidemiologic Studies ; }, abstract = {BACKGROUND: Mortality statistics are fundamental to public health decision making. Mortality varies by time and location, and its measurement is affected by well known biases that have been exacerbated during the COVID-19 pandemic. This paper aims to estimate excess mortality from the COVID-19 pandemic in 191 countries and territories, and 252 subnational units for selected countries, from Jan 1, 2020, to Dec 31, 2021.<br><br>METHODS: All-cause mortality reports were collected for 74 countries and territories and 266 subnational locations (including 31 locations in low-income and middle-income countries) that had reported either weekly or monthly deaths from all causes during the pandemic in 2020 and 2021, and for up to 11 year previously. In addition, we obtained excess mortality data for 12 states in India. Excess mortality over time was calculated as observed mortality, after excluding data from periods affected by late registration and anomalies such as heat waves, minus expected mortality. Six models were used to estimate expected mortality; final estimates of expected mortality were based on an ensemble of these models. Ensemble weights were based on root mean squared errors derived from an out-of-sample predictive validity test. As mortality records are incomplete worldwide, we built a statistical model that predicted the excess mortality rate for locations and periods where all-cause mortality data were not available. We used least absolute shrinkage and selection operator (LASSO) regression as a variable selection mechanism and selected 15 covariates, including both covariates pertaining to the COVID-19 pandemic, such as seroprevalence, and to background population health metrics, such as the Healthcare Access and Quality Index, with direction of effects on excess mortality concordant with a meta-analysis by the US Centers for Disease Control and Prevention. With the selected best model, we ran a prediction process using 100 draws for each covariate and 100 draws of estimated coefficients and residuals, estimated from the regressions run at the draw level using draw-level input data on both excess mortality and covariates. Mean values and 95% uncertainty intervals were then generated at national, regional, and global levels. Out-of-sample predictive validity testing was done on the basis of our final model specification.<br><br>FINDINGS: Although reported COVID-19 deaths between Jan 1, 2020, and Dec 31, 2021, totalled 5&#xb7;94 million worldwide, we estimate that 18&#xb7;2 million (95% uncertainty interval 17&#xb7;1-19&#xb7;6) people died worldwide because of the COVID-19 pandemic (as measured by excess mortality) over that period. The global all-age rate of excess mortality due to the COVID-19 pandemic was 120&#xb7;3 deaths (113&#xb7;1-129&#xb7;3) per 100&#x2009;000 of the population, and excess mortality rate exceeded 300 deaths per 100&#x2009;000 of the population in 21 countries. The number of excess deaths due to COVID-19 was largest in the regions of south Asia, north Africa and the Middle East, and eastern Europe. At the country level, the highest numbers of cumulative excess deaths due to COVID-19 were estimated in India (4&#xb7;07 million [3&#xb7;71-4&#xb7;36]), the USA (1&#xb7;13 million [1&#xb7;08-1&#xb7;18]), Russia (1&#xb7;07 million [1&#xb7;06-1&#xb7;08]), Mexico (798&#x2009;000 [741&#x2009;000-867&#x2009;000]), Brazil (792&#x2009;000 [730&#x2009;000-847&#x2009;000]), Indonesia (736&#x2009;000 [594&#x2009;000-955&#x2009;000]), and Pakistan (664&#x2009;000 [498&#x2009;000-847&#x2009;000]). Among these countries, the excess mortality rate was highest in Russia (374&#xb7;6 deaths [369&#xb7;7-378&#xb7;4] per 100&#x2009;000) and Mexico (325&#xb7;1 [301&#xb7;6-353&#xb7;3] per 100&#x2009;000), and was similar in Brazil (186&#xb7;9 [172&#xb7;2-199&#xb7;8] per 100&#x2009;000) and the USA (179&#xb7;3 [170&#xb7;7-187&#xb7;5] per 100&#x2009;000).<br><br>INTERPRETATION: The full impact of the pandemic has been much greater than what is indicated by reported deaths due to COVID-19 alone. Strengthening death registration systems around the world, long understood to be crucial to global public health strategy, is necessary for improved monitoring of this pandemic and future pandemics. In addition, further research is warranted to help distinguish the proportion of excess mortality that was directly caused by SARS-CoV-2 infection and the changes in causes of death as an indirect consequence of the pandemic.<br><br>FUNDING: Bill &amp; Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.}, }
@article {pmid35136960, year = {2022}, author = {Toller Erausquin, J and Tan, RKJ and Uhlich, M and Francis, JM and Kumar, N and Campbell, L and Zhang, WH and Hlatshwako, TG and Kosana, P and Shah, S and Brenner, EM and Remmerie, L and Mussa, A and Klapilova, K and Mark, K and Perotta, G and Gabster, A and Wouters, E and Burns, S and Hendriks, J and Hensel, DJ and Shamu, S and Marie Strizzi, J and Esho, T and Morroni, C and Eleuteri, S and Sahril, N and Yun Low, W and Plasilova, L and Lazdane, G and Marks, M and Olumide, A and Abdelhamed, A and López Gómez, A and Michielsen, K and Moreau, C and Tucker, JD and , }, title = {The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {75}, number = {1}, pages = {e991-e999}, pmid = {35136960}, issn = {1537-6591}, support = {K24 AI143471/AI/NIAID NIH HHS/United States ; R34 MH119963/MH/NIMH NIH HHS/United States ; UG3 HD096929/HD/NICHD NIH HHS/United States ; }, mesh = {Adult ; *COVID-19 ; Condoms ; Cross-Sectional Studies ; *HIV Infections ; Humans ; Reproductive Health ; Sexual Behavior ; *Sexual Health ; Sexual Partners ; *Sexually Transmitted Diseases/epidemiology ; }, abstract = {BACKGROUND: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium.<br><br>METHODS: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence.<br><br>RESULTS: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15&#x2005;144, 7.0%) compared to before COVID-19 measures (1469 of 15&#x2005;887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10&#x2005;790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy.<br><br>CONCLUSIONS: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.}, }
@article {pmid34488897, year = {2021}, author = {Fernando, ME and Drovandi, A and Golledge, J}, title = {Meta-analysis of the association between angiotensin pathway inhibitors and COVID-19 severity and mortality.}, journal = {Systematic reviews}, volume = {10}, number = {1}, pages = {243}, pmid = {34488897}, issn = {2046-4053}, support = {1117061//National Health and Medical Research Council/ ; }, mesh = {*Angiotensin Receptor Antagonists/adverse effects ; Angiotensin-Converting Enzyme Inhibitors/adverse effects ; Angiotensins ; *COVID-19 ; Humans ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Conflicting findings and the analysis of unpublished and retracted data have led to controversy on the safety of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in people with COVID-19 infection. This meta-analysis examined the association of prescription of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) with the outcome from COVID-19.<br><br>METHODS: A systematic search was conducted to find published studies that reported the outcome of COVID-19 in relation to prescription of ACEI or ARB. Two authors (MF and AD) independently screened and extracted data and assessed study quality and strength of association using standardised tools. The endpoints for the meta-analyses were severe or critical disease outcome and mortality based on standardised criteria.<br><br>RESULTS: Twenty-six studies including 8389 people prescribed ACEI or ARB and 20,989 people not prescribed these medications were included. The quality of studies varied, and the overall strength of association was poor with a high risk of confounding bias. Patients prescribed ACEI or ARB had a greater prevalence of risk factors. Meta-analysis found an association between prescription of ACEI or ARB with severe or critical disease outcome (risk ratio, RR, 1.23, 95% confidence interval, CI, 1.06 to 1.42, p = 0.006, I[2] = 88%) but this association was lost in sensitivity analyses. There was no association between ACEI or ARB prescription and mortality (RR 1.18, 95% CI 0.92 to 1.50, p = 0.19, I[2] = 82%).<br><br>CONCLUSIONS: This meta-analysis suggests that people prescribed ACEI or ARB more commonly had severe or critical disease outcome, but not mortality, in published cohorts of patients diagnosed with COVID-19. This finding is most likely due to a greater prevalence of risk factors in these patients rather than due to exposure to angiotensin pathway inhibitors.}, }
@article {pmid34474482, year = {2021}, author = {Cuker, A and Tseng, EK and Nieuwlaat, R and Angchaisuksiri, P and Blair, C and Dane, K and Davila, J and DeSancho, MT and Diuguid, D and Griffin, DO and Kahn, SR and Klok, FA and Lee, AI and Neumann, I and Pai, A and Righini, M and Sanfilippo, KM and Siegal, D and Skara, M and Terrell, DR and Touri, K and Akl, EA and Bou Akl, I and Bognanni, A and Boulos, M and Brignardello-Petersen, R and Charide, R and Chan, M and Dearness, K and Darzi, AJ and Kolb, P and Colunga-Lozano, LE and Mansour, R and Morgano, GP and Morsi, RZ and Muti-Schünemann, G and Noori, A and Philip, BA and Piggott, T and Qiu, Y and Roldan, Y and Schünemann, F and Stevens, A and Solo, K and Wiercioch, W and Mustafa, RA and Schünemann, HJ}, title = {American Society of Hematology living guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19: May 2021 update on the use of intermediate-intensity anticoagulation in critically ill patients.}, journal = {Blood advances}, volume = {5}, number = {20}, pages = {3951-3959}, pmid = {34474482}, issn = {2473-9537}, support = {K01 HL135466/HL/NHLBI NIH HHS/United States ; UL1 TR001863/TR/NCATS NIH HHS/United States ; }, mesh = {Anticoagulants/adverse effects ; *COVID-19 ; Critical Illness ; Evidence-Based Medicine ; *Hematology ; Humans ; SARS-CoV-2 ; United States ; *Venous Thromboembolism/etiology/prevention &amp; control ; }, abstract = {BACKGROUND: COVID-19-related critical illness is associated with an increased risk of venous thromboembolism (VTE).<br><br>OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in making decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.<br><br>METHODS: ASH formed a multidisciplinary guideline panel that included 3 patient representatives and applied strategies to minimize potential bias from conflicts of interest. The McMaster University Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline development process by performing systematic evidence reviews (up to 5&#xa0;March 2021). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the GRADE approach to assess evidence and make recommendations, which were subject to public comment. This is an update on guidelines published in February 2021.<br><br>RESULTS: The panel agreed on 1 additional recommendation. The panel issued a conditional recommendation in favor of prophylactic-intensity over intermediate-intensity anticoagulation in patients with COVID-19-related critical illness who do not have confirmed or suspected VTE.<br><br>CONCLUSIONS: This recommendation was based on low certainty in the evidence, which underscores the need for additional high-quality, randomized, controlled trials comparing different intensities of anticoagulation in critically ill patients. Other key research priorities include better evidence regarding predictors of thrombosis and bleeding risk in critically ill patients with COVID-19 and the impact of nonanticoagulant therapies (eg, antiviral agents, corticosteroids) on thrombotic risk.}, }
@article {pmid34425827, year = {2021}, author = {He, Y and Bai, X and Zhu, T and Huang, J and Zhang, H}, title = {What can the neurological manifestations of COVID-19 tell us: a meta-analysis.}, journal = {Journal of translational medicine}, volume = {19}, number = {1}, pages = {363}, pmid = {34425827}, issn = {1479-5876}, mesh = {*COVID-19 ; Humans ; *Mental Disorders ; *Nervous System Diseases ; SARS-CoV-2 ; *Stroke ; }, abstract = {BACKGROUND: Covid-19 became a global pandemic in 2019. Studies have shown that coronavirus can cause neurological symptoms, but clinical studies on its neurological symptoms are limited. In this meta-analysis, we aimed to summarize the various neurological manifestations that occurred in COVID-19 patients and calculate the incidence of various neurological manifestations. At the same time, we further explored the mechanism of nervous system injury and prognosis in COVID-19 patients in combination with their nervous system manifestations. This study provides a reference for early clinical identification of COVID-19 nervous system injury in the future, so as to achieve early treatment and reduce neurological sequelae.<br><br>METHODS: We systematically searched all published English literature related to the neurological manifestations of COVID-19 from January 1, 2020, to April 30, 2021, in Pubmed, Embase, and Cochrane Library. The keywords used were COVID-19 and terminology related to the nervous system performance. All included studies were selected by two independent reviewers using EndNote and NoteExpress software, any disagreement was resolved by consensus or by a third reviewer, and the selected data were then collected for meta-analysis using a random-effects model.<br><br>RESULTS: A total of 168 articles (n&#x2009;=&#x2009;292,693) were included in the study, and the meta-analysis showed that the most common neurological manifestations of COVID-19 were myalgia(33%; 95%CI 0.30-0.37; I[2]&#x2009;=&#x2009;99.17%), smell impairment(33%; 95%CI 0.28-0.38; I[2]&#x2009;=&#x2009;99.40%), taste dysfunction(33%; 95%CI 0.27-0.39; I[2]&#x2009;=&#x2009;99.09%), altered mental status(32%; 95%CI 0.22-0.43; I[2]&#x2009;=&#x2009;99.06%), headache(29%; 95%CI 0.25-0.33; I[2]&#x2009;=&#x2009;99.42%), encephalopathy(26%; 95%CI 0.16-0.38; I[2]&#x2009;=&#x2009;99.31%), alteration of consciousness(13%; 95%CI 0.08-0.19; I[2]&#x2009;=&#x2009;98.10%), stroke(12%; 95%CI 0.08-0.16; I[2]&#x2009;=&#x2009;98.95%), dizziness(10%; 95%CI 0.08-0.13; I[2]&#x2009;=&#x2009;96.45%), vision impairment(6%; 95%CI 0.03-0.09; I[2]&#x2009;=&#x2009;86.82%), intracerebral haemorrhage(5%; 95%CI 0.03-0.09; I[2]&#x2009;=&#x2009;95.60%), seizure(4%; 95%CI 0.02 -0.05; I[2]&#x2009;=&#x2009;98.15%), encephalitis(2%; 95%CI 0.01-0.03; I[2]&#x2009;=&#x2009;90.36%), Guillan-Barr&#xe9; Syndrome (GBS) (1%; 95%CI 0.00-0.03; I[2]&#x2009;=&#x2009;89.48%).<br><br>CONCLUSIONS: Neurological symptoms are common and varied in Covid-19 infections, and a growing number of reports suggest that the prevalence of neurological symptoms may be increasing. In the future, the role of COVID-19 neurological symptoms in the progression of COVID-19 should be further studied, and its pathogenesis and assessment methods should be explored, to detect and treat early neurological complications of COVID-19 and reduce mortality.}, }
@article {pmid34392148, year = {2021}, author = {Biji, A and Khatun, O and Swaraj, S and Narayan, R and Rajmani, RS and Sardar, R and Satish, D and Mehta, S and Bindhu, H and Jeevan, M and Saini, DK and Singh, A and Gupta, D and Tripathi, S}, title = {Identification of COVID-19 prognostic markers and therapeutic targets through meta-analysis and validation of Omics data from nasopharyngeal samples.}, journal = {EBioMedicine}, volume = {70}, number = {}, pages = {103525}, doi = {10.1016/j.ebiom.2021.103525}, pmid = {34392148}, issn = {2352-3964}, support = {/WT_/Wellcome Trust/United Kingdom ; }, mesh = {Adult ; Animals ; Biomarkers/metabolism ; COVID-19/*genetics/pathology/virology ; Cell Line ; Chlorocebus aethiops ; Cohort Studies ; Female ; HEK293 Cells ; Humans ; Inflammation/genetics/virology ; Interleukin-6/genetics ; Male ; Mesocricetus ; Middle Aged ; Nasopharynx/pathology/*virology ; Pandemics ; Prognosis ; Proteome/*genetics ; RNA, Messenger/genetics ; SARS-CoV-2/pathogenicity ; Transcriptome/*genetics ; Up-Regulation/genetics ; Vero Cells ; Virus Replication/genetics ; }, abstract = {BACKGROUND: While our battle with the COVID-19 pandemic continues, a multitude of Omics data have been generated from patient samples in various studies. Translation of these data into clinical interventions against COVID-19 remains to be accomplished. Exploring host response to COVID-19 in the upper respiratory tract can unveil prognostic markers and therapeutic targets.<br><br>METHODS: We conducted a meta-analysis of published transcriptome and proteome profiles of respiratory samples of COVID-19 patients to shortlist high confidence upregulated host factors. Subsequently, mRNA overexpression of selected genes was validated in nasal swabs from a cohort of COVID-19 positive/negative, symptomatic/asymptomatic individuals. Guided by this analysis, we sought to check for potential drug targets. An FDA-approved drug, Auranofin, was tested against SARS-CoV-2 replication in cell culture and Syrian hamster challenge model.<br><br>FINDINGS: The meta-analysis and validation in the COVID-19 cohort revealed S100 family genes (S100A6, S100A8, S100A9, and S100P) as prognostic markers of severe COVID-19. Furthermore, Thioredoxin (TXN) was found to be consistently upregulated. Auranofin, which targets Thioredoxin reductase, was found to mitigate SARS-CoV-2 replication in vitro. Furthermore, oral administration of Auranofin in Syrian hamsters in therapeutic as well as prophylactic regimen reduced viral replication, IL-6 production, and inflammation in the lungs.<br><br>INTERPRETATION: Elevated mRNA level of S100s in the nasal swabs indicate severe COVID-19 disease, and FDA-approved drug Auranofin mitigated SARS-CoV-2 replication in preclinical hamster model.<br><br>FUNDING: This study was supported by the DBT-IISc partnership program (DBT (IED/4/2020-MED/DBT)), the Infosys Young Investigator award (YI/2019/1106), DBT-BIRAC grant (BT/CS0007/CS/02/20) and the DBT-Wellcome Trust India Alliance Intermediate Fellowship (IA/I/18/1/503613) to ST lab.}, }
@article {pmid34380456, year = {2021}, author = {Xu, J and Xiao, W and Liang, X and Shi, L and Zhang, P and Wang, Y and Wang, Y and Yang, H}, title = {A meta-analysis on the risk factors adjusted association between cardiovascular disease and COVID-19 severity.}, journal = {BMC public health}, volume = {21}, number = {1}, pages = {1533}, pmid = {34380456}, issn = {1471-2458}, support = {No. 81973105//National Natural Science Foundation of China/ ; }, mesh = {*COVID-19 ; *Cardiovascular Diseases/epidemiology ; Comorbidity ; Humans ; Male ; Risk Factors ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Cardiovascular disease (CVD), one of the most common comorbidities of coronavirus disease 2019 (COVID-19), has been suspected to be associated with adverse outcomes in COVID-19 patients, but their correlation remains controversial.<br><br>METHOD: This is a quantitative meta-analysis on the basis of adjusted effect estimates. PubMed, Web of Science, MedRxiv, Scopus, Elsevier ScienceDirect, Cochrane Library and EMBASE were searched comprehensively to obtain a complete data source up to January 7, 2021. Pooled effects (hazard ratio (HR), odds ratio (OR)) and the 95% confidence intervals (CIs) were estimated to evaluate the risk of the adverse outcomes in COVID-19 patients with CVD. Heterogeneity was assessed by Cochran's Q-statistic, I[2]test, and meta-regression. In addition, we also provided the prediction interval, which was helpful for assessing whether the variation across studies was clinically significant. The robustness of the results was evaluated by sensitivity analysis. Publication bias was assessed by Begg's test, Egger's test, and trim-and-fill method.<br><br>RESULT: Our results revealed that COVID-19 patients with pre-existing CVD tended more to adverse outcomes on the basis of 203 eligible studies with 24,032,712 cases (pooled ORs = 1.41, 95% CIs: 1.32-1.51, prediction interval: 0.84-2.39; pooled HRs = 1.34, 95% CIs: 1.23-1.46, prediction interval: 0.82-2.21). Further subgroup analyses stratified by age, the proportion of males, study design, disease types, sample size, region and disease outcomes also showed that pre-existing CVD was significantly associated with adverse outcomes among COVID-19 patients.<br><br>CONCLUSION: Our findings demonstrated that pre-existing CVD was an independent risk factor associated with adverse outcomes among COVID-19 patients.}, }
@article {pmid34091456, year = {2021}, author = {Funke-Chambour, M and Bridevaux, PO and Clarenbach, CF and Soccal, PM and Nicod, LP and von Garnier, C and , }, title = {Swiss Recommendations for the Follow-Up and Treatment of Pulmonary Long COVID.}, journal = {Respiration; international review of thoracic diseases}, volume = {100}, number = {8}, pages = {826-841}, pmid = {34091456}, issn = {1423-0356}, mesh = {Aftercare/*standards ; COVID-19/*complications/diagnostic imaging ; Humans ; Pulmonary Medicine/*standards ; Radiography, Thoracic ; *COVID-19 Drug Treatment ; Post-Acute COVID-19 Syndrome ; }, abstract = {INTRODUCTION: Emerging evidence suggests that long-term pulmonary symptoms and functional impairment occurs in a proportion of individuals following SARS-CoV-2 infection. Although the proportion of affected patients remains to be determined, physicians are increasingly being confronted with patients reporting respiratory symptoms and impairment beyond the acute phase of COVID-19. In face of limited evidence, the Swiss Society for Pulmonology established a working group to address this area of unmet need and formulated diagnostic and treatment recommendations for the care of patients with pulmonary long COVID (LC).<br><br>METHOD: The Swiss COVID Lung Study group and Swiss Society for Pulmonology (SSP) formulated 13 questions addressing the diagnosis and treatment of pulmonary LC. A survey within the SSP special interest groups involved in care of LC patients was conducted in Switzerland. A CORE process/Delphi-like process was used to formulate recommendations. Forty experienced pulmonologists replied to the first survey and 22 completed the second follow-up survey. Agreement of &#x2265;70% consensus led to formulation of a recommendation.<br><br>RESULTS: The participants in the survey reached consensus and formulated a strong recommendation for regarding the following points. Patients hospitalized for COVID-19 should have a pulmonary assessment including pulmonary function tests. Symptomatic subjects affected by COVID-19, including those with mild disease, should benefit from a pulmonary follow-up. Persistent respiratory symptoms after COVID-19 should be investigated by a pulmonary follow-up including plethysmography, diffusion capacity measurement, and blood gases analysis. Individuals having suffered from COVID-19 and who present with persistent respiratory symptoms should be offered a rehabilitation. Additional questions were given moderateor weak recommendations for. The panel did not reach sufficient consensus for pharmacological therapy (e.g., therapy specifically targeting lung fibrosis) to formulate recommendations for LC drug treatment.<br><br>CONCLUSION: The formulated recommendations should serve as an interim guidance to facilitate diagnosis and treatment of patients with pulmonary LC. As new evidence emerges, these recommendations may need to be adapted.}, }
@article {pmid33837048, year = {2021}, author = {Topriceanu, CC and Wong, A and Moon, JC and Hughes, AD and Chaturvedi, N and Conti, G and Bann, D and Patalay, P and Captur, G}, title = {Impact of lockdown on key workers: findings from the COVID-19 survey in four UK national longitudinal studies.}, journal = {Journal of epidemiology and community health}, volume = {75}, number = {10}, pages = {955-962}, pmid = {33837048}, issn = {1470-2738}, support = {MC_UU_00019/1/MRC_/Medical Research Council/United Kingdom ; MR/V002147/1/MRC_/Medical Research Council/United Kingdom ; SP/20/2/34841/BHF_/British Heart Foundation/United Kingdom ; }, mesh = {Adult ; *COVID-19/epidemiology/prevention &amp; control ; Female ; Humans ; Longitudinal Studies ; Male ; Middle Aged ; *Occupations/classification ; *Pandemics/prevention &amp; control ; *Quarantine ; Surveys and Questionnaires ; United Kingdom/epidemiology ; Young Adult ; }, abstract = {BACKGROUND: Key workers played a pivotal role during the national lockdown in the UK's response to the COVID-19 pandemic. Although protective measures have been taken, the impact of the pandemic on key workers is yet to be fully elucidated.<br><br>METHODS: Participants were from four longitudinal age-homogeneous British cohorts (born in 2001, 1990, 1970 and 1958). A web-based survey provided outcome data during the first UK national lockdown (May 2020) on COVID-19 infection status, changes in financial situation, trust in government, conflict with people around, household composition, psychological distress, alcohol consumption, smoking and sleep duration. Generalised linear models with logit link assessed the association between being a key worker and the above outcomes. Adjustment was made for cohort design, non-response, sex, ethnicity, adult socioeconomic position (SEP), childhood SEP, the presence of a chronic illness and receipt of a shielding letter. Meta-analyses were performed across the cohorts.<br><br>FINDINGS: 13 736 participants were included. During lockdown, being a key worker was associated with increased chances of being infected with COVID-19 (OR 1.43, 95% CI 1.22 to 1.68) and experiencing conflict with people around (OR 1.19, 95% CI 1.03 to 1.37). However, key workers were less likely to be worse off financially (OR 0.32, 95% CI 0.24 to 0.65), to consume more alcohol (OR 0.88, 95% CI 0.79 to 0.98) or to smoke more (OR 0.60, 95% CI 0.44 to 0.80) during lockdown. Interestingly, being a key worker was not associated with psychological distress (OR 0.95, 95% CI 0.85 to 1.05).<br><br>INTERPRETATION: Being a key worker during the first UK COVID-19 lockdown was a double-edged sword, with both benefits and downsides. The UK government had the basic duty to protect its key workers from SARS-CoV-2 infection, but it may have failed to do so, and there is an urgent need to rectify this in light of the ongoing third wave.}, }
@article {pmid33188451, year = {2021}, author = {Yao, X and Yan, X and Wang, X and Cai, T and Zhang, S and Cui, C and Wang, X and Hou, Z and Liu, Q and Li, H and Lin, J and Xiong, Z and Liu, D}, title = {Population-based meta-analysis of chloroquine: informing chloroquine pharmacokinetics in COVID-19 patients.}, journal = {European journal of clinical pharmacology}, volume = {77}, number = {4}, pages = {583-593}, pmid = {33188451}, issn = {1432-1041}, support = {No. INV-015694/GATES/Bill &amp; Melinda Gates Foundation/United States ; }, mesh = {Administration, Oral ; Adult ; Aged ; COVID-19/virology ; Chloroquine/administration &amp; dosage/adverse effects/*analogs &amp; derivatives/pharmacokinetics ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; *Drug Repositioning ; Female ; Gastrointestinal Absorption ; Humans ; Male ; Metabolic Clearance Rate ; Middle Aged ; *Models, Biological ; SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; }, abstract = {AIMS: Chloroquine (CQ) has been repurposed to treat coronavirus disease 2019 (COVID-19). Understanding the pharmacokinetics (PK) in COVID-19 patients is essential to study its exposure-efficacy/safety relationship and provide a basis for a possible dosing regimen optimization.<br><br>SUBJECT AND METHODS: In this study, we used a population-based meta-analysis approach to develop a population PK model to characterize the CQ PK in COVID-19 patients. An open-label, single-center study (ethical review approval number: PJ-NBEY-KY-2020-063-01) was conducted to assess the safety, efficacy, and pharmacokinetics of CQ in patients with COVID-19. The sparse PK data from 50 COVID-19 patients, receiving 500&#xa0;mg CQ phosphate twice daily for 7&#xa0;days, were combined with additional CQ PK data from 18 publications.<br><br>RESULTS: A two-compartment model with first-order oral absorption and first-order elimination and an absorption lag best described the data. Absorption rate (ka) was estimated to be 0.559&#xa0;h[-1], and a lag time of absorption (ALAG) was estimated to be 0.149&#xa0;h. Apparent clearance (CL/F) and apparent central volume of distribution (V2/F) was 33.3&#xa0;l/h and 3630&#xa0;l. Apparent distribution clearance (Q/F) and volume of distribution of peripheral compartment (Q3/F) were 58.7&#xa0;l/h and 5120&#xa0;l. The simulated CQ concentration under five dosing regimens of CQ phosphate were within the safety margin (400&#xa0;ng/ml).<br><br>CONCLUSION: Model-based simulation using PK parameters from the COVID-19 patients shows that the concentrations under the currently recommended dosing regimen are below the safety margin for side-effects, which suggests that these dosing regimens are generally safe. The derived population PK model should allow for the assessment of pharmacokinetics-pharmacodynamics (PK-PD) relationships for CQ when given alone or in combination with other agents to treat COVID-19.}, }
@article {pmid32887670, year = {2020}, author = {Jin, YH and Zhan, QY and Peng, ZY and Ren, XQ and Yin, XT and Cai, L and Yuan, YF and Yue, JR and Zhang, XC and Yang, QW and Ji, J and Xia, J and Li, YR and Zhou, FX and Gao, YD and Yu, Z and Xu, F and Tu, ML and Tan, LM and Yang, M and Chen, F and Zhang, XJ and Zeng, M and Zhu, Y and Liu, XC and Yang, J and Zhao, DC and Ding, YF and Hou, N and Wang, FB and Chen, H and Zhang, YG and Li, W and Chen, W and Shi, YX and Yang, XZ and Wang, XJ and Zhong, YJ and Zhao, MJ and Li, BH and Ma, LL and Zi, H and Wang, N and Wang, YY and Yu, SF and Li, LY and Huang, Q and Weng, H and Ren, XY and Luo, LS and Fan, MR and Huang, D and Xue, HY and Yu, LX and Gao, JP and Deng, T and Zeng, XT and Li, HJ and Cheng, ZS and Yao, X and Wang, XH and ,  and , }, title = {Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline (updated version).}, journal = {Military Medical Research}, volume = {7}, number = {1}, pages = {41}, pmid = {32887670}, issn = {2054-9369}, mesh = {Adult ; Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Chemoprevention/*methods ; Clinical Laboratory Techniques/*methods ; Coronavirus Infections/diagnosis/*drug therapy/prevention &amp; control ; Evidence-Based Medicine ; Female ; Humans ; Male ; Middle Aged ; Pandemics/prevention &amp; control ; Patient Discharge/standards ; Pneumonia, Viral/diagnosis/*drug therapy/prevention &amp; control ; Practice Guidelines as Topic ; SARS-CoV-2 ; }, abstract = {The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, coronavirus disease 2019 (COVID-19), affecting more than seventeen million people around the world. Diagnosis and treatment guidelines for clinicians caring for patients are needed. In the early stage, we have issued "A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)"; now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline. We formed a working group of clinical experts and methodologists. The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas: chemoprophylaxis, diagnosis, treatments, and discharge management. We searched the literature for direct evidence on the management of COVID-19, and assessed its certainty generated recommendations using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Recommendations were either strong or weak, or in the form of ungraded consensus-based statement. Finally, we issued 34 statements. Among them, 6 were strong recommendations for, 14 were weak recommendations for, 3 were weak recommendations against and 11 were ungraded consensus-based statement. They covered topics of chemoprophylaxis (including agents and Traditional Chinese Medicine (TCM) agents), diagnosis (including clinical manifestations, reverse transcription-polymerase chain reaction (RT-PCR), respiratory tract specimens, IgM and IgG antibody tests, chest computed tomography, chest x-ray, and CT features of asymptomatic infections), treatments (including lopinavir-ritonavir, umifenovir, favipiravir, interferon, remdesivir, combination of antiviral drugs, hydroxychloroquine/chloroquine, interleukin-6 inhibitors, interleukin-1 inhibitors, glucocorticoid, qingfei paidu decoction, lianhua qingwen granules/capsules, convalescent plasma, lung transplantation, invasive or noninvasive ventilation, and extracorporeal membrane oxygenation (ECMO)), and discharge management (including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge). We also created two figures of these recommendations for the implementation purpose. We hope these recommendations can help support healthcare workers caring for COVID-19 patients.}, }
@article {pmid41516301, year = {2025}, author = {Stojanovic, M and Djuric, M and Nenadic, I and Bojic, S and Andrijevic, A and Popovic, A and Pesic, S}, title = {Vascular Complications of Long COVID-From Endothelial Dysfunction to Systemic Thrombosis: A Systematic Review.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516301}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/complications/pathology ; *Thrombosis/etiology/pathology ; *Endothelium, Vascular/physiopathology/pathology ; SARS-CoV-2 ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated not only with respiratory illness but also with profound vascular and coagulation disturbances. Long COVID (LC) is characterized by persistent symptoms such as fatigue, dyspnea, cognitive impairment, and palpitations. Mechanistically, SARS-CoV-2 induces direct endothelial injury, promotes a pro-inflammatory cytokine milieu, and activates platelets, leading to immunothrombosis and impaired fibrinolysis. Consequently, patients exhibit microthrombosis, elevated plasma D-dimer, fibrinogen dysregulation, and persistent hypercoagulability. Clinically, this translates into an increased risk of venous thromboembolism, including deep vein thrombosis and pulmonary embolism, as well as arterial thrombotic events such as myocardial infarction and stroke, which may persist months after acute infection. Understanding the interplay between endothelial injury, inflammation, and coagulation is crucial for risk stratification and the development of preventive and therapeutic strategies. We conducted a systematic narrative review of the literature, including human clinical and mechanistic studies identified through PubMed, Scopus and Web of Science up to 30 September 2025. This review synthesizes current evidence on vascular complications in LC, highlighting endothelial dysfunction as a central pathophysiological nexus linking the acute phase of SARS-CoV-2 infection with chronic LC manifestations.}, }
@article {pmid41516190, year = {2025}, author = {Mcmillan, P and Turner, AJ and Uhal, BD}, title = {The Central Role of Macrophages in Long COVID Pathophysiology.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516190}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/immunology/physiopathology/pathology/virology ; *Macrophages/immunology/metabolism ; SARS-CoV-2/immunology ; Macrophage Activation/immunology ; Immunity, Innate ; Epigenesis, Genetic ; Spike Glycoprotein, Coronavirus/metabolism/immunology ; Animals ; }, abstract = {This review article attempts to provide a unifying hypothesis to explain the myriad of symptoms and predispositions underlying the development of PASC (Postacute Sequelae of COVID), often referred to as Long COVID. The hypothesis described here proposes that Long COVID is best understood as a disorder of persistent immune dysregulation, with chronic macrophage activation representing the fundamental underlying pathophysiology. Unlike transient post-viral syndromes, Long COVID involves a sustained innate immune response, particularly within monocyte-derived macrophages, driven by persistent spike protein (peripherally in MAIT cells and centrally in Microglial cells), epigenetic imprinting, and gut-related viral reservoirs. These macrophages are not merely activated temporarily but also become epigenetically "trained" into a prolonged inflammatory state, as demonstrated by enduring histone acetylation markers such as H3K27acDNA Reprogramming. It is proposed that recognizing macrophage activation as the central axis of Long COVID pathology offers a framework for personalized risk assessment, targeted intervention, and therapeutic recalibration.}, }
@article {pmid41516027, year = {2025}, author = {Yang, J and Qu, Y and Yuan, Z and Lun, Y and Kuang, J and Shao, T and Qi, Y and Li, Y and Zhu, L}, title = {Targeting Host Dependency Factors: A Paradigm Shift in Antiviral Strategy Against RNA Viruses.}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516027}, issn = {1422-0067}, mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use ; *RNA Viruses/drug effects/physiology ; SARS-CoV-2/drug effects ; Virus Replication/drug effects ; *Host-Pathogen Interactions/drug effects ; *RNA Virus Infections/drug therapy/virology/metabolism ; Animals ; COVID-19/virology ; }, abstract = {RNA viruses, such as SARS-CoV-2 and influenza, pose a persistent threat to global public health. Their high mutation rates undermine the effectiveness of conventional direct-acting antivirals (DAAs) and facilitate drug resistance. As obligate intracellular parasites, RNA viruses rely extensively on host cellular machinery and metabolic pathways throughout their life cycle. This dependency has prompted a strategic shift in antiviral research-from targeting the mutable virus to targeting relatively conserved host dependency factors (HDFs). In this review, we systematically analyze how RNA viruses exploit HDFs at each stage of infection: utilizing host receptors for entry; remodeling endomembrane systems to establish replication organelles; hijacking transcriptional, translational, and metabolic systems for genome replication and protein synthesis; and co-opting trafficking and budding machinery for assembly and egress. By comparing strategies across diverse RNA viruses, we highlight the broad-spectrum potential of HDF-targeting approaches, which offer a higher genetic barrier to resistance, providing a rational framework for developing host-targeting antiviral therapies.}, }
@article {pmid41516024, year = {2025}, author = {Cuppen, JJM and Savelkoul, HFJ}, title = {Immune Delay, Beyond Immune Evasion, as a Driver of Pathogen Propagation Competence Through Neutrophil Dysregulation, to be Mitigated by Low-Frequency Electromagnetic Fields (LF-EMF).}, journal = {International journal of molecular sciences}, volume = {27}, number = {1}, pages = {}, pmid = {41516024}, issn = {1422-0067}, mesh = {Humans ; *Neutrophils/immunology/radiation effects ; *Immune Evasion/radiation effects ; *Electromagnetic Fields ; *Bacterial Infections/immunology ; Animals ; *Virus Diseases/immunology ; Neutrophil Activation/immunology/radiation effects ; }, abstract = {This paper proposes that immune delay, beyond immune evasion, is key in the propagation competence of major viral and bacterial infections, and that the dynamics of infection and immune response suggest possibilities for mitigating the ensuing infectious diseases. Recent data show a critical role of neutrophils at various stages of viral and bacterial infections, revealing how early activation of neutrophils could help mitigate infectious diseases. It could prevent the gradual overactivation of subclasses of neutrophils and probably not induce it. In respiratory virus infections, an immune delay of several days allows the development of a high viral load supporting infectivity towards further hosts when a delayed and increased immune response takes place. Virus variants will optimize immune delay towards highest infectivity, supporting pandemic potential. The influenza virus, coronavirus, and several major bacterial infections exhibit such immune delay capability. Recurrent urinary tract infections (rUTI) are common, often associated with the causative uropathogenic E. coli (UPEC) that has this capability, suggesting that immune delay is crucial in the pathogenesis of rUTI and other widespread bacterial infections. Counteracting immune delay, therefore, is a promising approach for mitigating infectious diseases with epidemic and pandemic presence or potential. Previously proven low-frequency electromagnetic field (LF-EMF)-induced neutrophil activation is such an approach.}, }
@article {pmid41515644, year = {2026}, author = {Azman, SA and Kennedy, MP}, title = {Single-Use Flexible Bronchoscopy: Advances in Technology and Applications.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {16}, number = {1}, pages = {}, pmid = {41515644}, issn = {2075-4418}, abstract = {With advances in scope and imaging technology, the use of single-use flexible bronchoscopy (SUFB) has broadened beyond intensive care units and operating rooms to bronchoscopy units, with an expanding body of literature suggesting adequate and comparable procedure outcomes, including airway inspection, bronchoalveolar lavage, endobronchial brushing and endobronchial biopsy, in comparison to standard reusable flexible bronchoscopy (RFB). Advantages such as mobility, ease of use and lack of requirement for cleaning staff during the COVID-19 pandemic led to a global increase in usage, with many companies developing SUFB as part of their bronchoscopy portfolio. In parallel, there has been more attention and initiatives to minimise the risk of infection transmission related to bronchoscopy. RFB requires maximum adherence to manufacturer-recommended cleaning protocols. However, evidence of transmissible organisms after cleaning is reported in healthcare settings of all types. After initial benchtop, retrospective and single-arm studies, comparative bronchoscopy studies are identifying that SUFB are as versatile and non-inferior to RFB. However, cost-effectiveness and sustainability factors have to be included in deciding the use of SUFB in routine practice.}, }
@article {pmid41514815, year = {2026}, author = {Vasinioti, VI and Lucente, MS and Catella, C and Buonavoglia, C and Decaro, N and Pratelli, A and Capozza, P}, title = {Feline Infectious Peritonitis: A Challenging Diagnostic and Therapeutic Labyrinth.}, journal = {Animals : an open access journal from MDPI}, volume = {16}, number = {1}, pages = {}, pmid = {41514815}, issn = {2076-2615}, abstract = {Feline coronaviruses (FCoVs) are ubiquitous pathogens, exhibiting high prevalence across feline populations worldwide. Although the virulent mutated biotype feline infectious peritonitis virus (FIPV) is observed in only a small percentage of cats, it causes a systemic and often fatal disease. Diagnosis of feline infectious peritonitis (FIP) is challenging due to its non-specific clinical signs and the difficulty in differentiating between the two biotypes, feline enteric coronavirus (FECV) and FPIV. Currently, veterinarians rely on a combination of diagnostic methods, integrating laboratory tests, anamnesis and clinical signs to improve the diagnostic accuracy of FIP. Once considered untreatable, FIP now benefits from recent pharmacological advances that suggest promising therapeutic options, including antiviral drugs and immunomodulatory therapies. Despite these developments, the lack of an effective vaccine and definitive curative treatment highlights the need for continued research. This review provides a comprehensive analysis of the current literature on diagnostic and treatment approaches for FIP. The aim is to improve understanding of the available options and strategies for FIP to mitigate its severe consequences.}, }
@article {pmid41513611, year = {2026}, author = {Nunes, M and Kell, L and Slaghekke, A and Wüst, RC and Fielding, BC and Kell, DB and Pretorius, E}, title = {Virus-induced endothelial senescence as a cause and driving factor for ME/CFS and long COVID: mediated by a dysfunctional immune system.}, journal = {Cell death &amp; disease}, volume = {17}, number = {1}, pages = {16}, pmid = {41513611}, issn = {2041-4889}, support = {NNF20CC0035580//Novo Nordisk Fonden (Novo Nordisk Foundation)/ ; }, mesh = {Humans ; *COVID-19/immunology/virology/pathology/complications ; SARS-CoV-2 ; *Cellular Senescence ; *Fatigue Syndrome, Chronic/immunology/virology/pathology ; *Endothelial Cells/pathology/virology/immunology ; *Immune System/pathology ; *Endothelium, Vascular/pathology/virology ; }, abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID are two post-viral diseases, which share many common symptoms and pathophysiological alterations. Yet a mechanistic explanation of disease induction and maintenance is lacking. This hinders the discovery and implementation of biomarkers and treatment options, and ultimately the establishment of effective clinical resolution. Here, we propose that acute viral infection results in (in)direct endothelial dysfunction and senescence, which at the blood-brain barrier, cerebral arteries, gastrointestinal tract, and skeletal muscle can explain symptoms. The endothelial senescence-associated secretory phenotype (SASP) is proinflammatory, pro-oxidative, procoagulant, primed for vasoconstriction, and characterized by impaired regulation of tissue repair, but also leads to dysregulated inflammatory processes. Immune abnormalities in ME/CFS and long COVID can account for the persistence of endothelial senescence long past the acute infection by preventing their clearance, thereby providing a mechanism for the chronic nature of ME/CFS and long COVID. The systemic and tissue-specific effects of endothelial senescence can thus explain the multisystem involvement in and subtypes of ME/CFS and long COVID, including dysregulated blood flow and perfusion deficits. This can occur in all tissues, but especially the brain as evidenced by findings of reduced cerebral blood flow and impaired perfusion of various brain regions, post-exertional malaise (PEM), gastrointestinal disturbances, and fatigue. Paramount to this theory is the affected endothelium, and the bidirectional sustainment of immune abnormalities and endothelial senescence. The recognition of endothelial cell dysfunction and senescence as a core element in the aetiology of both ME/CFS and Long COVID should aid in the establishment of effective biomarkers and treatment regimens.}, }
@article {pmid41512436, year = {2026}, author = {Chau, MT and Spuur, KM and Vu, H}, title = {Health human resources shortages in radiography and sustainable workforce development in Australia.}, journal = {Radiography (London, England : 1995)}, volume = {32}, number = {2}, pages = {103319}, doi = {10.1016/j.radi.2025.103319}, pmid = {41512436}, issn = {1532-2831}, abstract = {OBJECTIVES: Health Human Resources (HHR) are critical for the effective functioning of healthcare systems, yet significant shortages exist, particularly in radiography. The increasing demand for diagnostic radiography services, driven by advancements in medical technology, an aging population, and the prevalence of chronic diseases, exacerbates these shortages. The COVID-19 pandemic further highlighted workforce vulnerabilities, increasing workloads and burnout. This review examines HHR shortages in radiography in Australia and proposes strategies for sustainable workforce development.<br><br>KEY FINDINGS: The aging radiography workforce, with a significant portion nearing retirement, intensifies HHR shortages. The pandemic disrupted education and training, delaying the entry of new professionals and increasing turnover intentions among existing staff. The result being delayed imaging services, increased wait times, and potentially compromised patient outcomes. To address these challenges, a multifaceted strategy is proposed. Policy changes and government initiatives, including funding educational programs and recognizing internationally trained radiographers, can provide immediate relief. Expanding enrolment capacities and developing new training programs are essential. Retention strategies, including improving working conditions and career advancement opportunities, are crucial for workforce stability. Promoting advanced practice models can optimize task distribution and better utilize specialized skills. Leveraging technology, such as artificial intelligence and telehealth, can enhance productivity and extend service reach.<br><br>CONCLUSION: A comprehensive approach combining policy changes, educational initiatives, retention strategies, technology integration, international recruitment, and awareness campaigns is essential for addressing HHR shortages in radiography. By implementing these strategies, the radiography workforce can be better equipped to meet the growing demands of healthcare, ensuring optimal patient outcomes and the sustainability of health services.<br><br>IMPLICATIONS FOR PRACTICE: Strengthening the radiography workforce will ensure timely and effective healthcare delivery, support health interventions, and progress towards universal health coverage and Sustainable Development Goals.}, }
@article {pmid41512080, year = {2026}, author = {Lee, D and Malathi, K and Okano, T and Nakajima, K and Cobat, A and Morio, T and Casanova, JL and Zhang, SY}, title = {The OAS-RNase L pathway: Insights from experiments of nature.}, journal = {Science immunology}, volume = {11}, number = {115}, pages = {eads9407}, doi = {10.1126/sciimmunol.ads9407}, pmid = {41512080}, issn = {2470-9468}, mesh = {Humans ; *2',5'-Oligoadenylate Synthetase/genetics/metabolism/immunology ; *Endoribonucleases/metabolism/immunology/genetics ; *COVID-19/immunology ; *SARS-CoV-2/immunology/physiology ; Animals ; Signal Transduction ; }, abstract = {The 2'-5' oligoadenylate synthetases (OASs) are type I interferon-inducible enzymes that, with ribonuclease L (RNase L), have been studied in the context of their coupled action as antiviral effectors. RNase L degrades host and viral ssRNA, affecting diverse cellular processes including translational arrest, interferon response, and apoptosis, all of which are thought to restrict viral replication. Recent studies of recessive inborn errors of human OAS1, OAS2, and RNase L, however, revealed that for SARS-CoV-2 infection, the main protective action of this pathway in natura may be through restricting phagocyte-driven postviral inflammation rather than restricting early viral replication in the respiratory tract. This finding is consistent with the identification of gain-of-function OAS1 mutations in humans with autoinflammation also driven by myeloid cells. Here, we retrace the investigation of the OAS-RNase L pathway, focusing on these recent in natura studies in humans that reposition the pathway as a determinant of the inflammatory response under natural conditions of infection.}, }
@article {pmid41510348, year = {2025}, author = {Tachibana, S and Bourgeois Yoshioka, CK}, title = {Take Fatigue or Fatigues into Account in Physiotherapy Interventions? A Rapid Scoping Review.}, journal = {Physical therapy research}, volume = {28}, number = {3}, pages = {157-173}, pmid = {41510348}, issn = {2189-8448}, abstract = {Fatigue is one of the most common symptoms encountered in rehabilitation and during physical therapy interventions. Although this phenomenon is known and experienced by everyone, its assessment is not straightforward. The lack of consensus on its definition, complex etiology, and multidimensional nature means that a large number of outcomes exist and continue to be reviewed. However, it seems essential that its assessment be better defined and standardized to understand the effects of physical therapy. To provide an initial exploratory overview, we conducted a rapid scoping review of the various fatigue assessments used in physiotherapy interventions or performed by physical therapists. A total of 139 articles published between 2020 and July 31, 2025 were included and explored. We found 43 different outcomes used across 46 population groups. While the most well-known chronic conditions such as cancer, multiple sclerosis (MS), and coronavirus disease 2019 (COVID-19) are representative, their assessment methods do not appear to be harmonized. These findings from the study support the idea that fatigue remains a complex phenomenon to assess. However, it appears that the lack of justification for the choice of an outcome prevents a better understanding of the reproducible effects on fatigue in physiotherapy interventions.}, }
@article {pmid40720978, year = {2026}, author = {Fan, BE and Tan, JHM and Tan, DS}, title = {COVID-19 and Anticoagulant Use: Did the Pandemic Push DOACs Ahead of Warfarin?.}, journal = {Seminars in thrombosis and hemostasis}, volume = {52}, number = {1}, pages = {139-143}, doi = {10.1055/a-2667-6770}, pmid = {40720978}, issn = {1098-9064}, mesh = {Humans ; *COVID-19/epidemiology ; *Warfarin/therapeutic use ; *Anticoagulants/therapeutic use ; *SARS-CoV-2 ; Pandemics ; Administration, Oral ; Vitamin K/antagonists &amp; inhibitors ; COVID-19 Drug Treatment ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic introduced unprecedented disruptions to health care delivery, compelling rapid adaptations in anticoagulation management. Direct oral anticoagulants (DOACs), already displacing warfarin due to their convenience and reduced monitoring requirements, appeared well-positioned for broader adoption during pandemic-induced lockdowns. This commentary examines whether the pandemic catalyzed a meaningful shift in anticoagulant prescribing patterns from vitamin K antagonists (VKAs) to DOACs, drawing on data from the United Kingdom, Australia, the United States, Europe, and Asia. In the United Kingdom, national guidance led to an abrupt and large-scale switch to DOACs, with sustained changes postpandemic. In contrast, Australia and the United States exhibited continuity in preexisting trends, with modest, transient shifts that did not persist. Asian and European data revealed a gradual trajectory toward DOACs, likely driven by long-term policy and infrastructure rather than acute pandemic pressures. While no universal transformation occurred, the pandemic accentuated existing preferences and exposed system-level vulnerabilities in warfarin monitoring. The global experience suggests that the COVID-19 crisis served as a selective accelerant of DOACs adoption, where health care systems and policies facilitated change. As health systems prepare for future disruptions, equitable access to DOACs and investment in remote care infrastructure will be essential to ensuring continuity and safety in anticoagulation therapy.}, }
@article {pmid40592569, year = {2026}, author = {Liem, B and Wali, G and Khan, S and Ieremia, E and Ramasamy, K and Thompson, A and Sen, A}, title = {Dermato-neuro syndrome triggered by SARS-CoV-2 vaccination.}, journal = {Practical neurology}, volume = {26}, number = {1}, pages = {51-54}, doi = {10.1136/pn-2025-004613}, pmid = {40592569}, issn = {1474-7766}, mesh = {Humans ; Female ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/adverse effects ; ChAdOx1 nCoV-19/adverse effects ; Middle Aged ; *Vaccination/adverse effects ; *Nervous System Diseases/etiology ; *Skin Diseases/etiology ; }, abstract = {There are many possible causes for acute encephalitis, and systemic causes can be easily overlooked. We report a woman with initial status epilepticus, marked working memory impairment and ataxia, which developed 1 week following the ChAdOx1 SARS-CoV-2 (Astra-Zeneca) vaccination. Although lumbar puncture detected a paraprotein, it was not until she developed the hallmark cutaneous features of scleromyxoedema several months later that we recognised this as the dermato-neuro syndrome. Given the temporal association, the SARS-CoV-2 vaccination was a likely trigger, and the decision whether to give subsequent vaccinations during the heat of the COVID-19 pandemic added a layer of complexity to decision making. We review the literature regarding dermato-neuro syndrome in the setting of SARS-CoV-2 vaccination and explore its unique features.}, }
@article {pmid41509876, year = {2026}, author = {Ärlebrant, L and Schimmer, R and Edin-Liljegren, A}, title = {Patients' experiences of video consultations: A qualitative systematic review.}, journal = {Digital health}, volume = {12}, number = {}, pages = {20552076251404513}, pmid = {41509876}, issn = {2055-2076}, abstract = {INTRODUCTION: Video consultation (VC) became vital for improving healthcare access during COVID-19 pandemic and remains so. Despite evidence of effectiveness, concerns including technology literacy and inconsistencies in experience highlight the need for larger, patient-focused studies. While patients appreciate the convenience of VC, challenges during complex issues and patients' preferences for in-person care persists. Synthesising qualitative studies offers insights into the fragmented understanding of patient experiences with VC. This review explores adult patients' experiences of VC.<br><br>METHODS: A systematic literature search was conducted for studies published between 2011 and 2024 and reported according to the PRISMA statement. Study quality was assessed using the CASP checklist, and data were analysed through thematic synthesis. Confidence in the findings was evaluated using GRADE-CERQual.<br><br>RESULTS: In total, 3203 unique studies were retrieved; 13 were included in the final synthesis, resulting in four main themes: (1) suitable for less complex issues when technical problems can be solved; (2) feeling secure, relaxed, and having mutual focus in an equitable partnership; (3) limitations regarding personal needs and practical help; and (4) increased vulnerability and lack of emotional feedback.<br><br>CONCLUSION: VC is experienced as ideal for managing less complex issues but is challenging for emotional topics due to technical concerns. It empowers patients by providing a neutral place for focused conversations but can create vulnerability and distance that can challenge the patient-professional relationship. Success requires technological adaptation, sufficient time during VC, and emotional support. VC should complement - not replace - traditional care, with its use determined in dialogue with patients.}, }
@article {pmid41506930, year = {2026}, author = {He, WT and Jiang, ZW and Veit, M and Merits, A and Zhang, FN and Wang, D and Su, S}, title = {Multiscale imaging of RNA virus: bridging structural mapping and functional insights.}, journal = {Trends in microbiology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.tim.2025.12.002}, pmid = {41506930}, issn = {1878-4380}, abstract = {RNA viruses, exemplified by the COVID-19 pandemic, pose a significant threat to global health. Their rapid mutation and host adaptability highlight the need for advanced tools for efficient viral studies and timely countermeasure development. Imaging technologies, such as cryo-electron microscopy and super-resolution microscopy, have been pivotal in advancing our understanding of viral structures, infection mechanisms, and virus-host interactions. However, each technique has limitations in the field of view or resolution. Recent advancements have focused on developing integrated multiscale imaging to better understand RNA virus pathogenesis. In this review, we examine recent progress in RNA virus imaging across molecular, cellular, and tissue scales, including cryo-electron tomography and correlative multiscale imaging, which link structural mapping with functional insights.}, }
@article {pmid41506147, year = {2026}, author = {Huai, Y and Wang, X and Yan, J and Li, S and Zhao, H and Liao, B}, title = {Emerging viroporins, RBP dynamics, and skeletal remodeling: Targeting liquid-liquid phase separation for dual antiviral and bone-protective therapies.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101445}, doi = {10.1016/j.mam.2026.101445}, pmid = {41506147}, issn = {1872-9452}, abstract = {Emerging and re-emerging viral pathogens, particularly Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Zika virus (ZIKV), and Chikungunya virus (CHIKV), are currently recognized as a significant global public health issue, commonly leading to devastating persistent complications including inflammatory bone disorders and long-lasting arthralgia. Although systemic cytokine storm has been reported as a significant factor, the particular intracellular processes through which these viruses affect bone homeostasis are still poorly understood. Recent studies underscore Liquid-Liquid Phase Separation (LLPS) and RNA-Binding Proteins (RBPs) as significant regulatory mechanisms manipulated by these viruses. Particularly, the SARS-CoV-2 Nucleocapsid protein exploits its intrinsically disordered regions to promote LLPS, facilitating viral assembly by the active inhibition of a key host anti-viral mechanism, known as host Stress Granules. Studies suggest that this biophysical interaction can affect the stability of the HuR RBD, impairing the nuclear β-catenin localization and then Wnt-mediated osteogenesis. Despite increasing recognition of post-viral musculoskeletal complications, the mechanistic links between viral persistence, host RBP dysfunction, and impaired bone remodeling remain poorly defined. This review incorporates viral LLPS, stress granule impairment, and osteogenic signaling into a unified 'Two-Hit' pathogenic framework. It also addresses key knowledge gaps, including the lack of longitudinal clinical validation and in vivo evidence associating LLPS impairment to skeletal disorders. Interestingly, this framework represents translational opportunities for dual-action therapeutic strategies that simultaneously impair viral condensates and recover host RBP-associated osteogenic signaling. Targeting the virus-host phase interface can introduce a potential approach not only for antiviral therapies but also for inhibiting post-viral musculoskeletal complications.}, }
@article {pmid41504868, year = {2026}, author = {Khan, S and Tang, P and Yang, P and Li, J and Wu, H}, title = {Dual-function cytokines as modulators of autophagy: reprogramming inflammatory resolution in severe COVID-19.}, journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]}, volume = {75}, number = {1}, pages = {11}, pmid = {41504868}, issn = {1420-908X}, mesh = {Humans ; *Autophagy/immunology ; *COVID-19/immunology ; *Cytokines/immunology/physiology ; *Inflammation/immunology ; SARS-CoV-2 ; Endoplasmic Reticulum Stress ; Animals ; Cytokine Release Syndrome/immunology ; }, abstract = {BACKGROUND: Acute respiratory distress syndrome (ARDS) and systemic immune-mediated damage are two of the severe COVID-19 outcomes that are primarily caused by cytokine storms triggered by dysregulated immune responses. The limited benefits of current immunosuppressive treatments highlight the need for mechanistic understanding to direct focused interventions.<br><br>OBJECTIVE: The dual functions of cytokines in controlling autophagy during SARS-CoV-2 infection are examined in this review, along with the potential for autophagy modulation to limit hyperinflammation and restore immune homeostasis.<br><br>KEY FINDINGS: Emerging evidence suggests that autophagy critically modulates the balance between pro- and anti-inflammatory cytokines in COVID-19. Through anti-inflammatory feedback mechanisms, cytokines contribute to resolution while promoting inflammation in the early stages. The IRE1&#x3b1;-XBP1 axis is activated by SARS-CoV-2-induced endoplasmic reticulum stress, which increases cytokine production and modifies autophagic flux. Concurrently, extracellular vesicles containing cytokines, damage-associated molecular patterns, and viral components are released as secretory autophagy reroutes cytoplasmic cargo toward multivesicular bodies and amphisomes, increasing paracrine immune activation. Suppressed degradative autophagy and increased secretory autophagy-mediated inflammatory signaling are the hallmarks of this pathological state.<br><br>CONCLUSIONS: In severe COVID-19, targeted autophagy restoration is a promising therapeutic approach to restore immune responses, reduce excessive inflammation, and encourage the resolution of cytokine storms. Restoring immune homeostasis through more targeted immunointerventions may be made possible by modifying autophagy pathways.}, }
@article {pmid41504442, year = {2026}, author = {Masters, PS}, title = {Coronavirus genome packaging and nucleocapsid assembly.}, journal = {Journal of virology}, volume = {}, number = {}, pages = {e0133025}, doi = {10.1128/jvi.01330-25}, pmid = {41504442}, issn = {1098-5514}, abstract = {Coronaviruses are a family of positive-strand RNA viruses that exhibit highly selective packaging of their genomic RNA (gRNA) into assembled virions, despite the presence of a large excess of subgenomic viral RNA species and host RNA in infected cells. While this high selectivity is critical to evading host innate immune responses, surprisingly, it is not essential for virion assembly. This review focuses on four main topics: (i) coronavirus genome packaging signals (PSs)-how they are found and the function they serve; (ii) the viral components that recognize the PS in order to bring about selective gRNA packaging; (iii) coronavirus nucleocapsid structure and assembly; and (iv) the relationship between nucleocapsid protein phosphorylation and nucleocapsid assembly versus RNA synthesis. Current understanding of these areas has benefited immensely from advances made by recent studies, most of which were performed in response to the emergence of the coronavirus responsible for the COVID-19 pandemic. Throughout this review, emphasis is placed on the counterintuitive distinction between coronavirus selective gRNA packaging and nucleocapsid assembly.}, }
@article {pmid41504094, year = {2025}, author = {Galuia, M and Hussain, A and Ahmad, S}, title = {Biosimilars in Gynecologic Cancers: Basic Principles and New Horizons.}, journal = {Frontiers in bioscience (Elite edition)}, volume = {17}, number = {4}, pages = {33415}, doi = {10.31083/FBE33415}, pmid = {41504094}, issn = {1945-0508}, mesh = {Humans ; *Biosimilar Pharmaceuticals/therapeutic use/economics ; *Genital Neoplasms, Female/drug therapy ; Female ; Cost-Benefit Analysis ; *Antineoplastic Agents/therapeutic use ; }, abstract = {Biological therapies have transformed cancer treatment by targeting the molecular mechanisms involved in carcinogenesis. However, higher costs, limited accessibility, and supply chain disruptions-such as those caused by COVID-19 in recent years-underscore the need for cost-effective alternatives. Biosimilars, which are drugs that are highly similar to their reference biologics in terms of safety, efficacy, and quality, offer a viable solution (as these demonstrate clinically meaningful outcomes). This review article examines the role of biosimilars, mainly in gynecological cancers. The primary focus of this article is to compare the efficacy, safety, and cost-effectiveness of biosimilars, as well as to explore the barriers that restrict their widespread adoption. A comprehensive literature review was conducted, analyzing various studies, regulatory guidelines, and the latest data on biosimilars for the treatment of gynecological cancers. Pivotal trials, such as the GOG-0218, ICON7, and RUBY, were reviewed to assess the efficacy, safety, and cost-effectiveness of these biosimilars. This review highlights key oncologic therapies, including bevacizumab, trastuzumab, pembrolizumab, and their biosimilars, mainly for gynecological cancers. Additionally, this review considers the challenges of immunogenicity, interchangeability, and clinician awareness. After reviewing the latest peer-reviewed literature and related online materials, we found that biosimilars demonstrate comparable efficacy and safety to their reference biologics while also being more cost-effective. Recent clinical trials support the role of biosimilars in limiting the progression of disease and improving overall survival while reducing the financial burden of cancer treatments.}, }
@article {pmid41481750, year = {2026}, author = {Hamilton, DO and Simpson, V and Fox, T and Lutje, V and Kohl, A and Ferreira, DM and Morton, B}, title = {Attenuated viral strains of priority pathogens for potential use in controlled human infection model studies: A scoping review.}, journal = {PLoS neglected tropical diseases}, volume = {20}, number = {1}, pages = {e0013243}, doi = {10.1371/journal.pntd.0013243}, pmid = {41481750}, issn = {1935-2735}, mesh = {Humans ; *Virus Diseases/virology/prevention &amp; control ; Chikungunya virus/immunology ; Rift Valley fever virus/immunology ; *Viral Vaccines/immunology/administration &amp; dosage ; *Viruses/genetics ; Animals ; }, abstract = {BACKGROUND: There are several known pathogens and families identified as high risk for pandemic potential. It is essential to study these pathogens and develop medical countermeasures to mitigate disease prior to potential pandemics. Controlled human infection models (CHIMs) using attenuated viral strains may offer an efficient and safe way to do this.<br><br>OBJECTIVE: Our aim was to systematically examine the literature for attenuated, but replication competent, strains of Coalition for Epidemic Preparedness Innovations (CEPI) identified priority pathogens (Ebola, Lassa virus, Nipah virus, Rift Valley fever virus, chikungunya virus and Middle East respiratory syndrome-related coronavirus) that have been administered to humans.<br><br>DESIGN: A comprehensive literature search of multiple databases was performed by an information specialist. All search results were screened by two authors against inclusion/exclusion criteria from a pre-specified protocol. The primary outcome was confirmation that the administered viral strain could subsequently be recovered from participants. The secondary outcome was attenuated virus safety.<br><br>RESULTS: Our searches yielded 13078 results and 5998 articles remained for screening after removing duplicates and animal studies. Subsequently, 351 articles were selected for full text review and nine were included for data extraction. Four distinct attenuated strains were identified across two priority pathogens - TSI-GSD-218 and VLA1553 for chikungunya virus and MP-12 and hRVFV-4s for Rift Valley Fever virus. Attenuated virus was recovered for each strain except hRVFV-4s. There were no major safety concerns for these identified strains in Phase 1-3 studies.<br><br>CONCLUSIONS: We have identified three attenuated viral strains that may be amenable to development into novel CHIMs for two priority pathogens. Of these, VLA1553 for chikungunya is a licenced and commercially available vaccine product suitable for use in CHIM. There is a research gap for the creation of new attenuated mutants that could be utilised in CHIM for other priority pathogens.}, }
@article {pmid41048061, year = {2025}, author = {Simons, G and Opalinski, D and Jenkins, J and Boxley, E and Baldwin, DS}, title = {Measurement of doctor wellbeing prior to the Covid pandemic: a methodological systematic review.}, journal = {Occupational medicine (Oxford, England)}, volume = {75}, number = {9}, pages = {612-619}, doi = {10.1093/occmed/kqaf088}, pmid = {41048061}, issn = {1471-8405}, support = {//Health Education England South/ ; }, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Physicians/psychology ; *Burnout, Professional/psychology ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: There is no consensus definition of wellbeing, yet it is a key outcome for workforces.<br><br>AIMS: To describe which wellbeing outcomes had been measured in doctors and which wellbeing outcome measurement instruments had been used with doctors.<br><br>METHODS: A methodological review of existing literature. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO and the International Bibliography of Social Science were searched for all study types, in all languages. Wellbeing outcomes were categorized as being operationalized in the aims, methods or results and by whether the outcome used to represent wellbeing included the word wellbeing, another positive concept, a pathological symptom, a pathology and were work- or doctor-specific. The outcome measurement instruments used were then categorized and the frequency collected.<br><br>RESULTS: A total of 218 studies were included in this review. The total number of unique outcomes used to capture wellbeing in the eligible studies was 57, with 369 non-unique outcomes. Two hundred and fifty-eight of the outcomes used contained the word wellbeing, its components and other positive concepts. For the outcome 'general wellbeing' alone, 92 different measurement tools were used. The Maslach Burnout Inventory was the most frequently used measurement tool for all outcomes and was used in 34 studies.<br><br>CONCLUSIONS: Wellbeing has been measured heterogeneously in doctors in terms of the outcomes and the outcome measurement instruments used. In approximately one-third of the times it was measured, the best that could be achieved was an absence of pathological symptoms, as a negative concept operationalized it.}, }
@article {pmid39079021, year = {2025}, author = {Morris, M and Serrano, LP and Patel, K and Cervantes, J}, title = {I can't get no satisfaction: burnout, stress, and depression in Latin medical students.}, journal = {Trends in psychiatry and psychotherapy}, volume = {47}, number = {}, pages = {e20240818}, doi = {10.47626/2237-6089-2024-0818}, pmid = {39079021}, issn = {2238-0019}, mesh = {Humans ; *Students, Medical/psychology/statistics &amp; numerical data ; *COVID-19/epidemiology ; Latin America/epidemiology ; *Burnout, Professional/epidemiology/psychology ; *Depression/epidemiology/psychology ; *Stress, Psychological/epidemiology ; Prevalence ; Female ; }, abstract = {The state of emotional, physical, and mental exhaustion caused by excessive and prolonged stress, known as burnout syndrome (BS), is not only affecting the medical workforce but medical students in training. Gender, race, ethnicity, and potentially other variables can serve as significant risk factors contributing to BS among medical students. Despite the importance of understanding these disparities, very few studies in the U.S. have analyzed race or ethnicity amongst their cohorts. However, there exists extensive information on burnout in students from Latin America, which serves as the primary focus of this review. A systematic literature search was conducted using pertinent terms in English and Spanish. Our review found that the prevalence of BS in Latin American countries varies widely, ranging from 4.3 to 43.90% pre-COVID-19 pandemic. Variability in the educational environment and the complex interplay of cultural, academic, and systemic factors appear to contributing to burnout among students. Post-pandemic investigations reveal even higher prevalences, particularly among women. High rates of depression and anxiety are also reported during the COVID-19 pandemic. The reviewed data showed that BS can become further exacerbated and complicated by existing psychiatric comorbidities amongst Latin American medical students. It is possible that we may observe continued upward trajectories in burnout trends among both healthcare workers and medical students in this post-COVID-19 pandemic era. These insights call for tailored interventions addressing not only burnout but also the interconnected mental health challenges faced by medical students in Latin America.}, }
@article {pmid41503324, year = {2025}, author = {Dameche, K and Shams, S and AlMesallam, MS}, title = {Herpes Zoster (HZ) Over the Past 10 Years: A Systematic Review on Trends, Triggers, and Post-COVID-19 Impact.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e98556}, pmid = {41503324}, issn = {2168-8184}, abstract = {Herpes zoster (HZ) is a reactivation of varicella-zoster virus (VZV), which has been traditionally associated with aging and immunosuppression. However, new data indicate that the coronavirus disease 2019 (COVID-19) pandemic has changed HZ epidemiology, with a higher incidence of HZ in post-COVID-19 patients and vaccinated subjects. This systematic review assesses the trends and triggers of HZ as well as the impact after the pandemic, focusing on the changes in the incidence rate among adult and pediatric patients during the last 10 years. All studies published between the years of 2014 and 2024 were accrued, based on a systematic review conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant articles were identified from searches of databases and other sources. Eligibility criteria of studies were applied, and qualitative and quantitative syntheses of studies were performed. A total of 11 studies were included in the review, which examined the association between COVID-19, vaccination, and HZ risk. Several studies suggested that psychological stress and immune dysfunction could be risk factors for HZ incidence. HZ cases after COVID-19 vaccination have been reported, although causation is not established. Based on countries in which COVID-19 was diagnosed, hospitalizations are estimated at 14.4 per 100,000 inhabitants (0.6 to 32.9 per 100,000), and mortality was 1.3 per 100,000, points in this IR Batch (assuming that these are of all diagnosed cases). The risk of HZ reactivation may be increased following COVID-19 infection and vaccination. Higher hospitalization rates with higher mortality risks and neurological consequences were also observed in some populations. Strengthening HZ vaccination programs and studying post-COVID-19 immune responses further can be essential for reducing long-term health risks.}, }
@article {pmid41502909, year = {2026}, author = {El Rassi, C and El Darzi, R and Abou Mansour, M and Arabi, M}, title = {MIS-C: Diagnosis, Management, and Outcomes.}, journal = {Open forum infectious diseases}, volume = {13}, number = {1}, pages = {ofaf762}, pmid = {41502909}, issn = {2328-8957}, abstract = {Multisystem inflammatory syndrome in children (MIS-C) is an emergent postinfectious hyperinflammatory disorder predominantly affecting the pediatric population following COVID-19 infection. Clinically, it is characterized by persistent fever, shock, multiorgan involvement, and potentially severe cardiovascular involvement. This comprehensive review synthesizes current evidence on the epidemiology, pathophysiology, clinical presentation, diagnostic criteria, with particular emphasis on the management of MIS-C. We also stress on the importance of distinguishing MIS-C from phenotypically similar entities. Acute-phase management centers on supportive care, hemodynamic stabilization, and targeted immunomodulation, with intravenous immunoglobulin, corticosteroids, and biologic forming the therapeutic cornerstone. Thromboprophylaxis is frequently warranted due to the elevated thromboembolic risk, and long-term follow-up is essential to monitor for cardiac, gastrointestinal, and neurologic complications. Additional considerations include postrecovery vaccination protocols and the use of extracorporeal membrane oxygenation in cases of refractory cardiorespiratory failure. Despite advancements in clinical outcomes, diagnostic ambiguity and heterogeneous management guidelines continue to pose significant challenges.}, }
@article {pmid41502328, year = {2026}, author = {Gimmon, Y and Gordon, CR}, title = {Neuro-vestibular rehab: new developments.}, journal = {Current opinion in neurology}, volume = {39}, number = {1}, pages = {83-87}, doi = {10.1097/WCO.0000000000001441}, pmid = {41502328}, issn = {1473-6551}, mesh = {Humans ; *Vestibular Diseases/rehabilitation/physiopathology ; *Reflex, Vestibulo-Ocular/physiology ; *Neurological Rehabilitation/methods/trends ; *Vestibule, Labyrinth/physiology ; Adaptation, Physiological/physiology ; Exercise Therapy/methods ; Telemedicine ; COVID-19 ; }, abstract = {PURPOSE OF REVIEW: This review highlights recent advances in neuro-vestibular rehabilitation, with emphasis on vestibular adaptation and emerging mobile technologies. It summarizes developments in promoting vestibular plasticity and discusses novel tools such as virtual reality, wearable sensors, and telehealth platforms that enhance access, engagement, and outcomes. The scope is broad, focusing on general principles rather than specific populations.<br><br>RECENT FINDINGS: New methods to enhance vestibulo-ocular reflex (VOR) adaptation include incremental adaptation devices and gamified exercises. Inducing VOR gain-down adaptation temporarily increases postural sway, which normalizes via sensory reweighting, demonstrating central compensation. Portable tools like StableEyes show promise in boosting VOR gain with brief sessions. Concurrently, technology-driven approaches are gaining traction. Gamified mobile applications and wearable sensors allow home-based rehabilitation with remote supervision and monitoring, showing promising results in conditions like multiple sclerosis. Virtual reality interventions and telehealth models accelerated during the COVID-19 era, expanding therapy delivery to underserved populations. Adjunctive methods such as vibrotactile feedback and galvanic vestibular stimulation are emerging as complementary therapies.<br><br>SUMMARY: Recent developments are advancing vestibular rehabilitation by refining adaptive training techniques and leveraging digital tools to overcome barriers in access and adherence. These innovations point to a more personalized, technology-enabled approach to optimizing neuro-vestibular recovery.}, }
@article {pmid41501207, year = {2026}, author = {Murata, A and Tanaka, M and Takayoshi, M and Matsuyama, Y and Sato, R and Ishida, Y and Teragaki, M and Iwanari, S and Ikeda, M and Takeoka, H}, title = {Osmotic nephropathy as a potentially underrecognized cause of acute kidney injury during SGLT2 inhibitor therapy: a case report and literature review.}, journal = {CEN case reports}, volume = {15}, number = {1}, pages = {16}, pmid = {41501207}, issn = {2192-4449}, mesh = {Humans ; Male ; *Sodium-Glucose Transporter 2 Inhibitors/adverse effects/therapeutic use ; *Acute Kidney Injury/chemically induced/therapy/diagnosis ; Aged ; *Diabetes Mellitus, Type 2/drug therapy/complications ; *Benzhydryl Compounds/adverse effects/therapeutic use ; COVID-19/complications ; *Glucosides/adverse effects ; *Renal Insufficiency, Chronic/drug therapy/complications ; Renal Dialysis ; SARS-CoV-2 ; }, abstract = {In recent years, sodium-glucose cotransporter 2 (SGLT2) inhibitors have become essential therapeutic agents in the management of chronic kidney disease (CKD), owing to their established renoprotective effects. Although acute kidney injury (AKI) may occasionally occur during SGLT2 inhibitor therapy, its pathological features remain incompletely understood. Here, we report a case of AKI caused by osmotic nephropathy in a patient with underlying CKD following the initiation of an SGLT2 inhibitor. We also review previously reported cases of SGLT2 inhibitor-associated osmotic nephropathy. A 71-year-old man with type 2 diabetes and CKD developed oliguric AKI, with his serum creatinine level increasing from 2.0 to 8.3 mg/dL, one month after initiating dapagliflozin. During this period, he experienced transient appetite loss associated with a COVID-19 infection. Despite initial management for presumed prerenal AKI, his renal function did not improve with intravenous fluid therapy, and he required hemodialysis. Kidney biopsy revealed characteristic features of osmotic nephropathy, including numerous isometric vacuoles within the epithelial cells of proximal tubules with preserved brush borders. His renal function began to improve approximately two weeks after discontinuation of the SGLT2 inhibitor, and eventually returned to baseline. This case and literature review highlight the potential for osmotic nephropathy as a rare but reversible complication of SGLT2 inhibitor therapy, which may be triggered by volume depletion, particularly in diabetic patients with pre-existing renal dysfunction. Recognition of this underdiagnosed entity is crucial for timely diagnosis and appropriate management.}, }
@article {pmid41499962, year = {2026}, author = {Wang, B and Fu, Y and Duan, F and Pan, S and Zheng, Y}, title = {Decoding emerging viral sepsis: Molecular crosstalk, dysregulation, and precision strategies.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101442}, doi = {10.1016/j.mam.2025.101442}, pmid = {41499962}, issn = {1872-9452}, abstract = {Emerging and re-emerging viral pathogens pose a major challenge to global public health systems. One of the most significant complications associated with these viruses is viral sepsis, a severe condition characterized by organ dysfunction resulting from an unregulated host response to a viral infection. The present review comprehensively describes the molecular mechanisms underlying viral sepsis induced by emerging and re-emerging viral pathogens, such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), influenza virus, dengue virus (DENV), Ebola virus (EBOV), and human immunodeficiency virus (HIV). It discusses the complex molecular interactions between particular viral factors and host cellular pathways, highlighting significant dysregulations in various immune responses, metabolic reprogramming, and endothelial integrity that induce sepsis development. Furthermore, this review thoroughly addresses nascent precision strategies, including advanced diagnostics, targeted therapeutics, and immunomodulatory interventions, carefully tailored to distinct viral etiologies and host endotypes. By shedding light on the intricate molecular landscape of viral sepsis, this review aims to provide a robust framework for future mechanistic research and accelerate the development of effective, personalized interventions to combat this challenging complication.}, }
@article {pmid41498391, year = {2026}, author = {Zhang, X and Han, X and Xu, J and Li, G}, title = {Disease-associated adipose browning: current evidence and perspectives.}, journal = {Adipocyte}, volume = {15}, number = {1}, pages = {2610540}, pmid = {41498391}, issn = {2162-397X}, mesh = {Humans ; *Adipose Tissue, Brown/metabolism/pathology ; Animals ; Thermogenesis ; COVID-19/metabolism ; Energy Metabolism ; Adipose Tissue, White/metabolism ; }, abstract = {Brown and beige adipose tissue represent evolutionary adaptations in mammals, functioning as specialized thermogenic organs to maintain body temperature. Over the past two decades, researches have demonstrated that white adipose tissue (WAT) browning is an effective strategy to enhance energy expenditure. However, a growing body of evidence indicates that the browning process frequently occurs in a variety of chronic disease states, though its pathophysiological significance remains unclear. This review summarized evidence of pathological browning observed in human diseases and animal models, including breast cancer, colorectal cancer (CRC), clear cell renal cell carcinoma (ccRCC), kidney health, burn injury, atherosclerotic, SARS-CoV-2 and sepsis. Despite distinct pathological contexts, adipose tissue browning is consistently observed. This suggests that browning may not simply serve its classical metabolically protective role, but instead reflect an atypical response to pathological stress. It is currently unclear whether this is a compensatory mechanism by the organism in a diseased state or merely a byproduct of the disease process. Whether this response is adaptive or a cause of disease progression remains unresolved. Future research should therefore focus on identifying the triggers and functional outcomes of pathological browning to better understand adipocyte plasticity and its role in disease progression.}, }
@article {pmid41498334, year = {2026}, author = {Azasi, E and Asamoah, PE and Diaconu, K}, title = {Understanding the needs and key determinants of maternal, newborn, and child health among migrants in transit: a scoping review.}, journal = {Global health action}, volume = {19}, number = {1}, pages = {2607905}, pmid = {41498334}, issn = {1654-9880}, mesh = {Humans ; Female ; Pregnancy ; *Transients and Migrants/statistics &amp; numerical data ; Health Services Accessibility ; Infant, Newborn ; *Child Health ; *Maternal Health ; *Health Services Needs and Demand ; Child ; }, abstract = {The global surge in migration has exposed pregnant women and children in transit to heightened risk of maternal and child health (MCH) challenges, driven by systemic barriers and unstable conditions. Evidence on how these transitory factors influence MCH remains limited. This scoping review examined the health needs and key determinants affecting migrant populations in transit, specifically pregnant women and children travelling from their countries of origin to their intended destination countries, with the aim of identifying major barriers and proposing strategies for improved health outcomes. We screened 1202 sources of evidence using five databases (PubMed, Scopus, Europe PMC, CINAHL, and Medline) as well as grey literature. Seven studies met the inclusion criteria. Data were drawn from peer-reviewed literature, charted using a standardized framework, and analysed thematically. Key barriers included financial constraints, language obstacles, and limited access to healthcare services. Although humanitarian organizations offered some support, significant unmet needs remain, including exposure to transactional sex, absence of respectful maternity care, and restricted access to essential health services. These challenges are exacerbated in conflict and crisis settings. The review underscores the importance of addressing key determinants, including location, language, financial capacity, and community support, to improve health outcomes for pregnant women and children under five on the move. This review recommends strengthening community mobilization, leveraging technology, and ensuring equitable access irrespective of users' cultural or financial constraints.}, }
@article {pmid41498242, year = {2026}, author = {Kuperwasser, C and El-Deiry, WS}, title = {COVID vaccination and post-infection cancer signals: Evaluating patterns and potential biological mechanisms.}, journal = {Oncotarget}, volume = {17}, number = {}, pages = {1-29}, doi = {10.18632/oncotarget.28824}, pmid = {41498242}, issn = {1949-2553}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology/epidemiology/virology ; *Neoplasms/epidemiology/etiology/immunology ; *COVID-19 Vaccines/adverse effects ; SARS-CoV-2/immunology ; *Vaccination/adverse effects ; Incidence ; }, abstract = {A growing number of peer-reviewed publications have reported diverse cancer types appearing in temporal association with COVID-19 vaccination or infection. To characterize the nature and scope of these reports, a systematic literature search from January 2020 to October 2025 was conducted based on specified eligibility criteria. A total of 69 publications met inclusion criteria: 66 article-level reports describing 333 patients across 27 countries, 2 retrospective population-level investigations (Italy: ~300,000 cohort, and Korea: ~8.4 million cohort) quantified cancer incidence and mortality trends among vaccinated populations, and one longitudinal analysis of ~1.3 million US miliary service members spanning the pre-pandemic through post-pandemic periods. Most of the studies documented hematologic malignancies (non-Hodgkin's lymphomas, cutaneous lymphomas, leukemias), solid tumors (breast, lung, melanoma, sarcoma, pancreatic cancer, and glioblastoma), and virus-associated cancers (Kaposi and Merkel cell carcinoma). Across reports, several recurrent themes emerged: (1) unusually rapid progression, recurrence, or reactivation of preexisting indolent or controlled disease, (2) atypical or localized histopathologic findings, including involvement of vaccine injection sites or regional lymph nodes, and (3) proposed immunologic links between acute infection or vaccination and tumor dormancy, immune escape, or microenvironmental shifts. The predominance of case-level observations and early population-level data demonstrates an early phase of potential safety-signal detection. These findings underscore the need for rigorous epidemiologic, longitudinal, clinical, histopathological, forensic, and mechanistic studies to assess whether and under what conditions COVID-19 vaccination or infection may be linked with cancer.}, }
@article {pmid41497937, year = {2025}, author = {Idahor, CO and Ogunfuwa, O and Ogbonna, N and Ogbeide, OA and Abe, O and Oore-Ofe, O}, title = {Transforming Emergency Care Through Telemedicine: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {12}, pages = {e98481}, pmid = {41497937}, issn = {2168-8184}, abstract = {Telemedicine has fleetly evolved from a niche result to a central pillar in modern emergency and critical care systems. This narrative review delves into the multifaceted role of telemedicine in emergency settings, tracing its historical development, present applications, and future possibilities. It examines how telemedicine islands geographical and infrastructural gaps, particularly in underserved communities, by enabling timely access to specialist care similar to telestroke services and remote ferocious care. Substantiation highlights advancements in clinical outcomes, functional effectiveness, and patient satisfaction, with global case studies demonstrating successful perpetration across both high- and low-resource settings. Despite these advances, challenges persist. Technological restrictions, regulatory barriers, digital knowledge gaps, and unlikeness in assent continue to hamper wide relinquishment. This review discusses these obstacles and underscores the significance of strategic investment, cross-sector collaboration, and policy reform. Arising inventions, including artificial intelligence, wearable devices, and scalable telehealth platforms, signal promising directions for perfecting reach and adaptability in emergency systems. Additionally, this paper identifies crucial areas for unborn research, including long-term outgrowth assessment and telemedicine's part in disaster and pandemic response. By synthesizing current substantiation and practical perceptivity, this review aims to inform clinicians, health system leaders, and policymakers about the transformative eventuality and ongoing challenges of telemedicine in emergency care. Eventually, it calls for sustained invention, equity-concentrated perpetration, and cooperative sweats to completely realize telemedicine's pledge in erecting a more accessible, responsive, and flexible emergency care geography.}, }
@article {pmid41497729, year = {2025}, author = {Liu, T and Li, M and Zhu, L and Liang, R and Zhang, P and Liu, X}, title = {Ocular Lesions Related to COVID-19 and Its Vaccines.}, journal = {Journal of ophthalmology}, volume = {2025}, number = {}, pages = {7078264}, pmid = {41497729}, issn = {2090-004X}, abstract = {OBJECTIVE: To review COVID-19 infection and COVID-19 vaccine-related ocular lesions.<br><br>METHODS: We carried out a systematic search in PubMed, Web of Science, Embase, and the Cochrane Library on COVID-19 and ophthalmology and reviewed the incidence, specific manifestations, and risk factors for COVID-19-related eye diseases and the relationship between the detection of COVID-19 in the conjunctiva and tears and eye involvement.<br><br>RESULTS: Conjunctivitis was the most common ocular lesion caused by 2019-nCoV infection, followed by uveitis and retinopathy. Conjunctivitis can be the first manifestation of COVID-19 infection and may be clinically related to the severity of pneumonia caused by COVID-19. In particular, conjunctivitis that occurs after pneumonia suggests that the patient has severe systemic disease. COVID-19 infection can cause uveitis, but the infection rate of COVID-19 in patients with uveitis is similar to that of the general population. Patients with uveitis need to reduce the dosage of systemic hormones and discontinue biological agents after being infected with COVID-19. Retinopathy caused by COVID-19 infection is mainly manifested as retinal microvascular disease, and the prognosis is good. SARS-CoV-2 detection in the conjunctiva and tears has high sensitivity and is of great value for disease diagnosis. Eye lesions caused by the COVID-19 vaccine, similar to other vaccines, have a low incidence and a good prognosis.<br><br>CONCLUSION: COVID-19-related ocular lesions are mainly manifested as conjunctivitis, uveitis, and retinal microvascular changes. These diseases are somewhat self-limiting and have a good prognosis.}, }
@article {pmid41497535, year = {2025}, author = {Yang, Y and Wang, K and Chen, S}, title = {Effects of Hypoglycemic Agents on Pulmonary Diseases: A Comprehensive Narrative Review.}, journal = {Journal of inflammation research}, volume = {18}, number = {}, pages = {18053-18078}, pmid = {41497535}, issn = {1178-7031}, abstract = {Beyond glycemic control, hypoglycemic agents exhibit multifaceted effects that may influence pulmonary health in patients with diabetes mellitus. This narrative review synthesizes available evidence from preclinical and clinical studies on the impact of major hypoglycemic drug classes-including biguanides, sulfonylureas, thiazolidinediones, α-glucosidase inhibitors, DPP-4 inhibitors, SGLT-2 inhibitors, GLP-1 receptor agonists, and insulin-on pulmonary diseases. Evidence suggests that these agents exert class-specific, and often conflicting, effects: preclinical studies support their protective potential in acute lung injury, while clinical data indicate variable efficacy in asthma, COPD, and respiratory infections including COVID-19. Conversely, some agents may be associated with increased risks of lung cancer or COPD exacerbations, underscoring the need for context-specific prescribing. Mechanistic insights from animal models primarily involve modulation of inflammatory, oxidative, and immune pathways. This narrative review aims to provide a clinical framework for personalizing hypoglycemic therapy in patients with comorbid pulmonary conditions, while underscoring the need for well-designed prospective studies to resolve existing controversies.}, }
@article {pmid41497304, year = {2025}, author = {Fadaei, MR and Fadaei, MS and Kheirieh, AE and Hatami, H and Rahmanian-Devin, P and Tayebi-Khorrami, V and Fathabadi, MF and Baradaran Rahimi, V and Askari, VR}, title = {Overview of dendrimers as promising drug delivery systems with insight into anticancer and anti-microbial applications.}, journal = {International journal of pharmaceutics: X}, volume = {10}, number = {}, pages = {100390}, pmid = {41497304}, issn = {2590-1567}, abstract = {Dendrimers are tree-like polymeric molecules that have three main compartments: the core, branching units, and functional end groups. They are nanosized and monodispersed, with an almost spherical shape. For the past few decades, dendrimers have been evaluated in numerous studies as a promising category of candidates for gene delivery and diagnostic applications. Nowadays, some advanced dendrimers are considered promising anticancer delivery systems due to the vast types and applicable modifications. They also showed their effectiveness as antibacterial and antiviral agents. Smart dendrimers with pH-, redox-, or directly tumor microenvironment-responsive properties are investigated. pH-sensitive dendrimers enhance drug release in the tumor's acidic environment and inhibit release at physiological pH, thereby increasing the hemocompatibility of these chemical agents. Dendrimers have been examined for years to prevent sexually transmitted diseases, such as HIV, HPV, HSV, etc. In this regard, some studies yielded encouraging results and opened new avenues. Following the onset of the COVID-19 pandemic, researchers have shifted their focus toward seeking remedies to prevent and treat this viral disease. Dendrimers have already demonstrated favorable efficacy in protection against COVID-19 and other respiratory viral diseases. Furthermore, they may mitigate the neuroinflammatory manifestations of COVID-19 in individuals experiencing a critical disease state.}, }
@article {pmid41497070, year = {2026}, author = {Obeagu, EI}, title = {Immunomodulatory strategies for managing cytokine storms in chronic COVID: mechanisms, therapeutic targets, and clinical advances.}, journal = {Annals of medicine and surgery (2012)}, volume = {88}, number = {1}, pages = {653-659}, pmid = {41497070}, issn = {2049-0801}, abstract = {Chronic COVID, characterized by persistent symptoms following acute SARS-CoV-2 infection, is increasingly linked to sustained immune dysregulation, particularly cytokine storms that drive chronic inflammation and multi-organ complications. Understanding the mechanisms underlying cytokine dysregulation in chronic COVID is essential for developing effective therapeutic strategies aimed at restoring immune balance and mitigating long-term morbidity. This review critically examines current immunomodulatory strategies for managing cytokine storms in chronic COVID, including corticosteroids, cytokine-specific biologics, Janus kinase inhibitors, and emerging cell-based therapies. Additionally, the role of biomarker-guided precision medicine in personalizing treatment to optimize efficacy and safety is discussed. Challenges such as patient heterogeneity, timing and duration of therapy, and potential adverse effects are also addressed. Future research directions emphasize the need for robust clinical trials, novel therapeutic development, and integrated multidisciplinary care to improve patient outcomes. By tailoring immunomodulatory approaches based on individual immune profiles, it is possible to enhance the management of cytokine-driven inflammation in chronic COVID and advance the field toward more effective, personalized treatments.}, }
@article {pmid41496808, year = {2025}, author = {Woods, JA and Hutchinson, NT and Powers, SK and Gomez-Cabrera, MC and Radak, Z and Leeuwenburgh, C and Cacciatore, S and Marzetti, E and Zhang, T and Garza, R and Sidebottom, C and Anderson, E and Durstine, JL and Sun, J and Ji, LL}, title = {Physical activity during COVID-19 pandemic: A 5-year retrospect.}, journal = {Sports medicine and health science}, volume = {7}, number = {6}, pages = {405-418}, pmid = {41496808}, issn = {2666-3376}, abstract = {The purpose of this article is to provide a follow-up review of the impact of the SARS-CoV-2 Disease or Coronavirus Disease 2019 (COVID-19) pandemic on human health and the role of physical activity (PA) during the 5-year pandemic. We aim to cover the immune system, the cardiopulmonary system, the musculoskeletal system, and the central nervous system (brain function), particularly among older adults, college students, and individuals with post-acute sequelae of COVID-19 (Long-COVID). The COVID-19 pandemic has given us many lessons, learned from the death of six million lives and tremendous disturbance to human life. First, we need to continue to investigate cellular and molecular mechanisms that mediate various organistic failures resulting from the viral infection. Such investigations are the only way to completely understand the etiology of the diseases and to develop new drugs and vaccines. The molecular pathways that transmit the signals of viral infection to each organ system are different requiring both basic and clinical research. Available evidence suggests that mitochondrial dysfunction, reduced microcirculation and latent immune activation play a major role, eventually impairing cardiovascular tolerance and peripheral bioenergetics. Second, the COVID-19 pandemic has manifested major disturbances to human lifestyles with reduced PA and exercise standing out as a major factor. Conversely, physical inactivity due to social confinement and mental/psychological stresses has been clearly linked to intensified pathogenic symptoms and amplification of adverse effects on multiple physiological systems. If not intervened, this interaction can lead to Long-COVID, a dangerous futile circle to cause systemic failure. Finally, the COVID-19 pandemic has exerted differential impacts on different populations. Thus, the strategy to develop and conduct to cope with the negativity of pandemic needs to be specific, flexible and tailored to fit different patient populations.}, }
@article {pmid40754932, year = {2026}, author = {Alzoubaidi, M and Randhawa, G and Reynhout, J and Galloway, C and Jensen, M and Sweet, K}, title = {Wernicke Encephalopathy in a Pediatric Patient Secondary to Avoidant Restrictive Food Intake Disorder Following COVID-19 Infection: A Case Report and Literature Review.}, journal = {Journal of child neurology}, volume = {41}, number = {2}, pages = {247-251}, doi = {10.1177/08830738251356139}, pmid = {40754932}, issn = {1708-8283}, mesh = {Humans ; *COVID-19/complications ; *Wernicke Encephalopathy/etiology/diagnostic imaging ; Adolescent ; *Avoidant Restrictive Food Intake Disorder/complications/etiology ; Male ; Female ; SARS-CoV-2 ; }, abstract = {Wernicke encephalopathy is most commonly associated with alcohol consumption and in patients with malnutrition. This case report discusses a rare presentation in an adolescent due to avoidant restrictive food intake disorder following COVID-19 infection. We performed a review of the literature and compiled reported cases of pediatric Wernicke encephalopathy.}, }
@article {pmid41494490, year = {2026}, author = {Messina, A and Bella, F and Maccarone, G and Avincola, G and Signorelli, MS}, title = {Astrocyte-mediated hippocampal damage in the pathogenesis of dysexecutive syndrome following COVID-19: A narrative review.}, journal = {Journal of psychiatric research}, volume = {194}, number = {}, pages = {164-173}, doi = {10.1016/j.jpsychires.2026.01.007}, pmid = {41494490}, issn = {1879-1379}, abstract = {SARS-CoV-2 infection has been implicated in hippocampal damage, contributing to the pathogenesis of dysexecutive syndrome observed in post-COVID-19 patients. Given the growing prevalence of long-COVID worldwide, understanding how SARS-CoV-2 affects hippocampal structure and function has become an urgent scientific and clinical priority. The hippocampus-crucial for memory, emotional regulation, and executive functioning-is especially susceptible to viral-driven neuroinflammatory cascades. SARS-CoV-2 triggers astrocyte and microglia activation, disrupts blood-brain barrier integrity, and induces cytokine-mediated neurotoxicity, ultimately impairing neuroplasticity and neurogenesis. These mechanisms converge to produce cognitive and affective disturbances-most notably fatigue, apathy, low mood, and executive dysfunction-that typify dysexecutive syndrome in long-COVID. This review synthesizes current evidence from clinical and experimental studies, integrating findings on viral neurotropism, hippocampal hypometabolism, and astrocyte-mediated neurodegeneration. Distinctions between depressive symptoms driven by neuroinflammation and classical depressive disorders are clarified to improve diagnostic accuracy and guide personalized treatment. Emerging data on the neuroprotective role of COVID-19 vaccination-particularly its capacity to modulate microglial activation and support hippocampal neurogenesis-are also examined. Overall, the findings underscore the need for targeted therapeutic strategies aimed at modulating neuroinflammation and supporting hippocampal plasticity, including cognitive rehabilitation approaches. Longitudinal studies are essential to elucidate the enduring impact of SARS-CoV-2 on hippocampal function and to inform effective clinical interventions.}, }
@article {pmid41494305, year = {2025}, author = {Pupillo, E and Leone, MA and Amato, A and Bianchi, E and Damian, MS and Dyck, J and Garcia-Azorin, D and Giussani, G and Guekht, A and Koike, H and Khadilkar, S and Lehmann, H and Pochigaeva, K and Povolnova, J and Tumurov, D and Vetrov, F and de Visser, M and Winkler, AS and Grisold, W}, title = {Prevalence and trajectories of post-COVID-19 neuromuscular conditions: A systematic-review and meta-analysis.}, journal = {Journal of the neurological sciences}, volume = {481}, number = {}, pages = {125710}, doi = {10.1016/j.jns.2025.125710}, pmid = {41494305}, issn = {1878-5883}, abstract = {INTRODUCTION: Neuromuscular diseases (NMDs) are a significant component of the post-acute sequelae of COVID-19. However, their long-term prevalence and trajectories remain poorly defined. This systematic review and meta-analysis aimed to determine the long-term prevalence in COVID-19 survivors of fourteen specific NMDs and related symptoms: cranial nerve diseases, Guillain-Barré syndrome, small fiber neuropathy, (poly)radiculopathies, (poly)neuropathies, plexopathies, motor neuron disease, myasthenia gravis, Lambert-Eaton syndrome, neuropathic pain, sarcopenia, myalgia, myalgia associated with other symptoms, and of other muscle diseases.<br><br>METHODS: We searched MEDLINE, Embase, and the Cochrane Library (January 2020 through November 2024) for studies with at least 3&#xa0;months of follow-up. Pooled prevalence estimates were calculated at multiple time points (acute phase to 24&#xa0;months) using random effects models.<br><br>RESULTS: Among 180 unique studies representing 15,865,322 cases (54&#xa0;% female, mean age 50.0&#xa0;years), the pooled prevalence for individuals with at least one NMD or related symptoms decreased from 36&#xa0;% in the acute phase to 8&#xa0;% at 24&#xa0;months. Myalgia prevalence steadily declined from 35&#xa0;% to 8&#xa0;% by two years. A trend towards lower prevalences across the time points was observed also for Guillain-Barr&#xe9; syndrome, and other muscle diseases, while other conditions showed a more erratic pattern. The prevalence of neuropathic pain remained high and persisted almost unchanged through the follow-up period (from 31&#xa0;% in the acute phase to 25&#xa0;% at 12&#xa0;months).<br><br>CONCLUSIONS: NMDs and related symptoms are common following COVID-19, but their general prevalence decreases with time. However, trajectories varied depending on the type of NMD or symptom.}, }
@article {pmid41494304, year = {2025}, author = {Kung, PJ and Chen, CM and Lin, EC and Shu, BC and Tew, Y and He, J and Fang, CJ and Reynolds, NR and Ornstein, KA}, title = {Ethical challenges around mandatory vaccination among nurses: A systematic review of qualitative and quantitative evidence.}, journal = {International journal of nursing studies}, volume = {175}, number = {}, pages = {105313}, doi = {10.1016/j.ijnurstu.2025.105313}, pmid = {41494304}, issn = {1873-491X}, abstract = {BACKGROUND: Mandatory vaccination policies have sparked global ethical debates, particularly in the context of COVID-19. Among healthcare workers, nurses-the largest segment of the frontline workforce-face distinct tensions between professional responsibilities and personal autonomy. Yet, the ethical challenges these policies pose from nurses' perspectives remain insufficiently examined.<br><br>AIM: This review examines the ethical challenges of mandatory vaccination from nurses' perspectives, informs ethical policymaking, and provides insights to navigate similar future scenarios.<br><br>DESIGN: A mixed-methods systematic review guided by the Joanna Briggs Institute methodology.<br><br>DATA SOURCES: Final searches of five databases-Embase, MEDLINE, CINAHL, Web of Science, and Scopus-were conducted in September 2025. Additional records were identified through citation tracking and supplementary searches.<br><br>METHODS: Empirical studies published from 2019 onward were screened for relevance and assessed for methodological quality using standardized critical appraisal tools. Studies were included if they examined nurses' experiences, attitudes, or ethical perspectives regarding mandatory vaccination. A narrative synthesis approach was applied to integrate qualitative, quantitative, and mixed-methods findings.<br><br>RESULTS: Twenty-eight studies were included (19 quantitative, 5 qualitative, and 4 mixed methods). Four themes emerged: (1) Walking a Tightrope-Between Vaccine Safety and Effectiveness; (2) Silent Burden-Navigating Stigma in the Shadows; (3) Navigating the Fine Line-Balancing Rights and Public Health in Times of Crisis; and (4) Strengthening Leadership and Communication.<br><br>CONCLUSIONS: While mandatory vaccination policies may serve public health goals, they can also generate ethical distress, undermine trust, and increase stigmatization among nurses who remain unvaccinated. Future policies should move beyond enforcement toward fostering ethical alignment through education, open dialog, and respectful engagement.<br><br>REGISTRATION: PROSPERO registration number: CRD42024551112, registered 03/06/2024.}, }
@article {pmid41494094, year = {2026}, author = {Cao-Lei, L and Vrantsidis, D and Giesbrecht, GF}, title = {Epigenetic Insights into the Impact of Disaster-Related Prenatal Stress: A Narrative Review.}, journal = {Harvard review of psychiatry}, volume = {34}, number = {1}, pages = {7-22}, doi = {10.1097/HRP.0000000000000446}, pmid = {41494094}, issn = {1465-7309}, mesh = {Humans ; Pregnancy ; *Prenatal Exposure Delayed Effects/genetics ; *Stress, Psychological/genetics ; Female ; *Epigenesis, Genetic ; *Disasters ; DNA Methylation ; *Pregnancy Complications/genetics ; }, abstract = {Disaster-related prenatal maternal stress, whether due to natural or human-made crises, can have profound effects on offspring health and development. This narrative review synthesizes research findings on the epigenetic mechanisms through which prenatal maternal stress influences long-term offspring health outcomes. Focusing primarily on DNA methylation, we examine how exposure to stress during gestation alters the epigenetic profile and may contribute to mental, cognitive, and physical health vulnerabilities. Studies were categorized based on disaster type, including time-limited events such as hurricanes, floods, and earthquakes, and stressors like the COVID-19 pandemic and famine. Key findings highlight the timing of exposure, sex-specific epigenetic effects, and the potential for epigenetic markers to mediate stress-induced health outcomes. While considerable progress has been made, our review emphasizes the need for further research on how epigenetics may mediate mental health outcomes and the development of interventions that target these molecular mechanisms.}, }
@article {pmid41493556, year = {2026}, author = {Pathak, R and Vandeliwala, M and Patel, P and Patel, N and Patel, K}, title = {Resurgence of human metapneumovirus: an overview of past and current trends.}, journal = {Archives of microbiology}, volume = {208}, number = {2}, pages = {93}, pmid = {41493556}, issn = {1432-072X}, mesh = {*Metapneumovirus/physiology/genetics/pathogenicity ; Humans ; *Paramyxoviridae Infections/epidemiology/virology/diagnosis/drug therapy ; Antiviral Agents/therapeutic use ; *Respiratory Tract Infections/virology/epidemiology ; Host-Pathogen Interactions ; }, abstract = {Human metapneumovirus (HMPV) is a major respiratory pathogen belonging to the Pneumoviridae family that primarily affects children, the elderly, and immunocompromised individuals. Since its discovery in 2001, HMPV has been recognized as a significant cause of acute respiratory infections (ARIs) worldwide, exhibiting seasonal peaks and recurring outbreaks. In recent years, the virus has shown an unusual resurgence, particularly in the post-COVID-19 era, emphasizing the need for renewed clinical and epidemiological attention. This review provides a comprehensive overview of HMPV, encompassing its epidemiology, virion structure, replication mechanisms, host-pathogen interaction, clinical manifestations, diagnostic strategies, and current therapeutic approaches. Special attention is given to recent epidemiological trends, molecular insights derived from structural studies of viral proteins, and the challenges faced in developing vaccines and antiviral agents. Additionally, the review discusses the potential of plant-derived bioactive compounds as alternative or complementary therapeutic options. By consolidating the latest global data and highlighting existing knowledge gaps, the work aims to facilitate a better understanding of HMPV pathogenesis and guide future research directions for improved surveillance, diagnosis, and management of HMPV infections.}, }
@article {pmid41492414, year = {2026}, author = {Govorchin, A and Leduc, M and Atleo, CG and Hoogeveen, D and Borgos, I and Patrick, L}, title = {The right to health: indigenous data sovereignty in Canada during and beyond the COVID-19 pandemic.}, journal = {Lancet regional health. Americas}, volume = {54}, number = {}, pages = {101335}, pmid = {41492414}, issn = {2667-193X}, abstract = {The COVID-19 pandemic disproportionately impacted Indigenous Peoples in Canada, highlighting preexisting health inequities. These disparities were exacerbated by inadequate data management policies across Canadian governments, which contribute to inaccurate health information and access challenges for Indigenous Nations. Indigenous data sovereignty, which recognizes the right of Indigenous Peoples to govern their own data, has been identified as essential for achieving self-determination and improving health outcomes. We focus on British Columbia (BC) given its unique health and data governance structure with First Nations. This policy paper examines the challenges related to health data management that arose during COVID-19 in BC, and the regulatory barriers hindering Indigenous health equity. We present four policy recommendations that address data issues as a promising avenue to reducing health inequities in Canada. This includes supporting research by and with Indigenous Peoples, promoting ethical responsibilities of non-Indigenous researchers, implementing anti-racism policies, and adopting Indigenous data management frameworks.}, }
@article {pmid41491167, year = {2026}, author = {Liao, Y and Liu, Y and Xu, S and Yang, J and Chen, Y}, title = {Incomplete Kawasaki disease associated with acute icteric hepatitis and Torque teno virus infection: a case report and literature review.}, journal = {BMC pediatrics}, volume = {26}, number = {1}, pages = {14}, pmid = {41491167}, issn = {1471-2431}, support = {0102018005//the 2024 Guangdong Renowned Traditional Chinese Medicine Practitioner Inheritance Studio Construction Project- Xu Youjia/ ; E43729//the State Administration of Traditional Chinese Medicine, under the project "a project for Chinese Medicine on Ying Lv's Renowned Expert Inheritance Studio"/ ; 2023B1111020004//the Department of Science and Technology of Guangdong Province, under the project "Efficacy and safety of the Jianer Jiedu Formula for the treatment of novel coronavirus infections in children- a real-world and randomized controlled study"/ ; 2024A03J0125//Bureau of Science and Technology of Guangzhou Municipality, under the project "Mechanism Study on the Regulation of NLRP3-mediated Pyroptosis by Jianer Jiedu Formula for the Treatment of RSV Pneumonia in Children Based on the Lingnan DampHeat Theory"/ ; }, mesh = {Humans ; Male ; *Mucocutaneous Lymph Node Syndrome/complications/diagnosis ; Infant ; *Torque teno virus/isolation &amp; purification ; *DNA Virus Infections/complications/diagnosis ; *Jaundice/etiology ; Acute Disease ; *Hepatitis/diagnosis/complications ; Immunoglobulins, Intravenous/therapeutic use ; }, abstract = {INTRODUCTION: Kawasaki disease (KD) is an acute, self-limiting vasculitis that primarily affects children under five years of age. Its classic clinical features include prolonged fever, bilateral conjunctival injection, changes in the lips and oral cavity, cervical lymphadenopathy, rash, and extremity changes. Acute jaundice and liver dysfunction are atypical manifestations of KD. Cases in which jaundice is the initial presenting symptom-especially when accompanied by Torque Teno Virus (TTV) infection-are rarely reported.<br><br>CASE PRESENTATION: We describe a 17-month-old boy diagnosed with incomplete Kawasaki disease (IKD), who initially presented with persistent fever, jaundice, and elevated liver enzymes. At disease onset, characteristic mucocutaneous signs of KD were absent. As the illness progressed, the patient developed dorsal foot edema, erythematous lips, and cervical lymphadenopathy. On the ninth day of illness, echocardiography revealed dilation of the left coronary artery, confirming a retrospective diagnosis of IKD. Additionally, high-throughput sequencing of peripheral blood identified TTV type 28. The patient was treated with intravenous immunoglobulin, methylprednisolone, and hepatoprotective agents. Following treatment, his fever resolved, jaundice subsided, liver function normalized, and coronary artery dimensions gradually returned to within the normal range.<br><br>CONCLUSIONS: This case highlights an atypical presentation of IKD, characterized by early-onset jaundice and later development of coronary artery dilation, in a patient also infected with TTV. To our knowledge, this is the first reported case of IKD associated with acute icteric hepatitis and TTV infection. This case may inform clinical evaluation in similar presentations and contribute to future research on the etiology of KD.}, }
@article {pmid41489056, year = {2026}, author = {Boesen, K and Hemkens, LG and Janiaud, P and Hirt, J}, title = {Topic-specific living databases of clinical trials: A scoping review of public databases.}, journal = {Clinical trials (London, England)}, volume = {}, number = {}, pages = {17407745251400635}, doi = {10.1177/17407745251400635}, pmid = {41489056}, issn = {1740-7753}, abstract = {INTRODUCTION: Conducting systematic reviews of clinical trials is time-consuming and resource-intensive. One potential solution is to design databases that are continuously and automatically populated with clinical trial data from harmonised and structured datasets. This scoping review aimed to identify and map publicly available, continuously updated, topic-specific databases of clinical trials.<br><br>METHODS: We systematically searched PubMed, Embase, the preprint servers medRxiv, arXiv, Open Science Framework, and Google. We characterised each database using seven predefined features (access model, database type, data input sources, retrieval methods, data-extraction methods, trial presentation, and export options) and narratively summarised the results.<br><br>RESULTS: We identified 14 continuously updated databases of clinical trials, seven related to COVID-19 (initiated in 2020) and seven non-COVID-19 databases (initiated as early as in 2009). All databases, except one, were publicly funded and accessible without restrictions. Most relied on traditional methods used in static article-based systematic reviews sourcing data from journal publications and trial registries. The COVID-19 databases and some non-COVID-19 databases implemented semi-automated features of data import, which combined automated and manual data curation, whereas the non-COVID-19 databases mainly relied on manual workflows. Most reported information was metadata, such as author names, years of publication, and link to publication or trial registry. Only two databases included trial appraisal information (such as risk of bias assessments). Six databases reported aggregate group-level results, but only one database provided individual participant data on request.<br><br>DISCUSSION: Continuously updated topic-specific databases of clinical trials remain limited in number, and existing initiatives mainly employ traditional static systematic review methodologies. A key barrier to developing truly living platforms is the lack of accessible, machine-readable, and standardised clinical trial data.}, }
@article {pmid41488929, year = {2025}, author = {Du, S and Cui, Z and Xu, X and Liu, T and Ye, J}, title = {Clinical efficacy of exercise in the treatment of post-COVID-19 syndrome: a systematic review and network meta-analysis.}, journal = {Frontiers in physiology}, volume = {16}, number = {}, pages = {1656713}, pmid = {41488929}, issn = {1664-042X}, abstract = {BACKGROUND: Post-COVID-19 syndrome (PCS) describes a constellation of persistent or new symptoms lasting beyond the acute phase of SARS-CoV-2 infection. Emerging evidence suggests that exercise is a cost-effective and accessible intervention that may enhance pulmonary function, improve cardiopulmonary circulation, regulate emotional status, and alleviate symptoms of PCS. However, robust evidence supporting the efficacy of exercise therapy in PCS remains limited. This systematic review and meta-analysis aimed to elucidate the therapeutic potential of exercise therapy in PCS.<br><br>METHOD: A search of the PubMed, Embase, Web of Science, and Ovid databases up to March 25, 2025 yielded 33 randomized controlled trials (with 2,895 participants) for meta-analysis.<br><br>RESULT: The results showed that exercise therapy significantly improved the multi-dimensional outcomes of patients with PCS. Bayesian network meta-analysis indicated that the combination of aerobic exercise and respiratory muscle training had the best effect on lung function. Multimodal exercise significantly improved the results of the six-minute walk test, the dyspnea score, and peak oxygen uptake. Mental Health and Mental Component Summary scores improved significantly in the group that received exercise therapy (P<0.01).<br><br>CONCLUSION: The results of this meta-analysis confirm that exercise can significantly improve quality of life and the emotional state of patients with PCS. They also provide evidence for a treatment strategy in patients with post-COVID-19 sequelae.<br><br>https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD420251034187.}, }
@article {pmid41488667, year = {2025}, author = {Zheng, Y and Liu, C and Li, Y and Wang, W and Dou, Q}, title = {The dual role of thrombospondin-1 in inflammatory regulation during acute respiratory distress syndrome: a mini-review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1699900}, pmid = {41488667}, issn = {1664-3224}, mesh = {Humans ; *Thrombospondin 1/metabolism/immunology ; *Respiratory Distress Syndrome/immunology/metabolism/pathology ; *COVID-19/immunology ; Animals ; *Inflammation/immunology/metabolism ; *SARS-CoV-2/immunology ; }, abstract = {Inflammation serves as a fundamental defense against tissue injury and infection, yet dysregulation can lead to pathological outcomes. Thrombospondin-1 (Thbs1/TSP1), a multifunctional glycoprotein significantly upregulated during inflammation, exemplifies a dualistic regulator with context-dependent roles. Through modulation of cytokine networks and inflammatory cell activity (notably macrophages), Thbs1 critically governs inflammatory responses. Acute respiratory distress syndrome (ARDS), a life-threatening condition fueled by systemic inflammation secondary to infection or trauma, presents complex pathophysiology requiring elucidation. COVID-19 research highlights elevated Thbs1 expression in severe patients, where it demonstrates protective effects against pulmonary damage primarily via extracellular matrix protection, inhibition of neutrophil serine proteases, and TGF-β-dependent repair pathways. However, paradoxical evidence indicates that dysregulated Thbs1 can also contribute to ARDS pathogenesis, potentially by amplifying inflammation, promoting thromboinflammation, or driving fibrosis. Mechanistic insights reveal Thbs1's influence on ARDS progression through ECM remodeling, serine protease inhibition, and TGF-β activation. While significant progress has been made in understanding Thbs1 signaling, the precise mechanisms dictating its context-dependent switch between protective and pathogenic functions in inflammatory pathways remain a critical area for future investigation.}, }
@article {pmid41488628, year = {2025}, author = {Yin, L and Sun, CY and Chen, GL and Xiang, Z and Hu, BQ and Zhou, F and Wang, Q}, title = {Modular mastery of inflammation: umbilical cord mesenchymal stem cells as a therapeutic frontier.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1721947}, pmid = {41488628}, issn = {1664-3224}, mesh = {Humans ; *Mesenchymal Stem Cells/immunology ; *Umbilical Cord/cytology ; *Mesenchymal Stem Cell Transplantation/methods ; *COVID-19/therapy/immunology ; *Inflammation/therapy/immunology ; SARS-CoV-2 ; *Inflammatory Bowel Diseases/therapy/immunology ; Graft vs Host Disease/therapy/immunology ; Animals ; }, abstract = {Inflammation operates as a dual-edged sword in physiological defense and pathological damage, driving conditions from diabetes to neurodegeneration. Current anti-inflammatory therapies-NSAIDs, corticosteroids, and biologics-face clinical bottlenecks including non-specific toxicity, therapeutic ceiling effects, and drug resistance. Umbilical cord mesenchymal stem cells (UC-MSCs) emerge as a transformative alternative, leveraging three synergistic modules: Immune reprogramming, Inflammasome inhibition, Intercellular communication. Clinical trials demonstrate efficacy in inflammatory bowel disease, COVID-19 ARDS, and graft-versus-host disease. UC-MSCs outperform conventional therapies by multi-pathway modulation and tissue-regenerative capacity, though challenges persist in cell heterogeneity and long-term safety. Future work must standardize dosing protocols and validate scalable production for clinical translation.}, }
@article {pmid41488618, year = {2025}, author = {Rodrigues, T and Beltrão, GS and Girardi, H and Pinto, AR}, title = {Viral reprogramming of glial metabolism as a driver of neuroinflammation.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1686774}, pmid = {41488618}, issn = {1664-3224}, mesh = {Humans ; *Neuroinflammatory Diseases/metabolism/virology/immunology ; *SARS-CoV-2/immunology ; Animals ; *COVID-19/immunology/metabolism/virology ; *Neuroglia/metabolism/virology/immunology ; Astrocytes/virology/metabolism/immunology ; HIV-1 ; Microglia/metabolism/virology/immunology ; Glycolysis ; Zika Virus/immunology ; }, abstract = {Considerable attention has been recently devoted to the involvement of immune cells in the central nervous system (CNS) during infections with neurotropic viruses, such as SARS-CoV-2, HIV-1, and ZIKV. These viruses are capable of infecting astrocytes and microglia, the main glial cells in the CNS, responsible for regulating neuronal activity. Here, we discuss how viral infections lead to metabolic reprogramming toward aerobic glycolysis in these cells, enhancing pro-inflammatory pathways, such as inflammasome activation, resulting in the secretion of inflammatory cytokines that favor the development of neuroinflammation. In this mini review, we discuss the pivotal interplay between metabolism and immunity towards viral pathogenesis in the CNS, pointing out the relevance of therapeutic strategies targeting both metabolic and immunological pathways to enhance antiviral and neuroprotective responses.}, }
@article {pmid41488474, year = {2025}, author = {Yamin, M and Alsahafi, N and Abdulal, RH and Asad, M and Bosaeed, M and Zohaib, A}, title = {Non-coding RNAs in the viral host-pathogen interaction: molecular regulation and therapeutic potential.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1734182}, pmid = {41488474}, issn = {2235-2988}, mesh = {Humans ; *Host-Pathogen Interactions/genetics ; *RNA, Untranslated/genetics ; COVID-19/virology ; SARS-CoV-2/genetics ; MicroRNAs/genetics/antagonists &amp; inhibitors ; RNA, Circular/genetics ; Hepacivirus/genetics ; RNA, Long Noncoding/genetics ; Virus Replication ; *Virus Diseases/virology/genetics ; Antiviral Agents/therapeutic use ; Animals ; }, abstract = {Non-coding RNAs (ncRNAs), including microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA), serve as key regulatory molecules in the context of viral infection. They play dual roles by modulating host immune responses and influencing viral replication, persistence, and disease progression. Numerous ncRNAs have been implicated in infections caused by viruses such as HCV, DENV and SARS-CoV. This review highlights the biogenesis and multifaceted functions of both host-encoded and virus-encoded ncRNAs in shaping host-pathogen interactions. It also examines their potential as novel biomarkers and therapeutic agents for viral infections. We discuss translational applications such as Miravirsen, a miRNA inhibitor that reached clinical trials for Hepatitis C Virus (HCV) and diagnostic relevance of lncRNA NEAT1 in SARS-CoV-2 infection. In the end, we have also addressed the current challenges and limitations involved in translating research observations of ncRNAs to clinical outcomes.}, }
@article {pmid41488438, year = {2025}, author = {Maulana, I and Shalahuddin, I and Eriyani, T and Pebrianti, S}, title = {"Exploring Psychosocial Interventions to Improve Mental Health Outcomes Among Healthcare Workers": Scoping Review.}, journal = {Journal of multidisciplinary healthcare}, volume = {18}, number = {}, pages = {8293-8303}, pmid = {41488438}, issn = {1178-2390}, abstract = {BACKGROUND: Healthcare workers (HCWs) face heightened risks of stress, anxiety, depression, and burnout, particularly during and after the COVID-19 pandemic. Psychosocial interventions have been increasingly implemented, yet the evidence remains fragmented across diverse settings and modalities. This scoping review aimed to map current psychosocial interventions designed to improve mental health outcomes among HCWs.<br><br>METHODS: Guided by the PRISMA-ScR framework, five databases (PubMed, Scopus, ScienceDirect, EBSCOhost, Google Scholar) were searched from January 2000 to September 2025. Eligible studies involved HCWs, assessed psychosocial interventions, and reported mental health outcomes. The Joanna Briggs Institute (JBI) appraisal tool was applied, and only studies scoring &#x2265;70% were retained. Although multiple designs were eligible, only randomized controlled trials (RCTs) met the quality threshold and were included. Data were synthesized descriptively and thematically.<br><br>RESULTS: Of 312 identified records, 15 RCTs (2021-2025) were included. Interventions were grouped into mindfulness and meditation programs (n=6), digital and mHealth approaches (n=5), and coaching or AI-assisted resilience training (n=4). Specifically, mindfulness interventions reduced stress and anxiety by up to 30% and consistently improved well-being. Notably, digital modalities-including mobile apps and internet-delivered cognitive behavioral therapy (CBT)-were widely used during the pandemic and demonstrated benefits for burnout, sleep quality, and resilience. Across all studies, coaching and AI-assisted interventions improved work engagement and reduced exhaustion, particularly in non-pandemic contexts.<br><br>CONCLUSION: Psychosocial interventions demonstrate strong potential to improve HCWs' mental health. Digital programs offer scalable support, while resilience-based approaches promote long-term well-being. Future research should examine implementation in low-resource settings, compare digital versus in-person modalities, and explore organizational-level strategies to complement individual interventions.}, }
@article {pmid41488437, year = {2025}, author = {Pluetrattanabha, N and Direksunthorn, T}, title = {Mobile Health Clinics and Telehealth Outreach in Thailand: A Focus on Elderly Care and NCDs.}, journal = {Journal of multidisciplinary healthcare}, volume = {18}, number = {}, pages = {8321-8331}, pmid = {41488437}, issn = {1178-2390}, abstract = {BACKGROUND: Thailand faces a rapidly aging population alongside a high burden of non-communicable diseases (NCDs). Ensuring equitable healthcare access for older adults with NCDs is a pressing challenge. Mobile health clinics and telehealth services have emerged as key strategies to reach underserved elderly populations and maintain continuity of NCD care in remote or resource-limited settings.<br><br>OBJECTIVE: To examine current mobile clinic initiatives and telehealth outreach in Thailand focused on elderly care and NCD management, and to evaluate their impact on healthcare access and outcomes for older adults.<br><br>METHODS: We conducted a narrative review of published literature, policy reports, and program descriptions on mobile health clinics and telehealth interventions in Thailand, with emphasis on applications for older adults and chronic disease care (eg, diabetes, hypertension). A comprehensive search (2010-2025) of PubMed, Google Scholar, and Thai government/organization websites identified relevant sources. Data on intervention models, settings, target populations, and reported outcomes were extracted. In total, 15 key publications and reports were reviewed, from which 8 major mobile clinic or telehealth initiatives were identified.<br><br>RESULTS: Mobile health clinics have expanded primary care access for vulnerable elderly in both urban and rural areas. The Thai Red Cross Society's mobile clinic serves remote mountainous communities and provides primary care, NCD screenings, vaccinations, and medications to about 5,000 underserved people annually. Past mobile outreach programs have uncovered many untreated cases-in one survey, 58% of hypertensive and 75% of diabetic elderly were first diagnosed via a mobile unit. Telehealth services have likewise grown substantially. During the COVID-19 pandemic, telemedicine was rapidly adopted for routine consultations and chronic disease follow-ups. The National Health Security Office (NHSO) introduced a nationwide telemedicine service under the Universal Coverage Scheme, enabling remote consultations and medication deliveries for stable chronic NCD patients, ensuring continuity of care during lockdowns. Numerous telehealth applications emerged (public and private); for example, smartphone apps like MorDee ("Good Doctor") gained wide usage in Thailand. In an urban pilot "Dusit Telemedicine" model, integrating community clinics with a tertiary hospital, over 300 elderly patients received teleconsultations, reducing overcrowding. An acceptance study in this Bangkok pilot found older generations significantly less likely to adopt telemedicine than younger people - perceived ease of use was a strong predictor of acceptance (adjusted OR 3.95 for usability). Community-based telehealth pilots in rural areas, such as a Chiang Mai program using Community Health Leaders, demonstrated high satisfaction (&#x2265;90%) and successful NCD risk screenings, but also highlighted the need for training and support for both health workers and patients.<br><br>CONCLUSION: Mobile clinics and telehealth are complementary strategies for enhancing healthcare delivery to elderly Thais with NCDs. Mobile clinics physically bring essential services to those unable to travel, while telehealth connects patients to providers for continuous care and monitoring. The Thai experience illustrates that integrating these innovations into primary healthcare systems can enhance equity of care for aging populations. Continued support, digital literacy training for seniors, and policy integration of telehealth into the health system are recommended to ensure healthy aging under universal health coverage.}, }
@article {pmid41488264, year = {2025}, author = {Kumar, C and Akhileshwar,  and Kumar Neeraj, R and Hameed, S and Husain, N and Roy, SS and Mohan, L and Anantsaznam, }, title = {Systematic Review and Meta-Analysis of the Incidence of Myocarditis and Guillain-Barré Syndrome in Adolescents Receiving COVID-19 mRNA Vaccine.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e98208}, pmid = {41488264}, issn = {2168-8184}, abstract = {This study aimed to evaluate the incidence and risk of rare long-term adverse events, specifically myocarditis and Guillain-Barré syndrome (GBS), in adolescents (12-19 years) following COVID-19 mRNA vaccination. We systematically searched MEDLINE, Embase, Cochrane CENTRAL, and Scopus, supplemented by trial registries and reference lists (PROSPERO: CRD420251045173). Eligible studies included randomized controlled trials (RCTs), cohort studies, case-control studies, self-controlled case series, and pharmacovigilance database analyses reporting myocarditis or GBS outcomes in adolescents receiving BNT162b2 or mRNA-1273. The search was conducted in June 2025, and all published studies were included. Risk of bias was assessed using the Cochrane RoB-2 tool, Newcastle-Ottawa Scale, or adapted criteria for pharmacovigilance studies. Effect measures were expressed as incidence rate or incidence rate ratios (IRRs) with 95% confidence intervals (CIs). Meta-analyses were conducted using random-effects models. Ten studies met the inclusion criteria. Myocarditis incidence was elevated in adolescent and young adult males, particularly after the second dose. Pooled analyses indicated a higher risk with mRNA-1273 compared to BNT162b2 (pooled IRR ≈ 3.9), although heterogeneity was very high (I[2] > 95%). For GBS, global pharmacovigilance data suggested only a modest association with mRNA vaccines (ROR 9.66), substantially weaker than for adenoviral vector or influenza vaccines. COVID-19 mRNA vaccination in adolescents is associated with a small but measurable increased risk of myocarditis, particularly in males, after the second dose, with a higher incidence following mRNA-1273. No consistent evidence of increased GBS risk was observed. Absolute risks remain low, and outcomes are generally favorable compared to SARS-CoV-2 infection. Continued surveillance and long-term follow-up are warranted.}, }
@article {pmid41488148, year = {2025}, author = {Shitaye, G and Getie, M and Mekonnen, Z and D'Abrosca, G and Fattorusso, R and Isernia, C and Amuamuta, A and Malgieri, G}, title = {Molecular analysis of long COVID and new-onset diabetes mellitus: pathobiological relationships and current mechanistic views.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1737894}, pmid = {41488148}, issn = {1664-2392}, mesh = {Humans ; *COVID-19/complications/metabolism/pathology/epidemiology ; *SARS-CoV-2 ; *Diabetes Mellitus, Type 2/epidemiology/etiology/virology/metabolism/pathology ; *Diabetes Mellitus, Type 1/epidemiology/metabolism/etiology/virology ; Renin-Angiotensin System ; Post-Acute COVID-19 Syndrome ; Insulin Resistance ; }, abstract = {Long COVID, or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), refers to a range of persistent health effects associated with SARS-CoV-2 infection. Long COVID is a complex, multisystem disorder that can affect nearly every organ system and is strongly linked with the incidence of diabetes and other chronic conditions. Increasing evidence also connects persistent SARS-CoV-2 infection with the development of new-onset diabetes and other metabolic disorders. In this review, we assess the current evidence and discuss the incidence of new-onset diabetes, along with the pathobiological mechanisms by which SARS-CoV-2 may contribute to the progression of both new-onset type 1 and type 2 diabetes mellitus (T1DM and T2DM). We summarize the latest understanding of the molecular and cellular mechanisms underlying SARS-CoV-2-associated new-onset diabetes. Potential mechanisms include direct damage to pancreatic β-cells, inflammation, insulin resistance, and autoimmune responses. Dysregulation of the ACE2/renin-angiotensin system (RAS) pathway has been linked to multiple inter-organ pathologies, and increased inflammatory cytokines together with dysregulation of interferon regulatory factors (IRFs)-such as overexpression of IRF1-appear to represent key mechanistic links to widespread tissue damage and metabolic alterations. Moreover, the presence of viral RNA or viral RNA fragments may directly damage pancreatic islets, contributing to insulin resistance and β-cell dysfunction that, in turn, may promote the development of new-onset diabetes. In light of these findings, this review further examines evidence supporting the persistence of SARS-CoV-2 RNA in PASC reservoir tissues, including the pancreas, and its potential association with the development of new-onset diabetes mellitus.}, }
@article {pmid41488032, year = {2026}, author = {Suresh, RR and Abuduani, T and Kasthuri, M and Chen, Z and Tber, Z and Loubidi, M and Zhang, H and Zhou, L and Zhou, S and Li, C and Kumari, A and Tao, S and Wiseman, JM and Hurwitz, SJ and Amblard, F and Schinazi, RF}, title = {Prodrug strategies in developing antiviral nucleoside analogs.}, journal = {RSC medicinal chemistry}, volume = {}, number = {}, pages = {}, pmid = {41488032}, issn = {2632-8682}, abstract = {Prodrug strategies are used to enhance the physicochemical and pharmaceutical properties of drug candidates that may not be suitable for specific delivery or are limited by formulation options. A prodrug derivative is converted into its active pharmaceutical ingredient (drug) through enzymatic or chemical reactions within the body. Antiviral nucleoside prodrugs have garnered considerable interest in drug discovery, leading to the approval of key drugs such as remdesivir (SARS-CoV-2), Sovaldi (hepatitis C virus, HCV), and tenofovir disoproxil fumarate [hepatitis B virus (HBV) and human immunodeficiency viruses (HIV)]. Their success lies in improving the oral bioavailability and delivering the parent drug to the targeted tissues. This review focuses on the prodrugs of antiviral nucleosides evaluated in humans (approved, in development or terminated), providing an overview of the different approaches utilized and discussing their in vitro and in vivo benefits.}, }
@article {pmid41487586, year = {2025}, author = {Fan, H and Wang, L and Zhai, L and Deng, S and Li, Y and Niu, H and Zhao, B and Gao, J and Gao, X}, title = {Mapping three decades of air pollution-lung cancer research: trends, hotspots, and networks (1990-2025).}, journal = {Frontiers in oncology}, volume = {15}, number = {}, pages = {1698246}, pmid = {41487586}, issn = {2234-943X}, abstract = {BACKGROUND: The relationship between air pollution and lung cancer has attracted considerable attention from researchers worldwide. To systematically assess the scholarly landscape and pinpoint research fronts, this study employs bibliometric analysis to delineate global trends, collaborative networks, and key publications within this field.<br><br>METHODS: Publications from 1990 to 2025 were extracted from Web of Science Core Collection and Scopus databases. Bibliometric tools including VOSViewer, Citespace, and Bibliometrix R were used to examine trends, key contributors, research themes, and prominent journals.<br><br>RESULTS: Among 4,238 publications, citation rates rose significantly. China produced the most publications, with leading institutions such as Harvard University and the Chinese Academy of Sciences. Key researchers included Lan Q, Rothman N, and Vermeulen R. Major journals were Environmental Health Perspectives and Atmospheric Environment. Frequently used keywords like "Lung Cancer" and "Particulate Matter" indicate core themes, while emerging terms such as "Covid-19" and "Machine Learning" reflect evolving interests.<br><br>CONCLUSION: Fine particulate matter is an established environmental risk factor for lung cancer, and research on polycyclic aromatic hydrocarbons and asbestos remains active. The field has shifted from exposure assessment to mechanistic investigations focusing on oxidative stress, gene expression, and machine learning applications, defining key future research directions.}, }
@article {pmid41486438, year = {2025}, author = {Seo, JW and Seo, YB and Kim, SE and Kim, Y and Kim, EJ and Kim, T and Kim, T and Lee, SH and Lee, E and Lee, J and Jeong, YH and Jung, YH and Choi, YJ and Song, JY}, title = {Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19.}, journal = {Infection &amp; chemotherapy}, volume = {57}, number = {4}, pages = {478-521}, doi = {10.3947/ic.2025.0151}, pmid = {41486438}, issn = {2093-2340}, support = {HD22C2045//Korea Health Industry Development Institute/Republic of Korea ; }, abstract = {The guidelines presented herewith are based on the "Clinical Practice Guideline Recommendations for Post-Acute Sequelae of COVID-19 (PASC)" published in Infection &amp; Chemotherapy in March 2024; these guidelines have been refined by incorporating the most recent Korean and international research findings and clinical evidence published since then. In the context of patients experiencing various physical and mental symptoms that persist long after the acute phase of coronavirus disease 2019 (COVID-19) infection, the diagnosis and management of PASC has emerged as a novel public health challenge. These guidelines are intended to provide standardized diagnostic and management recommendations applicable to the Korean healthcare setting and were developed through a comprehensive review of existing guidelines from organizations such as the World Health Organization, the United States National Institutes of Health, the United Kingdom National Institute for Health and Care Excellence, and the European Society of Clinical Microbiology and Infectious Diseases, along with the latest meta-analyses and Korean cohort studies. PASC is defined as the persistent presence of symptoms and signs lasting more than 3 months after COVID-19 diagnosis for which the symptoms cannot be explained by alternative diagnoses. The revised guidelines emphasize the importance of integrated management for patients with PASC, including a multidisciplinary approach considering risk groups, symptom-specific assessment, and rehabilitation and psychological interventions, based on a total of 32 key questions. This revision reflects rapidly evolving research trends regarding the long-term effects of COVID-19 and is expected to serve as an evidence-based standard guideline for future patient care, clinical research, and health policy development in Korea.}, }
@article {pmid41486437, year = {2025}, author = {Park, WB and Hwang, YH and Kwon, KT and Noh, JY and Park, SH and Song, JY and Choo, EJ and Choi, MJ and Choi, JY and Heo, JY and Choi, WS and , }, title = {COVID-19 Vaccination Recommendations for 2025-2026 in Korea.}, journal = {Infection &amp; chemotherapy}, volume = {57}, number = {4}, pages = {472-477}, doi = {10.3947/ic.2025.0130}, pmid = {41486437}, issn = {2093-2340}, abstract = {The Korean Society of Infectious Diseases has regularly updated its adult immunization guidelines, including the coronavirus disease 2019 (COVID-19) vaccination recommendations in 2023 and the 2024-2025 seasonal update. This article provides a comprehensive update as of September 2025, reflecting the latest evidence and international guidance. Focusing on the 2025-2026 season, it reviews vaccines currently authorized in Korea and their effectiveness against predominant JN.1 sublineage variants, including LP.8.1, NB.1.8.1, and XFG. The updated recommendations prioritize vaccination with LP.8.1-adapted vaccines for high-risk groups-adults aged 65 years and older, individuals aged 6 months and older at increased risk for severe disease, and residents of facilities vulnerable to infection-while vaccination remains available for all individuals aged 6 months and older. A single-dose strategy is generally recommended, although older adults and immunocompromised individuals may consider an additional dose at 6-month intervals in consultation with healthcare professionals. These updates aim to refine Korea's COVID-19 vaccination strategy and sustain protection in high-risk populations, with recommendations remaining subject to revision as new evidence and epidemiological conditions evolve.}, }
@article {pmid41486189, year = {2026}, author = {Terrones-Campos, C and Gallardo-Pizarro, A and Martinez-Urrea, A and Castiella, A and Vergara, A and Gonzalez, A and Egri, N and Garcia-Vidal, C}, title = {Invasive pulmonary aspergillosis in the ICU: the corticosteroid link.}, journal = {Pneumonia (Nathan Qld.)}, volume = {18}, number = {1}, pages = {2}, pmid = {41486189}, issn = {2200-6133}, support = {SGR 01324 Q5856414G//Agencia de Gesti&#xf3;n de Ayudas Universitarias y de Investigaci&#xf3;n de Catalunya/ ; }, abstract = {Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection traditionally associated with severely immunocompromised hosts, particularly those with hematologic malignancies. However, its epidemiological profile has shifted in recent years, with a rising incidence among critically ill patients in intensive care units (ICUs), many of whom lack classical risk factors. This change is driven by increased use of corticosteroids and immunomodulatory therapies, the growing prevalence of chronic lung disease, and severe viral pneumonias such as influenza and COVID-19. In these patients, airway epithelial injury, immune dysregulation, and mechanical ventilation facilitate fungal invasion even in the absence of profound immunosuppression. Corticosteroids play a central role in IPA pathogenesis. While they limit hyperinflammation, they simultaneously impair fungal clearance by suppressing NF-κB signaling, downregulating TNF-α production, and promoting IL-10 secretion, resulting in a Th2-skewed immune profile. Neutrophil recruitment persists but becomes dysregulated, contributing to tissue injury rather than effective pathogen elimination. Corticosteroids may also directly enhance Aspergillus growth, further compounding risk. Diagnosis of IPA in ICU patients remain challenging because radiological hallmarks such as the halo sign are uncommon, and distinguishing colonization from invasive disease is difficult. Serum and bronchoalveolar lavage galactomannan, β-D-glucan assays, and PCR can improve early detection, but no single test is definitive in this heterogeneous population. As much as possible, high-quality lower respiratory tract samples should be obtained. Furthermore, effective treatment requires not only timely diagnosis, but also careful selection of antifungal taking into consideration pharmacologic challenges of ICU patients and pharmacodynamics of antifungals. Recognition of high-risk patients such as those receiving corticosteroids, those with chronic lung disease, severe viral pneumonia, or requiring invasive ventilation is critical to improve outcomes. Mortality in this group can exceed that of neutropenic patients, underscoring the need for heightened clinical suspicion and timely antifungal therapy. A deeper understanding of the immunopathogenesis of IPA in non-neutropenic patients, particularly the dual effects of corticosteroids on inflammation and host defense, may inform risk stratification and guide earlier intervention. Enhanced surveillance, prompt diagnostic workup, and judicious use of immunomodulatory therapy represent key strategies to mitigate the rising burden of this devastating infection in ICU settings.}, }
@article {pmid41110512, year = {2026}, author = {Carlson, AL and Althouse, J and Ahmed, N and Nazari, MA and Alkaissi, H}, title = {Acquired hemophilia A following SARS-CoV-2 infection and vaccination: clinical summary and insights.}, journal = {Journal of thrombosis and haemostasis : JTH}, volume = {24}, number = {1}, pages = {161-170}, pmid = {41110512}, issn = {1538-7836}, support = {Z99 DK999999/ImNIH/Intramural NIH HHS/United States ; }, mesh = {Humans ; *Hemophilia A/immunology/etiology/diagnosis/blood ; *COVID-19/complications/immunology/virology/blood/prevention &amp; control/diagnosis ; *SARS-CoV-2/immunology/pathogenicity ; Factor VIII/immunology ; *COVID-19 Vaccines/adverse effects/immunology ; Middle Aged ; Spike Glycoprotein, Coronavirus/immunology/chemistry ; Male ; *Vaccination/adverse effects ; Aged ; Molecular Mimicry ; Female ; Adult ; }, abstract = {BACKGROUND: Acquired hemophilia A (AHA) is a bleeding diathesis caused by antifactor (F)VIII antibodies produced spontaneously or in response to triggers such as infections, autoimmune disorders, and malignancies. Recently, SARS-CoV-2 exposure, through both infection and vaccination, has emerged as a potential trigger.<br><br>OBJECTIVES: This is the first systematic review to compare cases of AHA following both SARS-CoV-2 infection and vaccination, presented alongside an illustrative case of severe AHA following SARS-CoV-2 infection during the Omicron variant outbreak. This is also the first study to explore the potential for molecular mimicry between SARS-CoV-2 spike protein (S) and human FVIII.<br><br>METHODS: A systematic review of AHA cases associated with SARS-CoV-2 infection (n = 14) or vaccination (n = 28) was conducted. An in silico analysis was performed to compare surface epitopes between SARS-CoV-2 S and human FVIII.<br><br>RESULTS: AHA following SARS-CoV-2 infection or vaccination presented in individuals aged >60 years, with a significantly more rapid onset and potentially milder anti-FVIII response following vaccination. Spontaneous hemorrhagic shock was observed exclusively in AHA following infection. In silico analysis revealed 2 shared surface epitopes between SARS-CoV-2 S and FVIII, one of which is specific to the Omicron variant.<br><br>CONCLUSION: AHA following SARS-CoV-2 exposure is an emerging trend that may become more prominent with newer variants, highlighting the need for improved clinical characterization and earlier intervention. Preliminary evidence of shared surface epitopes between FVIII and SARS-CoV-2 S supports further investigation of molecular mimicry, and the identification of variant-specific epitopes offers insights into possible differences in immunogenicity between variants.}, }
@article {pmid40353410, year = {2025}, author = {Brasil-Oliveira, LL and Souza, PFN and Paier, CRK and Bandeira, MGL and Motta, LCB and Montenegro, RC and de Moraes, MEA}, title = {What Can Proteomics Tell us About COVID-19 Infections? Mass Spectrometry as a Tool to Find New Proteins as Biomarkers.}, journal = {Current protein &amp; peptide science}, volume = {26}, number = {9}, pages = {712-729}, pmid = {40353410}, issn = {1875-5550}, support = {305459/2019-8, 305003/2022-4//National Council for Scientific and Technological Development (CNPq)/ ; PVS-0215 00099.01.00/23, PS1-0186-00405.01.00/21//Cearense Foundation for Support Scientific and Technological (FUNCAP)/ ; 405934/2022-0//Funda&#xe7;&#xe3;o Coordena&#xe7;&#xe3;o de Aperfei&#xe7;oamento do Pessoal do Ensino Superior (CAPES)/ ; }, mesh = {Humans ; *COVID-19/blood/diagnosis ; *Proteomics/methods ; Biomarkers/blood ; *Mass Spectrometry/methods ; SARS-CoV-2 ; *Blood Proteins/analysis ; }, abstract = {The COVID-19 outbreak, caused by the SARS-CoV-2 coronavirus, has threatened and taken many lives since the end of 2019. Given the importance of COVID-19 worldwide, since its spread, many research groups have been seeking blood markers that could help to understand the disease establishment and prognosis. Usually, those markers are proteins with a differential accumulation only during infection. Based on that, proteomic studies have played a crucial role in elucidating diseases. Mass spectrometry (MS) is a promising technique in COVID-19 studies, allowing the identification and quantification of proteins present in the plasma or serum of affected patients. It helps us to understand pathological mechanisms, predict clinical outcomes, and develop specific therapies. MS proteomics revealed biomarkers associated with infection, disease severity, and immune response. Plasma or blood serum is easy to collect and store; however, its composition and the higher concentration of proteins (e.g., albumins) shadow the identification of less abundant proteins, which usually are essential markers. So, clean-up approaches such as depletion strategies and fractionating are often required to analyze blood samples, allowing the identification of low-abundant proteins. This review will discuss many proteomic approaches to discovering new plasma biomarkers of COVID-19 employed in recently published studies. The challenges inherent to blood samples will also be discussed, such as sample preparation, data processing, and identifying reliable biomarkers.}, }
@article {pmid41485706, year = {2026}, author = {Salmanton-García, J and Almeida, JN and Colombo, AL}, title = {Candidozyma auris (formerly Candida auris): Resistant, long-lasting, and everywhere.}, 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.2025.12.022}, pmid = {41485706}, issn = {1469-0691}, abstract = {BACKGROUND: Invasive fungal diseases are a growing global health concern, with Candidozyma auris (formerly Candida auris) emerging as a major healthcare-associated pathogen. Its multidrug resistance, environmental persistence, prolonged skin colonization, and efficient nosocomial transmission have driven sustained outbreaks and endemicity worldwide, while recent taxonomic changes have complicated surveillance and diagnostics.<br><br>OBJECTIVES: This narrative review summarizes current evidence on the taxonomy, epidemiology, clinical impact, antifungal resistance, transmission, and infection prevention and control of C. auris, highlighting outbreak drivers, regional endemicity, and key gaps relevant to surveillance and policy.<br><br>SOURCES: We conducted a structured narrative review of peer-reviewed and grey literature published between 2009 and 2025, drawing from PubMed/MEDLINE, Embase, Scopus, Web of Science, and major public health websites (WHO, CDC, ECDC, UKHSA, and national surveillance portals).<br><br>CONTENT: C. auris has rapidly evolved into an endemic healthcare threat across multiple continents, with substantial regional variation in incidence, outbreak dynamics, antifungal resistance, and control capacity. Candidemia mortality averages &#x223c;30% but differs by region and patient population. Azole resistance is widespread in several clades, while resistance to amphotericin B and echinocandins is increasingly reported, particularly in high-endemic settings. Outbreaks are sustained by environmental persistence, prolonged skin colonization, and healthcare-associated transmission, amplified by intensive care exposure, antimicrobial pressure, and system strain during the COVID-19 pandemic. Despite broadly aligned IPC guidance, major challenges persist in screening, decolonization, laboratory identification, and long-term outbreak control.<br><br>IMPLICATIONS: The continued global expansion of C. auris has major clinical, economic, and public health implications. Effective control requires sustained investment in laboratory capacity, standardized nomenclature adoption, active surveillance, genomic monitoring, and rigorous IPC measures tailored to the pathogen's unique biology. Without coordinated regional and international responses, C. auris is likely to continue shifting from epidemic emergence to entrenched endemicity in diverse healthcare systems worldwide.}, }
@article {pmid41485125, year = {2026}, author = {Miao, G and Lu, R and Pipanmekaporn, T and Kacha, S and Supphapipat, A and Phothikun, N and Jewprasertpan, P and Chittawatanarat, K}, title = {Association Between Blood Glucose Variability and Clinical Outcomes in Patients With Sepsis: A Systematic Review and Meta-Analysis.}, journal = {Diabetes/metabolism research and reviews}, volume = {42}, number = {1}, pages = {e70119}, doi = {10.1002/dmrr.70119}, pmid = {41485125}, issn = {1520-7560}, mesh = {Humans ; *Sepsis/mortality/blood ; *Blood Glucose/analysis ; Prognosis ; Hospital Mortality ; }, abstract = {AIMS: Glycaemic variability (GV) has emerged as an important prognostic indicator in critical illness, yet its predictive value among patients with sepsis remains unclear. This systematic review and meta-analysis aimed to evaluate the association between GV metrics and mortality outcomes in adult patients with sepsis.<br><br>METHODS: Cohort studies enrolling septic patients and reporting in-hospital, 28-day, or 30-day mortality in relation to GV were identified through PubMed, Embase, Cochrane Library, Scopus, CNKI, and Wanfang databases. Pooled odds ratios (ORs) were calculated using a random-effects model. Sensitivity analyses were performed to assess the robustness of the findings.<br><br>RESULTS: Ten studies comprising 18,337 patients were included. For categorical analysis, high-GV patients had nearly twice the mortality risk (OR&#xa0;=&#xa0;1.99, 95% CI: 1.66-2.40, p&#xa0;<&#xa0;0.0001; I[2]&#xa0;=&#xa0;45%). For continuous analysis, all 4&#xa0;GV metrics showed significant associations with mortality: CoV (OR&#xa0;=&#xa0;1.050, I[2]&#xa0;=&#xa0;76.6%), SD (OR&#xa0;=&#xa0;1.0037, I[2]&#xa0;=&#xa0;83.5%), GLI (OR&#xa0;=&#xa0;1.0171, I[2]&#xa0;=&#xa0;0.0%), and MAGE (OR&#xa0;=&#xa0;1.0062, I[2]&#xa0;=&#xa0;0.0%). High GV was associated with prolonged ICU stay (0.95&#xa0;days, p&#xa0;=&#xa0;0.0018). Sensitivity analyses confirmed the result robustness.<br><br>CONCLUSIONS: Elevated GV is independently linked to an increased risk of death among patients with sepsis. GLI and MAGE are the most reliable GV metrics for prognostic assessment, whereas CoV and SD are less consistent. Standardised GV measurement and prospective studies are warranted to evaluate whether interventions targeting GV can improve outcomes in this population.}, }
@article {pmid41484775, year = {2026}, author = {Dhuria, M and VanderEnde, K and Tanwar, S and Vaze, A and Yadav, S and Choudhary, S and Yadav, R and Desai, M and Bahl, A and Jain, SK and Singh, SK and Chauhan, H and Goel, A}, title = {Rapid expansion of the Frontline Field Epidemiology Training Program across 124 districts in India, 2021-2023.}, journal = {Health research policy and systems}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12961-025-01431-8}, pmid = {41484775}, issn = {1478-4505}, abstract = {BACKGROUND: India conducts all three tiers of the Field Epidemiology Training Program (FETP). During the coronavirus disease 2019 (COVID-19) pandemic, the country committed to rapid scale-up of its frontline public health workforce capacity through the 3-month in-service Frontline FETP.<br><br>Between January 2021 and May 2023, 300 district-level public health workers and 73 mentors were trained across 124 districts in eight states. Frontline FETP officers successfully completed 236 field assignments, nearly half of which were surveillance systems evaluations or surveillance data analyses and another half of which were case, cluster or outbreak investigations. Acute diarrhoeal disease (ADD) was the most frequently assessed or investigated condition and was one of many diseases exemplifying how FETP officers may need to work across multiple sectors (for example, health, water and sanitation) to help mitigate the public health impact of disease on the affected communities. Challenges (for example, time-consuming process of tailoring learning content, attrition, identification of qualified mentors and task-shifting) and lessons learned (for example, pivoting to a self-paced learning model, using case studies with real-world examples, and a blended learning approach) are described.<br><br>CONCLUSION: This paper portrays the feasibility of not only implementing a 3-month FETP in India's diverse context but, given the complexity of health challenges in an increasingly interconnected environment, its flexibility to be naturally transitioned towards One Health FETP (named SectorConnect in India). It highlights a milestone in India's journey towards realizing the goals set under the One India FETP Roadmap for having at least one trained field epidemiologist per district.}, }
@article {pmid41484399, year = {2026}, author = {Mols, F and van Cappellen-van Maldegem, S and Hoedjes, M and Horevoorts, N and Oerlemans, S and de Rooij, BH and Ezendam, N and de Theije, C and Hageman, G and Schoormans, D}, title = {Remote blood collection among cancer patients and age- and sex-matched controls for biomarker and genetic analyses using the PROFILES registry.}, journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer}, volume = {34}, number = {1}, pages = {61}, pmid = {41484399}, issn = {1433-7339}, mesh = {Humans ; *Neoplasms/blood/genetics ; Registries ; *Blood Specimen Collection/methods ; Male ; Female ; Patient Reported Outcome Measures ; Case-Control Studies ; *Biomarkers, Tumor/blood ; Cohort Studies ; Cancer Survivors ; }, abstract = {Studies on patient-reported outcomes (PROs) among cancer survivors are increasing but are most often limited to PRO and clinical data. To better understand the underlying biological mechanisms that mediate a decline in health after cancer, several PROFILES-registry studies were enriched with biological data. This paper summarizes lessons learned from collecting blood samples to obtain biomarker data among survivors and controls in large-scale ambulatory cohort studies. These lessons address financial challenges, ethical issues, insurance, legal matters, standardization of assessment, recruitment, communication with participants, lab facilities and protocols, transportation, the need for a biobank, and the value of a normative population. We also describe our experiences with collecting remote blood samples in these studies among cancer patient populations and a study in our normative population to illustrate these issues further.}, }
@article {pmid40796161, year = {2026}, author = {Afroze, CA and Ahmed, MN and Azam, MNK and Jahan, R and Rahman, H}, title = {Microplastics pollution in Bangladesh: a decade of challenges, impacts, and pathways to sustainability.}, journal = {Integrated environmental assessment and management}, volume = {22}, number = {1}, pages = {98-115}, doi = {10.1093/inteam/vjaf108}, pmid = {40796161}, issn = {1551-3793}, mesh = {*Microplastics/analysis ; Bangladesh ; *Water Pollutants, Chemical/analysis ; Environmental Monitoring ; Waste Management ; COVID-19/epidemiology ; }, abstract = {This review revisits microplastic pollution in Bangladesh from 2014-2024, synthesizing research on distribution, plastic types, policies, and mitigation strategies. Using PubMed and Google Scholar, peer-reviewed articles and documents were analyzed to assess sources, impacts, and policy effectiveness. Microplastics contaminate rivers, soil, air, fertilizers, and food products. The dominant polymers, including polyethylene, polypropylene, polystyrene, polyethylene terephthalate, and polyamide, originate from fishing nets, industrial discharge, and urban waste, threatening ecosystems and food chains. Plastic pollution is exacerbated by transboundary river systems, excessive plastic production, use of single-use plastics, and ineffective waste management. The Meghna, Karnaphuli, and Rupsha Rivers transport 1 million metric tons of mismanaged waste annually to coastal areas. The plastics industry, employing 1.2 million people across 5,000 manufacturers, has increased per capita plastic consumption from 3 kg in 2005 to 9 kg in 2020, worsening waste accumulation. The COVID-19 pandemic accelerated the crisis, with polythene bag usage increasing to 21 billion, generating 78,433 tons of waste. Plastic pollution costs USD 39 million annually, affecting tourism, fisheries, and municipal budgets, and microplastic contamination threatens seafood exports. Clean-up costs consume 30% of Bangladesh's environmental budget. Using an agent-based system dynamics model, simulations predict that per capita plastic waste will rise to 11.6 kg by 2040, with landfill accumulation reaching 70,000 tons and riverine discharge increasing from 512 to 834 tons, raising the plastic waste footprint index (PWFI) to 24. Policy 2, which implements 69% conversion, 80% source separation, and 50% riverine discharge reduction, proves most effective, lowering PWFI to 1.07 and ensuring sustainable waste management. However, an integrated approach combining research, policy enforcement, technological innovation, and global collaboration is crucial. Strengthening the waste management framework, regulatory enforcement, and sustainable economic strategies will enable Bangladesh to mitigate microplastic pollution, advance its circular economy, and contribute to global environmental conservation.}, }
@article {pmid41484272, year = {2026}, author = {Liu, X and Zou, Y and Jin, C and Wang, Y and Zhang, J and Yan, M and Xie, Y and Ding, M and Wang, K and Liu, L and Ding, C and Chen, X}, title = {Viral infections are associated with apical periodontitis: A meta-analysis of prevalence, clinical symptoms, and lesion sizes across 31 clinical studies.}, journal = {Clinical oral investigations}, volume = {30}, number = {1}, pages = {37}, pmid = {41484272}, issn = {1436-3771}, support = {HB2023093//Top Talent Support Program for young and middle-aged people of Wuxi Health Committee/ ; A20210056//Health and Science Project of Hangzhou/ ; 2023WJC034//Hangzhou Biological Medicine and Health Industry Development Support Science and Technology Project/ ; 2021WJCY131//Hangzhou Biological Medicine and Health Industry Development Support Science and Technology Project/ ; 2024ZL724//Zhejiang Science and Technology Program of Chinese Medicine/ ; 20211231Y028//Guided Project of Science and Technology of Hangzhou/ ; }, mesh = {Humans ; *Periapical Periodontitis/virology/epidemiology/pathology ; Prevalence ; *Virus Diseases/complications/epidemiology ; }, abstract = {OBJECTIVE: Bacteria and viruses are components of the oral microbiome and are linked to various oral diseases. Clinical observations indicate a higher prevalence of apical periodontitis (AP) during viral epidemics. However, research on this association is limited. This meta-analysis aimed to explore the relationship between viral infections and AP.<br><br>METHODS: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Relevant studies were identified through systematic database searches, and data were extracted for eligible studies. Three validated quality assessment tools were used to ensure rigor. The pooled odds ratio (OR) with 95% confidence interval (CI) was calculated to quantify the strength of the association.<br><br>RESULTS: Out of 427 screened records, 31 studies comprising 1,341,636 participants met the inclusion criteria. The meta-analysis revealed that the prevalence of AP was 2.78 times higher in patients with viral infections compared to controls (95% CI&#x2009;=&#x2009;1.88-4.12, p&#x2009;<&#x2009;0.001). Infected individuals demonstrated more severe clinical symptoms (OR&#x2009;=&#x2009;3.49, 95% CI&#x2009;=&#x2009;2.07-5.90, p&#x2009;<&#x2009;0.001) and significantly larger periapical lesions (OR&#x2009;=&#x2009;3.84, 95% CI&#x2009;=&#x2009;1.08-13.67, p&#x2009;<&#x2009;0.05).<br><br>CONCLUSIONS: The evidence suggests a significant association between viral infections and AP, particularly in cases of viral co-infections.<br><br>CLINICAL RELEVANCE: These findings suggest that evaluating viral infections, particularly herpesviruses, could inform the clinical management of AP. However, further research is required to establish causality.}, }
@article {pmid41482979, year = {2026}, author = {Hecht, JD and Heitkemper, EM and Danesh, V and Clark, AP and Yoder, LH}, title = {A Concept Analysis of Expertise Associated With Practicing Clinical Nurses in Hospital Settings.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.70455}, pmid = {41482979}, issn = {1365-2648}, abstract = {AIM: Analyse the concept of expertise among practicing clinical nurses in hospital settings.<br><br>BACKGROUND: The generational loss of expert clinical nurses was exacerbated globally by the novel coronavirus. This ongoing loss combined with the increased complexity of hospitalised patients has prompted an urgent need to understand expertise among clinical nurses who practice in hospital settings.<br><br>METHODS: Walker and Avant's concept analysis method was used. PubMed, Medline, CINAHL and Access Medicine were searched (1982-2025) for research studies and literature reviews published in English that addressed clinical nursing expertise in hospitals.<br><br>RESULTS: Expertise is the knowledge and skills that are enculturated from immersion in a domain. Common attributes include obtaining salient information from different sources, interpreting patient situations rapidly and holistically, and performing actions that are individualised, immediate and appear instinctive. Common antecedents include deliberate accumulation of relevant experience and contextual connections within the hospital. Facilitating improved outcomes and facilitating improved outcomes are common consequences.<br><br>CONCLUSION: The attributes, antecedents and consequences of clinical nursing expertise are complementary and cross specialties. Experts' apparently instinctive actions are not intuitive but rather related to relevant past experiences, pattern recognition and skilled know-how. The requirements to develop expertise have evolved with the increased volume of available knowledge.<br><br>Expertise requires cultivating relevant experiences through active engagement with patients and creating contextual connections with others regarding hospital systems and processes. Experts should be formally included when developing processes and guidelines. Low-fidelity proxy measures like years of experience should be replaced with psychometrically validated instruments to measure expertise.<br><br>IMPACT: This concept analysis addresses the ambiguity of clinical nursing expertise by synthesising over 40&#x2009;years of literature and provides insights for clinical nurses and researchers regarding the importance of context and the growing complexity of care delivery.<br><br>No patient or public involvement.}, }
@article {pmid41482705, year = {2026}, author = {Sabeena, S and Beynon, C}, title = {The Impact of the COVID-19 Pandemic on HPV Vaccination Coverage Among Adolescents From High-Income Countries and Challenges: A Scoping Review.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70102}, doi = {10.1002/rmv.70102}, pmid = {41482705}, issn = {1099-1654}, mesh = {Humans ; Adolescent ; *COVID-19/epidemiology/virology ; *Papillomavirus Vaccines/administration &amp; dosage ; *Papillomavirus Infections/prevention &amp; control/virology/epidemiology ; Female ; *Vaccination Coverage/statistics &amp; numerical data ; Developed Countries ; Vaccination ; Male ; SARS-CoV-2 ; Patient Acceptance of Health Care ; Uterine Cervical Neoplasms/prevention &amp; control/virology ; Vaccination Hesitancy ; Health Knowledge, Attitudes, Practice ; }, abstract = {Persistent high-risk Human Papillomavirus (HPV) infection causes anogenital and oropharyngeal cancers across all genders. The primary cancer associated with HPV is cervical cancer and the HPV vaccination before sexual exposure is recommended for cervical cancer elimination globally. This scoping review aims to map the preliminary evidence regarding the determinants of adolescent HPV vaccine acceptance and hesitancy during the COVID-19 pandemic in high income countries. A scoping review was conducted as per the updated Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Using the PCC (Population, Concept, and Context) framework, search keywords and search strategies were developed. Electronic databases were searched using specific search terms and the last search date noted as February 8, 2025. A thematic content analysis was carried out to identify the themes and subthemes by a deductive approach. Fourteen studies were included as the potential sources of evidence in this review. The study population included 493,819 adolescents from Australia, Hong Kong, Italy, Poland, Saudi Arabia, and the USA. The themes identified were inequity, attitude and behaviour, knowledge and communication, and engagement and influence. The COVID-19 pandemic generated a negative parental attitude towards HPV vaccines for a brief period. The adolescent HPV vaccine acceptance mainly depended on strong parental support and appropriate access to healthcare professionals and vaccination services. Travel restrictions, lockdowns, school closures, and social distancing contributed to significant HPV vaccine hesitancy in high income countries.}, }
@article {pmid41482689, year = {2026}, author = {Yang, YJ and Kim, KH and Park, JH and Ro, YS and Song, KJ and Shin, SD}, title = {Impact of the COVID-19 Pandemic on the Mortality of Traumatic Brain Injury Patients Transported by Emergency Medical Services.}, journal = {Asia-Pacific journal of public health}, volume = {}, number = {}, pages = {10105395251407042}, doi = {10.1177/10105395251407042}, pmid = {41482689}, issn = {1941-2479}, abstract = {The purpose of this study was to investigate the effects of the COVID-19 pandemic on the mortality of traumatic brain injury (TBI) patients transported by emergency medical services (EMS). Adult TBI patients who were assessed and transported by EMS between January 2018 and December 2021 were analyzed. The main exposure was during the COVID-19 pandemic period at the time of the event. The primary outcome was in-hospital mortality. A total of 18 988 patients were analyzed. The in-hospital mortality in the COVID-19 era group was 1812 (20.9%), and that in the non-COVID-19 era group was 2040 (19.8%). Multivariate logistic regression analysis revealed a significantly greater probability of in-hospital mortality in the COVID-19-era group; adjusted odds ratio [95% confidence interval] of 1.16 [1.07, 1.25]. Compared with non-COVID-19 era patients, TBI patients who were assessed and transported during the COVID-19 era were more likely to have higher in-hospital mortality.}, }
@article {pmid41482260, year = {2025}, author = {Ticinesi, A and Zuliani, G and Spaggiari, R and Volpato, S and Maggi, S and Franceschi, C}, title = {The social microbiome of older people.}, journal = {Ageing research reviews}, volume = {}, number = {}, pages = {103008}, doi = {10.1016/j.arr.2025.103008}, pmid = {41482260}, issn = {1872-9649}, abstract = {The human gut microbiome (GM) is increasingly recognized as one of the main systems influencing the aging trajectory. Age-related dysbiosis, with imbalance between symbionts and pathobionts, can in fact fuel chronic inflammation (inflammaging) and promote frailty. In older individuals, GM composition is characterized by marked inter-individual variability and consistently influenced by environmental exposures. Studies conducted in animals and closed human communities suggest that social contacts are associated with horizontal transmission of commensal bacteria, enhancing biodiversity and preventing dysbiosis. Recent studies also suggest transmission of intestinal commensal bacteria from animals to humans sharing the same household. Bacterial populations residing on environmental surfaces may also have an influence on GM composition. In this framework, impoverishment of social relationships in older individuals may not be only associated with cognitive and emotional disengagement, but also with unfavorable changes in GM composition, driven by isolation and top-down neuromodulation of intestinal function. In fact, studies conducted during forced social distancing in the COVID-19 pandemic show GM changes pointing towards dysbiosis. Therefore, the detrimental consequences of social isolation for health outcomes of older individuals, including frailty progression towards disability, could be at least partly mediated by GM dysbiosis. Conversely, interventions aimed at restoring sociality, including animal-assisted activities, could expose older individuals to a range of novel bacterial species helping to counteract GM dysbiosis. This perspective article critically discusses the concept of social microbiome, its possible relevance for maintenance of good health in human beings, and its implications for the care of older patients.}, }
@article {pmid41482169, year = {2025}, author = {Kwon, CY and Won, J and Lee, B}, title = {The health effects of diaphragmatic breathing: a systematic review.}, journal = {Complementary therapies in medicine}, volume = {}, number = {}, pages = {103317}, doi = {10.1016/j.ctim.2025.103317}, pmid = {41482169}, issn = {1873-6963}, abstract = {BACKGROUND: Diaphragmatic breathing (DB) is widely used clinically, but a comprehensive synthesis of randomized controlled trial (RCT) evidence on its health effects is lacking. This systematic review evaluated the health effects of DB interventions in adults based on RCT evidence.<br><br>METHODS: Six electronic databases were searched through January 2025 for RCTs comparing DB to control conditions in adults. Two reviewers independently selected studies, extracted data, and assessed risk of bias (Cochrane RoB 2). A narrative synthesis was performed due to substantial heterogeneity across studies.<br><br>RESULTS: We included 48 RCTs. DB protocols were highly heterogeneous, with parameters varying widely in breathing frequency (2-10 breaths/min), session duration (3-45min), and total duration (single session to 12 weeks). Methodological quality was a significant concern (only 2.12% of outcomes low risk of bias). Consistent benefits were found for gastroesophageal reflux disease (GERD) (including reduced medication use), anxiety, post-COVID-19 syndrome, and gestational diabetes). In healthy adults, DB showed acute cardiovascular benefits. However, evidence was inconsistent for chronic obstructive pulmonary disease, and DB was less effective than standard care after cardiac surgery. Safety was underreported (18.75% of studies), but no serious adverse events were noted.<br><br>CONCLUSIONS: DB is a promising complementary therapy for specific conditions, including GERD, but the evidence base is constrained by methodologically weak and heterogeneous primary studies. Future research requires rigorous, standardized trial designs to establish its clinical value. Despite these limitations, DB is a low-cost, accessible, and apparently safe intervention for select conditions.}, }
@article {pmid41481892, year = {2025}, author = {Cornejo, M and Tang, R and Han, C and Trinh, NH}, title = {Culturally Responsive Mental Health Care for Asian Americans: A Call to Action.}, journal = {Harvard review of psychiatry}, volume = {33}, number = {6}, pages = {333-340}, doi = {10.1097/HRP.0000000000000441}, pmid = {41481892}, issn = {1465-7309}, mesh = {Humans ; *Asian/psychology ; *COVID-19/psychology/ethnology ; United States ; *Culturally Competent Care ; *Mental Health Services ; *Racism/psychology/ethnology ; *Mental Disorders/therapy/ethnology ; }, abstract = {Though Asian Americans (AAs) are the fastest growing racially minoritized group in the United States, their mental health care needs have not received adequate attention. AAs are less likely to seek mental health care than other minoritized groups. When they do, they often present more acutely, a trend exacerbated by events amidst the COVID-19 pandemic. During the pandemic, AAs experienced increased discrimination and anti-Asian hate crimes that still persist today. One in five AAs who has encountered racism has suffered psychological and emotional effects as a result. Recent studies have shown an increased risk of depression associated with anti-Asian crime rates. Although the psychological toll of COVID-19-related racism has led to increased prevalence of overall mental health symptoms, the likelihood that AAs seek care still remains low. This column highlights the specific challenges faced by AAs and the critical need for culturally responsive mental health initiatives and resources to better serve the unique needs of this community.}, }
@article {pmid41480694, year = {2026}, author = {Zhang, YC and Zhang, L and Zhou, PT and Xie, ZH and Zhang, WJ and Fan, M and Han, YX and Liu, YH and Liu, YC}, title = {Environmental exposure to air pollution and climate: Intersecting the impact on ear and nose health and chemosensory function (Review).}, journal = {International journal of molecular medicine}, volume = {57}, number = {3}, pages = {}, doi = {10.3892/ijmm.2025.5726}, pmid = {41480694}, issn = {1791-244X}, mesh = {Humans ; *Air Pollution/adverse effects ; *Environmental Exposure/adverse effects ; Climate Change ; *Nose Diseases/etiology/epidemiology ; *Climate ; COVID-19/epidemiology ; *Ear Diseases/etiology/epidemiology ; }, abstract = {Air pollution, an emerging global environmental issue, alongside extreme meteorological conditions exacerbated by climate change, threaten the sustainability of modern society and contribute to the onset and progression of various ear and nose diseases. Nonetheless, the impact of these environmental factors on ear and nose diseases and related dysfunctions remain inadequately explored. The present review involved a comprehensive search of PubMed, Web of Science, the Cochrane Library and Embase for relevant epidemiological and experimental data. How environmental factors contribute to olfactory and auditory system dysfunctions as well as the potential underlying mechanisms from the perspectives of immunity and inflammation were examined in the present review. It was found that air pollution and meteorological factors significantly influence the prevalence of major ear and nose diseases, including allergic rhinitis, otitis media and sudden sensorineural hearing loss. Of note, the present review also provides an examination of the interaction between severe acute respiratory syndrome coronavirus 2 and environmental factors in ear and nose diseases, highlighting how environmental stressors may worsen disease progression. In conclusion, the present review underscores the burden of multimorbidity caused by air pollution and extreme weather and emphasizes the need for more targeted prevention and management strategies for ear and nose diseases.}, }
@article {pmid41480490, year = {2026}, author = {Berhe, TT and Jara, D and Kifle, D}, title = {Health Misinformation in Ethiopia: Myths, Media Dynamics, Public Response, and Policy Implications: A Narrative Review.}, journal = {Public health challenges}, volume = {5}, number = {1}, pages = {e70181}, pmid = {41480490}, issn = {2769-2450}, abstract = {BACKGROUND: Health misinformation in Ethiopia undermines public trust and weakens the effectiveness of health interventions. Cultural beliefs, religious influences, and the expansion of digital media contribute to myths that fuel vaccine hesitancy, stigma, and delayed health-seeking behavior.<br><br>OBJECTIVE: To synthesize evidence on the scope, drivers, and impacts of health misinformation in Ethiopia and to highlight actionable strategies for improving public health communication.<br><br>METHODS: A narrative literature review was conducted using PubMed, Scopus, and African Journals Online, supplemented with grey literature from the Ministry of Health, World Health Organization (WHO), United Nations Children's Fund (UNICEF), and Regional fact checking organizations. Sources published between 2010 and 2025 that addressing misinformation, communication channels, or public responses in Ethiopia were included. Findings were summarized using descriptive narrative synthesis.<br><br>RESULT: Misconceptions related to traditional remedies, vaccine safety, COVID-19 cures, and modern contraceptives are widespread. Narratives spread rapidly across social media, particularly Facebook and Telegram, whereas oral traditions reinforce misinformation in rural communities. These Documented impacts include reduced uptake of immunization and maternal services, delayed treatment for diseases such as TB and HIV, and persistent stigma. Interventions involving community health workers, religious leaders, and youth-led campaigns have proven effective in countering misinformation.<br><br>CONCLUSION: Health misinformation remains a significant barrier to Ethiopia's health targets. Strengthening media literacy, engaging trusted community actors, and building partnerships between government, civil society, and digital platforms are crucial to mitigate health misinformation and improve public health outcomes.}, }
@article {pmid41480483, year = {2026}, author = {Safeer, F and Murali, TS}, title = {Extracellular vesicles in viral disease management.}, journal = {Current research in microbial sciences}, volume = {10}, number = {}, pages = {100527}, pmid = {41480483}, issn = {2666-5174}, abstract = {INTRODUCTION/BACKGROUND: Extracellular vesicles (EVs) are non-replicating lipid-bilayered bodies that are naturally released by a cell that aid in various biological functions including cell-to-cell communication. They resemble the cells that they originate from, mimicking their composition and contents. The shared Endosomal Sorting Complex Required for Transport (ESCRT) mechanism between virions and EVs allows EVs to aid in the dispersion and infection of viruses.<br><br>SCOPE/OBJECTIVES: The aim of this review is to encapsulate important studies that highlight the potential use of EVs in diagnosis and therapeutics against viral diseases. It also discusses their benefits and limitations compared to currently available anti-virals, for their use in the medical sector.<br><br>SUMMARY OF KEY FINDINGS: Virus-infected host cells release extracellular vesicles that are markedly different from EVs secreted by a healthy host cell. Increase in certain biomarker levels in EVs prove to be highly beneficial in diagnostics. Depending on the cell source, EVs also exhibit the natural ability to defend against viral diseases. This innate ability to defend against viral infections, can thus be exploited to produce potent anti-viral responses in infected hosts.<br><br>CONCLUSION/IMPLICATIONS: By navigating the challenges associated with EVs, they can be utilised to prepare alternatives to anti-viral drugs currently available in the market that show low specificity and high toxicity, thus helping mitigate and manage viral diseases.}, }
@article {pmid40254579, year = {2025}, author = {Ewing, AG and Joffe, D and Blitshteyn, S and Brooks, AES and Wist, J and Bar-Yam, Y and Bilodeau, S and Curtin, J and Duncan, R and Faghy, M and Galland, L and Pretorius, E and Salamon, S and Buonsenso, D and Hastie, C and Kane, B and Khan, MA and Lal, A and Lau, D and MacIntyre, R and McFarland, S and Munblit, D and Nicholson, J and Ollila, HM and Putrino, D and Rosario, A and Tan, T and , }, title = {Long COVID clinical evaluation, research and impact on society: a global expert consensus.}, journal = {Annals of clinical microbiology and antimicrobials}, volume = {24}, number = {1}, pages = {27}, pmid = {40254579}, issn = {1476-0711}, mesh = {Humans ; *COVID-19/diagnosis/therapy/complications/epidemiology ; Consensus ; SARS-CoV-2 ; Delphi Technique ; Post-Acute COVID-19 Syndrome ; Global Health ; Child ; }, abstract = {BACKGROUND: Long COVID is a complex, heterogeneous syndrome affecting over four hundred million people globally. There are few recommendations, and no formal training exists for medical professionals to assist with clinical evaluation and management of patients with Long COVID. More research into the pathology, cellular, and molecular mechanisms of Long COVID, and treatments is needed. The goal of this work is to disseminate essential information about Long COVID and recommendations about definition, diagnosis, treatment, research and social issues to physicians, researchers, and policy makers to address this escalating global health crisis.<br><br>METHODS: A 3-round modified Delphi consensus methodology was distributed internationally to 179 healthcare professionals, researchers, and persons with lived experience of Long COVID in 28 countries. Statements were combined into specific areas: definition, diagnosis, treatment, research, and society.<br><br>RESULTS: The survey resulted in 187 comprehensive statements reaching consensus with the strongest areas being diagnosis and clinical assessment, and general research. We establish conditions for diagnosis of different subgroups within the Long COVID umbrella. Clear consensus was reached that the impacts of COVID-19 infection on children should be a research priority, and additionally on the need to determine the effects of Long COVID on societies and economies. The consensus on COVID and Long COVID is that it affects the nervous system and other organs and is not likely to be observed with initial symptoms. We note, biomarkers are critically needed to address these issues.<br><br>CONCLUSIONS: This work forms initial guidance to address the spectrum of Long COVID as a disease and reinforces the need for translational research and large-scale treatment trials for treatment protocols.}, }
@article {pmid39740220, year = {2024}, author = {Denny, A and Ndemera, I and Chirwa, K and Wu, JTS and Chirambo, GB and Yosefe, S and Chilima, B and Kagoli, M and Lee, HY and Yu, KLJ and O'Donoghue, J}, title = {Evaluation of the Development, Implementation, Maintenance, and Impact of 3 Digital Surveillance Tools Deployed in Malawi During the COVID-19 Pandemic: Protocol for a Modified Delphi Expert Consensus Study.}, journal = {JMIR research protocols}, volume = {13}, number = {}, pages = {e58389}, pmid = {39740220}, issn = {1929-0748}, mesh = {*COVID-19/epidemiology/prevention &amp; control/diagnosis ; Malawi/epidemiology ; Humans ; *Delphi Technique ; *Consensus ; *Pandemics/prevention &amp; control ; Telemedicine/standards ; }, abstract = {BACKGROUND: The COVID-19 pandemic has highlighted the importance of strengthening national monitoring systems to safeguard a globally connected society, especially those in low- and middle-income countries. Africa's rapid adoption of digital technological interventions created a new frontier of digital advancement during crises or pandemics. The use of digital tools for disease surveillance can assist with rapid outbreak identification and response, handling duties such as diagnosis, testing, contact tracing, and risk communication. Malawi was one of the first countries in the region to launch a government-led coordinated effort to harmonize and streamline the necessary COVID-19 digital health implementation through an integrated system architecture.<br><br>OBJECTIVE: The aim of this study is to seek expert consensus using the Delphi methodology to examine Malawi's COVID-19 digital surveillance response strategy and to assess the digital tools using the World Health Organization mHealth (mobile health) Assessment and Planning for Scale (MAPS) toolkit.<br><br>METHODS: This protocol follows the Guidance on Conducting and REporting DElphi Studies. Participants must have first-hand experience on the design, implementation or maintenance with COVID-19 digital surveillance systems. There will be no restrictions on the level of expertise or years of experience. The panel will consist of approximately 40 participants. We will use a modified Delphi process whereby rounds 1 and 2 will be hosted online by Qualtrics and round 3 will encompass a face-to-face workshop held in Malawi. Consensus will be defined as &#x2265;70% of participants strongly disagree, disagree, or somewhat disagree, or strongly agree, agree, or somewhat agree. During round 3, the face-to-face workshop, participants will be asked to complete, the MAPS toolkit assessment on the digital tool on which they are experts. The MAPS toolkit will enable the panel members to assess the digital tools from a sustainable perspective from six distinct, yet complementary axes: (1) groundwork, (2) partnerships, (3) financial health, (4) technology and architecture, (5) operations, and (6) monitoring and evaluation.<br><br>RESULTS: The ability of a country to collate, diagnose, monitor, and analyze data forms the cornerstone of an efficient surveillance system, allowing countries to plan and implement appropriate control actions. Malawi was one of the first countries in the African region to launch a government-led coordinated effort to harmonize and streamline the necessary COVID-19 digital health implementation through an integrated system architecture.<br><br>CONCLUSIONS: We anticipate findings from this Delphi study will provide insights into how and why Malawi was successful in deploying digital surveillance systems. In addition, findings should produce recommendations and guidance for the rapid development, implementation, maintenance, and impact of digital surveillance tools during a health crisis.<br><br>DERR1-10.2196/58389.}, }
@article {pmid39655884, year = {2025}, author = {Garabedian, C and Sibiude, J and Anselem, O and Attie-Bittach, T and Bertholdt, C and Blanc, J and Dap, M and de Mézerac, I and Fischer, C and Girault, A and Guerby, P and Le Gouez, A and Madar, H and Quibel, T and Tardy, V and Stirnemann, J and Vialard, F and Vivanti, A and Sananès, N and Verspyck, E}, title = {Fetal death: Expert consensus of the French College of Obstetricians and Gynecologists.}, journal = {International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics}, volume = {168}, number = {3}, pages = {999-1008}, pmid = {39655884}, issn = {1879-3479}, mesh = {Humans ; Female ; Pregnancy ; *Fetal Death/prevention &amp; control/etiology ; France ; Obstetrics/standards ; COVID-19/prevention &amp; control ; Consensus ; Gynecology ; Societies, Medical ; Obstetricians ; Gynecologists ; }, abstract = {Fetal death is defined as the spontaneous cessation of cardiac activity after 14 weeks gestational age (GA). Regarding prevention of fetal death in the general population, it is not recommended to counsel or prescribe rest, aspirin, vitamin A, vitamin D, or micronutrient supplementation; systematically look for nuchal cord during prenatal screening ultrasound; or perform systematic antepartum monitoring by cardiotocography for the sole purpose of reducing the risk of fetal death. It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2. Regarding evaluation in the event of fetal death, it is recommended that a fetal autopsy and anatomopathologic examination of the placenta be performed; chromosomal analysis be performed by microarray testing, rather than by conventional karyotype (with postnatal sampling of the fetal placental surface preferred for genetic purposes); testing for antiphospholipid antibodies be performed, with systematic Kleihauer-Betke testing and for irregular agglutinins; and summary consultation to discuss these examination results be offered. Regarding announcement and support, it is recommended that fetal death be announced without ambiguity, using simple words adapted to each situation, after which the couple should be supported with empathy across the different stages of their care. Regarding patient management in cases of fetal death, it is recommended that: in the absence of risks for disseminated intravascular coagulation or maternal demise, the patient's wishes regarding the timing between the fetal death diagnosis and labor induction should be considered; return home is possible, according to the patient's wishes; in all situations except maternal life-threatening emergencies, the preferred mode of delivery is vaginal, regardless of previous cesarean section(s); mifepristone 200 mg be prescribed at least 24 h before induction; and perimedullary analgesia be initiated at the start of induction if requested by the patient, regardless of GA. Of note, there is insufficient evidence to recommend either the administration route (i.e., vaginal or oral) of misoprostol or prostaglandin type. Regarding the risk of recurrence after unexplained fetal death: the incidence does not appear to be increased in subsequent pregnancies; in cases with a history of fetal death due to vascular problems, low-dose aspirin is recommended to reduce perinatal morbidity (otherwise, evidence is insufficient to recommend the prescription of aspirin); no optimal delay in initiating another pregnancy should be recommended based solely on a history of fetal death; fetal heart rate monitoring is not indicated based solely on a history of fetal death; although systematic labor induction is not recommended, induction may be considered depending on the context and parental request, and considering fetal age, benefits, and risks, especially before 39 weeks GA. Note that if the cause of fetal death is identified, management should be adjusted on a case-by-case basis. Regarding fetal death in a twin pregnancy, it is recommended that the surviving twin be examined immediately upon fetal death diagnosis; in a dichorionic twin pregnancy, preterm delivery induction is not recommended; in a monochorionic twin pregnancy, the surviving twin should be immediately evaluated for signs of acute fetal anemia, with weekly ultrasound monitoring for the first month, though immediate labor induction is not recommended.}, }
@article {pmid39153884, year = {2024}, author = {Garabedian, C and Sibiude, J and Anselem, O and Attie-Bittach, T and Bertholdt, C and Blanc, J and Dap, M and de Mézerac, I and Fischer, C and Girault, A and Guerby, P and Le Gouez, A and Madar, H and Quibel, T and Tardy, V and Stirnemann, J and Vialard, F and Vivanti, A and Sananès, N and Verspyck, E}, title = {[Fetal death: Expert consensus from the College of French Gynecologists and Obstetricians].}, journal = {Gynecologie, obstetrique, fertilite &amp; senologie}, volume = {52}, number = {10}, pages = {549-611}, doi = {10.1016/j.gofs.2024.07.005}, pmid = {39153884}, issn = {2468-7189}, mesh = {Humans ; Pregnancy ; Female ; *Fetal Death/prevention &amp; control ; France ; *Obstetrics/methods ; *COVID-19/prevention &amp; control ; Gynecology ; Consensus ; SARS-CoV-2 ; Societies, Medical ; Prenatal Diagnosis/methods ; Gynecologists ; Obstetricians ; }, abstract = {Fetal death is defined as the spontaneous cessation of cardiac activity after fourteen weeks of amenorrhea. In France, the prevalence of fetal death after 22 weeks is between 3.2 and 4.4/1000 births. Regarding the prevention of fetal death in the general population, it is not recommended to counsel for rest and not to prescribe vitamin A, vitamin D nor micronutrient supplementation for the sole purpose of reducing the risk of fetal death (Weak recommendations; Low quality of evidence). It is not recommended to prescribe aspirin (Weak recommendation; Very low quality of evidence). It is recommended to offer vaccination against influenza in epidemic periods and against SARS-CoV-2 (Strong recommendations; Low quality of evidence). It is not recommended to systematically look for nuchal cord encirclements during prenatal screening ultrasounds (Strong Recommendation; Low Quality of Evidence) and not to perform systematic antepartum monitoring by cardiotocography (Weak Recommendation; Very Low Quality of Evidence). It is not recommended to ask women to perform an active fetal movement count to reduce the risk of fetal death (Strong Recommendation; High Quality of Evidence). Regarding evaluation in the event of fetal death, it is suggested that an external fetal examination be systematically offered (Expert opinion). It is recommended that a fetopathological and anatomopathological examination of the placenta be carried out to participate in cause identification (Strong Recommendation. Moderate quality of evidence). It is recommended that chromosomal analysis by microarray testing be performed rather than conventional karyotype, in order to be able to identify a potentially causal anomaly more frequently (Strong Recommendation, moderate quality of evidence); to this end, it is suggested that postnatal sampling of the placental fetal surface for genetic purposes be preferred (Expert Opinion). It is suggested to test for antiphospholipid antibodies and systematically perform a Kleihauer test and a test for irregular agglutinins (Expert opinion). It is suggested to offer a summary consultation, with the aim of assessing the physical and psychological status of the parents, reporting the results, discussing the cause and providing information on monitoring for a subsequent pregnancy (Expert opinion). Regarding announcement and support, it is suggested to announce fetal death without ambiguity, using simple words and adapting to each situation, and then to support couples with empathy in the various stages of their care (Expert opinion). Regarding management, it is suggested that, in the absence of a situation at risk of disseminated intravascular coagulation or maternal vitality, the patient's wishes should be taken into account when determining the time between the diagnosis of fetal death and induction of birth. Returning home is possible if it's the patient wish (Expert opinion). In all situations excluding maternal life-threatening emergencies, the preferred mode of delivery is vaginal delivery, regardless the history of cesarean section(s) history (Expert opinion). In the event of fetal death, it is recommended that mifepristone 200mg be prescribed at least 24hours before induction, to reduce the delay between induction and delivery (Low recommendation. Low quality of evidence). There are insufficient data in the literature to make a recommendation regarding the route of administration (vaginal or oral) of misoprostol, neither the type of prostaglandin to reduce induction-delivery time or maternal morbidity. It is suggested that perimedullary analgesia be introduced at the start of induction if the patient asks, regardless of gestational age. It is suggested to prescribe cabergoline immediately in the postpartum period in order to avoid lactation, whatever the gestational age, after discussing the side effects of the treatment with the patient (Expert opinion). The risk of recurrence of fetal death after unexplained fetal death does not appear to be increased in subsequent pregnancies, and data from the literature are insufficient to make a recommendation on the prescription of aspirin. In the event of a history of fetal death due to vascular issues, low-dose aspirin is recommended to reduce perinatal morbidity, and should not be combined with heparin therapy (Low recommendation, very low quality of evidence). It is suggested not to recommend an optimal delay before initiating another pregnancy just because of the history of fetal death. It is suggested that the woman and co-parent be informed of the possibility of psychological support. Fetal heart rate monitoring is not indicated solely because of a history of fetal death. It is suggested that delivery not be systematically induced. However, induction can be considered depending on the context and parental request. The gestational age will be discussed, taking into account the benefits and risks, especially before 39 weeks. If a cause of fetal death is identified, management will be adapted on a case-by-case basis (expert opinion). In the event of fetal death occurring in a twin pregnancy, it is suggested that the surviving twin be evaluated as soon as the diagnosis of fetal death is made. In the case of dichorionic pregnancy, it is suggested to offer ultrasound monitoring on a monthly basis. It is suggested not to deliver prematurely following fetal death of a twin. If fetal death occurs in a monochorionic twin pregnancy, it is suggested to contact the referral competence center, in order to urgently look for signs of acute fetal anemia on ultrasound in the surviving twin, and to carry out weekly ultrasound monitoring for the first month. It is suggested not to induce birth immediately.}, }
@article {pmid37226478, year = {2025}, author = {Bidoli, C and Pegoraro, V and Dal Mas, F and Bagnoli, C and Bert, F and Bonin, M and Butturini, G and Cobianchi, L and Cordiano, C and Minto, G and Pilerci, C and Stocco, P and Zantedeschi, M and Campostrini, S}, title = {Virtual hospitals: The future of the healthcare system? An expert consensus.}, journal = {Journal of telemedicine and telecare}, volume = {31}, number = {1}, pages = {121-133}, doi = {10.1177/1357633X231173006}, pmid = {37226478}, issn = {1758-1109}, mesh = {Humans ; *COVID-19/epidemiology ; *Telemedicine/organization &amp; administration/standards ; *Consensus ; *Delivery of Health Care/organization &amp; administration/standards ; *SARS-CoV-2 ; Italy ; Pandemics ; Hospitals/standards ; }, abstract = {Today, social and healthcare systems at a global level are facing constant challenges dictated by an increasing mismatch between the demand for care services and the supply of human and economic resources. Such a situation has been exacerbated in the past two years by the Covid-19 pandemic. This has led to an increase in the leverage of digitalisation, which has proved to be a crucial tool for the development and application of new organisational models at both hospital and territorial levels, thus addressing the various criticalities already present in the system. In this sense, the Virtual Hospital has emerged as a potential model for increasing effectiveness and efficiency in delivering sociomedical services. Starting from these premises, an EFTE (estimate, feedback, talk, estimate) approach was used to acquire an expert consensus within a multidisciplinary panel of academics and healthcare managers of the Veneto Region in Italy. This article reports the expert opinion on the possible application of the Virtual Hospital model in the national context, starting from the existing international evidence and good practices, highlighting the potential advantages and barriers to its implementation. Furthermore, the article analyses the most relevant areas of investment for the development of intangible assets and the acquisition of tangible assets necessary for its implementation.}, }
@article {pmid36541203, year = {2023}, author = {Ruberg, FL and Baggish, AL and Hays, AG and Jerosch-Herold, M and Kim, J and Ordovas, KG and Reddy, G and Shenoy, C and Weinsaft, JW and Woodard, PK}, title = {Utilization of Cardiovascular Magnetic Resonance Imaging for Resumption of Athletic Activities Following COVID-19 Infection: An Expert Consensus Document on Behalf of the American Heart Association Council on Cardiovascular Radiology and Intervention Leadership and Endorsed by the Society for Cardiovascular Magnetic Resonance.}, journal = {Circulation. Cardiovascular imaging}, volume = {16}, number = {1}, pages = {e014106}, pmid = {36541203}, issn = {1942-0080}, support = {R01 HL139671/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; United States/epidemiology ; *COVID-19 ; SARS-CoV-2 ; Consensus ; American Heart Association ; Leadership ; Magnetic Resonance Imaging ; *Sports ; Magnetic Resonance Spectroscopy ; *Radiology ; }, abstract = {The global pandemic of COVID-19 caused by infection with SARS-CoV-2 is now entering its fourth year with little evidence of abatement. As of December 2022, the World Health Organization Coronavirus (COVID-19) Dashboard reported 643 million cumulative confirmed cases of COVID-19 worldwide and 98 million in the United States alone as the country with the highest number of cases. Although pneumonia with lung injury has been the manifestation of COVID-19 principally responsible for morbidity and mortality, myocardial inflammation and systolic dysfunction though uncommon are well-recognized features that also associate with adverse prognosis. Given the broad swath of the population infected with COVID-19, the large number of affected professional, collegiate, and amateur athletes raises concern regarding the safe resumption of athletic activity (return to play) following resolution of infection. A variety of different testing combinations that leverage ECG, echocardiography, circulating cardiac biomarkers, and cardiovascular magnetic resonance imaging have been proposed and implemented to mitigate risk. Cardiovascular magnetic resonance in particular affords high sensitivity for myocarditis but has been employed and interpreted nonuniformly in the context of COVID-19 thereby raising uncertainty as to the generalizability and clinical relevance of findings with respect to return to play. This consensus document synthesizes available evidence to contextualize the appropriate utilization of cardiovascular magnetic resonance in the return to play assessment of athletes with prior COVID-19 infection to facilitate informed, evidence-based decisions, while identifying knowledge gaps that merit further investigation.}, }
@article {pmid35926987, year = {2022}, author = {Zhang, Y and Li, YX and Zhong, DL and Liu, XB and Zhu, YY and Jin, RJ and Li, J}, title = {Clinical practice guidelines and expert consensus statements on rehabilitation for patients with COVID-19: protocol for a systematic review.}, journal = {BMJ open}, volume = {12}, number = {8}, pages = {e060767}, pmid = {35926987}, issn = {2044-6055}, mesh = {*COVID-19/rehabilitation ; China ; Consensus ; Humans ; Medicine, Chinese Traditional ; Pandemics ; Practice Guidelines as Topic ; Research Design ; Systematic Reviews as Topic ; }, abstract = {INTRODUCTION: COVID-19 is a highly infectious disease, characterised by respiratory, physical and psychological dysfunctions. Rehabilitation could effectively alleviate the symptoms and promote recovery of the physical and mental health of patients with COVID-19. Recently, rehabilitation medical institutions have issued clinical practice guidelines (CPGs) and expert consensus statements involving recommendations for rehabilitation assessments and rehabilitation therapies for COVID-19. This systematic review aims to assess the methodological quality and reporting quality of the guidance documents, evaluate the heterogeneity of the recommendations and summarise the recommendations with respect to rehabilitation assessments and rehabilitation therapies for COVID-19 to provide a quick reference for front-line clinicians, therapists and patients as well as reasonable suggestions for future guidelines.<br><br>METHODS AND ANALYSIS: The electronic databases including PubMed, Embase, Chinese Biomedical Literature Database (CBM), Chinese Science and Technology Periodical Database (VIP), Wanfang Database and China National Knowledge Infrastructure (CNKI) and websites of governments or organisations (eg, National Guideline Clearinghouse, Guidelines International Network, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network and WHO) will be searched for eligible CPGs and expert consensus statements from inception to August 2022. CPGs and expert consensus statements published in Chinese or English and presenting recommendations for modern functional rehabilitation techniques and/or traditional Chinese medicine rehabilitation techniques for COVID-19 will be included. Reviews, interpretations, old versions of CPGs and expert consensus statements and those for the management of other diseases during the pandemic will be excluded. Two reviewers will independently review each article, extract data, appraise the methodological quality following the Appraisal of Guidelines for Research &amp; Evaluation II tool and assess the reporting quality with the Reporting Items for Practice Guidelines in Healthcare statement. The Measurement Scale of Rate of Agreement will be used to evaluate the heterogeneity of the recommendations in different CPGs and expert consensus statements. Agreement between reviewers will be calculated using the intraclass correlation coefficient. We will also summarise the recommendations for rehabilitation in patients with COVID-19. The results will be narratively described and presented as tables or figures.<br><br>ETHICS AND DISSEMINATION: Ethics approval is not needed for this systematic review because information from published documents will be used. The findings will be submitted for publication in a peer-reviewed journal and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<br><br>PROSPERO REGISTRATION NUMBER: CRD42020190761.}, }
@article {pmid35771014, year = {2022}, author = {Indolfi, C and Barillà, F and Basso, C and Ciccone, MM and Curcio, A and Gargiulo, P and Nodari, S and Mercuro, G and Mancone, M and Muscoli, S and Pedrinelli, R and Porcari, A and Spaccarotella, C and Romeo, F and Sinagra, G and Filardi, PP}, title = {[Italian Society of Cardiology (SIC) Expert consensus document: Post-acute cardiovascular sequelae of SARS-CoV-2 infection].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {23}, number = {7}, pages = {491-503}, doi = {10.1714/3831.38166}, pmid = {35771014}, issn = {1972-6481}, mesh = {*COVID-19/complications ; Cardiology ; *Cardiovascular Diseases/virology ; Consensus ; Humans ; SARS-CoV-2 ; Societies, Medical ; Post-Acute COVID-19 Syndrome ; }, abstract = {Although the clinical course of COVID-19 in its acute phase is now delineated, less known is its late phase characterized by a heterogeneous series of sequelae affecting various organs and systems, including the cardiovascular system, which continue after the acute episode or arise after their resolution. This syndrome, now referred with the new acronym "PASC" (post-acute sequelae of SARS-CoV-2 infection) has been formally recognized by various scientific societies and international organizations that have proposed various definitions. The World Health Organization defines PASC, distinguishing it from "ongoing symptomatic COVID-19", as a condition that arises few weeks after infection, persists at least 8 weeks, and cannot be explained by alternative diagnoses.There are multiple mechanisms responsible for PASC: inflammation, immune activation, viral persistence, activation of latent viruses, endothelial dysfunction, impaired response to exercise, and profound cardiac deconditioning following viral infection. The key symptoms of PASC are palpitations, effort dyspnea, chest pain, exercise intolerance, and postural orthostatic tachycardia syndrome.For PASC treatment, it may be useful to take salt and fluid loading, to reduce symptoms such as tachycardia, palpitations, and/or orthostatic hypotension, or in some subjects the use of drugs such as beta-blockers, non-dihydropyridine calcium channel blockers, ivabradine, and fludrocortisone.Finally, in PASC a gradual resumption of physical activity is recommended, starting with recumbent or semi-recumbent exercise, such as cycling, swimming, or rowing, and then moving on to exercise in an upright position such as running when the ability to stand improves without dyspnea appearance. Exercise duration should also be short initially (5 to 10 min per day), with gradual increases as functional capacity improves.}, }
@article {pmid35680591, year = {2022}, author = {,  and , }, title = {[Experts' consensus on severe acute respiratory syndrome coronavirus-2 vaccination in adult patients with hematological diseases in China (2022)].}, journal = {Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi}, volume = {43}, number = {5}, pages = {359-364}, pmid = {35680591}, issn = {0253-2727}, mesh = {Adult ; *COVID-19/prevention &amp; control ; China ; Consensus ; *Hematologic Diseases ; Humans ; SARS-CoV-2 ; Vaccination ; }, }
@article {pmid35307156, year = {2022}, author = {,  and Gluckman, TJ and Bhave, NM and Allen, LA and Chung, EH and Spatz, ES and Ammirati, E and Baggish, AL and Bozkurt, B and Cornwell, WK and Harmon, KG and Kim, JH and Lala, A and Levine, BD and Martinez, MW and Onuma, O and Phelan, D and Puntmann, VO and Rajpal, S and Taub, PR and Verma, AK}, title = {2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play: A Report of the American College of Cardiology Solution Set Oversight Committee.}, journal = {Journal of the American College of Cardiology}, volume = {79}, number = {17}, pages = {1717-1756}, pmid = {35307156}, issn = {1558-3597}, mesh = {*COVID-19/complications ; *Cardiology ; Consensus ; Humans ; *Myocarditis/diagnosis/therapy ; Return to Sport ; SARS-CoV-2 ; United States/epidemiology ; Post-Acute COVID-19 Syndrome ; }, }
@article {pmid35272130, year = {2022}, author = {Buske, C and Dreyling, M and Alvarez-Larrán, A and Apperley, J and Arcaini, L and Besson, C and Bullinger, L and Corradini, P and Giovanni Della Porta, M and Dimopoulos, M and D'Sa, S and Eich, HT and Foà, R and Ghia, P and da Silva, MG and Gribben, J and Hajek, R and Harrison, C and Heuser, M and Kiesewetter, B and Kiladjian, JJ and Kröger, N and Moreau, P and Passweg, JR and Peyvandi, F and Rea, D and Ribera, JM and Robak, T and San-Miguel, JF and Santini, V and Sanz, G and Sonneveld, P and von Lilienfeld-Toal, M and Wendtner, C and Pentheroudakis, G and Passamonti, F}, title = {Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus.}, journal = {ESMO open}, volume = {7}, number = {2}, pages = {100403}, pmid = {35272130}, issn = {2059-7029}, mesh = {Humans ; Consensus ; *COVID-19 ; COVID-19 Testing ; *Hematologic Neoplasms/epidemiology/therapy ; Pandemics ; }, abstract = {BACKGROUND: The COVID-19 pandemic has created enormous challenges for the clinical management of patients with hematological malignancies (HMs), raising questions about the optimal care of this patient group.<br><br>METHODS: This consensus manuscript aims at discussing clinical evidence and providing expert advice on statements related to the management of HMs in the COVID-19 pandemic. For this purpose, an international consortium was established including a steering committee, which prepared six working packages addressing significant clinical questions from the COVID-19 diagnosis, treatment, and mitigation strategies to specific HMs management in the pandemic. During a virtual consensus meeting, including global experts and lead by the European Society for Medical Oncology and the European Hematology Association, statements were discussed and voted upon. When a consensus could not be reached, the panel revised statements to develop consensual clinical guidance.<br><br>RESULTS AND CONCLUSION: The expert panel agreed on 33 statements, reflecting a consensus, which will guide clinical decision making for patients with hematological neoplasms during the COVID-19 pandemic.}, }
@article {pmid35147382, year = {2022}, author = {Płaczkiewicz-Jankowska, E and Czupryniak, L and Gajos, G and Lewiński, A and Ruchała, M and Stasiak, M and Strojek, K and Szczepanek-Parulska, E and Wyleżoł, M and Ostrowska, L and Jankowski, P}, title = {Management of obesity in the times of climate change and COVID-19: an interdisciplinary expert consensus report.}, journal = {Polish archives of internal medicine}, volume = {132}, number = {3}, pages = {}, doi = {10.20452/pamw.16216}, pmid = {35147382}, issn = {1897-9483}, mesh = {*COVID-19 ; Climate Change ; Consensus ; Humans ; Obesity/complications/therapy ; *Quality of Life ; United States ; }, abstract = {Obesity is a chronic disease associated with increased metabolic and cardiovascular risk, excessive morbidity and mortality worldwide. The authors of the present consensus, clinicians representing medical specialties related to the treatment of obesity and its complications, reviewed a number of European and American guidelines, published mostly in 2019-2021, and summarized the principles of obesity management to provide a practical guidance considering the impact that increased adiposity poses to health. From a clinical perspective, the primary goal of obesity treatment is to prevent or slow down the progression of diseases associated with obesity, reduce metabolic and cardiovascular risk, and improve the quality of life by achieving adequate and stable weight reduction. However, obesity should be not only considered a disease requiring treatment in an individual patient, but also a civilization disease requiring preventive measures at the populational level. Despite the evident benefits, obesity management within the health care system-whether through pharmacotherapy or bariatric surgery-is only a symptomatic treatment, with all its limitations, and will not ultimately solve the problem of obesity. The important message is that available treatment options fail to correct the true drivers of the obesity pandemic. To this end, new solutions and efforts to prevent obesity in the populations are needed.}, }
@article {pmid34668835, year = {2022}, author = {Piñana, JL and Vázquez, L and Martino, R and de la Cámara, R and Sureda, A and Rodríguez-Veiga, R and Garrido, A and Sierra, J and Ribera, JM and Torrent, A and Mateos, MV and de la Rubia, J and Tormo, M and Díez-Campelo, M and García-Gutiérrez, V and Álvarez-Larrán, A and Sancho, JM and MartínGarcía-Sancho, A and Yañez, L and Pérez Simón, JA and Barba, P and Abrisqueta, P and Álvarez-Twose, I and Bonanad, S and Lecumberri, R and Ruiz-Camps, I and Navarro, D and Hernández-Rivas, J&#xc1; and Cedillo, &#xc1; and García-Sanz, R and Bosch, F}, title = {Spanish Society of Hematology and Hemotherapy expert consensus opinion for SARS-CoV-2 vaccination in onco-hematological patients.}, journal = {Leukemia &amp; lymphoma}, volume = {63}, number = {3}, pages = {538-550}, pmid = {34668835}, issn = {1029-2403}, mesh = {*COVID-19/epidemiology/prevention &amp; control ; COVID-19 Vaccines/therapeutic use ; Consensus ; *Hematology ; Humans ; Pandemics/prevention &amp; control ; SARS-CoV-2 ; Vaccination ; }, abstract = {In the midst of the COVID-19 pandemic, different vaccines in front of SARS-CoV-2 have been approved and administered in different vulnerable populations. As patients with cancer were excluded from pivotal trials of vaccination, little is known on their immunogenic response to these vaccines, particularly in patients with severely impaired immune system. In response to that uncertainty, the Spanish Society of Hematology and Hemotherapy launched an initiative aimed to provide recommendations for vaccination of the main hematological conditions. This document is based on the available information on COVID-19 outcomes, prior knowledge on vaccination in hematological patients, recent published data on serological response in oncohematological patients and expert opinions. New information about SARS-CoV-2 vaccination will be gathered in the near future, providing new scientific grounds to delineate the most adequate management of vaccination in patients with hematological diseases. The current limited data on SARS-CoV-2 vaccines in hematological patients represents a major limitation of this expert consensus opinion. In fact, the speed in which this field evolves may reduce their validity in the near future.}, }
@article {pmid34187457, year = {2021}, author = {Corby, S and Whittaker, K and Ash, JS and Mohan, V and Becton, J and Solberg, N and Bergstrom, R and Orwoll, B and Hoekstra, C and Gold, JA}, title = {The future of medical scribes documenting in the electronic health record: results of an expert consensus conference.}, journal = {BMC medical informatics and decision making}, volume = {21}, number = {1}, pages = {204}, pmid = {34187457}, issn = {1472-6947}, support = {R01 HS025141/HS/AHRQ HHS/United States ; T15 LM007088/LM/NLM NIH HHS/United States ; }, mesh = {*COVID-19 ; Documentation ; *Electronic Health Records ; Humans ; SARS-CoV-2 ; Workflow ; }, abstract = {BACKGROUND: With the use of electronic health records (EHRs) increasing and causing unintended negative consequences, the medical scribe profession has burgeoned, but it has yet to be regulated. The purpose of this study was to describe scribe workflow as well as identify the threats and opportunities for the future of the scribe industry.<br><br>METHODS: The first phase of the study used ethnographic methods consisting of interviews and observations by a multi-disciplinary team of researchers at five United States sites. In April 2019, a two-day conference of experts representing different stakeholder perspectives was held to discuss the results from site visits and to predict the future of medical scribing. An interpretive content analysis approach was used to discover threats and opportunities for the future of medical scribes.<br><br>RESULTS: Threats facing the medical scribe industry were related to changes in the documentation model, EHR usability, different payment structures, the need to acquire disparate data during clinical encounters, and workforce-related changes relevant to the scribing model. Simultaneously, opportunities for medical scribing in the future included extension of their role to include workflow analysis, acting as EHR-related subject-matter-experts, and becoming integrated more effectively into the clinical care delivery team. Experts thought that if EHR usability increases, the need for medical scribes might decrease. Additionally, the scribe role could be expanded to allow scribes to document more or take on more informatics-related tasks. The experts also anticipated an increased use of alternative models of scribing, like tele-scribing.<br><br>CONCLUSION: Threats and opportunities for medical scribing were identified. Many experts thought that if the scribe role could be expanded to allow scribes to document more or take on more informatics activities, it would be beneficial. With COVID-19 continuing to change workflows, it is critical that medical scribes receive standardized training as tele-scribing continues to grow in popularity and new roles for scribes as medical team members are identified.}, }
@article {pmid34169495, year = {2021}, author = {Gerotziafas, GT and Catalano, M and Theodorou, Y and Dreden, PV and Marechal, V and Spyropoulos, AC and Carter, C and Jabeen, N and Harenberg, J and Elalamy, I and Falanga, A and Fareed, J and Agathaggelou, P and Antic, D and Antignani, PL and Bosch, MM and Brenner, B and Chekhonin, V and Colgan, MP and Dimopoulos, MA and Douketis, J and Elnazar, EA and Farkas, K and Fazeli, B and Fowkes, G and Gu, Y and Gligorov, J and Ligocki, MA and Indran, T and Kannan, M and Kantarcioglu, B and Kasse, AA and Konstantinidis, K and Leivano, F and Lewis, J and Makatsariya, A and Mbaye, PM and Mahé, I and Panovska-Stavridis, I and Olinic, DM and Papageorgiou, C and Pecsvarady, Z and Pillon, S and Ramacciotti, E and Abdel-Razeq, H and Sabbah, M and Sassi, M and Schernthaner, G and Siddiqui, F and Shiomura, J and Slama-Schwok, A and Wautrecht, JC and Tafur, A and Taher, A and Klein-Wegel, P and Zhai, Z and Zoubida, TM and , }, title = {The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper.}, journal = {Thrombosis and haemostasis}, volume = {121}, number = {8}, pages = {992-1007}, pmid = {34169495}, issn = {2567-689X}, mesh = {COVID-19/diagnosis/*epidemiology/*prevention &amp; control ; COVID-19 Testing/methods ; COVID-19 Vaccines/therapeutic use ; Disease Management ; Humans ; Immunization Programs/methods ; Pandemics/prevention &amp; control ; *Public Health/methods ; Risk Assessment ; SARS-CoV-2/isolation &amp; purification ; }, abstract = {BACKGROUND: One year after the declaration of the coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization (WHO) and despite the implementation of mandatory physical barriers and social distancing, humanity remains challenged by a long-lasting and devastating public health crisis.<br><br>MANAGEMENT: Non-pharmacological interventions (NPIs) are efficient mitigation strategies. The success of these NPIs is dependent on the approval and commitment of the population. The launch of a mass vaccination program in many countries in late December 2020 with mRNA vaccines, adenovirus-based vaccines, and inactivated virus vaccines has generated hope for the end of the pandemic.<br><br>CURRENT ISSUES: The continuous appearance of new pathogenic viral strains and the ability of vaccines to prevent infection and transmission raise important concerns as we try to achieve community immunity against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and its variants. The need of a second and even third generation of vaccines has already been acknowledged by the WHO and governments.<br><br>PERSPECTIVES: There is a critical and urgent need for a balanced and integrated strategy for the management of the COVID-19 outbreaks organized on three axes: (1) Prevention of the SARS-CoV-2 infection, (2) Detection and early diagnosis of patients at risk of disease worsening, and (3) Anticipation of medical care (PDA).<br><br>CONCLUSION: The "PDA strategy" integrated into state policy for the support and expansion of health systems and introduction of digital organizations (i.e., telemedicine, e-Health, artificial intelligence, and machine-learning technology) is of major importance for the preservation of citizens' health and life world-wide.}, }
@article {pmid33844056, year = {2021}, author = {Centonze, D and Rocca, MA and Gasperini, C and Kappos, L and Hartung, HP and Magyari, M and Oreja-Guevara, C and Trojano, M and Wiendl, H and Filippi, M}, title = {Disease-modifying therapies and SARS-CoV-2 vaccination in multiple sclerosis: an expert consensus.}, journal = {Journal of neurology}, volume = {268}, number = {11}, pages = {3961-3968}, pmid = {33844056}, issn = {1432-1459}, mesh = {*COVID-19 ; COVID-19 Vaccines ; Consensus ; Humans ; *Multiple Sclerosis/drug therapy ; SARS-CoV-2 ; Vaccination ; }, abstract = {Coronavirus disease (COVID-19) appeared in December 2019 in the Chinese city of Wuhan and has quickly become a global pandemic. The disease is caused by the severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), an RNA beta coronavirus phylogenetically similar to SARS coronavirus. To date, more than 132 million cases of COVID19 have been recorded in the world, of which over 2.8 million were fatal (https://coronavirus.jhu.edu/map.html). A huge vaccination campaign has started around the world since the end of 2020. The availability of vaccines has raised some concerns among neurologists regarding the safety and efficacy of vaccination in patients with multiple sclerosis (MS) taking immunomodulatory or immunosuppressive therapies.}, }
@article {pmid33766471, year = {2021}, author = {Guarracino, F and Shernan, SK and Tahan, ME and Bertini, P and Stone, ME and Kachulis, B and Paternoster, G and Mukherjee, C and Wouters, P and Rex, S}, title = {EACTA/SCA Recommendations for the Cardiac Anesthesia Management of Patients With Suspected or Confirmed COVID-19 Infection: An Expert Consensus From the European Association of Cardiothoracic Anesthesiology and Society of Cardiovascular Anesthesiologists With Endorsement From the Chinese Society of Cardiothoracic and Vascular Anesthesiology.}, journal = {Journal of cardiothoracic and vascular anesthesia}, volume = {35}, number = {7}, pages = {1953-1963}, pmid = {33766471}, issn = {1532-8422}, mesh = {*Anesthesia, Cardiac Procedures ; Anesthesiologists ; *Anesthesiology ; *COVID-19 ; China ; Consensus ; Humans ; Pandemics ; SARS-CoV-2 ; }, abstract = {The European Association of Cardiothoracic Anaesthesiology (EACTA) and the Society of Cardiovascular Anesthesiologists (SCA) aimed to create joint recommendations for the perioperative management of patients with suspected or proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection undergoing cardiac surgery or invasive cardiac procedures. To produce appropriate recommendations, the authors combined the evidence from the literature review, reevaluating the clinical experience of routine cardiac surgery in similar cases during the Middle East Respiratory Syndrome (MERS-CoV) outbreak and the current pandemic with suspected coronavirus disease 2019 (COVID-19) patients, and the expert opinions through broad discussions within the EACTA and SCA. The authors took into consideration the balance between established procedures and the feasibility during the present outbreak. The authors present an agreement between the European and US practices in managing patients during the COVID-19 pandemic. The recommendations take into consideration a broad spectrum of issues, with a focus on preoperative testing, safety concerns, overall approaches to general and specific aspects of preparation for anesthesia, airway management, transesophageal echocardiography, perioperative ventilation, coagulation, hemodynamic control, and postoperative care. As the COVID-19 pandemic is spreading, it will continue to present a challenge for the worldwide anesthesiology community. To allow these recommendations to be updated as long as possible, the authors provided weblinks to international public and academic sources providing timely updated data. This document should be the basis of future task forces to develop a more comprehensive consensus considering new evidence uncovered during the COVID-19 pandemic.}, }
@article {pmid33726819, year = {2021}, author = {Nasa, P and Azoulay, E and Khanna, AK and Jain, R and Gupta, S and Javeri, Y and Juneja, D and Rangappa, P and Sundararajan, K and Alhazzani, W and Antonelli, M and Arabi, YM and Bakker, J and Brochard, LJ and Deane, AM and Du, B and Einav, S and Esteban, A and Gajic, O and Galvagno, SM and Guérin, C and Jaber, S and Khilnani, GC and Koh, Y and Lascarrou, JB and Machado, FR and Malbrain, MLNG and Mancebo, J and McCurdy, MT and McGrath, BA and Mehta, S and Mekontso-Dessap, A and Mer, M and Nurok, M and Park, PK and Pelosi, P and Peter, JV and Phua, J and Pilcher, DV and Piquilloud, L and Schellongowski, P and Schultz, MJ and Shankar-Hari, M and Singh, S and Sorbello, M and Tiruvoipati, R and Udy, AA and Welte, T and Myatra, SN}, title = {Expert consensus statements for the management of COVID-19-related acute respiratory failure using a Delphi method.}, journal = {Critical care (London, England)}, volume = {25}, number = {1}, pages = {106}, pmid = {33726819}, issn = {1466-609X}, mesh = {COVID-19/*complications ; *Consensus ; *Delphi Technique ; Humans ; Respiratory Insufficiency/*therapy/*virology ; }, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented pressure on healthcare system globally. Lack of high-quality evidence on the respiratory management of COVID-19-related acute respiratory failure (C-ARF) has resulted in wide variation in clinical practice.<br><br>METHODS: Using a Delphi process, an international panel of 39 experts developed clinical practice statements on the respiratory management of C-ARF in areas where evidence is absent or limited. Agreement was defined as achieved when&#x2009;>&#x2009;70% experts voted for a given option on the Likert scale statement or&#x2009;>&#x2009;80% voted for a particular option in multiple-choice questions. Stability was assessed between the two concluding rounds for each statement, using the non-parametric Chi-square (&#x3c7;[2]) test (p&#x2009;<&#x2009;0&#xb7;05 was considered as unstable).<br><br>RESULTS: Agreement was achieved for 27 (73%) management strategies which were then used to develop expert clinical practice statements. Experts agreed that COVID-19-related acute respiratory distress syndrome (ARDS) is clinically similar to other forms of ARDS. The Delphi process yielded strong suggestions for use of systemic corticosteroids for critical COVID-19; awake self-proning to improve oxygenation and high flow nasal oxygen to potentially reduce tracheal intubation; non-invasive ventilation for patients with mixed hypoxemic-hypercapnic respiratory failure; tracheal intubation for poor mentation, hemodynamic instability or severe hypoxemia; closed suction systems; lung protective ventilation; prone ventilation (for 16-24&#xa0;h per day) to improve oxygenation; neuromuscular blocking agents for patient-ventilator dyssynchrony; avoiding delay in extubation for the risk of reintubation; and similar timing of tracheostomy as in non-COVID-19 patients. There was no agreement on positive end expiratory pressure titration or the choice of personal protective equipment.<br><br>CONCLUSION: Using a Delphi method, an agreement among experts was reached for 27 statements from which 20 expert clinical practice statements were derived on the respiratory management of C-ARF, addressing important decisions for patient management in areas where evidence is either absent or limited.<br><br>TRIAL REGISTRATION: The study was registered with Clinical trials.gov Identifier: NCT04534569.}, }
@article {pmid33349726, year = {2020}, author = {Palagini, L and Manni, R and Aguglia, E and Amore, M and Brugnoli, R and Girardi, P and Grassi, L and Mencacci, C and Plazzi, G and Minervino, A and Nobili, L and Biggio, G}, title = {[Evaluation and management of insomnia in clinical practice and in the time of CoViD-19 in Italy: expert consensus and task-force recommendations from five scientific societies].}, journal = {Rivista di psichiatria}, volume = {55}, number = {6}, pages = {337-341}, doi = {10.1708/3503.34891}, pmid = {33349726}, issn = {2038-2502}, mesh = {Aged ; Antidepressive Agents/therapeutic use ; COVID-19/complications/*epidemiology ; Cognitive Behavioral Therapy ; *Consensus ; *Epidemics ; GABA Agonists/therapeutic use ; Humans ; Hypnotics and Sedatives/therapeutic use ; Italy/epidemiology ; Middle Aged ; Receptors, Melatonin/agonists ; *SARS-CoV-2 ; Sleep Aids, Pharmaceutical/*therapeutic use ; Sleep Initiation and Maintenance Disorders/*drug therapy/etiology/therapy ; Societies, Scientific ; }, abstract = {Insomnia symptoms might affect about 60% of the Italian population. Insomnia is a "24 hours syndrome" and a risk factor for medical and mental disorders. It should always be assessed and treated in the clinical practice. Cognitive Behavioral Therapy for Insomnia is the first line treatment but its availability in Italy is scarce. Pharmacological options in Italy are: melatonin 2 mg prolonged release that should be the first choice in subjects ≥55 years old and used until 13 weeks; and for a short term use (≤4 weeks) Z-drugs or short-acting benzodiazepines (in subjects <65 years old) or a sedating antidepressant.}, }
@article {pmid33256990, year = {2021}, author = {Wei, H and Jiang, B and Behringer, EC and Hofmeyr, R and Myatra, SN and Wong, DT and Sullivan, EPO and Hagberg, CA and McGuire, B and Baker, PA and Li, J and Pylypenko, M and Ma, W and Zuo, M and Senturk, NM and Klein, U}, title = {Controversies in airway management of COVID-19 patients: updated information and international expert consensus recommendations.}, journal = {British journal of anaesthesia}, volume = {126}, number = {2}, pages = {361-366}, pmid = {33256990}, issn = {1471-6771}, support = {R01 AG061447/AG/NIA NIH HHS/United States ; }, mesh = {COVID-19/*transmission ; Consensus ; *Exhalation ; Humans ; Infectious Disease Transmission, Patient-to-Professional/*prevention &amp; control ; International Cooperation ; *Personal Protective Equipment ; Practice Guidelines as Topic/*standards ; SARS-CoV-2 ; }, }
@article {pmid33236964, year = {2021}, author = {Galpin, K and Sikka, N and King, SL and Horvath, KA and Shipman, SA and , }, title = {Expert Consensus: Telehealth Skills for Health Care Professionals.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {27}, number = {7}, pages = {820-824}, doi = {10.1089/tmj.2020.0420}, pmid = {33236964}, issn = {1556-3669}, mesh = {*COVID-19 ; Health Personnel ; Humans ; Pandemics ; SARS-CoV-2 ; *Telemedicine ; }, abstract = {Background: The COVID-19 pandemic has driven most clinicians, from those practicing in small independent practices to those in large system, to adopt virtual care. However, individuals and organizations may lack the experience and skills that would be considered fundamental prerequisites to adopting telehealth in less urgent times. What are those skills? Before the pandemic, the Association of American Medical Colleges (AAMC) convened national experts to identify and articulate a consensus set of critical telehealth skills for clinicians. Methods: Through a structured review of the literature, followed by several rounds of review and refinement by committee and community members via a modified Delphi process, the committee came to consensus on a set of skills required by clinicians to provide quality care via telehealth. Conclusion: The consensus set of telehealth skills presented in this paper, developed by the AAMC and national experts, can serve providers and health systems seeking to ensure that clinicians are prepared to meet the demand for care delivered via telehealth now and in the future.}, }
@article {pmid33138634, year = {2021}, author = {O' Neill, SB and Byrne, D and Müller, NL and Jalal, S and Parker, W and Nicolaou, S and Bilawich, AM}, title = {Radiological Society of North America (RSNA) Expert Consensus Statement Related to Chest CT Findings in COVID-19 Versus CO-RADS: Comparison of Reporting System Performance Among Chest Radiologists and End-User Preference.}, journal = {Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes}, volume = {72}, number = {4}, pages = {806-813}, doi = {10.1177/0846537120968919}, pmid = {33138634}, issn = {1488-2361}, mesh = {COVID-19/*diagnostic imaging ; Consensus ; Humans ; Lung/diagnostic imaging ; North America ; Observer Variation ; *Radiologists ; Radiology ; Radiology Information Systems/*statistics &amp; numerical data ; Reproducibility of Results ; Retrospective Studies ; SARS-CoV-2 ; Sensitivity and Specificity ; Societies, Medical ; Tomography, X-Ray Computed/*methods ; }, abstract = {PURPOSE: The RSNA expert consensus statement and CO-RADS reporting system assist radiologists in describing lung imaging findings in a standardized manner in patients under investigation for COVID-19 pneumonia and provide clarity in communication with other healthcare providers. We aim to compare diagnostic performance and inter-/intra-observer among chest radiologists in the interpretation of RSNA and CO-RADS reporting systems and assess clinician preference.<br><br>METHODS: Chest CT scans of 279 patients with suspected COVID-19 who underwent RT-PCR testing were retrospectively and independently examined by 3 chest radiologists who assigned interpretation according to the RSNA and CO-RADS reporting systems. Inter-/intra-observer analysis was performed. Diagnostic accuracy of both reporting systems was calculated. 60 clinicians participated in a survey to assess end-user preference of the reporting systems.<br><br>RESULTS: Both systems demonstrated almost perfect inter-observer agreement (Fleiss kappa 0.871, P < 0.0001 for RSNA; 0.876, P < 0.0001 for CO-RADS impressions). Intra-observer agreement between the 2 scoring systems using the equivalent categories was almost perfect (Fleiss kappa 0.90-0.92, P < 0.001). Positive predictive values were high, 0.798-0.818 for RSNA and 0.891-0.903 CO-RADS. Negative predictive value were similar, 0.573-0.585 for RSNA and 0.573-0.58 for CO-RADS. Specificity differed between the 2 systems, 68-73% for CO-RADS and 52-58% for RSNA with superior specificity of CO-RADS. Of 60 survey participants, the majority preferred the RSNA reporting system rather than CO-RADS for all options provided (66.7-76.7%; P < 0.05).<br><br>CONCLUSIONS: RSNA and CO-RADS reporting systems are consistent and reproducible with near perfect inter-/intra-observer agreement and excellent positive predictive value. End-users preferred the reporting language in the RSNA system.}, }
@article {pmid32745693, year = {2020}, author = {Curigliano, G and Banerjee, S and Cervantes, A and Garassino, MC and Garrido, P and Girard, N and Haanen, J and Jordan, K and Lordick, F and Machiels, JP and Michielin, O and Peters, S and Tabernero, J and Douillard, JY and Pentheroudakis, G and , }, title = {Managing cancer patients during the COVID-19 pandemic: an ESMO multidisciplinary expert consensus.}, journal = {Annals of oncology : official journal of the European Society for Medical Oncology}, volume = {31}, number = {10}, pages = {1320-1335}, pmid = {32745693}, issn = {1569-8041}, mesh = {Humans ; *Betacoronavirus ; *Consensus ; *Coronavirus Infections/epidemiology/immunology/therapy ; COVID-19 ; Disease Management ; Europe/epidemiology ; Granulocyte Colony-Stimulating Factor/pharmacology/therapeutic use ; *Medical Oncology/methods/standards ; *Neoplasms/epidemiology/immunology/therapy ; Pandemics/prevention &amp; control ; *Pneumonia, Viral/epidemiology/immunology/therapy ; Real-Time Polymerase Chain Reaction/methods/standards ; SARS-CoV-2 ; *Societies, Medical/standards ; T-Lymphocytes, Cytotoxic/drug effects/immunology ; Telemedicine/methods/standards ; }, abstract = {We established an international consortium to review and discuss relevant clinical evidence in order to develop expert consensus statements related to cancer management during the severe acute respiratory syndrome coronavirus 2-related disease (COVID-19) pandemic. The steering committee prepared 10 working packages addressing significant clinical questions from diagnosis to surgery. During a virtual consensus meeting of 62 global experts and one patient advocate, led by the European Society for Medical Oncology, statements were discussed, amended and voted upon. When consensus could not be reached, the panel revised statements until a consensus was reached. Overall, the expert panel agreed on 28 consensus statements that can be used to overcome many of the clinical and technical areas of uncertainty ranging from diagnosis to therapeutic planning and treatment during the COVID-19 pandemic.}, }
@article {pmid32599018, year = {2020}, author = {Singh, G and Nahirniak, S and Arora, R and Légaré, JF and Kanji, HD and Nagpal, D and Lamarche, Y and Fan, E and Singh Parhar, KK}, title = {Transfusion Thresholds for Adult Respiratory Extracorporeal Life Support: An Expert Consensus Document.}, journal = {The Canadian journal of cardiology}, volume = {36}, number = {9}, pages = {1550-1553}, pmid = {32599018}, issn = {1916-7075}, mesh = {Adult ; Anemia/blood/etiology/therapy ; *Anticoagulants/classification/therapeutic use ; Betacoronavirus ; Blood Coagulation Tests/methods ; Blood Component Transfusion/*methods ; COVID-19 ; Canada ; Consensus ; Coronavirus Infections/*complications ; *Extracorporeal Membrane Oxygenation/adverse effects/methods ; Humans ; Pandemics ; Pneumonia, Viral/*complications ; *Respiratory Distress Syndrome/blood/etiology/therapy ; SARS-CoV-2 ; Thrombosis/blood/etiology/prevention &amp; control ; }, abstract = {Severe acute respiratory distress syndrome (ARDS) can complicate novel pandemic coronavirus disease (COVID-19). Extracorporeal life support (ECLS) represents the final possible rescue strategy. Variations in practice, combined with a paucity of rigourous guidelines, may complicate blood-product resource availability and allocation during a pandemic. We conducted a literature review around venovenous extracorporeal membrane oxygenation (VV-ECMO) transfusion practices for platelets, packed red blood cells, fresh frozen plasma, prothrombin complex concentrate, and antithrombin. Pertinent society guidelines were examined, and the practice of Canadian ECLS experts was sampled through an environmental scan. This paper represents a synthesis of these explorations, combined with input from the Canadian Cardiovascular Critical Care (CANCARE) Society, Canadian Society of Cardiac Surgeons, and the Canadian Critical Care Society. We offer a pragmatic guidance document for restrictive transfusion thresholds in nonbleeding patients on VV-ECMO, which may attenuate transfusion-related complications and simultaneously shield national blood product inventory from strain during pandemic-induced activation of the National Plan for the Management of Shortages of Labile Blood Components.}, }
@article {pmid32587152, year = {2020}, author = {Manjandavida, FP and Honavar, SG and Kim, U and Singh, U and Menon, V and Das, S and Kaliki, S and Palanivelu, MS and Khetan, V and Shah, PK and Rishi, P and Mulay, K and Gandhi, A and Vadhiraja, BM and Reddy, VA and Bhat, S and Rao, V}, title = {Ocular oncology practice guidelines during COVID-19 pandemic-An expert consensus.}, journal = {Indian journal of ophthalmology}, volume = {68}, number = {7}, pages = {1281-1291}, pmid = {32587152}, issn = {1998-3689}, mesh = {*Betacoronavirus ; COVID-19 ; Consensus ; Coronavirus Infections/*epidemiology/transmission ; Disease Transmission, Infectious/*prevention &amp; control ; Eye Neoplasms/*therapy ; Humans ; Medical Oncology/*standards ; Ophthalmology/*standards ; *Pandemics ; Pneumonia, Viral/*epidemiology/transmission ; SARS-CoV-2 ; }, abstract = {The outbreak of rapidly spreading COVID-19 pandemic in December 2019 has witnessed a major transformation in the health care system worldwide. This has led to the re-organization of the specialty services for the effective utilization of available resources and ensuring the safety of patients and healthcare workers. Suspension of oncology services will have major implications on cancer care due to delayed diagnosis and treatment leading to irreversible adverse consequences. Therefore various oncology organizations have called for a continuation of cancer care during this crisis with diligence. The COVID-19 pandemic has forced the clinicians to transform the components of care from screening to outpatient care and primary management. The purpose of this article is to establish guidelines and recommendations for ocular oncology in the management of ocular tumors set by a multidisciplinary team of experts including ocular, medical and radiation oncologists, and pathologists. As the pandemic is evolving fast, it will require constant updates and reformation of health strategies and guidelines for safe and quality health care.}, }
@article {pmid32563593, year = {2020}, author = {Elledge, CR and Beriwal, S and Chargari, C and Chopra, S and Erickson, BA and Gaffney, DK and Jhingran, A and Klopp, AH and Small, W and Yashar, CM and Viswanathan, AN}, title = {Radiation therapy for gynecologic malignancies during the COVID-19 pandemic: International expert consensus recommendations.}, journal = {Gynecologic oncology}, volume = {158}, number = {2}, pages = {244-253}, pmid = {32563593}, issn = {1095-6859}, mesh = {Betacoronavirus/isolation &amp; purification ; COVID-19 ; Coronavirus Infections/epidemiology/*prevention &amp; control/transmission ; Female ; Genital Neoplasms, Female/*radiotherapy/*virology ; Humans ; Infection Control/methods/standards ; Pandemics/*prevention &amp; control ; Pneumonia, Viral/epidemiology/*prevention &amp; control/transmission ; Radiation Oncology/*methods/*standards ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To develop expert consensus recommendations regarding radiation therapy for gynecologic malignancies during the COVID-19 pandemic.<br><br>METHODS: An international committee of ten experts in gynecologic radiation oncology convened to provide consensus recommendations for patients with gynecologic malignancies referred for radiation therapy. Treatment priority groups were established. A review of the relevant literature was performed and different clinical scenarios were categorized into three priority groups. For each stage and clinical scenario in cervical, endometrial, vulvar, vaginal and ovarian cancer, specific recommendations regarding dose, technique, and timing were provided by the panel.<br><br>RESULTS: Expert review and discussion generated consensus recommendations to guide radiation oncologists treating gynecologic malignancies during the COVID-19 pandemic. Priority scales for cervical, endometrial, vulvar, vaginal, and ovarian cancers are presented. Both radical and palliative treatments are discussed. Management of COVID-19 positive patients is considered. Hypofractionated radiation therapy should be used when feasible and recommendations regarding radiation dose, timing, and technique have been provided for external beam and brachytherapy treatments. Concurrent chemotherapy may be limited in some countries, and consideration of radiation alone is recommended.<br><br>CONCLUSIONS: The expert consensus recommendations provide guidance for delivering radiation therapy during the COVID-19 pandemic. Specific recommendations have been provided for common clinical scenarios encountered in gynecologic radiation oncology with a focus on strategies to reduce patient and staff exposure to COVID-19.}, }
@article {pmid32521953, year = {2020}, author = {Lin, LJ and Zhu, L and Shi, GC and Wu, JQ and Li, HX and Sun, BJ and Lin, JT and Xu, ZJ and Sun, TY and Li, J and Yu, SY and Liu, XM and , }, title = {[Experts consensus for the diagnosis, treatment, and prevention of coronavirus disease 2019 in the elderly].}, journal = {Zhonghua nei ke za zhi}, volume = {59}, number = {8}, pages = {588-597}, doi = {10.3760/cma.j.cn112138-20200228-00151}, pmid = {32521953}, issn = {0578-1426}, support = {2020YFC2005400, 2020YFC2005401//National Key Research and Development Program of China/ ; }, mesh = {Aged ; *COVID-19 ; China ; Consensus ; Humans ; SARS-CoV-2 ; }, abstract = {Coronavirus disease 2019 (COVID-19) can cause great damage to the elderly patients and lead to high mortality. The clinical presentations and auxiliary examinations of the elderly patients with COVID-19 are atypical, due to the physiological ageing deterioration and basal pathological state. The treatment strategy for the elderly patients has its own characteristics and treatment protocol should be considered accordingly. To improve the diagnosis, treatment, and prevention of COVID-19 in the elderly, the Expert Committee of Geriatric Respiratory and Critical Care Medicine, China Society of Geriatrics established the "Expert consensus for the diagnosis, treatment, and prevention of coronavirus disease 2019 in the elderly" . We focused on the clinical characteristics and key points for better treatment and prevention of COVID-19 in the elderly. (1) For diagnosis, atypical clinical presentation of COVID-19 in the elderly should be emphasized, which may be complicated by underlying disease. (2) For treatment, strategy of multiple disciplinary team (mainly the respiratory and critical care medicine) should be adopted and multiple systemic functions should be considered. (3) For prevention, health care model about integrated management of acute and chronic diseases, in and out of hospital should be applied.}, }
@article {pmid32426890, year = {2020}, author = {Baracchini, C and Pieroni, A and Kneihsl, M and Azevedo, E and Diomedi, M and Pascazio, L and Wojczal, J and Lucas, C and Bartels, E and Bornstein, NM and Csiba, L and Valdueza, J and Tsivgoulis, G and Malojcic, B}, title = {Practice recommendations for neurovascular ultrasound investigations of acute stroke patients in the setting of the COVID-19 pandemic: an expert consensus from the European Society of Neurosonology and Cerebral Hemodynamics.}, journal = {European journal of neurology}, volume = {27}, number = {9}, pages = {1776-1780}, pmid = {32426890}, issn = {1468-1331}, mesh = {Brain/*diagnostic imaging ; *COVID-19 ; Consensus ; Hemodynamics ; Humans ; Ischemic Stroke/*diagnostic imaging ; Pandemics ; *Ultrasonography, Doppler, Transcranial ; }, abstract = {BACKGROUND AND PURPOSE: Patients with acute ischemic stroke are at high-risk for contracting COVID-19 infection. Additionally, healthcare professionals including neurovascular ultrasound providers are also at risk of being infected by SARS-CoV-2 virus. Yet, preparedness to continue to guarantee hyperacute treatment is vital for patients outcome. In light of this situation, the European Society of Neurosonology and Cerebral Hemodynamic (ESNCH) appointed a task force to provide consensus recommendations for the performance of neurovascular ultrasound investigations in acute ischemic stroke during the COVID-19 pandemic with the aim of protecting both patients and ultrasound providers.<br><br>METHODS: The "ultrasound in acute stroke working group" of the ESNCH examined literature articles and reviews using the following key words: "corona virus" or "COVID-19" or "SARS-CoV-2 virus", and "acute stroke" or "cerebrovascular disease", and "ultrasound". Thereafter, a thorough discussion was conducted with the "education and guidelines working group" of the ESNCH.<br><br>RESULTS: We propose rapid up-to-date recommendations for healthcare personnel involved in the pre-hospital and intra-hospital assessment of stroke patients, with a particular attention to neurovascular ultrasound performance.<br><br>CONCLUSION: The ESNCH provides a guidance summary for the performance of neurovascular ultrasound investigations in acute ischemic stroke in the time of COVID-19.}, }
@article {pmid32416154, year = {2020}, author = {Qiu, L and Morse, A and Di, W and Song, L and Kong, B and Wang, Z and Lang, J and Chai, W and Zhu, L and , }, title = {Management of gynecology patients during the coronavirus disease 2019 pandemic: Chinese expert consensus.}, journal = {American journal of obstetrics and gynecology}, volume = {223}, number = {1}, pages = {3-8}, pmid = {32416154}, issn = {1097-6868}, mesh = {Betacoronavirus ; COVID-19 ; China ; Clinical Trials as Topic ; Consensus ; Coronavirus Infections/diagnosis/*epidemiology ; Female ; Gynecologic Surgical Procedures ; Gynecology/*methods ; Hospitals ; Humans ; Infection Control ; Operating Rooms/standards ; Pandemics ; Pneumonia, Viral/diagnosis/*epidemiology ; Pregnancy ; SARS-CoV-2 ; }, abstract = {Since December 2019, the outbreak of novel coronavirus disease 2019 became a major epidemic threat in China and later spread worldwide. During the coronavirus disease 2019 outbreak in mainland China, the Chinese Obstetricians and Gynecologists Association distributed guidelines regarding the care of gynecologic patients. These guidelines were developed by the Department of Obstetrics and Gynecology at the Peking Union Medical College Hospital and represent an effort to integrate infection control strategy and promote professionalism in medical practice. The guidelines represent collaboration with experts from 31 provinces and autonomous regions of mainland China over 2 weeks' time. With the implementation of these guidelines, no nosocomial infections of coronavirus disease 2019 have been identified at the Peking Union Medical College Hospital. We think these guidelines might be helpful to departments of obstetrics and gynecology internationally during these unprecedented times. In our guidelines, we describe basic infection precaution principles, an epidemiologic screening tool, prioritization of surgical procedures, and operating room requirements. Using these principles, we then review the management of gynecologic patients during the coronavirus disease 2019 epidemic in the outpatient and operative and nonoperative inpatient settings and in clinical trials.}, }
@article {pmid32386011, year = {2020}, author = {Liu, J and Wang, W}, title = {Imaging examination, diagnosis, and control and prevention of nosocomial infection for coronavirus disease 2019: Expert consensus of Hunan radiologist.}, journal = {Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences}, volume = {45}, number = {3}, pages = {221-228}, doi = {10.11817/j.issn.1672-7347.2020.200081}, pmid = {32386011}, issn = {1672-7347}, mesh = {*Betacoronavirus ; COVID-19 ; Consensus ; Coronavirus Infections/*diagnostic imaging ; *Cross Infection ; Humans ; Pandemics ; Pneumonia, Viral/*diagnostic imaging ; Radiologists ; SARS-CoV-2 ; }, abstract = {The outbreak of coronavirus disease 2019 (COVID-19) is a huge threat to global public health because it develops rapidly. There is no specific treatment so far. Chest imaging examination is an important auxiliary examination method in diagnosis of COVID-19. To further standardize the imaging examination and diagnosis of COVID-19, Hunan Society of Radiology together with Imaging Technology Professional Committee of Hunan Medical Association reach an expert consensus document on imaging examination, diagnosis, and control and prevention of nosocomial infection for COVID-19. This document summarizes the epidemiological characteristics, clinical features, imaging examination procedure, imaging findings, CT staging, the value of imaging examination, and the methods for control and prevention of nosocomial infection for COVID-19 during imaging examination. Furthermore, it extends the clinical characteristics and imaging manifestations of COVID-19 in children.}, }
@article {pmid32385985, year = {2020}, author = {Chinese Research Hospital Association Of Critical Care Medicine,  and Youth Committee Of Chinese Research Hospital Association Of Critical Care Medicine, }, title = {[Chinese experts' consensus on diagnosis and treatment of severe and critical coronavirus disease 2019 (revised edition)].}, journal = {Zhonghua wei zhong bing ji jiu yi xue}, volume = {32}, number = {3}, pages = {269-274}, doi = {10.3760/cma.j.cn121430-20200218-00188}, pmid = {32385985}, issn = {2095-4352}, mesh = {Betacoronavirus ; COVID-19 ; China ; Consensus ; Coronavirus ; Coronavirus Infections/*diagnosis/therapy ; Humans ; Pandemics ; Pneumonia, Viral/*diagnosis/therapy ; SARS-CoV-2 ; }, abstract = {The outbreak of coronavirus disease 2019 (COVID-19) is serious and there is no effective treatment to date. In order to reduce the mortality of severe and critical COVID-19, experts from the first-line in related fields in China were organized to analyze, discuss and summarize the diagnosis and treatment of severe and critical COVID-19 patients in Wuhan and other severe epidemic areas, and formulate the expert consensus. The first edition was released on February 22, 2020, and the revised one on March 4, 2020.}, }
@article {pmid32324653, year = {2020}, author = {Simpson, S and Kay, FU and Abbara, S and Bhalla, S and Chung, JH and Chung, M and Henry, TS and Kanne, JP and Kligerman, S and Ko, JP and Litt, H}, title = {Radiological Society of North America Expert Consensus Statement on Reporting Chest CT Findings Related to COVID-19. Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA - Secondary Publication.}, journal = {Journal of thoracic imaging}, volume = {35}, number = {4}, pages = {219-227}, pmid = {32324653}, issn = {1536-0237}, mesh = {*Betacoronavirus ; COVID-19 ; Consensus ; Coronavirus Infections/*diagnostic imaging ; Humans ; Lung/*diagnostic imaging ; North America ; Pandemics ; Pneumonia, Viral/*diagnostic imaging ; Radiography, Thoracic/methods ; Radiologists ; SARS-CoV-2 ; Societies, Medical ; Tomography, X-Ray Computed/*methods ; United States ; }, abstract = {Routine screening CT for the identification of COVID-19 pneumonia is currently not recommended by most radiology societies. However, the number of CTs performed in persons under investigation (PUI) for COVID-19 has increased. We also anticipate that some patients will have incidentally detected findings that could be attributable to COVID-19 pneumonia, requiring radiologists to decide whether or not to mention COVID-19 specifically as a differential diagnostic possibility. We aim to provide guidance to radiologists in reporting CT findings potentially attributable to COVID-19 pneumonia, including standardized language to reduce reporting variability when addressing the possibility of COVID-19. When typical or indeterminate features of COVID-19 pneumonia are present in endemic areas as an incidental finding, we recommend contacting the referring providers to discuss the likelihood of viral infection. These incidental findings do not necessarily need to be reported as COVID-19 pneumonia. In this setting, using the term "viral pneumonia" can be a reasonable and inclusive alternative. However, if one opts to use the term "COVID-19" in the incidental setting, consider the provided standardized reporting language. In addition, practice patterns may vary, and this document is meant to serve as a guide. Consultation with clinical colleagues at each institution is suggested to establish a consensus reporting approach. The goal of this expert consensus is to help radiologists recognize findings of COVID-19 pneumonia and aid their communication with other healthcare providers, assisting management of patients during this pandemic.}, }
@article {pmid32270477, year = {2020}, author = {Ciavattini, A and Delli Carpini, G and Giannella, L and De Vincenzo, R and Frega, A and Cattani, P and Boselli, F and Sopracordevole, F and Barbero, M}, title = {Expert consensus from the Italian Society for Colposcopy and Cervico-Vaginal Pathology (SICPCV) for colposcopy and outpatient surgery of the lower genital tract during the COVID-19 pandemic.}, journal = {International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics}, volume = {149}, number = {3}, pages = {269-272}, pmid = {32270477}, issn = {1879-3479}, mesh = {Adult ; Ambulatory Surgical Procedures/*standards ; Biopsy ; COVID-19 ; Colposcopy/*standards ; Consensus ; *Coronavirus Infections/prevention &amp; control/transmission ; Disease Transmission, Infectious/*prevention &amp; control ; Female ; Genital Diseases, Female/diagnosis/pathology/*surgery ; Humans ; Infection Control/*standards ; Italy ; Mass Screening ; *Pandemics/prevention &amp; control ; *Pneumonia, Viral/prevention &amp; control/transmission ; Practice Guidelines as Topic ; Pregnancy ; Time Factors ; }, abstract = {In the context of the COVID-19 pandemic, patients need to be evaluated within 2-4 weeks in the following cases: cytology result of "squamous cell carcinoma," "atypical glandular cells, favor neoplastic," "endocervical adenocarcinoma in situ," or "adenocarcinoma"; histopathological diagnosis of suspected invasion from cervical/vaginal biopsy, or invasive disease after a cervical excision procedure, vaginal excision, or vulvar biopsy/excision; sudden onset of strongly suggestive symptoms for malignancy. Digital imaging technologies represent an important opportunity during the COVID-19 pandemic to share colposcopic images with reference centers, with the aim of avoiding any concentration of patients. All patients must undergo screening for COVID-19 exposure and should wear a surgical mask. A high-efficiency filter smoke evacuation system is mandatory to remove surgical smoke. Electrosurgical instruments should be set at the lowest possible power and not be used for long continuous periods to reduce the amount of surgical smoke. The following personal protective equipment should be used: sterile fluid-repellant surgical gloves, an underlying pair of gloves, eye protection, FFP3 mask, surgical cap, and gown. The colposcope should be protected by a disposable transparent cover. A protective lens that must be disinfected after each use should be applied. The use of a video colposcope should be preferred.}, }
@article {pmid32196655, year = {2020}, author = {Chen, D and Yang, H and Cao, Y and Cheng, W and Duan, T and Fan, C and Fan, S and Feng, L and Gao, Y and He, F and He, J and Hu, Y and Jiang, Y and Li, Y and Li, J and Li, X and Li, X and Lin, K and Liu, C and Liu, J and Liu, X and Pan, X and Pang, Q and Pu, M and Qi, H and Shi, C and Sun, Y and Sun, J and Wang, X and Wang, Y and Wang, Z and Wang, Z and Wang, C and Wu, S and Xin, H and Yan, J and Zhao, Y and Zheng, J and Zhou, Y and Zou, L and Zeng, Y and Zhang, Y and Guan, X}, title = {Expert consensus for managing pregnant women and neonates born to mothers with suspected or confirmed novel coronavirus (COVID-19) infection.}, journal = {International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics}, volume = {149}, number = {2}, pages = {130-136}, pmid = {32196655}, issn = {1879-3479}, mesh = {Betacoronavirus ; COVID-19 ; China ; Consensus ; Coronavirus Infections/*therapy/virology ; Delivery, Obstetric/methods ; Female ; Humans ; Infant, Newborn ; Infection Control/methods ; Infectious Disease Transmission, Vertical/*prevention &amp; control ; Pandemics ; Pneumonia, Viral/*therapy/virology ; Pregnancy ; Pregnancy Complications, Infectious/*therapy/virology ; Risk Factors ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To provide clinical management guidelines for novel coronavirus (COVID-19) in pregnancy.<br><br>METHODS: On February 5, 2020, a multidisciplinary teleconference comprising Chinese physicians and researchers was held and medical management strategies of COVID-19 infection in pregnancy were discussed.<br><br>RESULTS: Ten key recommendations were provided for the management of COVID-19 infections in pregnancy.<br><br>CONCLUSION: Currently, there is no clear evidence regarding optimal delivery timing, the safety of vaginal delivery, or whether cesarean delivery prevents vertical transmission at the time of delivery; therefore, route of delivery and delivery timing should be individualized based on obstetrical indications and maternal-fetal status.}, }
@article {pmid32164088, year = {2020}, author = {, }, title = {[Expert consensus for bronchoscopy during the epidemic of 2019 novel coronavirus infection (Trial version)].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {43}, number = {3}, pages = {199-202}, doi = {10.3760/cma.j.issn.1001-0939.2020.03.012}, pmid = {32164088}, issn = {1001-0939}, mesh = {*Betacoronavirus/pathogenicity ; Bronchoscopy/*methods/standards ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Consensus ; Coronavirus Infections/*diagnosis/transmission ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention &amp; control ; Pneumonia, Viral/*diagnosis/transmission ; Practice Guidelines as Topic ; SARS-CoV-2 ; }, abstract = {Infection with 2019 Novel Coronavirus (2019-nCoV) is mainly transmitted by respiratory droplets, airborne transmission and direct contact. However, conducting bronchoscopy on patients with 2019-nCoV is a high-risk procedure in which health care workers are directly exposed to the virus, and the protection and operation procedures need to be strictly regulated. According to the characteristics of bronchoscopy, it is necessary to formulate the procedure, requirements and precautions when conducting bronchoscopy in the current epidemic situation. Relevant standards for preventing from infections should be strictly implemented in the operation of bronchoscopy. It needs to emphasize that bronchoscopy should not be used as a routine means for the diagnosis of 2019-nCoV infection sampling. The indications for bronchoscopy for other diseases should be strictly mastered, and it is suggested that bronchoscopy should be postponed for those patients who is not in urgent situation.}, }
@article {pmid41480252, year = {2025}, author = {Salas, RL and la Asunción, M and Vásquez-Soto, C and Orta-Visbal, K and Serrano, V and Villarreal, E and Sepúlveda, S and Montalvo, MJ and Nuñez, JA and Borja, J}, title = {Scoping review of the emerging definition of long COVID: implications for future research and clinical practice.}, journal = {Revista de salud publica (Bogota, Colombia)}, volume = {27}, number = {6}, pages = {122127}, pmid = {41480252}, issn = {2539-3596}, mesh = {Humans ; *COVID-19/complications/diagnosis ; *Terminology as Topic ; Biomedical Research ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long COVID, Post-COVID19 syndrome and prolonged COVID-19, are concepts classified as the set of signs and symptoms that persist after an acute episode of COVID-19 disease.<br><br>OBJECTIVE: To describe what definitions have been published for the term "long COVID".<br><br>METHODS: The PRISMA ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) was used as a base for a scoping review, as suggested by Joanna Briggs Institute. A search of databases, Medline via PubMed, Embase, SciELO and The Cochrane Library was undertaken. The data registry and synthesis of the results was carried out independently by two reviewers.<br><br>RESULTS: Following removal of duplicates, 896 articles were retrieved of which 91 met the eligibility principles and 51 of which included a definition. At least four characteristics of the definitions were identified: time or term, organs affected, symptoms and clinical manifestations.<br><br>CONCLUSIONS: The review identified many concepts and definitions of "long COVID". These findings show that there is lack of consensus on the definition of long COVID-19.}, }
@article {pmid41479924, year = {2025}, author = {Wan, X and Wang, X and Liu, Y and Hong, L and Zhao, Z and Guo, P}, title = {Ferroptosis in human reproductive tract infections and associated disorders: mechanisms and emerging therapeutic opportunities.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1713074}, pmid = {41479924}, issn = {1664-3224}, mesh = {Humans ; *Ferroptosis/immunology ; *Reproductive Tract Infections/immunology/metabolism/pathology ; Female ; Iron/metabolism ; COVID-19 ; Animals ; SARS-CoV-2 ; Male ; }, abstract = {Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, is closely associated with mitochondrial damage, diminished glutathione peroxidase 4 activity, dysfunction of the System Xc[-] cystine/glutamate antiporter, and disruptions in iron metabolism. Infections of the human reproductive system and associated reproductive disorders pose a significant global public health challenge, characterized by diverse pathogens and complex pathogenic mechanisms. Recent research has revealed that ferroptosis plays a critical role in the pathological processes of many of these infections. This review systematically elaborates on the central mechanistic role of ferroptosis in various pathologies of the reproductive system. These include CD4[+] T cell depletion and immunological non-response in Human Immunodeficiency Virus (HIV) infection, the development of Human Papillomavirus (HPV)-associated cervical cancer, Staphylococcus aureus-induced endometritis and mastitis, as well as male infertility, pre-eclampsia, and ovarian cancer linked to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Despite the diversity of the pathogens, they can all trigger ferroptosis through common mechanisms, such as disrupting the Nrf2/GPX4 antioxidant axis, impairing the System Xc[-]-GSH-GPX4 pathway, and inducing dysregulation of iron metabolism. Furthermore, ferroptosis interacts intricately with pyroptosis and apoptosis, forming a complex network that collectively regulates the outcome of infections and the extent of tissue damage. Notably, ferroptosis plays a context-dependent dual role in various reproductive system infections. During the initial phases of infection, it exerts a protective effect by eliminating pathogens and curbing infection progression. In contrast, during advanced or chronic stages, ferroptosis exacerbates tissue injury and promotes disease pathogenesis. The ferroptosis pathway holds great therapeutic promise, either through inhibitors that safeguard host cells or inducers that eradicate drug-resistant bacteria by triggering a "ferroptosis-like" state. Nevertheless, challenges remain for clinical translation, as the ferroptosis network is incompletely understood, and the tissue selectivity and long-term safety of targeted drugs are unverified. Future studies must elucidate host-pathogen interactions to develop precise targeted therapies.}, }
@article {pmid41479918, year = {2025}, author = {Dhar, R and Singh, S and Sahoo, OS and Chandra, N and Gul, A and Mukherjee, I and Karmakar, S and Amanullah, M and Karmakar, S}, title = {The placental battlefield: viral strategies and immune countermeasures.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1667601}, pmid = {41479918}, issn = {1664-3224}, mesh = {Humans ; Pregnancy ; Female ; *Placenta/immunology/virology ; *Pregnancy Complications, Infectious/immunology/virology ; SARS-CoV-2/immunology ; *COVID-19/immunology/transmission/virology ; *Virus Diseases/immunology/transmission/virology ; Zika Virus Infection/immunology/transmission ; Zika Virus/immunology ; Animals ; Infectious Disease Transmission, Vertical ; }, abstract = {The placenta plays an essential role in connecting the maternal and fetal environments. It acts as both a protective barrier and a selective transport system during pregnancy. Despite its importance, we still do not fully understand how the placenta responds to viral infections, leaving a notable gap in maternal-fetal medicine. This review looks at how viral pathogens interact with placental tissue. It explores how viruses are transmitted, how the placenta's immune system responds, and how infections affect pregnancy outcomes. We examined recent findings on how viruses can penetrate placental barriers, the molecular processes that lead to placental damage, and the long-term effects on fetal development. We gathered evidence from SARS-CoV-2, Zika virus, cytomegalovirus, and other viral infections to highlight common pathways and point out possible treatment targets. As new viral threats continue to challenge healthcare systems worldwide, understanding placental virology is crucial for safeguarding both maternal and fetal health. This review outlines potential future research paths and emphasizes the urgent need for placenta-specific antiviral strategies as new infectious diseases emerge.}, }
@article {pmid41479106, year = {2026}, author = {Karageorgou, E and Adam, S and Doukakis, S and Vlamos, P}, title = {Digital Accessibility for Students with Disabilities and Inclusive Learning in Education.}, journal = {Advances in experimental medicine and biology}, volume = {1490}, number = {}, pages = {417-424}, pmid = {41479106}, issn = {0065-2598}, mesh = {Humans ; *Persons with Disabilities/education ; *COVID-19/epidemiology ; *Students ; SARS-CoV-2 ; Artificial Intelligence ; *Learning ; *Education, Distance ; }, abstract = {The rapid advancement of digital technologies has reshaped education, yet significant barriers persist in ensuring equitable access for students with disabilities. Digital accessibility in education extends beyond technological solutions, requiring institutional commitment, policy reform, and faculty preparedness. This study examines the challenges and opportunities associated with digital accessibility in higher education and workplace inclusion, emphasizing systemic barriers such as inadequate assistive technologies, inaccessible Learning Management Systems (LMSs), and insufficient faculty training. The findings highlight the transformative potential of adaptive learning strategies, including artificial intelligence (AI), extended reality (XR), and human-computer interaction (HCI), in fostering personalized and inclusive learning environments. However, ethical concerns, algorithmic biases, and inconsistent implementation pose substantial obstacles to their effectiveness. The COVID-19 pandemic further exposed critical shortcomings in digital accessibility policies, disproportionately affecting students and employees with disabilities and underscoring the need for inclusive digital literacy initiatives. Addressing these challenges necessitates a holistic approach that integrates universal design principles, strengthens faculty training programs, and fosters interdisciplinary collaboration between educators, policymakers, and technologists. Through this review, sustained investment in assistive technologies is advocated, along with regulatory frameworks mandating digital inclusivity, and the development of digital learning ecosystems. By embedding accessibility as a fundamental component of educational and employment policies, institutions can mitigate the digital divide and advance equitable opportunities for all learners.}, }
@article {pmid41479104, year = {2026}, author = {Karageorgou, E and Adam, S and Doukakis, S and Vlamos, P}, title = {Data-Driven Precision Learning: Transforming Adult Education with AI and Analytics.}, journal = {Advances in experimental medicine and biology}, volume = {1490}, number = {}, pages = {399-407}, pmid = {41479104}, issn = {0065-2598}, mesh = {Humans ; *Artificial Intelligence ; *COVID-19/epidemiology ; Adult ; SARS-CoV-2 ; *Education, Distance/methods ; Greece/epidemiology ; *Learning ; Data Mining ; Pandemics ; }, abstract = {Lifelong learning has become essential in modern society, driven by technological advancements and the increasing demand for continuous skill development. E-learning platforms have transformed education by enhancing accessibility, flexibility, and personalization. Artificial intelligence (AI) and data-driven technologies further refine these platforms, enabling adaptive learning, real-time feedback, and predictive analytics to improve engagement and outcomes. The COVID-19 pandemic accelerated the adoption of e-learning, shifting it from a supplementary tool to a primary mode of education.This study examines the impact of e-learning on adult education, focusing on AI-driven personalization and data analytics. In Greece, national and European policies have facilitated digital education, yet challenges such as infrastructure limitations and digital inequalities persist. Additionally, data mining in e-learning environments has the potential to optimize instructional methods and predict learning outcomes. A proposed framework for precision education integrates multimodal data sources, including biometric indicators, to enhance individualized learning experiences.While AI-powered e-learning systems offer transformative opportunities, ethical concerns surrounding data privacy and equitable access must be addressed. Ensuring responsible data management and inclusive policies will be crucial in maintaining the effectiveness of digital education and fostering lifelong learning in an increasingly technology-driven world.}, }
@article {pmid41477779, year = {2025}, author = {Vildanov, TR and Lukyanov, NG and Kozlov, KL and Vlasenko, SV and Shcherbak, SG and Vorobyovsky, DA}, title = {[Complexities of myocardial revascularization in patients over 75 years with acute coronary syndrome.].}, journal = {Advances in gerontology = Uspekhi gerontologii}, volume = {38}, number = {4}, pages = {546-552}, pmid = {41477779}, issn = {1561-9125}, mesh = {Humans ; *Acute Coronary Syndrome/surgery/diagnosis ; *Myocardial Revascularization/methods ; Aged ; *COVID-19/epidemiology ; Aged, 80 and over ; Geriatric Assessment/methods ; Prognosis ; SARS-CoV-2 ; }, abstract = {Acute myocardial infarction is the leading cause of hospitalization and mortality in elderly patients. The objective of this review is to demonstrate the importance of a comprehensive geriatric examination in cardiology, a balanced approach to choosing a myocardial revascularization method and postoperative patient management. The results of modern studies in emergency cardiology practice were studied and analyzed in such electronic bibliographic databases as Web of Science, Scopus, PubMed, Elibrary. This review presents known surgical strategies for myocardial revascularization, therapeutic options for postoperative management, the impact of geriatric syndromes and COVID-19 on the prognosis and outcome of the disease, clinical and angiographic difficulties in managing elderly patients with myocardial infarction.}, }
@article {pmid41316355, year = {2025}, author = {Chandrasekaran, S and Kamboj, M and Baddepudi, S and Raj, R and Suresh, C and Sanker, V and Dave, T and Wijenaike, N}, title = {Unraveling COVID-19-vaccination-induced bullous pemphigoid: a case report and review of the literature.}, journal = {Journal of medical case reports}, volume = {20}, number = {1}, pages = {1}, pmid = {41316355}, issn = {1752-1947}, mesh = {Humans ; *Pemphigoid, Bullous/chemically induced/etiology/drug therapy/diagnosis ; Male ; Aged, 80 and over ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/adverse effects ; SARS-CoV-2 ; BNT162 Vaccine/adverse effects ; Vaccination/adverse effects ; Diabetes Mellitus, Type 2/complications ; }, abstract = {BACKGROUND: Coronavirus disease 2019 vaccines have been instrumental in combating the global pandemic, yet their potential side effects, including autoimmune conditions such as bullous pemphigoid, remain an area of concern. This case highlights the development of bullous pemphigoid following coronavirus disease 2019 vaccination and includes a comprehensive review of similar cases reported in the literature, emphasizing its novelty and clinical significance.<br><br>CASE PRESENTATION: An elderly British man in his 80s with type 2 diabetes mellitus developed blistering lesions 21&#xa0;days after receiving his third dose of coronavirus disease 2019 vaccine (Moderna). Clinical examination revealed erythematous plaques and bullae on the trunk and limbs. Histopathological evaluation and immunofluorescence confirmed the diagnosis of bullous pemphigoid. Treatment included corticosteroids, doxycycline, and immunosuppressants. Despite initial improvement, a severe flare-up necessitated hospitalization and wound care management. A systematic review identified 50 reported cases of bullous pemphigoid linked to coronavirus disease 2019 vaccination, with the Pfizer-BioNTech vaccine implicated in most cases (64%), followed by Moderna (18%). Symptom onset typically occurred after the first dose in 52% of cases.<br><br>CONCLUSION: This case underscores the need for vigilance regarding autoimmune phenomena such as bullous pemphigoid following coronavirus disease 2019 vaccination. Awareness of such potential adverse effects is crucial to ensure timely diagnosis and management, ultimately contributing to patient safety and guiding future vaccine development.}, }
@article {pmid41477135, year = {2025}, author = {Syamal, M}, title = {The Effects of COVID-19 on Voice.}, journal = {World journal of otorhinolaryngology - head and neck surgery}, volume = {11}, number = {4}, pages = {524-529}, pmid = {41477135}, issn = {2589-1081}, abstract = {The COVID-19 pandemic had profound effects on vocal health, impacting both infected individuals, professional voice users and essential workers. The objective of this paper was to explore the multifaceted nature of dysphonia associated with COVID-19, arising from both direct and indirect consequences of the pandemic. Prevalence rates of dysphonia among COVID-19 patients range widely from 25% to 79%, with significant underreporting. Factors contributing to voice changes include laryngeal inflammation, respiratory function impairment, treatment-related interventions, and increased vocal strain from masking and virtual communication. Professional voice users, such as teachers and singers, experienced unique challenges, including increased voice fatigue and apprehension regarding aerosol transmission during singing. For the voice clinician, videolaryngoscopic examination remains the critical tool for capturing the broad landscape of diagnoses that can range from inflammation to surgically emergent airway stenoses. Innovations with voice also emerged, utilizing artificial intelligence voice analysis for COVID-19 detection. Overall, understanding the relationship between COVID-19 and voice health is crucial for appropriate diagnosis and treatment of dysphonic patients. Continued research is necessary to further delineate the long-term implications and optimal treatment approaches for those affected.}, }
@article {pmid41476991, year = {2025}, author = {Asadikaram, M and Bahrampour, S and Rahimi Naiini, M and Jafarzadeh, A and Rosen, C and Asadikaram, G}, title = {Prolactin: A Key Immunoregulator in Viral Infections and Autoimmune Diseases.}, journal = {International journal of endocrinology}, volume = {2025}, number = {}, pages = {2312675}, pmid = {41476991}, issn = {1687-8337}, abstract = {Prolactin (PRL) is secreted by various cells in the anterior pituitary gland, mammary glands, placenta, uterus, ovaries, testes, skin, adipose tissue, endothelial cells, immune system, and central nervous system. The expression and secretion of PRL are influenced by several factors such as suckling, thyrotropin-releasing hormone (TRH), cytokines, dopamine, estrogen, and vasoactive intestinal polypeptide. It operates through a complex receptor, which is expressed in mammary gland cells, pancreatic beta cells, adipocytes, and immune cells. PRL is essential for various physiological functions, in particular milk production, breast development, metabolism, and immune regulation. Serum PRL levels fluctuate daily and can be affected by exercise, diet, and stress. Hyperprolactinemia is linked to autoimmune diseases and viral infections. In viral infections such as HIV, HCMV, HCV, and COVID-19, PRL levels are often increased, which may influence the immune responses. PRL can modulate the activity of various immune cells, including T cells, B cells, natural killer cells, and macrophages, mounting an effective immune response against viral infections. Moreover, PRL influences the production of cytokines that mediate and regulate immunity and inflammation. PRL stimulates B cells to produce antivirus antibodies that are essential for neutralizing viruses and preventing their spread within the body. PRL levels, varying by sex and life stage, may affect immune responses and susceptibility to viral infections. Moreover, overexpression of PRL was indicated in various autoimmune diseases. Overall, PRL is a complex hormone with significant implications for endocrine function, immune regulation, and immune responses to viral infections, highlighting the need for further research into its diverse roles in health and disease. This review summarizes current knowledge of the immunomodulatory effects of PRL in human viral infections and possibly its contribution to the development of autoimmune diseases.}, }
@article {pmid41476798, year = {2025}, author = {Wang, L and Zhang, H and Jiang, H}, title = {Phosphorylation Modifications and Their Role in Viral Pneumonia: Mechanisms and Therapeutic Implications.}, journal = {Infection and drug resistance}, volume = {18}, number = {}, pages = {6915-6933}, pmid = {41476798}, issn = {1178-6973}, abstract = {Advances in diagnostic technologies have led to the identification of an increasing number of viruses associated with pneumonia, thereby drawing significant attention to viral pneumonia. The primary viral pathogens implicated in pneumonia include influenza virus, respiratory syncytial virus, coronavirus, adenovirus, parainfluenza virus, human metapneumovirus, and enterovirus. Post-translational modifications, especially phosphorylation, are pivotal in the lifecycle of these viruses. Phosphorylation affects key processes such as viral replication, transcription, assembly, and release, thereby influencing their propagation in host cells. Viral infection can also trigger kinase-associated pathways within host cells, activating host cell phosphatases and related signaling cascades. This results in alterations to host phosphorylation states, aggravating cellular pathology and facilitating viral proliferation. This review examines the common viral pathogens involved in pneumonia and highlights the role of phosphorylation in viral proliferation. Additionally, we explore the potential of phosphorylation inhibitors in controlling viral infections, with the aim of advancing our understanding of viral phosphorylation and promoting the use of these inhibitors in the treatment of viral pneumonia.}, }
@article {pmid41476768, year = {2025}, author = {Dommer, AC and Amaro, RE and Prather, KA}, title = {Understanding Aerosol-Mediated Disease Transmission.}, journal = {ACS central science}, volume = {11}, number = {12}, pages = {2319-2328}, pmid = {41476768}, issn = {2374-7943}, abstract = {This Outlook aims to update the longstanding treatment of airborne disease transmission through an interdisciplinary lens combining biology, surface chemistry, and aerosol physics, drawing parallels between environmental and human-generated infectious aerosols and examining their effects on human and ecosystem health. By recasting the lung surface as a dynamic interface akin to the ocean surface, this Outlook illustrates the importance of a multidisciplinary approach to elucidate the mechanisms of disease transmission at a depth that enables practical mitigation strategies. The urgency of this analysis is motivated by the evolving nature of airborne pathogens of concern, such as SARS-CoV-2 and influenza, and the global impact of dynamic environments on the poorly understood airborne microbiome.}, }
@article {pmid41476648, year = {2025}, author = {Li, Q and Xing, H and Naeem, A and Zhang, K and Zheng, A and Huang, Y and Lu, M}, title = {Extracellular Vesicle-Based mRNA Therapeutics and Vaccines.}, journal = {Exploration (Beijing, China)}, volume = {5}, number = {6}, pages = {20240109}, pmid = {41476648}, issn = {2766-2098}, abstract = {Messenger RNA (mRNA) therapeutics and vaccines have recently gained particular prominence following the COVID-19 epidemic. However, clinical translation of mRNAs is critically dependent on efficient and safe delivery in vivo. Currently, a plethora of mRNA delivery technology platforms (such as lipid nanoparticles) have been developed and have achieved stunning success. Nevertheless, many challenges remain to be overcome, including immunogenicity and toxicities, excessive liver accumulation, limited endosomal escape ability, low tissue bioavailability, poor mucosal immunity, and the need for cold chain storage. In recent years, extracellular vesicles (EVs) have emerged as an attractive mRNA delivery platform due to their favorable properties, such as low immunogenicity, natural capability to deliver RNAs, intrinsic targeting capacity, and the ability to negotiate with physiological barriers. In this review, we discuss the latest efforts to harness EVs for mRNA delivery and elaborate the behind mechanisms, aiming to offering insights into the rational design of effective and safe EV-based mRNA therapeutics and vaccines for biomedical applications. Additionally, we provide an overview of EV biogenesis, composition, cellular internalization, and their superiorities and challenges for mRNA delivery, with special emphasis on the state-of-the-art methodologies for packaging EVs with mRNAs.}, }
@article {pmid41476373, year = {2025}, author = {Joshi, R and Sharma, S and Kapoor, DU and Prajapati, BG and Huanbutta, K and Sriamornsak, P}, title = {mRNA-Based Therapeutics: Advances in Drug Delivery, Comparative Innovations, and Biomedical Applications.}, journal = {Molecular pharmaceutics}, volume = {}, number = {}, pages = {}, doi = {10.1021/acs.molpharmaceut.5c00774}, pmid = {41476373}, issn = {1543-8392}, abstract = {mRNA-based therapeutics represent a major advancement in modern medicine, offering programmable and nonintegrating treatment options for infectious diseases, malignancies, and hereditary disorders. This review addresses the chronological evolution, structural optimization, and delivery challenges of mRNA drugs, highlighting developments such as nucleoside modifications and lipid nanoparticle (LNP) platforms that improve the stability and promote cellular entry. Comparative analysis highlights the benefits of mRNA over DNA-, siRNA-, and protein-based medicine in safety, scalability, and rapid rearrangement. Applications vary from COVID-19 vaccines to individualized cancer immunotherapy and protein replacement strategies. New methods, including self-amplifying mRNA (saRNA), CRISPR-Cas9 gene editing, and tissue-specific delivery systems, enhance the therapeutic potential. While mRNA technology faces challenges in terms of immunogenicity, multiple dosing, and durability of safety considerations, it offers unparalleled precision, transient expression, and swift manufacturability. This review emphasizes the comparative design principles of mRNA delivery systems, bridging formulation innovation with translational biomedical applications. By integrating lipid-based and nonlipid nanocarrier insights, it highlights critical advances shaping next-generation mRNA therapeutics.}, }
@article {pmid41476292, year = {2025}, author = {Sasikumar, S and Patidar, S}, title = {Progressive fibrotic interstitial lung diseases in India: national challenges and implications for global health policies.}, journal = {Health research policy and systems}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12961-025-01425-6}, pmid = {41476292}, issn = {1478-4505}, abstract = {BACKGROUND: Interstitial lung diseases (ILDs) constitute a heterogeneous group of diffuse parenchymal lung disorders characterized by varying degrees of inflammation and fibrosis. Global estimates indicate that the incidence of ILDs has risen by over 50% in the recent years. In India, epidemiological data remain limited and inconsistent due to heterogeneity in diagnostic criteria and regional disparities, impeding accurate burden estimation and policy prioritization.<br><br>MAIN TEXT: Among ILDs, progressive fibrotic forms, idiopathic pulmonary fibrosis (IPF) in particular, cause substantial morbidity and mortality. Many ILDs progress to irreversible fibrosis, leading to declining lung function, impaired quality of life and shortened survival. Timely and precise diagnosis of progressive fibrotic (PF)-ILDs is imperative to facilitate early therapeutic intervention and potentially slow down fibrotic progression. Diagnostic evaluation necessitates high-resolution computed tomography, histopathological examination and multidisciplinary team consensus, all of which&#xa0;are often unavailable or prohibitively expensive outside tertiary care centres in India. Therapeutic options are confined primarily to two antifibrotic agents approved for IPF, which modestly attenuate disease progression but do not significantly improve survival in patients. Access to these therapies is limited by cost, lack of proper insurance coverage and non-uniform healthcare infrastructure. Clinical presentation is often delayed owing to low disease awareness and referral gaps. Although, pulmonary fibrosis following novel coronavirus disease 2019 has attracted recent attention, it constitutes a minor fraction of the PF-ILD burden. Despite the high morbidity and mortality associated with PF-ILDs, these conditions are inadequately represented in India's health policy instruments, research agendas and funding priorities.<br><br>CONCLUSIONS: The burden of PF-ILDs in India demands an urgent policy response, which involves integrating ILDs into national non-communicable disease frameworks, expanding diagnostic capacity in secondary care, improving affordability and access to antifibrotic drugs and supporting multicentre registries for surveillance and research. Addressing these gaps could reduce disease impact domestically and provide a model for other low- and middle-income countries confronting similar challenges in tackling fibrotic lung diseases.}, }
@article {pmid41475153, year = {2025}, author = {Daniel, N and Smith, C and Miah, N and Akroyd, C and Bingham, T and Brooks, H and Chowdhury, MA and Kaur, G and Kundra, R and Prendergast, M and Chantkowski, M and Galiza, E and Nakafero, G and Milton, C and Mejia, M and Murphy, D and Ramanan, A and Rex, D and Wilkinson, S and Owera, S and Khunti, K and Faust, SN and Ramasamy, MN and , }, title = {Enablers and barriers to participation in vaccine trials: a narrative synthesis.}, journal = {Vaccine}, volume = {73}, number = {}, pages = {128183}, doi = {10.1016/j.vaccine.2025.128183}, pmid = {41475153}, issn = {1873-2518}, abstract = {OBJECTIVE: To synthesise evidence on barriers and enablers to participation in vaccine clinical trials (2010-2024), with a focus on underserved populations, to support the design of more inclusive vaccine trials.<br><br>MATERIALS AND METHODS: A rapid narrative review was conducted using PubMed, identifying 145 peer-reviewed studies published between 2010 and 2024. Data extraction captured study design, participant population, and factors influencing trial enrolment. Findings were thematically analysed, with subgroup synthesis for underserved populations, including pregnant individuals, parents, ethnic minority groups, and LGBTQ+ communities.<br><br>RESULTS: Analysis of the 145 included studies identified five themes for enablers and four themes for barriers. Safety concerns were the most frequent deterrent, particularly for proxy decision-makers such as parents and pregnant participants. Institutional mistrust and misinformation were consistent barriers, with the COVID-19 pandemic heightening distrust of governments and pharmaceutical companies and amplifying misinformation through social media. Additional barriers included sociocultural expectations and logistical burdens, particularly in low-resource settings. Enrolment was enabled by altruistic motivations, perceived personal or community benefit, transparent safety communication, logistical ease, and community engagement. Community-led engagement, culturally concordant staff, and proportionate incentives were consistently associated with improved enrolment.<br><br>CONCLUSIONS: Vaccine trial participation is shaped by a dynamic risk-benefit calculus that manifests differently across populations. Addressing inequities requires sustained community partnerships, culturally competent trial design, proportionate material support, and proactive communication strategies to counter misinformation. These findings provide actionable guidance for designing more inclusive vaccine trials.}, }
@article {pmid41474629, year = {2026}, author = {Nikanjam, M and Kato, S and Nishizaki, D and Miyashita, H and Pabla, S and Nesline, MK and Ko, H and Conroy, JM and Naing, A and Kurzrock, R}, title = {Inducible T-Cell Co-Stimulator (ICOS) and ICOS Ligand: Dealing With a Two-Faced Cancer Immunoregulatory System.}, journal = {Cancer medicine}, volume = {15}, number = {1}, pages = {e71467}, pmid = {41474629}, issn = {2045-7634}, support = {5U01CA180888-08/NH/NIH HHS/United States ; 5UG1CA233198-05/NH/NIH HHS/United States ; }, mesh = {Humans ; *Inducible T-Cell Co-Stimulator Protein/metabolism/antagonists &amp; inhibitors/immunology ; *Inducible T-Cell Co-Stimulator Ligand/metabolism/immunology/antagonists &amp; inhibitors ; *Neoplasms/immunology/drug therapy/metabolism ; Signal Transduction ; Animals ; }, abstract = {BACKGROUND: ICOS (inducible T-cell co-stimulator) and ICOS ligand (ICOSL) are part of an important, complex pathway that can lead to both immune stimulation and suppression. ICOS and ICOSL have heterogeneous expression patterns between and within tumor types.<br><br>METHODS: This review provides an overview of ICOS and ICOSL, their mechanisms of action, expression in cancer and other diseases, and clinical trials exploring therapies targeting ICOS.<br><br>RESULTS: Because of the bidirectional immune impact of the ICOS/ICOSL signaling pathway, both ICOS agonists and antagonists are under development and evaluation in clinical trials. The majority of clinical trials have focused on the development of ICOS agonists, with only one study exploring an ICOS antagonist; there have been no clinical trials developing ICOSL agonists or antagonists in oncology. ICOS can be expressed on immune-activating effector T-cell and immunosuppressive regulatory T-cell (Tregs). Thus, it is critical to determine where and how ICOS is expressed in order to evaluate the role for agonists versus antagonists. To date, ICOS agonists have shown limited activity in patients with malignancies, perhaps because of the lack of biomarker-based trials. However, an ICOS antagonist demonstrated a 44% response rate in angioimmunoblastic T-cell lymphoma; ICOS is highly expressed on T-follicular helper cells (type of CD4 cell) and proliferation of these cells may be a pathogenic mechanism for these lymphomas. A role for the ICOS/ICOSL signaling pathway has also been implicated outside of oncology, including in viral infections such as COVID-19, and in autoimmune conditions such as asthma and systemic lupus erythematosus.<br><br>CONCLUSION: Biomarker-driven approaches will be important to individualize therapy and ascertain which cancer patients will derive the greatest benefit from ICOS-directed combination therapy approaches.}, }
@article {pmid41472518, year = {2025}, author = {Boulton, O and Farquharson, B and Hoyle, L}, title = {The Complexity of Emergency Nurse Retention and Turnover Pre- and Post-Covid 19: A Scoping Review.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.70467}, pmid = {41472518}, issn = {1365-2648}, abstract = {AIMS: To examine factors influencing emergency nurse turnover and retention pre- and post-COVID-19 and inform planned Participatory Systems Mapping research.<br><br>DESIGN: A scoping review of the literature reporting reasons emergency nurses leave, intend to leave or stay.<br><br>METHODS: Following the Joanna Briggs Institute methodology and a pre-registered protocol, databases and grey literature were systematically searched in January 2025 (updated August 2025). Literature published after 1st January 2010, was included. Two reviewers independently screened records, and 10% of extractions were cross-checked. Data were grouped thematically on a visual coding system using the Miro platform. Pre- and post-COVID-19 sources were categorised and analysed using a two-dimensional framework of intensity and frequency.<br><br>DATA SOURCES: MedLine, CINAHL, PsycINFO, Web of Science, Cochrane and grey literature.<br><br>RESULTS: Ninety-three sources were included. Burnout, workload, staffing and workplace violence (WPV) were linked across study designs to turnover, while job satisfaction, supportive leadership and team cohesion appeared to support retention. Problem-focused and resilience-based coping were associated with retention across study designs (n&#x2009;=&#x2009;5); emotion-focused strategies were linked with poorer outcomes (n&#x2009;=&#x2009;3). In a subset of 86 sources, traditional protective factors (leadership support and team camaraderie) appeared weakened post-COVID-19. A novel theme of moral obligation to remain, despite personal risk, emerged. Adaptive coping gave way to downshifting and emotional suppression.<br><br>CONCLUSION: The included evidence indicates that multiple, interacting factors shape emergency nurse turnover and retention, whilst systemic strategies aligning operational demands with psychological safety and core nursing values may contribute to sustainable retention.<br><br>Workforce interventions should address the psychological legacy of COVID-19 and focus on rebuilding trust, flexibility and moral sustainability in emergency departments.<br><br>IMPACT: While individual drivers of turnover are known, their complex interplay and retention factors are underexplored. This review identifies themes transcending boundaries and recurring across the turnover pathway, underscoring the need for multi-level interventions relevant to both nurse managers and policy makers.<br><br>REPORTING METHOD: Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR).<br><br>This study did not include patient or public involvement in its design, conduct or reporting.}, }
@article {pmid41472297, year = {2025}, author = {Liu, J and Luo, W and Li, J and Cai, B and Lei, Z and Lin, S and Chen, Z and Yue, Z and Chen, X and Li, Y and Luo, Z and Zhang, Q and Chen, X}, title = {A Review of Receptor Recognition Mechanisms in Coronaviruses.}, journal = {Viruses}, volume = {17}, number = {12}, pages = {}, pmid = {41472297}, issn = {1999-4915}, support = {82072834, 32400132, 2023A1515010318, 2021A1515011065//the National Natural Science Foundation of China , Guangdong Natural Science Foundation/ ; }, mesh = {Humans ; *Coronavirus/physiology/genetics/metabolism ; *Receptors, Virus/metabolism/genetics/chemistry ; Animals ; Host-Pathogen Interactions ; *Coronavirus Infections/virology/metabolism ; }, abstract = {Cellular receptor recognition exerts fundamental roles during coronavirus infection. Clarifying the regulatory mechanism of virus receptor helps to better understand viral infection, transmission and pathogenesis; predict potential host and how viral escape from immune system; prevent coronavirus infection or develop treatment therapy. Herein, we summarize current understanding of host receptor recognition mechanisms in the different genera of coronavirus family. And we also review diverse methodologies of identification and clarification of virus receptors. The integration of structural biology, multi-omics, computational predictions, synthetic biology and artificially engineered viral receptors, provide a powerful framework for elucidating coronavirus-receptor interactions. This also supports the development of broad-spectrum antiviral agents, smart biosensors, and intervention strategies against emerging coronaviruses.}, }
@article {pmid41472292, year = {2025}, author = {Ariza, ME and Mena Palomo, I and Williams, MV}, title = {Does Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Represent a Poly-Herpesvirus Post-Virus Infectious Disease?.}, journal = {Viruses}, volume = {17}, number = {12}, pages = {}, pmid = {41472292}, issn = {1999-4915}, support = {R01 A1084898//National Institute of Health/ ; }, mesh = {*Fatigue Syndrome, Chronic/virology/etiology ; Humans ; *Herpesviridae/physiology/pathogenicity ; *Herpesviridae Infections/virology/complications ; Virus Replication ; Animals ; Virus Latency ; }, abstract = {Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating multisystem illness with unknown etiology. An estimated 17-24 million people representing approximately 1% of the population are afflicted worldwide. In over half of cases, ME/CFS onset is associated with acute "flu-like" symptoms, suggesting a role for viruses. However, no single virus has been identified as the only etiological agent. This may reflect the approach employed or more strongly the central dogma associated with herpesviruses replication, which states that a herpesvirus exists in two states, either lytic or latent. The purpose of this review is to address the role that abortive lytic replication may have in the pathogenesis of ME/CFS and other post-acute viral infections and also to raise awareness that these syndromes might be poly-herpesviruses mediated diseases.}, }
@article {pmid41472204, year = {2025}, author = {Dong, J and He, X and Bao, S and Wei, Z}, title = {Diagnostic Methods for Bovine Coronavirus: A Review of Recent Advancements and Challenges.}, journal = {Viruses}, volume = {17}, number = {12}, pages = {}, pmid = {41472204}, issn = {1999-4915}, support = {KJZC-2024-15//Gansu Provincial Department of Agriculture and Rural Affairs Science and Technology Support Project/ ; }, mesh = {Animals ; Cattle ; *Coronavirus, Bovine/genetics/isolation &amp; purification ; *Cattle Diseases/diagnosis/virology ; *Molecular Diagnostic Techniques/methods ; *Coronavirus Infections/diagnosis/veterinary/virology ; Nucleic Acid Amplification Techniques/methods ; Sensitivity and Specificity ; CRISPR-Cas Systems ; }, abstract = {Bovine coronavirus(BCoV) is a significant pathogen causing substantial economic losses in the cattle industry through increased calf mortality, reduced growth performance, and decreased milk yield. Rapid and accurate diagnostic methods are therefore essential for controlling BCoV transmission. Current diagnostic methods comprise two primary categories: conventional techniques and cutting-edge innovations. Conventional approaches, including molecular methods like RT-PCR/qRT-PCR and immunological assays such as ELISA and neutralization tests, remain the main diagnostic methods. However, they are limited by laboratory dependency as well as the necessary balance between speed and sensitivity. These limitations have promoted the development of innovative methods, including isothermal amplification, CRISPR/Cas systems, droplet digital PCR, and integrated platforms. This review comprehensively analyzes the advantages, limitations, and applications of current diagnostic methods, highlighting integrated platforms such as RPA-CRISPR-LFA and microfluidics-based LFA. These innovations bridge critical performance gaps by enhancing sensitivity and specificity while enabling field application, demonstrating significant potential as next-generation point-of-care diagnostics for managing this economically critical pathogen.}, }
@article {pmid41472136, year = {2025}, author = {Liu, Y and Lu, H and Li, J and Xie, Y and Hu, G and Pang, S and Lian, S and Liu, J and Zhu, G and Ding, X}, title = {A Comprehensive View on the Mechanisms of Coronavirus Escaping Innate Immunity.}, journal = {Veterinary sciences}, volume = {12}, number = {12}, pages = {}, pmid = {41472136}, issn = {2306-7381}, support = {32503083//National Natural Science Foundation of China/ ; HN2024113//Henan Postdoctoral Research Foundation/ ; 22nya08//Science and Technology Plan Project of Taizhou/ ; }, abstract = {Coronaviruses are a group of widespread infectious pathogens that pose a serious threat to human and animal health. Corona Virus Disease 2019, instigated by severe acute respiratory SARS-CoV-2, has presented an unprecedented challenge to global public health in recent years. The host innate immune system is the first line of defense against pathogens, which plays a key role in inhibiting the initial infection of viruses and regulating the initiation and development of acquired immunity. However, coronaviruses can suppress the host's innate immune response through their unique immune escape mechanisms, which is one of the key strategies for coronavirus pathogenesis. This review focuses on the host's innate immune sensors, innate antiviral immune responses, and the mechanisms employed by coronaviruses to evade and suppress the innate immune system. And we hope that it will contribute to a comprehensive understanding of the escape mechanism of coronaviruses regarding innate immunity and the pathogenesis of coronaviruses.}, }
@article {pmid41355392, year = {2026}, author = {Jubran, A and Laghi, F and Tobin, MJ}, title = {Patient self-inflicted lung injury - does it really exist?.}, journal = {Current opinion in critical care}, volume = {32}, number = {1}, pages = {17-23}, doi = {10.1097/MCC.0000000000001354}, pmid = {41355392}, issn = {1531-7072}, mesh = {Humans ; *COVID-19/therapy/epidemiology ; *Respiration, Artificial/adverse effects/methods ; SARS-CoV-2 ; Tidal Volume ; *Lung Injury/etiology ; *Self-Injurious Behavior ; }, abstract = {PURPOSE OF REVIEW: P-SILI (patient self-inflicted lung injury) is a radically new idea based on the claim that patients taking larger tidal volumes (in response to respiratory stimuli) can cause alveolar injury. This review lays bare the lack of robust experimental data to establish the actual existence of P-SILI.<br><br>RECENT FINDINGS: At the height of the COVID-19 pandemic, world-renowned investigators argued that P-SILI was responsible for much of the lung injury in COVID-19 and recommended radical alterations in ventilator management: avoidance of noninvasive ventilation, preemptive intubation, widespread use of neuromuscular blockers to decrease patient-generated tidal volume, and postponement of ventilator weaning. When debated to provide proof for the existence of P-SILI, proponents imparted sparse unconvincing rejoinders.<br><br>SUMMARY: In a scientific debate, the party making a new claim carries the burden of proof, not the side defending the preexisting state of knowledge (analogous to a defendant's presumption of innocence until evidence is produced to the contrary). Claims for the existence of P-SILI are based on the shakiest of circumstantial evidence. Six decades of research on how to prudently select settings and remove/wean the ventilator at the earliest time were abrogated during a pandemic on the warrant of an unproven hypothetical entity.}, }
@article {pmid40957498, year = {2026}, author = {Bender, HA and Williams, NA and Burnfield, JM and Constantinidou, F and Bossuyt, FM and Bergquist, T and Bogdanova, Y and Cohen, E and Raber, J and Lokai, AD and Sacks-Zimmerman, A}, title = {Post-acute COVID-19 Syndrome: Brain Fog Phenotype, Patient-Centric Understanding, and Biopsychosocial-Oriented Treatment.}, journal = {Archives of physical medicine and rehabilitation}, volume = {107}, number = {1}, pages = {134-139}, doi = {10.1016/j.apmr.2025.09.002}, pmid = {40957498}, issn = {1532-821X}, mesh = {Humans ; *COVID-19/psychology/complications/rehabilitation ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Quality of Life ; Patient-Centered Care ; Phenotype ; }, abstract = {Post-acute COVID-19 syndrome (PACS), a term used to describe ongoing symptoms after SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) (COVID-19) infection, includes prominent neuropsychological sequela, such as a subjective sense of brain fog. Brain fog can be persistent and interfere with quality of life and daily functioning across multiple domains. Rehabilitation professionals can comprehensively address PACS-related brain fog through a biopsychosocial framework of chronic illness. Through emphasizing a patient-centric perspective, rehabilitation practitioners can understand lifestyle protective factors, as well as the reciprocal relationships between emotional processing and behaviors that potentially maintain symptomology manifesting as brain fog. However, current practice models do not fully address the biopsychosocial components for adults suffering from PACS-related brain fog. To address gaps in the literature, we present a biopsychosocial framework for PACS-related brain fog and provide treatment strategies based on evidence from current literature of neuropsychiatric sequela of mild traumatic brain injury. These recommendations will provide practice guidance to rehabilitation professionals in (1) identifying common protective factors that can be optimized in the context of persistent PACS-related brain fog and (2) addressing these symptoms via integrative interventions, considering the biopsychosocial presentation of brain fog.}, }
@article {pmid40737552, year = {2026}, author = {Kaur, U and Chakrabarti, SS}, title = {COVID-19 vaccine safety studies- the need for a third group for extended monitoring.}, journal = {Expert opinion on drug safety}, volume = {25}, number = {1}, pages = {1-7}, doi = {10.1080/14740338.2025.2542249}, pmid = {40737552}, issn = {1744-764X}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage ; *COVID-19/prevention &amp; control/immunology ; Vaccination/adverse effects/methods ; Time Factors ; Vaccine Efficacy ; }, abstract = {INTRODUCTION: Studies assessing COVID-19 vaccine effectiveness have generally categorized individuals into 'vaccinated' and 'unvaccinated' groups. Long-term safety studies are sparse and have usually compared adverse events with background rates. Studies on timing of COVID-19 vaccination as a determinant of long COVID have provided variable results, while there is scarce data on timing of vaccination as a determinant of adverse events.<br><br>AREAS COVERED: We discuss some of our observations as well as the global evidence on the timing of COVID-19 vaccination as a determinant of long-COVID and adverse events. This special report is hypothesis-generating and aims to propose a conceptual framework and not establish causality.<br><br>EXPERT OPINION: We propose an alternative classification strategy for COVID-19 vaccinees, with special emphasis on individuals who received any dose of vaccination after recovering from natural COVID-19, i.e. the 'vaccine-after-COVID' (VAC) group. These individuals should be followed up for an extended period through multicentric and database studies. This may help in understanding the long-term safety of COVID-19 vaccines and the natural course of long COVID. Immunological characteristics of this group should also be scrutinized. The evidence gained might be useful in planning vaccination policies in the event of future pandemics.}, }
@article {pmid41471393, year = {2025}, author = {Shaer, NA and Mohamed, AA and Schnug, E}, title = {Potential of Artemisia annua Bioactives as Antiviral Agents Against SARS-CoV-2 and Other Health Complications.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {12}, pages = {}, pmid = {41471393}, issn = {1424-8247}, abstract = {This review highlights Artemisia annua, a medicinal plant which grows in the Kingdom of Saudi Arabia, known for its abundant therapeutic properties. A. annua serves as a rich source of various bioactive compounds, including sesquiterpenoid lactones, flavonoids, phenolic acids, and coumarins. Among these, artemisinin and its derivatives are most extensively studied due to their potent antimalarial properties. Extracts and isolates of A. annua have demonstrated a range of therapeutic effects, such as antioxidant, anticancer, anti-inflammatory, antimicrobial, antimalarial, and antiviral properties. Given its significant antiviral activity, A. annua could be investigated for the development of new nutraceutical bioactive compounds to combat SARS-CoV-2. Artificial Intelligence (AI) can assist in drug discovery by optimizing the selection of more effective and safer natural bioactives, including artemisinin. It can also predict potential clinical outcomes through in silico modeling of protein-ligand interactions. In silico studies have reported that artemisinin and its derivatives possess a strong ability to bind with the Lys353 and Lys31 hotspots of the SARS-CoV-2 spike protein, demonstrating their effective antiviral effects against COVID-19. This integrated approach may accelerate the identification of effective and safer natural antiviral agents against COVID-19.}, }
@article {pmid41471153, year = {2025}, author = {Ramasamy, R}, title = {Perspective Overview of Changing Population Immunity to COVID-19 in the Context of Infection, Vaccination, and Emerging SARS-CoV-2 Variants.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {12}, pages = {}, doi = {10.3390/pathogens14121197}, pmid = {41471153}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/immunology/prevention &amp; control/epidemiology/virology/transmission ; *SARS-CoV-2/immunology/genetics ; *COVID-19 Vaccines/immunology ; Vaccination ; Immune Evasion ; }, abstract = {The changing state of protective immunity to COVID-19 in the global population in the six years since COVID-19's origin in 2019 is examined in the context of the (i) circulation of SARS-CoV-2 in the population, (ii) widespread use of different types of COVID-19 vaccines beginning in December 2020 and continuing to the present time, and (iii) ongoing evolution of SARS-CoV-2 to produce mutant viruses with greater infectivity, replication rate, evasion of immunity, and transmissibility. The outlook, and possible vaccine strategies, for the future control of COVID-19 are also examined.}, }
@article {pmid41469295, year = {2025}, author = {Collins, N and Devon, C and Bentley, S and Dixon, E and Jones, D and Kenny, S and Makhecha, S and Moledina, S and Murray, N and Puckey, M and Worger, C and Balfour-Lynn, IM}, title = {Home intravenous antibiotics for cystic fibrosis - setting up a hospital @home service.}, journal = {Paediatric respiratory reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.prrv.2025.12.002}, pmid = {41469295}, issn = {1526-0550}, abstract = {This paper reviews the use of home intravenous antibiotics (IVABs) in children with cystic fibrosis (CF). We outline a program we developed during the COVID-19 pandemic for enhancing the experience for children and families by involving full multidisciplinary follow up via video for the duration of the antibiotic course. We did find though, that the majority of families were unsuitable for home IVABs. We hope that this information will be useful for other CF units considering setting up a hospital at home service.}, }
@article {pmid41467992, year = {2025}, author = {Mendlovic, F and Plett, T and Santiago-Olivares, C and Avila-Ramírez, G and Flisser, A and Rivera-Toledo, E}, title = {Immune and Virological Factors Influencing Human Respiratory Syncytial Virus Circulation and Increased Prevalence During and After the COVID-19 Pandemic.}, journal = {Viral immunology}, volume = {}, number = {}, pages = {}, doi = {10.1177/08828245251407618}, pmid = {41467992}, issn = {1557-8976}, abstract = {Human respiratory syncytial virus (hRSV) is a leading cause of respiratory infections in infants and older adults. The COVID-19 pandemic disrupted hRSV transmission due to non-pharmaceutical interventions (NPI), resulting in atypical circulation patterns, earlier seasonal peaks, and increased post-pandemic prevalence. Two key factors are proposed to underlie these changes: a reduced specific immune response due to decreased viral exposure and the emergence of novel hRSV variants. These factors contributed to a larger cohort of immunologically naïve children and lower levels of maternally derived antibodies, increasing susceptibility to severe hRSV disease, particularly in infants and children. Additionally, adults experienced waning immunity following prolonged periods of limited hRSV circulation. The post-pandemic resurgence was accompanied by the emergence of novel hRSV variants with altered transmissibility and virulence, such as GB5.0.6a in Europe and B.D.E.1 in China. These variants may reflect mutations driven by the reduced immunity, though further research is needed to assess their pathogenicity. Understanding the interplay between the reduced immunity due to NPI and virological factors is essential for addressing hRSV epidemiology. Enhanced molecular surveillance and immunological monitoring are crucial for guiding vaccination strategies and protecting vulnerable populations against future hRSV outbreaks.}, }
@article {pmid41467340, year = {2026}, author = {Yang, D and Wang, G}, title = {Post-Vaccination Syndromes: The Evidence and a Roadmap for Rigorous Research.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70100}, doi = {10.1002/rmv.70100}, pmid = {41467340}, issn = {1099-1654}, support = {//The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University/ ; }, mesh = {Humans ; *Vaccination/adverse effects ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention &amp; control ; SARS-CoV-2/immunology ; Syndrome ; Fatigue Syndrome, Chronic/etiology ; }, abstract = {The recent review by Yong et al. (Rev Med Virol. 2025; 35:e70070) proposes the entity of "Long Vax Syndrome" or Post-COVID-19 Vaccination Syndrome (PCVS). While this synthesis of anecdotal and early observational reports is a timely contribution, it necessitates a critical evaluation of the underlying evidence. This letter highlights substantial methodological limitations, including a reliance on data susceptible to significant ascertainment bias and the conflation of correlation with causation, given the non-negligible background prevalence of conditions like POTS and chronic fatigue. We argue that the pathophysiological narrative, while plausible, remains highly speculative due to a lack of direct mechanistic validation in human subjects. Furthermore, the proposed therapeutic strategies, borrowed from analogous disorders, are empiric and untested in this specific context, posing potential risks if adopted without evidence. The review by Yong et al. should thus serve not as a definitive guide, but as a critical catalyst for a disciplined research agenda. We outline essential next steps, including the urgent need for large, prospective controlled cohort studies to establish true incidence, deep phenotyping to identify distinct endotypes, and the development of standardised diagnostic criteria before randomised controlled trials can ethically evaluate interventions. Only through such rigorous inquiry can we ensure both compassionate care for affected individuals and the preservation of public confidence in vaccines.}, }
@article {pmid41467276, year = {2025}, author = {Petrov, S and Donkov, D and Orbetzova, M}, title = {AI and telemedicine in management of diabetes.}, journal = {Folia medica}, volume = {67}, number = {6}, pages = {}, doi = {10.3897/folmed.67.e153728}, pmid = {41467276}, issn = {1314-2143}, mesh = {Humans ; *Telemedicine ; *Artificial Intelligence ; *Diabetes Mellitus/therapy/diagnosis ; COVID-19/epidemiology ; SARS-CoV-2 ; Deep Learning ; Decision Support Systems, Clinical ; Machine Learning ; Natural Language Processing ; }, abstract = {This review explores how two cutting-edge technologies-telemedicine and artificial intelligence (AI)-are reshaping diabetes care. Diabetes remains one of healthcare's toughest challenges, demanding round-the-clock monitoring and treatments that adapt to each patient's needs. During COVID-19, telemedicine proved its worth as a vital tool for maintaining patient care and improving health outcomes. Meanwhile, AI-through machine learning (ML) and deep learning (DL)-brings fresh capabilities for catching diabetes early, assessing patient risk, and spotting complications like eye and nerve damage before they become serious. We examined recent research on these technologies, particularly their roles in predicting who might develop diabetes, using Natural Language Processing (NLP) to decode messy patient records, and supporting doctors through clinical decision support systems (CDSS). Our findings reveal that telemedicine works-it helps patients control their blood sugar better and keeps them satisfied with their care. However, not everyone has equal access to technology, and some healthcare providers remain skeptical. AI diagnostic tools, especially for eye screening, now match human doctors in accuracy. Though merging these technologies could revolutionize personalized diabetes care, we first need to tackle real-world obstacles: ensuring fair access for all patients, protecting sensitive health data, and making different systems work together seamlessly.}, }
@article {pmid41467021, year = {2025}, author = {Sun, D and Tan, W and Zhao, J and Tian, Y and Li, S and Zhang, Z and Dong, X and Liu, X and Liu, N and Jiao, P and Ma, J}, title = {Delivery of nucleic acid drugs for tumor therapy: Opportunities and challenges.}, journal = {Fundamental research}, volume = {5}, number = {6}, pages = {2948-2959}, pmid = {41467021}, issn = {2667-3258}, abstract = {The global pandemic of COVID-19 has underscored the huge potential of nucleic acid drugs in effective and rapid vaccine development. Hence, it is significant to accelerate the research and clinical transformation of nucleic acid drugs. However, when administered systemically, nucleic acid molecules are vulnerable to degradation by nucleases, and their structural hydrophilicity hampers cellular entry, limiting their efficacy. Moreover, free nucleic acid drugs may cause some side effects in vivo, and the application of small nucleic acid drugs is largely restricted by intratumoral or peritumoral administration. Currently, the design and preparation of nucleic acid delivering systems face many scientific problems and technical challenges. Breaking through the technical bottlenecks in intraneous delivery of nucleic acid molecules is anticipated to open a new era of efficient, precise and safe nucleic acid drugs. This program, based on the new advances in nanotechnology and biomedical engineering, aims to advance the nucleic acid nano drug delivery systems (NDDS) and overcome intraneous delivery barriers. This review explores the barriers in nucleic acid drug delivery and presents methods for enhancing intracellular uptake, offering guidance for the design of nucleic acid carriers. Furthermore, it discusses the latest advancements in applying NDDS to nucleic acid drugs.}, }
@article {pmid41466823, year = {2026}, author = {Arjun, MM and Sreekanth, GP}, title = {Engineering Nipah virus: Reverse genetics as a gateway to novel drug discovery.}, journal = {New microbes and new infections}, volume = {69}, number = {}, pages = {101682}, pmid = {41466823}, issn = {2052-2975}, abstract = {Nipah virus (NiV) is a highly pathogenic and re-emerging virus that requires containment in biosafety level 4 (BSL-4) laboratories. The limited accessibility of these high-security facilities poses major obstacles to investigating immunopathogenesis and developing effective antiviral treatments. Reverse genetics allows manipulation of viral genomes without the need to handle the wild-type virus and has become instrumental in understanding NiV pathogenesis and advancing therapeutic research. These tools have proven vital for other high-containment viruses, notably during the SARS-CoV-2 pandemic, and have been adapted effectively for NiV. Reverse genetics-derived systems were used to evaluate the drug candidates in the preclinical studies of NiV, with several candidates in the development pipeline. This narrative review summarizes established reverse genetics and pseudotyping methodologies for NiV, highlighting their contributions to understanding viral pathogenesis and accelerating vaccine and therapeutic development.}, }
@article {pmid41465787, year = {2025}, author = {Tiwari, S and Dhakal, T and Kim, BJ and Jang, GS and Oh, Y}, title = {Genomics in Epidemiology and Disease Surveillance: An Exploratory Analysis.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {12}, pages = {}, pmid = {41465787}, issn = {2075-1729}, support = {RS-2023-KH140418//Government-wide R&amp;D to Advance Infectious Disease Prevention and Control, Republic of Korea/ ; }, abstract = {Genomics has revolutionized epidemiology and disease surveillance by providing powerful tools for identifying, tracking, and analyzing pathogens at the molecular level. This exploratory analysis examines the integration of genomic with traditional epidemiological approaches, highlighting the role of whole-genome sequencing as a key method for pathogen identification, outbreak investigation, and understanding transmission dynamics. By enabling the detection of mutations and monitoring of antimicrobial resistance, genomics allows for precise mapping of infection sources and transmission pathways, thereby improving the timeliness and accuracy of public health responses. Furthermore, genomic surveillance supports the early detection of emerging variants, such as those observed during viral outbreaks like COVID-19, facilitating proactive intervention strategies. Despite its transformative potential, challenges related to data privacy, infrastructure, and interdisciplinary collaboration persist. This analysis emphasizes the importance of genomics in building resilient surveillance systems to address future infectious disease threats and advocates for sustained investment in genomic technologies to advance global health security.}, }
@article {pmid41465600, year = {2025}, author = {Ben Khlifa, E and Campese, A and Corsi, A and Bombieri, C and Romanelli, MG and Valenti, MT and Zipeto, D and Castelli, M and Lievens, PM and Ruggiero, A}, title = {Post-Translational Modifications in Respiratory Virus Infection: Recent Insights into the Development of In Vitro Models.}, journal = {International journal of molecular sciences}, volume = {26}, number = {24}, pages = {}, pmid = {41465600}, issn = {1422-0067}, support = {CUP B53D23003290001//the PRIN 2022 (NextGenerationEU, MUR n. 972)/ ; CUP B53D23003410006//NextGenerationEU, MUR n. 972/ ; Department of Neuroscience, Biomedicine and Movement Sciences of the University of Verona//MUR - Excellence Project 2023-2027/ ; }, mesh = {Humans ; *Protein Processing, Post-Translational ; SARS-CoV-2/metabolism ; Influenza A virus/metabolism ; Animals ; Host-Pathogen Interactions ; *Respiratory Tract Infections/virology/metabolism ; COVID-19/virology/metabolism ; *Respiratory Syncytial Virus Infections/metabolism/virology ; Virus Replication ; }, abstract = {Post-translational modifications (PTMs) are crucial chemical alterations occurring on proteins post-synthesis, impacting various cellular processes. During viral infections, PTMs are shown to play a multitude of roles in viral replication, host interaction, and immune evasion. Thus, these modifications can influence infectivity, with direct impact on the anti-viral host immune responses and potentially viral adaptation across species. This field is still scarcely explored, whilst understanding PTMs is not only important to advance the knowledge of virus pathology but also potentially to provide insights for vaccine development. In this review, we attempt to summarize the latest findings mainly published over the last 10 years, focusing on the roles of PTMs involved in virus infection and anti-viral immune responses, in the context of relevant human respiratory infections: influenza A virus (IAV), respiratory syncytial virus (RSV), and SARS-CoV-2. We decided to concentrate on these three viruses because they currently represent a global health problem due to recurrent outbreaks and pandemic potential. A deeper characterization of the PTMs may help in understanding virus-host interaction with possible implications on curative strategies. Further, we will report on cutting-edge technologies to study in vitro virus infection in different cellular-based systems. In particular, we describe and discuss the application of 2D and 3D lung organoid cell-culture systems as in vitro models to mimic respiratory environments and to study the PTMs in a controlled setting. Finally, we will discuss the importance of PTMs in the context of next-generation vaccine design, especially for their potential role to offer effective protection against respiratory viruses.}, }
@article {pmid41465254, year = {2025}, author = {Guria, K and Melnikov, I and Shtelmakh, V and Avtaeva, Y and Okhota, S and Saburova, O and Kozlov, S and Gabbasov, Z}, title = {Fibrin Monomer in Thrombosis and Haemostasis: A Clinical Biomarker and Beyond.}, journal = {International journal of molecular sciences}, volume = {26}, number = {24}, pages = {}, pmid = {41465254}, issn = {1422-0067}, support = {24-15-00092//the Russian Science Foundation/ ; }, mesh = {Humans ; Biomarkers/blood/metabolism ; *Hemostasis ; *Thrombosis/metabolism/blood/diagnosis ; COVID-19/blood/complications ; *Fibrin Fibrinogen Degradation Products/metabolism ; SARS-CoV-2 ; Fibrin/metabolism ; Blood Coagulation ; Fibrinolysis ; }, abstract = {Fibrin monomer (FM) is a transient intermediate of blood coagulation that functions as both an active regulator of haemostasis and a sensitive biomarker for prothrombotic states. Clinically, FM is measured indirectly as its derivative, soluble fibrin monomer complexes (SFMC), which is also often referred to as FM throughout the clinical literature. FM participates in a complex regulatory network modulating thrombin generation and fibrinolysis, interacting with platelet receptors, including integrin αIIbβ3 and GPVI, and engaging GPIb-vWF interactions. This comprehensive review examines FM's molecular mechanisms in haemostatic regulation and evaluates clinical evidence for FM as a biomarker. Particular focus is placed on FM's utility for risk stratification across thrombotic conditions, including disseminated intravascular coagulation, venous thromboembolism, ischemic stroke, myocardial infarction, and COVID-19-associated coagulopathy. Current challenges, including assay standardization and universal cut-off values, are discussed. By synthesizing mechanistic insights with clinical data, this integrated perspective may accelerate the translation of FM biology into improved risk assessment tools and novel therapeutic strategies.}, }
@article {pmid41464674, year = {2025}, author = {Duque-Clavijo, V and Doan, HQ and Tyring, SK}, title = {A Review of Cutaneous Viral Infections and Their Potential Role in Neurologic Diseases.}, journal = {Journal of clinical medicine}, volume = {14}, number = {24}, pages = {}, pmid = {41464674}, issn = {2077-0383}, abstract = {Background: Cutaneous viral infections, defined as viral pathogens that either primarily affect the skin (e.g., herpesviruses, enteroviruses) or frequently produce dermatologic manifestations despite systemic tropism (e.g., HIV, SARS-CoV-2), can trigger systemic inflammatory and neurotropic responses that extend their impact to the nervous system. A growing body of evidence suggests that viruses with dermatologic manifestations may play a significant role in the pathogenesis of neurologic disorders. Summary: Although individual viruses have been studied in isolation, the skin-brain axis in viral infections remains incompletely characterized. This review synthesizes existing knowledge and highlights gaps in understanding the mechanisms linking cutaneous viral infections to neurologic disease. We explore the principal mechanisms linking viral skin infections to central and peripheral nervous system damage, including direct neuroinvasion, immune-mediated injury, and vascular or endothelial dysfunction. Particular attention is given to herpesviruses, retroviruses, enteroviruses, and respiratory viruses, which have been associated with conditions such as dementia, multiple sclerosis, myelopathies, Guillain-Barré syndrome, and the post-acute neurologic sequelae of COVID-19. Furthermore, we discuss the role of neuroinflammation in viral-associated neurodegeneration and highlight emerging evidence supporting the recombinant zoster vaccine (Shingrix) as a potential modulator of neuroinflammatory processes and a protective factor against dementia. Conclusions: Cutaneous viral infections extend beyond local skin pathology, contributing to a broad spectrum of neurologic complications through intertwined infectious and inflammatory mechanisms. A clearer understanding of how peripheral viral activity shapes central nervous system vulnerability remains a major unmet need. A multidisciplinary approach integrating dermatologic and neurologic perspectives is essential for early recognition and prevention. While observational studies suggest that zoster vaccination may reduce viral reactivation and modulate neuroinflammatory pathways, definitive evidence of neuroprotection is still lacking. Future studies should clarify causal relationships, test mechanistic hypotheses regarding skin-brain immune crosstalk, and explore vaccine-mediated neuroprotection as a novel therapeutic strategy.}, }
@article {pmid41464475, year = {2025}, author = {Jia, Y and Turcu, C}, title = {Climate, Health, and Urban Green Infrastructure: The Evidence Base and Implications for Urban Policy and Spatial Planning.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {12}, pages = {}, pmid = {41464475}, issn = {1660-4601}, mesh = {*Climate Change ; *City Planning ; Humans ; Cities ; COVID-19 ; }, abstract = {Urban green infrastructure (UGI) is widely used to adapt to the impacts of climate change. Its multiple benefits are well documented, with health-related benefits receiving growing attention, especially post-COVID-19. However, the existing evidence remains fragmented and limited to narrow disciplinary perspectives, offering only partial insights into the intersection of UGI and climate adaptation measures with health co-benefits. This paper addresses these gaps by providing an interdisciplinary review of the field. It presents a systematic literature review of studies between 2015 and 2025, assessing the extent of documented evidence and drawing out key policy implications. The review adopts the PRISMA framework and synthesizes evidence from 178 primary research articles across seven databases. Health co-benefits are reported across ten types of UGI: residential greenery, urban vegetation, school greenery, trees, urban parks, urban forests, green roofs and walls, green streets, grasslands, and community or private gardens. Building on the review's findings and additional literature, the paper discusses seven key implications for urban policy and spatial planning, which are relevant to climate adaptation policymakers, urban planners, and public health authorities working in cities.}, }
@article {pmid41464441, year = {2025}, author = {Abdel-Motaal, KA and El Kheir-Mataria, WA and Chun, S}, title = {Global Health Governance and the WHO Pandemic Agreement: A Scoping Review of Challenges and Analysis of Reforms.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {12}, pages = {}, pmid = {41464441}, issn = {1660-4601}, mesh = {*Global Health ; Humans ; *COVID-19/epidemiology/prevention &amp; control ; *World Health Organization ; *Pandemics/prevention &amp; control ; *International Cooperation ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic exposed persistent weaknesses in global health governance, particularly in preparedness, equity, and accountability. The WHO Pandemic Agreement, adopted in May 2025, aims to address these systemic gaps through a binding international framework.<br><br>OBJECTIVE: To identify key challenges in global pandemic preparedness and health governance reported in the literature (2019-2024) through a systematic scoping review, and to evaluate how these challenges are addressed in the provisions of the WHO Pandemic Agreement via qualitative document analysis.<br><br>METHODS: Using Joanna Briggs Institute methodology and PRISMA-ScR guidelines, we systematically identified and thematically analyzed 52 peer-reviewed studies published between 2020 and 2024. The thematic results informed a qualitative document analysis of the WHO Pandemic Agreement text to assess the extent to which its provisions address the identified challenges.<br><br>RESULTS: Persistent gaps in governance (limited enforceability, fragmented coordination), equity (inequitable access to medical countermeasures), capacity (technology transfer and financing), and accountability were identified. Health systems in low- and middle-income countries continue to face critical resource constraints and lack robust mechanisms to ensure accountability and continuous learning. Document analysis showed the WHO Pandemic Agreement addresses coordination and financing but offers limited advances in enforcement, technology transfer, and independent monitoring.<br><br>CONCLUSION: The WHO Pandemic Agreement introduces important institutional and financing measures, but persistent gaps remain in enforcement, technology transfer, and inclusive implementation. Strengthening these domains is crucial to achieving equitable and resilient preparedness. By systematically linking evidence from the pandemic preparedness literature to Treaty provisions, this study offers a novel analytical framework for assessing how global health treaties respond to research-identified challenges.}, }
@article {pmid41464401, year = {2025}, author = {Wright, T and Smith, R and Sah, RK and Keys, C and Keval, H and Onyejekwe, C}, title = {The Impact of COVID-19 on Racialised Minority Populations: A Systematic Review of Experiences and Perspectives.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {12}, pages = {}, pmid = {41464401}, issn = {1660-4601}, mesh = {*COVID-19/ethnology/epidemiology/psychology ; Humans ; *Minority Groups/psychology ; SARS-CoV-2 ; Health Status Disparities ; Racism ; }, abstract = {Racialised minority populations were disproportionately affected by COVID-19 and saw the highest rate of COVID-19 infections and mortality. Low socioeconomic status, working as frontline workers, temporary employment, precarious immigration status and pre-existing medical conditions were factors that contributed to disadvantaged experiences. This systematic review looked at the impact of COVID-19 on racialised minority populations globally, recognising their experiences, perspectives and the effects on their physical and mental health. Eight electronic databases were searched (MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Social Sciences Citation Index (SSCI), Social Policy and Practice (SPP), Applied Social Sciences Index and Abstracts (ASSIA), MedRxiv and Research Square) for English language qualitative studies. Reference lists of relevant literature reviews and reference lists of articles were hand-searched for additional potentially relevant articles. Duplicates were removed, and articles were screened for titles and abstracts, followed by full-text screening. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies (n = 70). Data were synthesised using thematic synthesis. Seven major and three minor themes were identified. The major themes related to (i) children and young people's experiences of COVID-19; (ii) exacerbated pre-existing disparities relating to income, employment and housing security, health insurance and immigration status; (iii) lack of knowledge and information about COVID-19 and COVID-19 misinformation; (iv) racial history of medicine and treatment of racialised populations; (v) contemporary experiences of racism; (vi) impact on physical and mental health and wellbeing; (vii) concerns about safety at work. Minor themes related to (a) experiences of intercommunity mutual aid; (b) adherence to preventative guidance/COVID-19 restrictions; (c) the role of faith. Research needs to focus on developing and testing interventions that support transformation of social, cultural and economic systems towards equity of access to healthcare and healthcare knowledge. Research should be cognisant of interventions that have worked in shifting the equity dial in the past, implement these and use them to inform new approaches. Policy and practice should be mechanisms for enabling the implementation of interventions.}, }
@article {pmid41464319, year = {2025}, author = {Raycheva, R and Kostadinov, K and Rangelova, V and Kevorkyan, A}, title = {Economic Analyses of COVID-19 Interventions: A Narrative Review of Global Evidence.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {24}, pages = {}, pmid = {41464319}, issn = {2227-9032}, abstract = {Background/Objectives: The coronavirus disease 2019 (COVID-19) pandemic imposed an unprecedented global health and economic burden, prompting rapid implementation of diverse public health interventions. This review aimed to synthesize global evidence on the cost-effectiveness of key COVID-19 control strategies, including vaccination, testing, and social distancing and to identify methodological, contextual, and equity-related determinants of their economic value. Methods: A narrative literature review was conducted using peer-reviewed studies published between January 2020 and September 2025 and indexed in PubMed, Scopus, and Web of Science. Eligible studies included economic evaluations and modeling analyses addressing COVID-19 interventions in healthcare, community, or educational settings. Data on costs, outcomes, and methodological features were extracted and synthesized descriptively. Results: Across 74 included studies, vaccination-particularly with messenger RNA (mRNA) platforms-emerged as the most cost-effective intervention across all settings, often cost-saving among high-risk populations. Combined or layered strategies integrating vaccination, testing, and selective social distancing consistently outperformed single interventions in both health and economic outcomes. Early and targeted implementation yielded the highest cost-effectiveness by preventing exponential transmission and healthcare overload. However, heterogeneity in modeling assumptions, analytic perspectives, and outcome measures limited comparability. Few studies applied extended or distributional cost-effectiveness frameworks to address equity, while indirect and long-term effects such as productivity losses and "long COVID" were frequently omitted. Conclusions: COVID-19 interventions are most efficient when early, targeted, and adaptive to local epidemiologic conditions. Integrating equity, methodological consistency, and broader societal impacts into future evaluations will strengthen evidence-based, economically sustainable pandemic preparedness and response strategies.}, }
@article {pmid41463124, year = {2025}, author = {Fleser, RC and Necula, V and Ujvary, LP and Osman, A and Orasan, A and Maniu, AA}, title = {Hearing Loss in Young Adults: Risk Factors, Mechanisms and Prevention Models.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, pmid = {41463124}, issn = {2227-9059}, abstract = {Hearing loss is increasingly recognized as a major public health concern among young adults, who are traditionally considered a low-risk group. This narrative review synthesizes recent evidence on risk and aggravating factors of early-onset hearing impairment, including recreational and occupational noise exposure, genetic susceptibility, infections, ototoxic medications, and lifestyle contributors. Pathophysiological mechanisms include cochlear synaptopathy, oxidative stress, excitotoxicity, vascular compromise, and immune-mediated injury. Global Burden of Disease data and World Health Organization reports indicate that more than one billion young people are at risk due to unsafe listening practices. Studies highlight emerging risk factors such as hidden hearing loss, extended high-frequency impairment and associations with COVID-19. Aggravating factors include delayed diagnosis, cumulative exposures and lack of preventive strategies. Early detection via advanced audiological assessments, such as extended high-frequency audiometry, otoacoustic emissions, speech-in-noise testing and auditory brainstem responses, is critical to prevent permanent damage. Public health interventions-particularly safe listening campaigns, early screening and monitoring in high-risk populations-are essential to reduce long-term disability.}, }
@article {pmid41463036, year = {2025}, author = {Andriankaja, OM and Whiteheart, S and Mattos, MBA}, title = {Biological Plausibility Between Long-COVID and Periodontal Disease Development or Progression.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, doi = {10.3390/biomedicines13123023}, pmid = {41463036}, issn = {2227-9059}, abstract = {Background: Long COVID (LC) is a multi-system disorder with persistent symptoms following SARS-CoV-2 infection. The presence of SARS-CoV-2 in the oral cavity and periodontium raises questions about its potential impact on periodontal health. Methods: A comprehensive literature search was conducted in PubMed using terms related to LC (e.g., "long-COVID," "post-acute sequelae of SARS-CoV-2 infection," "PASC," "post-COVID-19," "long-haul COVID") and oral/periodontal diseases (e.g., "periodontal disease," "periodontitis," "gingiva," "oral disease," "dental"), filtered for English-language full-text articles published from 2019 to 2024. The search yielded 260 articles, which were supplemented with targeted searches on pathogenesis, immune mechanisms, microbiome alterations, and clinical outcomes, resulting in approximately 248 studies included in this review. Results: LC exhibits systemic immunoinflammatory dysregulation, including neutrophil activation, elevated pro-inflammatory cytokines, and complement activation, overlapping with mechanisms implicated in periodontitis. LC also leads to gastrointestinal and pulmonary dysbiosis, with potential effects on oral microbial communities. Gingival epithelium and periodontal ligament cells express ACE2, which is increased in periodontitis, facilitating viral entry. LC has been associated with reactivation of herpesviruses, such as Epstein-Barr virus, which are linked to autoimmune disorders and periodontitis. Conclusions: LC may act as a systemic risk factor for periodontitis. This review provides the theoretical foundation for the interactions between LC and oral health and highlights priorities for future epidemiologic and mechanistic research to better understand these relationships.}, }
@article {pmid41462936, year = {2025}, author = {Haralović, V and Mokos, M and Špoljar, S and Dolački, L and Šitum, M and Lugović-Mihić, L}, title = {Hypochlorous Acid: Clinical Insights and Experience in Dermatology, Surgery, Dentistry, Ophthalmology, Rhinology, and Other Specialties.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, doi = {10.3390/biomedicines13122921}, pmid = {41462936}, issn = {2227-9059}, abstract = {Background: Hypochlorous acid (HOCl) is an integral component of the human innate immune system. It possesses antimicrobial properties and is available in solution, dermal spray, and scar gel forms. Objectives/Methods: This review presents data from studies on the clinical use of HOCl in various specialties, including dermatology, surgery, dentistry, ophthalmology, and rhinology. Results: Due to its anti-inflammatory/antimicrobial/immunomodulatory and healing properties, HOCl is advantageous in treating various skin disorders: ulcus cruris (and wound care), diabetic ulcers, atopic dermatitis, seborrheic dermatitis, pruritus, acne vulgaris, etc. Also, the application of a HOCl spray/gel after surgical procedures may prevent infection, reduce inflammation, and accelerate healing. HOCl is also effective and safe for the prevention and treatment of hypertrophic and keloid scars. Growing evidence shows a broader role for HOCl in limiting cancer cell survival and slowing tumor growth. It is also important in treating various viral infections like SARS-CoV-2 (coronavirus), influenza, and herpes, thereby helping to prevent the spread of aerosols. In addition, since HOCl is an endogenous compound naturally present in mammals with a high safety profile, it may be an effective bacterial disinfectant in dental waterlines. In ophthalmology, adjuvant treatment with HOCl ophthalmic spray can reduce the duration of antibiotic/corticosteroid use, even in severe blepharitis. To fully harness the protective/therapeutic properties of HOCl, future advancements will rely on the development of new chemical compounds and sophisticated pharmaceutical formulations. Conclusions: The majority of clinical studies have confirmed that HOC1 is useful in therapy, although the results are not entirely consistent. Further research is essential to optimize HOCl dosing and to develop controlled-release systems aimed at maximizing its anti-inflammatory and photoprotective effects while minimizing tissue irritation and damage.}, }
@article {pmid41462903, year = {2025}, author = {Młynarska, E and Hossa, K and Krupińska, N and Pietruszewska, H and Przybylak, A and Włudyka, K and Rysz, J and Franczyk, B}, title = {Atrial Fibrillation in COVID-19: Mechanisms, Clinical Impact, and Monitoring Strategies.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, doi = {10.3390/biomedicines13122889}, pmid = {41462903}, issn = {2227-9059}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has revealed a close and multifaceted relationship between viral infection, systemic inflammation, and cardiovascular health. Among the cardiac complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), atrial fibrillation (AF)-especially new-onset atrial fibrillation (NOAF)-has emerged as a major determinant of disease severity and prognosis. Clinical studies and meta-analyses show that 5-10% of hospitalized COVID-19 patients develop AF, with markedly higher rates in critically ill individuals. Both pre-existing and NOAF are independently associated with increased risks of intensive care admission, mechanical ventilation, thromboembolic events, and mortality. The underlying mechanisms involve a combination of cytokine-mediated inflammation, endothelial dysfunction, microvascular injury, and dysregulation of the renin-angiotensin-aldosterone system (RAAS). Viral downregulation of angiotensin-converting enzyme 2 (ACE2) receptors contributes to myocardial fibrosis, while hypoxia, oxidative stress, and autonomic imbalance further promote electrical remodeling and arrhythmogenesis. Post-infectious studies indicate that atrial structural changes and autonomic dysfunction may persist for months, predisposing survivors to recurrent arrhythmias. Technological advances in telecardiology and digital medicine have provided new tools for early detection and long-term monitoring. Wearable electroencephalography (ECG) devices, implantable loop recorders (ILRs), and artificial intelligence (AI)-based diagnostic algorithms enable continuous rhythm surveillance and individualized management, improving outcomes in post-COVID patients. This review summarizes current evidence on the epidemiology, pathophysiology, clinical implications, and monitoring strategies of AF in COVID-19. It underscores the importance of integrating telemedicine and AI-assisted diagnostics into cardiovascular care to mitigate the long-term arrhythmic and systemic consequences of SARS-CoV-2 infection.}, }
@article {pmid41462874, year = {2025}, author = {Halas, RG and Berceanu Vaduva, DM and Radulescu, M and Bredicean, AC and Mateescu, DM and Toma, AO and Cotet, IG and Guse, CE and Marginean, A and Margan, MM and Lazureanu, VE}, title = {Long COVID Prevalence and Risk Factors: A Systematic Review and Meta-Analysis of Prospective Cohort Studies.}, journal = {Biomedicines}, volume = {13}, number = {12}, pages = {}, doi = {10.3390/biomedicines13122859}, pmid = {41462874}, issn = {2227-9059}, abstract = {Background: Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), affects millions globally, with persistent symptoms impacting quality of life. This meta-analysis synthesizes prospective cohort studies to estimate the prevalence of Long COVID symptoms and identify risk factors. Methods: We systematically searched PubMed for prospective cohort studies (2020-2025) on Long COVID, focusing on prevalence and risk factors. Studies with ≥100 participants and follow-up ≥3 months were included. Data were extracted on symptom prevalence (e.g., fatigue, dyspnoea) and risk factors (e.g., sex, hospitalization). Random-effects models were used to pool prevalence and odds ratios (OR). Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Results: Fourteen prospective studies (n = 168,679) were included. Pooled prevalence of Long COVID was 18.0% (95% CI: 12.5-23.5%, I[2] = 9.8%) among survivors followed for ≥6 months. Fatigue (41.0%, 95% CI: 33.2-49.4%) and dyspnoea (22.5%, 95% CI: 15.6-29.8%) were the most common symptoms. Female sex (OR = 1.52, 95% CI: 1.25-1.92) and prior hospitalization (OR = 2.35, 95% CI: 1.98-2.90) were significant risk factors. High heterogeneity (I[2] > 90%) was noted. Conclusions: Long COVID affects over one-fifth of SARS-CoV-2 survivors, with fatigue and dyspnoea persisting in many. Female sex and severe acute infection increase risk. Standardized definitions and longer follow-up are needed.}, }
@article {pmid41461731, year = {2025}, author = {Wu, Z and Li, Y and Chen, J and Guo, Q and Pan, Y and Liu, S and Liu, J and Luo, C}, title = {The occurrence of thromboembolism among patients with coronavirus disease 2019: A systematic review and meta-analysis.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {44783}, pmid = {41461731}, issn = {2045-2322}, support = {X202410417056//the Jiangxi College Students Innovation and Entrepreneurship Training Program and the Science/ ; }, mesh = {Humans ; *COVID-19/complications/epidemiology ; SARS-CoV-2/isolation &amp; purification ; *Thromboembolism/epidemiology/etiology ; *Venous Thromboembolism/epidemiology/etiology ; Pulmonary Embolism/epidemiology ; Risk Factors ; }, abstract = {The results of reported thrombosis occurrences in patients with COVID-19 are inconsistent. Objectives To elucidate the occurrence of thromboembolism in COVID-19 patients with different types. The search was conducted up to May 10, 2024. The observational studies reporting the occurrence of venous thromboembolism (VTE) and/or arterial thromboembolism (ATE) in COVID-19 patients were included, which were independently evaluated by two researchers. The outcomes were VTE and ATE, including deep vein thrombosis, pulmonary embolism, myocardial infarction, and stroke. The effect sizes were combined using a random-effects model with inverse variance weighting, and a 95% confidence interval was calculated through arcsine transformation. A total of 224 studies was included. The occurrence of VTE was 5.8% (95% CI, 5.0%-6.7%, I2 = 99.912%; 91 studies; 4,545,285 patients). The occurrence of VTE was higher in the intensive care unit compared to the ward (13.2%, 95% CI, 11.7%-14.7%; I2 = 96.840%; 47 studies; 172,571 patients, vs. 3.2%, 95% CI, 2.9%-3.5%; I2 = 95.714%; 40 studies; 1,046,738 patients; P < 0.001), and was even lower among outpatient and discharged cohorts (0.0%, 95% CI, 0.0%-0.0%; I2 = 99.410%; 10 studies; 2,566,194 patients, vs. 0.7%, 95% CI, 0.4%-1.1%; I2 = 98.924%; 16 studies; 828,884 patients; P < 0.001). In contrast, the occurrence of ATE was lower, which was 2.6% (95% CI, 1.8%-3.5%, I2 = 99.924%; 44 studies; 2,884,839 patients). This study found that COVID-19 patients had a relatively high risk of VTE and ATE, but with significant variations among different types. Consequently, the selection of anticoagulant measures for them should be careful.}, }
@article {pmid41458994, year = {2025}, author = {Malaeb, D and Mansour, S and Dia, N and Kassem, NM and Haddad, C and Dabbous, M and Ismail, O and Adel, F and Gamal, M and Lucca, JM and El Khatib, S and Salameh, P and Hallit, S and Hosseini, H}, title = {Scoping review about pathogenesis, risk factors, and treatment of venous and arterial thrombosis in coronavirus infection.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1688115}, pmid = {41458994}, issn = {2297-055X}, abstract = {INTRODUCTION: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is now understood as a systemic illness marked by a distinctive coagulopathy that extends beyond its primary respiratory manifestations. Direct viral injury to the endothelium and an exaggerated inflammatory "cytokine storm" and complement activation disrupt normal hemostasis and create a prothrombotic environment. This scoping review aims to synthesize and compare the mechanisms, risk factors, and antithrombotic strategies associated with venous and arterial thrombosis in COVID-19.<br><br>METHODS: A scoping review of English-language studies indexed in PubMed/Medline, OVID, and Wiley Library was conducted from January 2020 to June 2024. Search terms related to COVID-19, thrombotic complications, pathophysiological mechanisms, and antithrombotic therapies were included. Clinical trials, cohort and retrospective observational studies, systematic reviews, meta-analyses, and case reports are included. Two reviewers independently screened titles, abstracts, and full texts for relevance and extracted data to map current evidence on venous and arterial thrombosis in COVID-19.<br><br>RESULTS: COVID-19-related coagulation problems can cause both venous and arterial thrombosis. Venous thromboembolism, which includes deep vein thrombosis and pulmonary embolism, occurs in about 4% to 15% of hospitalized patients and can increase to 30% in those in intensive care, even with standard prevention. Elevated D-dimer levels are strongly associated with a higher risk of clot formation. Arterial clots, like strokes or heart damage, are less common but generally more serious, caused by platelet activation, inflammation, and small vessel blockage rather than just slow blood flow in veins. Evidence indicates that low-molecular-weight heparin is the preferred anticoagulant because it reduces both inflammation and clotting. Therapeutic doses may be especially beneficial for high-risk patients, and continuing clot prevention after hospital discharge helps lower the risk of late clots without significantly increasing bleeding risk.<br><br>CONCLUSION: Recognition of COVID-19-associated coagulopathy underscores the necessity of early risk stratification and individualized anticoagulation to mitigate thrombotic events and improve outcomes. Extended post-discharge prophylaxis appears promising in reducing late thrombotic complications. Future research should aim to refine optimal anticoagulant regimens and determine ideal prophylaxis duration for COVID-19-related thrombosis to reduce morbidity and mortality rates.}, }
@article {pmid41458637, year = {2025}, author = {Mohamed, A and Elasad, A and Fuad, U and Pengas, IP and Abdelazim, M}, title = {The Rise of Telemedicine in Orthopaedic Trauma Follow-Up Care and Its Long-Term Outcomes: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97896}, pmid = {41458637}, issn = {2168-8184}, abstract = {Telemedicine has rapidly transformed healthcare delivery, especially following the COVID-19 pandemic, which accelerated its use across nearly all medical specialties. Virtual consultations have become an integral part of patient follow-up and management in orthopedic trauma care. This review explores the evolution and current applications of telemedicine in orthopaedic trauma, highlighting its implementation and patient and clinician responses. We examine evidence comparing virtual and in-person care in terms of clinical outcomes, cost-effectiveness, and accessibility. This review also discusses the common barriers to adoption, practical solutions, and strategies that promote successful integration. Finally, we consider the long-term sustainability of telemedicine platforms and outline future directions for virtual orthopaedic trauma services. Together, these insights aim to guide ongoing efforts to optimize patient care delivery in the digital era.}, }
@article {pmid41458293, year = {2025}, author = {Fagundes Silva, JK and Lins-Kusterer, L and Moreira, MBA and Carvalho, FM}, title = {Burnout in Dentists and the COVID-19 Pandemic: A Systematic Review.}, journal = {Clinical practice and epidemiology in mental health : CP &amp; EMH}, volume = {21}, number = {}, pages = {e17450179400081}, pmid = {41458293}, issn = {1745-0179}, abstract = {INTRODUCTION: This study aimed to identify and analyze research on burnout in dentists, measured both prior to and during the COVID-19 pandemic, using the Maslach Burnout Inventory (MBI).<br><br>METHODS: A systematic literature review was conducted across five databases using the search terms "Dentists" and "Burnout, Psychological." Articles published between 1981 and December 2024 that utilized the MBI were included. Studies were classified based on the time of data collection: either prior to or during the COVID-19 pandemic (defined as January 30, 2020, to May 5, 2023).<br><br>RESULTS: We selected 15 of the 1,486 articles identified. Eleven of these reported means and standard deviations for the burnout scales. Among them, eight calculated scale means and standard deviations according to the guidelines recommended in the MBI manual; six studies were conducted prior to the pandemic, and two during it. An initial analysis suggests that mean levels of Emotional Exhaustion and Depersonalization increased during the pandemic, while mean levels of Personal Accomplishment remained comparable to pre-pandemic levels. However, five studies used different cutoff points to define low, moderate, or high burnout levels for each scale, limiting comparability across studies.<br><br>DISCUSSION: Few articles have adequately utilized the MBI to assess burnout in dental surgeons either before or during the COVID-19 pandemic.<br><br>CONCLUSION: Theoretical arguments suggest that the COVID-19 pandemic may have adversely affected burnout levels in dentists. However, the studies we analyzed offer only limited evidence supporting an increase in the burnout dimensions of Emotional Exhaustion and Depersonalization during the pandemic.}, }
@article {pmid41458164, year = {2025}, author = {Richardson, T and Ashworth, S and Sood, M and McKell, E and Maguire, N and Alwan, NA and Smith, D}, title = {The relationship between financial disruption during the COVID-19 pandemic and mental health: A systematic review and meta-analysis.}, journal = {Journal of public health research}, volume = {14}, number = {4}, pages = {22799036251395263}, pmid = {41458164}, issn = {2279-9028}, abstract = {OBJECTIVE: Financial difficulties are associated with poor mental health. This paper aimed to systematically review the impact of COVID-19 related financial difficulties on mental health in adults.<br><br>METHODS: A systematic search was conducted across Web of Science, Medline, and PsycINFO, from March 2020 to March 2023 to identify studies examining the mental health impact of COVID-19 related financial disruption in adults. We performed two meta-analyses to quantify the effect of income loss due to the pandemic on anxiety and depression. Studies were rated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies from the National Heart, Lung and Blood Institute was used.<br><br>RESULTS: A total of 2659 papers were identified of which 76 (59 cross-sectional and 17 longitudinal) met inclusion criteria. The results show that COVID-19 related financial disruption (income loss and financial stress) negatively impact mental health across a range of adult populations globally, including the general population, students, and other specific groups. The meta-analyses examined data from 278,854 participants from 15 studies indicated that those who lost income reported greater anxiety levels than those who did not experience income loss. Similarly for 268,128 participants across 16 studies, a meta-analysis showed greater depression symptoms for those experiencing income loss.<br><br>CONCLUSION: COVID-related financial constraints, both objective and subjective, are associated with poor mental health outcomes (particularly anxiety and depression) in various populations around the world. The results highlight the need for targeted clinical interventions for those experiencing mental health problems linked to financial problems during global crises.}, }
@article {pmid41456955, year = {2025}, author = {Hao, H and Chen, D and Qian, C and Zhou, X and Peng, X and Wang, G and Tang, J and Liu, HX}, title = {Immune Inflammation at the Crossroads of Atherosclerosis and Ischemic Stroke: Mechanisms, Trends, and Translational Perspectives.}, journal = {CNS neuroscience &amp; therapeutics}, volume = {31}, number = {12}, pages = {e70712}, pmid = {41456955}, issn = {1755-5949}, support = {2024PY-NS-027//the National Natural Science Foundation of China Cultivation Project/ ; 2024ZYYC113//National Administration of Traditional Chinese Medicine/ ; }, mesh = {Humans ; *Ischemic Stroke/immunology ; *Atherosclerosis/immunology ; *Inflammation/immunology ; *Translational Research, Biomedical/trends ; Animals ; }, abstract = {BACKGROUND: Atherosclerosis is a chronic inflammatory disorder and a major cause of ischemic stroke. Immune-mediated mechanisms are increasingly recognized as central in this continuum, yet the global research landscape and its clinical translation remain insufficiently characterized.<br><br>METHODS: We conducted a multi-level bibliometric analysis using the Web of Science Core Collection and MEDLINE. Searches targeted atherosclerosis, ischemic stroke, and immunity, restricted to English-language articles and reviews. After screening, 1760 WoSCC records and 708 human-only MEDLINE articles were analyzed with VOSviewer, CiteSpace, and Bibliometrix. Comparative assessment between China and the United States examined differences in research output, thematic focus, and methodological orientation.<br><br>RESULTS: Global publications rose steadily from 1999 to 2025, peaking in 2022. Inflammation, atherosclerosis, and ischemic stroke were the dominant themes, with growing interest in causal inference (e.g., Mendelian randomization) and translational biomarkers. China showed rapid post-2015 growth with focus on immune-cell mechanisms, while the United States maintained leadership in scholarly impact, clinical orientation, and collaboration. Human-only studies confirmed these patterns and highlighted emerging topics such as microRNAs, COVID-19, insulin resistance, and lipoprotein(a).<br><br>CONCLUSIONS: Research has shifted from associative links to mechanistic insights and early translational strategies. However, gaps remain between molecular and clinical domains, and causal pathways are underdeveloped. Future work should emphasize molecular-clinical integration, expand immunological targets, apply multi-omics and AI approaches, and strengthen international collaboration-particularly between China and the United States-to advance precision prevention and intervention in atherosclerotic ischemic stroke.}, }
@article {pmid41455627, year = {2025}, author = {Yasuda, H and Ando, J and Ando, M}, title = {Persistent COVID-19 in Patients With Hematological Malignancies: A Focused Review in the Omicron Era.}, journal = {Clinical lymphoma, myeloma &amp; leukemia}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.clml.2025.11.009}, pmid = {41455627}, issn = {2152-2669}, abstract = {COVID-19 is a threat to patients with hematological malignancies (HM) even in the Omicron era, because mortality rates are still high in HM patients, and a significant number of patients develop a protracted disease course called "persistent COVID-19 (pCOVID-19)" which can continue for weeks to months. pCOVID-19 can be life-threatening by itself, but also drastically affects the disease course of the underlying HM by delaying or terminating chemotherapy. Also, patients with pCOVID-19 can be potentially contagious, and timing of ending isolation is a dilemma the hematology ward faces. Furthermore, pCOVID-19 has been reported to lead to acquisition of SARS-CoV-2 multidrug-resistant mutations, which is an alarming issue for both the patient and public health. The optimal management method of pCOVID-19 is currently unknown, and because HM patients are excluded from randomized clinical trials, evidence is limited to case reports and small case series. We carried out a comprehensive literature review of Omicron pCOVID-19 occurring in HM patients, compiled the scattered evidence, and provide practical recommendations which can be of guide to clinicians. Main topics discussed within this review include efficacy of vaccinations in HM patients, risk factors for developing pCOVID-19 (B-cell depleting agents, bendamustine + rituximab therapy, bispecific T-cell engagers, etc.), treatment of pCOVID-19 including extended/sequential/combination therapy incorporating antivirals (nirmatrelvir/ritonavir, remdesivir, molnupiravir, and ensitrelvir) and convalescent plasma/intravenous immunoglobulin therapy, monitoring pCOVID-19 with reverse transcription (RT)-PCR, and optimal target cycle threshold values as goals of therapy.}, }
@article {pmid41455447, year = {2025}, author = {Albertson, FA and Alnakhi, W and Barksdale, S and Taylor, SS and Criss, S and Friedman, DB and Kemper, KA and Donelle, L and Thompson, W and MacGilvray, P and Natafgi, N}, title = {Teach-back techniques in telehealth: A review and insights for future directions.}, journal = {Patient education and counseling}, volume = {144}, number = {}, pages = {109453}, doi = {10.1016/j.pec.2025.109453}, pmid = {41455447}, issn = {1873-5134}, abstract = {BACKGROUND AND OBJECTIVES: The rapid expansion of telehealth during the COVID-19 pandemic has created new challenges in patient-provider communication due to the absence of in-person interactions and visual cues. Teach-back, a method where patients repeat information to confirm understanding, is a promising tool for improving communication in virtual care. This review evaluates the effectiveness of teach-back techniques in telehealth settings.<br><br>METHODS: A search of four databases (CINAHL, EMBASE, PsycINFO, PubMed) was conducted, yielding 10 studies that met the inclusion criteria. The article inclusion/exclusion criteria consisted of the following: (1) telehealth services topic; (2) direction provision related to teach-back; and (3) English, peer-reviewed, empirical journal publication. Risk of bias in included studies was assessed using established tools for randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and qualitative studies. Data synthesis followed the PICO framework, and thematic analysis was used to compare outcomes across studies.<br><br>RESULTS: Included studies which varied in design, modality, and telehealth specialty. Teach-back was consistently associated with improved patient knowledge, confidence, and self-management, as well as clinical outcomes such as better glycemic control and medication adherence. Overall evidence quality was moderate, with common limitations including small sample sizes and brief follow-up periods.<br><br>Teach-back is effective in enhancing patient understanding and outcomes in telehealth settings. However, variability in study design and implementation highlights the need for standardized protocols and additional research. Provider training in effective virtual teach-back strategies may enhance patient comprehension, strengthen communication, and advance health equity in telehealth delivery.}, }
@article {pmid41455394, year = {2025}, author = {Reid, JC and Semrau, JS and O'Grady, HK and Hoogenes, J and Gill, J and Hasan, H and von Teichman, S and Bogdanova, Y and McKenney, S and Sokol, O and Pereira, TJ and Dannenberg, VC and Farley, C and Junior, JC and Deis, A and Williamson, D and Herridge, M and Kho, M}, title = {Rehabilitation in critically ill patients with COVID-19 infection: A systematic review and meta-analysis.}, journal = {Australian critical care : official journal of the Confederation of Australian Critical Care Nurses}, volume = {39}, number = {1}, pages = {101500}, doi = {10.1016/j.aucc.2025.101500}, pmid = {41455394}, issn = {1036-7314}, abstract = {INTRODUCTION: Before the pandemic, intensive care unit rehabilitation was common. However, for critically ill patients with COVID-19 infection, rehabilitation became secondary to lifesaving measures and managing scarce resources.<br><br>OBJECTIVE: In this systematic review, we investigated the impact of rehabilitation for critically ill adults with COVID-19 infection on outcomes.<br><br>DATA SOURCES: Five electronic databases from 2020 to 2024 were searched for this study.<br><br>STUDY SELECTION: Randomised controlled trials (RCTs) and nonrandomised studies of critically ill adults with COVID-19 infection receiving in-hospital rehabilitation interventions were included in this study.<br><br>DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened titles/abstracts and full texts. Intervention types were organised into 13 categories. We assessed completeness of study reporting using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and intervention reporting using the Consensus on Exercise Reporting Template. For RCTs, we assessed risk of bias, conducted meta-analyses using random-effect models, and evaluated certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.<br><br>MAIN OUTCOMES AND MEASURES: There were 11 prespecified outcomes including physical function and resource utilisation.<br><br>RESULTS: Sixty-eight studies (n = 50 observational, 8 RCTs, 4 experimental non-RCTs, and 6 other designs) enrolling 23,630 participants met inclusion criteria. Thirty-one reported interventions; mobility was the most common activity (74% of studies). Authors used 87 outcome measures at 57 reported time points. Strengthening the Reporting of Observational Studies in Epidemiology scores were adequate with >75% items reported. Mean Consensus on Exercise Reporting Template reporting for intervention (n = 45) was moderate (54% [23%]), and that for control groups (n = 11) was poor (48% [20%]). Risk of bias was low; very-low-certainty evidence showed that multidisciplinary functional and respiratory rehabilitation and bed cycling + tilt table may result in shorter duration of mechanical ventilation (2 RCTs, n = 116, intervention = 9.1 days, control = 11.7 days; standardised mean difference: 0.44 days [95% confidence interval: -0.81 to-0.07]) and shorter hospital length of stay (three RCTs, n = 116, intervention = 17.6-days, control = 26.2-days; standardised mean difference: 2 days [95% confidence interval: -4.22 to 0.04]).<br><br>CONCLUSIONS AND RELEVANCE: Based on very-low-certainty evidence, rehabilitation may lead to shorter mechanical ventilation duration and hospital length of stay. Substantial heterogeneity across interventions, outcomes, and time points limited evidence synthesis. This review may aid in planning future rehabilitation studies with critically ill patients and for future pandemics where rehabilitation will have an important role.<br><br>PROSPERO REGISTRATION: CRD42023340256.}, }
@article {pmid41454696, year = {2025}, author = {Yang, XM and Bian, H and Chen, ZN}, title = {CD147/Basigin: From Integrative Molecular Hub to Translational Therapeutic Target.}, journal = {Advanced science (Weinheim, Baden-Wurttemberg, Germany)}, volume = {}, number = {}, pages = {e18884}, doi = {10.1002/advs.202518884}, pmid = {41454696}, issn = {2198-3844}, support = {92169211//National Natural Science Foundation of China/ ; 82130084//National Natural Science Foundation of China/ ; 2023-JC-YB-166//Shaanxi Natural Science Foundation/ ; }, abstract = {CD147 (Basigin/EMMPRIN), a multifunctional member of the immunoglobulin superfamily (IgSF), is a critical regulator of tumor progression, immune modulation, and metabolic adaptation. Under physiological conditions, it acts as a dynamic scaffold, interacting with monocarboxylate transporters (MCTs), integrins, and cyclophilin A (CyPA) to orchestrate spermatogenesis, embryo implantation, and neural network function. Pathological overexpression of CD147 induces the secretion of matrix metalloproteinases (MMPs), epithelial-mesenchymal transition (EMT), metabolic reprogramming, and immune evasion, functioning as an independent prognostic biomarker in multiple malignancies. Beyond oncology, CD147 is exploited as an entry receptor for pathogens, including SARS‑CoV‑2, HIV‑1, Plasmodium falciparum, and contributes mechanistically to cardiovascular, autoimmune, and neurodegenerative diseases. Notably, CD147 acts as a fundamental "Energy-Structure Coupler," coordinating metabolic flux (via MCTs) with morphogenetic plasticity (via integrins/MMPs) to maintain cellular homeostasis. This review summarizes current insights into CD147's molecular structure, isoforms, post-translational modifications, and signaling pathways, highlighting its pivotal roles across cancer, infection, autoimmunity, and cardiovascular disease. Finally, we discuss challenges such as the "specificity paradox" and propose emerging strategies to exploit CD147 as a precision biomarker and therapeutic target across diverse diseases.}, }
@article {pmid41454589, year = {2025}, author = {Gillespie, LK and Richards, TN and Whitehouse, E}, title = {Remote and Hybrid Work in Crime Victim Services: A Scoping Review.}, journal = {Trauma, violence &amp; abuse}, volume = {}, number = {}, pages = {15248380251397414}, doi = {10.1177/15248380251397414}, pmid = {41454589}, issn = {1552-8324}, abstract = {Remote and hybrid options for crime victim services grew slowly during the late 20th and early 21st centuries, followed by rapid expansion on the heels of the COVID-19 pandemic. While there has been significant focus on remote work in other sectors such as healthcare and tech industries, there have been no scoping reviews on remote service delivery in crime victim services. Using the PRISMA-ScR framework for scoping reviews, we identified 27 studies on remote or hybrid services in victim service agencies that met our inclusion criteria (empirical studies on remote and/or hybrid work in community- and/or systems-based victim service agencies, written in English). Studies were examined regarding the (a) methods and data used in empirical studies; (b) provider-level and client-level challenges and benefits; and (c) recommendations. Findings show that most studies were exploratory or descriptive in nature, collected qualitative data from service providers, and were conducted, at least in part, to learn about the impact of the COVID-19 pandemic. Common provider-level challenges included technological barriers, concerns about the security of online services, and the development of rapport with clients virtually, while strengths included personal-professional flexibility, new collaborations, and work productivity/efficiency. Client-level challenges included technology access, digital literacy, and confidentiality and safety concerns, while strengths included increased access to services, reduced cost, and increased anonymity of online services. Results suggest that we need additional, rigorous evaluation research to understand how processes and outcomes differ between remote and in-person services for crime victims and victim service providers.}, }
@article {pmid41452653, year = {2025}, author = {Agorsor, PI and Eze, MO}, title = {Early Detection of Infectious Diseases: A Review of Recent Advances in Pathogen Identification, Molecular Tools, and Metabolomics-Driven Biomarker Discovery.}, journal = {Journal of proteome research}, volume = {}, number = {}, pages = {}, doi = {10.1021/acs.jproteome.5c01014}, pmid = {41452653}, issn = {1535-3907}, abstract = {The recent COVID-19 pandemic has heightened public interest in noninvasive methods for early diagnosis of infectious diseases. In addition, various government agencies have implemented "infectious disease preparedness" to mitigate future outbreaks. This review highlights conventional and advanced methods for infectious disease diagnosis with an emphasis on emerging mass spectrometry methods. Conventional methods for pathogen identification, such as culture-based techniques and molecular methods, have limitations with respect to sensitivity, specificity, and turnaround time. Recent advances in high-resolution mass spectrometry have revolutionized the field of infectious disease biomarker discovery. These techniques enable the comprehensive profiling of metabolites in various biological samples, identification of disease-specific biomarkers, and elucidation of complex host-pathogen interactions. While liquid chromatography-mass spectrometry has been extensively used to identify metabolic alterations in diseases, such as COVID-19, tuberculosis, pneumonia, and influenza, this often requires the use of body fluids. On the other hand, advances in gas chromatography-high resolution mass spectrometry are enabling noninvasive detection of infectious diseases by means of breath-based volatile organic compounds. These methods offer high sensitivity and specificity, enabling the detection of low-abundance biomolecules and the elucidation of complex biological pathways. This review further examines the limitations of each approach while emphasizing the essential applications of metabolomics in infectious disease diagnosis.}, }
@article {pmid41452424, year = {2025}, author = {Tzang, CC and Sheng, H and Kuo, VF and Luo, CA and Lin, TA and Lee, YT and Huang, ES and Wu, PH and Tzang, BS and Hsu, TC}, title = {Association between COVID-19 and New-Onset Autoimmune Diseases: Updated Systematic Review and Meta-Analysis of 97 Million Individuals.}, journal = {Clinical reviews in allergy &amp; immunology}, volume = {68}, number = {1}, pages = {111}, pmid = {41452424}, issn = {1559-0267}, mesh = {Humans ; *Autoimmune Diseases/epidemiology/immunology/etiology ; *COVID-19/epidemiology/immunology/complications ; Risk Factors ; }, abstract = {SARS-CoV-2 infection may induce long-term immune dysregulation; however, its contribution to the development of autoimmune disease remains disputed. We aim to quantify the relative risk of new-onset autoimmune diseases following COVID-19 and its modifiers through a systematic review and meta-analysis of population-based cohort studies. MEDLINE, Embase, Cochrane Library, and Web of Science were searched to March 31, 2025, for cohort studies comparing individuals with and without confirmed COVID-19. Random-effects meta-analysis estimated pooled hazard ratios (HRs) with 95% CIs. Subgroup analyses examined the severity of acute COVID-19, vaccination status, and demographics. Risk of bias was evaluated with the Newcastle-Ottawa Scale, certainty of evidence with GRADE, and publication bias with funnel plots and Egger's test. The review protocol was prospectively registered in PROSPERO (CRD42025646186). Seventeen cohort studies, including over 250 million person-years, were included. COVID-19 was associated with a 49% increased risk of new-onset autoimmune-related diseases (AIRD; HR = 1.49, 95% CI: 1.21-1.83; p = 0.0002). Significant associations (p < 0·05) were observed for 17 of 23 outcomes, with the strongest risks in antiphospholipid syndrome (HR = 2·16), ANCA-associated vasculitis (HR = 2·15), mixed connective tissue disease (HR = 2·12), and immune thrombocytopenic purpura (HR = 1·87). Risk was higher after severe infection (HR = 1.70), but was reduced in vaccinated individuals (HR = 0.56, compared to 1.42 in unvaccinated individuals). The certainty of evidence was moderate for conditions with large effect sizes, but low overall, reflecting heterogeneity across studies and the non-randomized design of the included studies. SARS-CoV-2 infection increases the risk of autoimmune diseases, particularly those affecting vascular and connective tissue. Risk is amplified by severe infection and attenuated by vaccination. These findings highlight the necessity of vaccination and targeted follow-up in severe COVID survivors.}, }
@article {pmid40926588, year = {2025}, author = {Trump, BD and Galaitsi, S and Cegan, J and Linkov, I}, title = {How Will AI Shape the Future of Pandemic Response? Early Clues From Data Analytics.}, journal = {Risk analysis : an official publication of the Society for Risk Analysis}, volume = {45}, number = {12}, pages = {4544-4556}, pmid = {40926588}, issn = {1539-6924}, mesh = {Humans ; *COVID-19/epidemiology ; *Artificial Intelligence ; *Pandemics ; SARS-CoV-2 ; Machine Learning ; *Data Science ; Deep Learning ; Data Analytics ; }, abstract = {The COVID-19 pandemic has exposed critical gaps in our management of systemic risks within complex, interconnected systems. This review examines 10 key areas where artificial intelligence (AI) and data analytics can significantly enhance pandemic preparedness, response, and recovery. Inadequate early warning systems, insufficient real-time data on resource needs, and the limitations of traditional epidemiological models in capturing complex disease dynamics are among the challenges analyzed. To address these issues, we explore the potential of AI applications, including machine learning-based surveillance, deep learning for improved epidemiological modeling, and AI-driven optimization of non-pharmaceutical interventions. These technologies offer the promise of more timely, accurate, and granular analysis of pandemic risks, thereby supporting evidence-based decision-making in rapidly evolving crises. However, implementing AI in pandemic response raises significant ethical and governance challenges, particularly concerning privacy, fairness, and accountability. We parse the promise and challenges of AI in the evolving space of emergency response data analytics and highlight critical steps forward.}, }
@article {pmid41451353, year = {2025}, author = {Chaudhary, V and Bhadola, P}, title = {Artificial Intelligence-Powered Nanosensor Platforms for Non-Invasive Breathomic Diagnostics.}, journal = {Nanotechnology, science and applications}, volume = {18}, number = {}, pages = {611-641}, pmid = {41451353}, issn = {1177-8903}, abstract = {Global healthcare settings are increasingly burdened by critical diseases, where conventional diagnostics are often expensive, invasive, time-consuming and centralised. It creates a critical gap for rapid, accessible, portable and non-invasive health assessment. AI-powered Nanosensors for Breathomics Diagnostics (AND) platforms have emerged as a transformative solution to this complex global problem, integrating highly sensitive nanomaterials with advanced machine intelligence to detect disease biomarkers in exhaled breath. These platforms have already demonstrated high performance, with reports of 90-95% diagnostic accuracy for conditions such as lung cancer and achieving sub-ppb detection limits. These platforms are not limited to controlled laboratory settings but have been employed to monitor a spectrum of diseases, including cancer, asthma, diabetes, coronavirus disease, and renal failure. Their integration into wearable systems, smartphones, smart masks and multimodal laboratory systems further extends their applications in predictive analytics, personalised medicine and real-time human-machine interaction. However, challenges related to data standardisation, sensor selectivity, ethical AI, and clinical validation have limited their commercialization. It necessitates solutions such as Explainable AI, physics-informed modelling, network theory, and the development of large-scale clinical breath databases to enhance clinical reliability, model robustness, diagnose sensor drift, and attain transparency. This article critically details the recent progress and charts a new path forward for translating AND platforms from research to clinical reality as next-generation healthcare.}, }
@article {pmid41451231, year = {2025}, author = {Tamura, M and Yagi, Y and Hanayama, S and Yoshizaki, S and Shibuya, K and Masuda, H and Mori, M}, title = {MRI-negative myelitis, especially after COVID-19: a case report and literature review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1708018}, pmid = {41451231}, issn = {1664-3224}, mesh = {Humans ; Female ; *COVID-19/complications ; Magnetic Resonance Imaging ; Young Adult ; SARS-CoV-2 ; *Myelitis/therapy/diagnostic imaging/etiology/diagnosis ; Methylprednisolone/therapeutic use/administration &amp; dosage ; Evoked Potentials, Somatosensory ; Plasma Exchange ; Spinal Cord/diagnostic imaging ; Betacoronavirus ; }, abstract = {BACKGROUND: Neurological sequelae of coronavirus disease 2019 (COVID-19) include inflammatory myelopathies. Among these, magnetic resonance imaging (MRI)-negative myelitis- defined as normal spinal cord MRI findings despite compatible clinical features-presents diagnostic and therapeutic challenges.<br><br>CASE PRESENTATION: A 22-year-old Japanese woman developed progressive distal paresthesia, gait disturbance, bladder and rectal dysfunction, and sensory loss approximately three months after COVID-19. Neurological examination presented with pyramidal tract signs and sensory deficits in both lower limbs. Cerebrospinal fluid oligoclonal bands were positive. Brain MRI showed subtle corticospinal tract hyperintensities, whereas spinal MRI findings remained normal throughout the course. Somatosensory-evoked potentials (SEP) demonstrated absent right N20 and bilateral P37 responses, localizing dysfunction to the thoracic cord. Treatment with intravenous methylprednisolone pulse therapy with plasma exchange resulted in marked clinical recovery and SEP normalization, with only mild residual paresthesia at two-year follow-up.<br><br>DISCUSSION: The present case illustrates the clinical utility of SEPs for monitoring disease activity and establishing objective criteria for treatment escalation in post-COVID-19 MRI-negative myelitis. Although MRI-negative myelitis can be observed in myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), lupus myelitis, and glial fibrillary acidic protein (GFAP) astrocytopathy, post-COVID-19 myelitis lacks specific biomarkers, complicating both diagnosis and treatment. A review of 20 reported cases of post-COVID-19 MRI-negative myelitis revealed a mean age of 54.4 years, a male-to-female ratio of 3:2, frequent bladder and rectal disturbances and paresis (85% each), high severity (63.2%), a median infection-to-neurological interval of 28 days, oligoclonal bands in 25% (4/16), multiple immunotherapies in 66.7%, and marked improvement or recovery in 66.7%.<br><br>CONCLUSION: In post-COVID-19 MRI-negative myelitis, SEPs offer critical diagnostic and prognostic information. Early recognition and timely escalation of combination immunotherapy may optimize neurological outcomes.}, }
@article {pmid41451228, year = {2025}, author = {Galvan, C and Ovsyannikova, IG and Kennedy, RB}, title = {Glycosylation as a strategic mechanism for measles virus and mumps virus immune evasion.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1716829}, pmid = {41451228}, issn = {1664-3224}, mesh = {Glycosylation ; *Measles virus/immunology ; *Mumps virus/immunology ; Humans ; *Immune Evasion ; *Mumps/immunology/virology ; *Measles/immunology/virology ; Animals ; }, abstract = {Glycosylation of viral surface proteins by host cell factors is one strategy paramyxoviruses employ to evade the host's immune system during infection. Viral glycosylation thus has the potential for innate and adaptive immune modulation. However, an adequate assessment of the effects glycosylation has on immune recognition and response for two important paramyxoviruses, Measles virus (MeV) and Mumps virus (MuV), is lacking. This review aims to provide a comparison of epitope-site sequence changes in the surface glycoproteins MeV-H, MeV-F, MuV-HN, and MuV-F across different wild type and vaccine strains of measles and mumps. Such changes may alter glycosylation patterns at antigenic sites, thus altering the virus' efficiency to induce an immune response as well. Further investigation of measles and mumps viral glycosylation studies will aid the development of specific therapeutics that modulate viral glycosylation during immune diseases, viral infections, and oncolytic treatments. Moreover, determining how glycosylation affects measles and mumps immune responses may pave the way for the development of novel vaccine strains for the improved immunogenicity and immune durability of measles and mumps vaccines.}, }
@article {pmid41450745, year = {2025}, author = {Putra, BA}, title = {Digital Technologies in a Post-Pandemic Southeast Asia: Measures for Enhancing Regional Approaches.}, journal = {F1000Research}, volume = {14}, number = {}, pages = {623}, pmid = {41450745}, issn = {2046-1402}, mesh = {Asia, Southeastern/epidemiology ; Humans ; *Telemedicine ; *Digital Technology ; *Pandemics ; *COVID-19/epidemiology ; Health Policy ; }, abstract = {The Association of Southeast Asian Nations (ASEAN) has taken some measures to advance collective action to accelerate telehealth in the region. Still, it has encountered the problem of digital readiness and digital health preparedness disparities within the region. To maintain the consolidation of digital health utilization across ASEAN member states, this article offers policy recommendations to address the diverse approaches taken and compensate for capacity differences among members. Drawing on insights from published official policies, government health ministry websites of Southeast Asian nations, and ASEAN's digital health policies, the article first reviews the diversities of digital technologies in a post-pandemic Southeast Asia and then assesses measures to enhance regional approaches. Several recommendations are presented: First, ASEAN can standardize regional frameworks for telehealth by sharing digital health transformation blueprints and leveraging ASEAN and ASEAN Plus forums to bridge divergent understandings and advance the region's digital health initiatives. Second, ASEAN facilitates investment through a telehealth sandbox and fosters collaboration among stakeholders. Although the recommendations are consistent with the 'ASEAN Way,' lingering concerns in Southeast Asia's telehealth landscape include different commitments and expectations, risks of privacy infringements, and the misuse of technology in the region's authoritarian states.}, }
@article {pmid41450491, year = {2025}, author = {Mukherjee, D and Sagar, K and Kobialka, RM and Ghosh, P and Weidmann, M and Savareh, BA and Joardar, SN and Truyen, U and Abd El Wahed, A and Ceruti, A}, title = {Filling the gap: artificial intelligence-driven one health integration to strengthen pandemic preparedness in resource-limited settings.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1707306}, pmid = {41450491}, issn = {2296-2565}, mesh = {Humans ; *Artificial Intelligence ; *Pandemics/prevention &amp; control ; *One Health ; COVID-19/epidemiology ; *Developing Countries ; Health Resources ; Resource-Limited Settings ; Pandemic Preparedness ; }, abstract = {Emerging zoonotic pathogens like SARS-CoV-2 and Nipah virus demonstrate the critical need for integrated surveillance systems connecting human, animal, and environmental health. This review examines how artificial intelligence can address One Health integration gaps in pandemic surveillance, focusing on resource-limited settings. While global digitization levels now support Artificial Intelligence (AI)-powered platforms, LMICs face barriers including limited resources and fragmented data systems. Current AI tools remain domain-specific and designed for high-income settings, limiting its applicability to pandemic preparedness in low-resource settings. Existing AI-tools and gaps are described and put into perspective within an AI-driven One Health framework, specifically for LMICs. The framework exemplifies resource optimization, governance, sectoral collaboration, capacity building, health system integration, geographic accessibility, and prioritization. The framework also features an exemplified dual solution combining Graph Neural Networks for integrated risk assessment with offline-first mobile applications for community surveillance. AI technologies offer substantial potential for pandemic preparedness through automated data harmonization, predictive modeling, and resource optimization. However, successful implementation requires concurrent digitization, cultural adaptation, and local capacity building. Prioritizing mobile solutions with minimal infrastructure requirements alongside community engagement will be essential for creating equitable AI-based surveillance systems in LMICs.}, }
@article {pmid41450139, year = {2026}, author = {Singh, E and Nishi, N and Tripathi, M and Prakash, K}, title = {SARS-CoV-2 Genome and S2 Spike Protein: IRF-Driven Interferon Regulation and Host Cell Responses.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70094}, doi = {10.1002/rmv.70094}, pmid = {41450139}, issn = {1099-1654}, mesh = {Humans ; *Spike Glycoprotein, Coronavirus/genetics/immunology/metabolism ; *SARS-CoV-2/genetics/immunology/pathogenicity ; *COVID-19/immunology/virology ; *Interferon Regulatory Factor-1/genetics/immunology ; Animals ; *Interferons/immunology ; Genome, Viral ; *Interferon Regulatory Factor-2/genetics/immunology ; Angiotensin-Converting Enzyme 2/genetics ; Host-Pathogen Interactions/immunology ; Virus Internalization ; *Interferon Regulatory Factors/immunology/genetics ; }, abstract = {Coronaviruses, members of the betacoronavirus genus. They are mostly enveloped and has +ve sense RNA which infects a wide range of hosts, including mammals and birds. This SARS-CoV-2 in December 2019 triggered a global pandemic, with transmission primarily occurring through respiratory droplets. SARS-CoV-2 comprises four structural proteins namely: spike, membrane, envelope and nucleocapsid protein (S, M, E, and N respectively) along with multiple non-structural proteins (nsp1-nsp16) essential for infections. The trimeric S protein, composed of S1 and S2 subunits which helps in virus entry into the cell after attachment to the ACE2 recpetor of host cell. Interferon regulatory factors (IRF-1 and IRF-2) are critical transcription factors in antiviral immune responses, yet their specific roles in SARS-CoV-2 infection remain insufficiently understood. Disruption of their regulatory functions may compromise host antiviral defenses and influence disease progression. Elucidating the mechanistic roles of IRF-1 and IRF-2 could facilitate the production of novel therapeutic strategies which further modulates the immune responses, mitigates the viral pathogenicity, and hence clinical outcomes will be improved. A deep insight of these immune pathways is pivotal for designing targeted interventions to strengthen host resilience against coronavirus infections.}, }
@article {pmid41449370, year = {2025}, author = {Onakpoya, IJ and Plüddemann, A and Rosca, EC and Gandini, S and Maltoni, S and Brassey, J and Jefferson, T and Heneghan, CJ and Evans, DH and Conly, JM}, title = {Viral cultures for assessing airborne infectiousness of SARS-CoV-2: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12879-025-12430-z}, pmid = {41449370}, issn = {1471-2334}, abstract = {INTRODUCTION: There is uncertainty about the quantification, viability and infectivity of SARS-CoV-2 in air samples. Our objective was to systematically review the evidence for air sample virus infectiousness with high-level confirmatory studies.<br><br>METHODS: We conducted literature searches in LitCovid, medRxiv, PubMed, the WHO Covid-19 databases, and Google Scholar. We included studies that assessed viral infectiousness in the air using viral culture or serial qRT-PCR with or without genomic sequencing. Our primary outcome was the proportion of culture-positive air samples of SARS-CoV-2. Secondary outcomes explored the relationship between infectiousness and Cycle threshold (Ct). We used published methods for assessing quality, and R software for meta-analysis.<br><br>RESULTS: We included 26 studies that used viral culture to assess air sample positivity of SARS-CoV-2. The overall reporting quality was moderate. The overall pooled frequency of positive viral cultures was 14% (95% CI 7-17, I[2]&#x2009;=&#x2009;52.3%; p&#x2009;=&#x2009;0.001). The data were not sufficient to compute a threshold for infectivity, or to explore the relationship between distance and infectiousness.<br><br>CONCLUSIONS: The proportion of positive SARS-CoV-2 viral cultures following positive RNA samples in the air is low, suggesting that while viral RNA may be present, the likelihood of detecting culturable, infectious viruses is substantially lower. Our findings underscore the need for standardized guidelines to assess and report the infectivity and potential for transmissibility of airborne viruses, including the consistent reporting of Ct values and methods to mitigate bias.}, }
@article {pmid41448305, year = {2025}, author = {Habashy, NH}, title = {Antiviral potential of major royal jelly proteins.}, journal = {International journal of biological macromolecules}, volume = {}, number = {}, pages = {149884}, doi = {10.1016/j.ijbiomac.2025.149884}, pmid = {41448305}, issn = {1879-0003}, abstract = {Royal jelly (RJ), a honeybee secretion, contains nine distinct water-soluble proteins known as major RJ proteins (MRJPs). MRJPs are the primary constituents of RJ and have demonstrated significant potential as antiviral agents. MRJPs exhibit antiviral effects against various viruses, including HCV, HBV, HIV, and SARS-CoV-2. Previous research has indicated that MRJPs can interfere with viral replication by targeting specific stages of the viral life cycle, such as by inhibiting key enzymes, including RNA-dependent RNA polymerase and reverse transcriptase. They also block viral entry into host cells and influence immune responses. In addition to their direct antiviral actions, MRJPs exhibit antioxidant, anti-inflammatory, and immunomodulatory properties, further enhancing their therapeutic potential. Despite these promising preclinical findings, further mechanistic and translational investigations are required to validate and enhance the therapeutic potential of MRJPs. This review presents a narrative and systematic summary of the antiviral effects of MRJPs supplemented by original in silico docking analyses and highlights their potential as natural candidates for antiviral drug development.}, }
@article {pmid41447763, year = {2025}, author = {Zhao, Y}, title = {Research progress and applications of reverse genetics systems for infectious bronchitis virus.}, journal = {Poultry science}, volume = {105}, number = {2}, pages = {106312}, doi = {10.1016/j.psj.2025.106312}, pmid = {41447763}, issn = {1525-3171}, abstract = {Infectious bronchitis virus (IBV) poses a persistent threat to global poultry health, driving the need for advanced molecular tools to study and combat this pathogen. Reverse genetics has emerged as a pivotal technology in IBV research, enabling precise manipulation of the viral genome to investigate pathogenesis, design novel vaccines, and identify potential antiviral targets. This review systematically examines the development, applications, and challenges of reverse genetics platforms for IBV. Established methods, including vaccinia virus supported systems, in vitro ligation and transcription, targeted RNA recombination, bacterial artificial chromosome cloning, transformation associated recombination, and circular polymerase extension reaction are detailed, with their principles, advantages, and limitations highlighted. Furthermore, contributions of these platforms to elucidating gene function, rational vaccine design, and the development of IBV as a viral vector for multipathogen vaccines are discussed. Current technical hurdles, safety considerations, and knowledge gaps are addressed, along with future perspectives integrating CRISPR/Cas9, synthetic biology, and computational approaches. This comprehensive overview aims to guide researchers in selecting appropriate reverse genetics strategies and to inspire innovative solutions for IBV control.}, }
@article {pmid41446966, year = {2025}, author = {Lazaretti, CR and Aguzzoli, C}, title = {Clinical Manifestations.}, journal = {Alzheimer's &amp; dementia : the journal of the Alzheimer's Association}, volume = {21 Suppl 3}, number = {Suppl 3}, pages = {e105305}, doi = {10.1002/alz70857_105305}, pmid = {41446966}, issn = {1552-5279}, mesh = {Humans ; *COVID-19/complications/psychology/epidemiology ; *Cognitive Dysfunction/epidemiology/etiology ; SARS-CoV-2 ; Executive Function ; }, abstract = {BACKGROUND: The COVID-19 pandemic significantly impacted the overall health of those affected, often harming general cognition distinct and higher cortical functions. Recent studies suggest that the infection may result in prolonged cognitive deficits. This study aims to review differences in long-term cognitive impairment in individuals who developed mild-to-moderate COVID-19 symptoms relative to severe cases.<br><br>METHOD: We conducted a scoping review on the long-term cognitive effects of COVID-19, selecting articles from 2020 to 2024 indexed in the PubMed database. Inclusion criteria required studies that assessed long-term cognitive impairment in individuals recovering from COVID-19.<br><br>RESULT: A total of twenty articles were screened for eligibility, and eight full-text publications were assessed (Figure 1). The prevalence of cognitive impairment in the acute phase of COVID-19 ranged from 61.5% in mild to moderate cases to 80% in moderate to severe cases. We found that executive function, working memory, verbal fluency, and attention were the cognitive domains most impacted. In the long-term, more than 50% of patients continued to experience cognitive deficits even after full recovery, particularly in attention, memory, and executive function. A Swedish study reported that 48% of severe-symptom survivors exhibited cognitive deficits-such as short memory deficit-five months after hospital discharge, while another study showed that 38% of moderate and 11.2% of severe cases experienced immediate verbal memory impairment. Another single-center study assessing 726 survivors of COVID-19 from the Intensive Care Unit with a median age of 62 years found that 87.5% had not fully regained their daily activity levels, and only 6.2% had returned to their previous functional level.<br><br>CONCLUSION: A growing body of evidence indicates that post-COVID-19 cognitive impairment may persist in a significant proportion of survivors, indicating that cognitive impairment are not limited to severe cases but can affect individuals across clinical stages. Among the various cognitive difficulties observed, memory impairment stands out as the predominant domain among patients recovering from COVID-19. Therefore, the clinical evaluation of long-term follow-up of these patients is important, with special attention to cognitive function.}, }
@article {pmid41446849, year = {2025}, author = {Kohler, MM and Kolbe, M and Körtgen, B and Angst, S and Barbul, AMS and Seufert, L and Hasal, R and Bührer, L and Held, U and Grande, B}, title = {Efficacy of simulation-based training for airway management in preparing hospitals for the COVID-19 pandemic: a systematic review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1656737}, pmid = {41446849}, issn = {2296-858X}, abstract = {BACKGROUND: In response to the coronavirus pandemic, hospitals worldwide implemented simulation-based training to help healthcare providers (HCPs) adapt to revised protocols for airway management in patients with infectious coronavirus disease 2019 (COVID-19). We conducted a systematic review of simulation-based studies on airway management in COVID-19 patients, with the aim of analyzing the findings of these studies and consolidating evidence-based recommendations to optimize responses to possible future pandemics.<br><br>METHODS: We performed a systematic literature search of PubMed, Embase, Medline, and the Cochrane Library on 25 August 2022. As different studies measured different outcomes (e.g., only confidence, only knowledge, or both) in different ways, a random-effects model was used for meta-analysis and change scores were calculated.<br><br>RESULTS: The systematic review included 20 studies after screening 141 articles. The meta-analysis revealed significant improvements in participants' confidence and knowledge after simulation training, as evidenced by negative standardized mean differences (SMDs, Cohen's d). Sensitivity analysis confirmed that the results were robust across various correlation estimates. However, there was a high risk of publication bias, as funnel plots showed asymmetry and studies fell outside the 95% confidence interval.<br><br>CONCLUSION: This systematic review highlights the effectiveness of simulation training in improving healthcare providers' confidence and knowledge regarding airway management during pandemics. The findings underscore the positive impact of simulation-based education, as demonstrated by significant improvements from pre-training to post-training assessments. However, the observed publication bias suggests that additional high-quality, unbiased studies are necessary to strengthen the evidence base and inform future training programs for pandemic preparedness.<br><br>PROSPERO, CRD42022293708.}, }
@article {pmid41446839, year = {2025}, author = {Jin, T and Peng, J and Peng, R and Hu, Z}, title = {Research trends and hotspots of traditional Chinese medicine for asthenopia: a comprehensive visualization and bibliometric study as of 2024.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1613177}, pmid = {41446839}, issn = {2296-858X}, abstract = {OBJECTIVE: To explore the preventive and therapeutic effects of traditional Chinese medicine (TCM) for asthenopia.<br><br>METHODS: The literatures on TCM for asthenopia published in Web of Science, PubMed, China National Knowledge Infrastructure and Wanfang from the inception of each database to December 31, 2024 were retrieved and summarized. Network cluster co-occurrence analysis and qualitative narrative methods were used for this review.<br><br>RESULTS: The related research has shown a fluctuating upward trend. The institutions that published more relevant studies were Chinese medicine universities and their affiliated hospitals. The analysis found that the research mainly focused on elucidating the treatment mechanism, optimizing the acupoint stimulation mode of external treatment, and optimizing the systematic regulation of the TCM decoction program.<br><br>CONCLUSION: The research on TCM for asthenopia is unevenly distributed among countries and regions, and mainly concentrated in China. However, since the outbreak of COVID-19, the research on asthenopia abroad has gradually increased, which may be related to lifestyle and the development of modern electronic technology. Current research trends mainly focus on the establishment of evidence-based TCM clinical intervention programs and the establishment of a comorbidity model of asthenopia.}, }
@article {pmid41445958, year = {2025}, author = {Xiao, Y and Song, Z and Zhou, L and Lu, W and Fang, W and Xu, J and Li, X}, title = {Coronavirus nucleocapsid proteins: a multifaceted modulator in the innate immune evasion.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1658339}, pmid = {41445958}, issn = {1664-302X}, abstract = {Coronaviruses are capable of inducing diverse infectious diseases that pose significant threats to the public health and the economic development. With a single positive-stranded RNA genome, coronaviruses utilize viral proteins to execute diverse immune escape strategies to facilitate their replication. Of all the identified structural proteins and non-structural proteins within the coronaviruses, nucleocapsid (N) protein is highly conserved and is the most abundant viral protein in infected host cells. N protein regulates the more complex and diverse mechanisms through which viruses suppress host immunity. In this review, we analyzed the basic structure of coronavirus N protein, and further elaborate on its multifaceted regulatory functions in the virion assembly, pathogenesis, host innate immune responses, as well as the innate immunity-related programmed cell death and cell cycle, and also other cell processes. A better understanding of the immune evasion strategy regulated by N protein will help to provide a theoretical basis for the development of broad-spectrum anti-coronavirus drugs targeting N proteins.}, }
@article {pmid41444990, year = {2025}, author = {Barrera, I and Wang, G and Rajakumar, B and Muthupalaniappan, S and Cronin, AE and Chatterjee, A}, title = {Mobile addiction treatment units: a narrative review.}, journal = {Addiction science &amp; clinical practice}, volume = {20}, number = {1}, pages = {99}, pmid = {41444990}, issn = {1940-0640}, mesh = {Humans ; *Mobile Health Units/organization &amp; administration ; United States ; *Opioid-Related Disorders ; Drug Overdose/prevention &amp; control ; *Substance-Related Disorders/therapy ; COVID-19/epidemiology ; Health Services Accessibility ; Program Evaluation ; Telemedicine ; }, abstract = {BACKGROUND: Drug overdose deaths have increased in the last decade, becoming a substantial public health priority. Mobile Addiction Treatment Units (MATU) are vans, vehicles, or portable clinics that provide low-threshold, low-barrier, community-based services for addiction treatment including opioid agonist medications. MATUs are a point of entry for care, particularly for individuals who have faced barriers to access at in-person healthcare facilities.<br><br>OBJECTIVE: This narrative review aims to synthesize and conduct a thematic analysis of the research on implementation and outcomes of MATUs in the United States. Our study's primary objectives were threefold: 1) to evaluate MATU program reach, 2) to evaluate MATU program effectiveness, and 3) to evaluate MATU program implementation.<br><br>METHODS: We identified studies examining MATUs by searching electronic databases MEDLINE (Ovid), Embase (Elsevier), PsycINFO (EBSCO), and Web of Science Core Collection (Clarivate). Records were selected for full-text review if their abstract referenced any mobile modality for substance use treatments. Exclusion criteria included review articles, opinion articles, theoretical articles, abstracts, dissertations, studies conducted outside of the United States, and studies focused solely on mobile harm-reduction interventions without offering medication treatment for SUD. This review is reported per the Preferred Reporting Items of Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR) guidelines.<br><br>RESULTS: A total of 2,232 articles were screened at the title and abstract level, of which 83 were assessed for full text eligibility. The 34 articles selected for inclusion were varied in methodology, and included randomized controlled trials (RCTs), observational studies, cohort studies, and mixed-methods research. The most common study locations were Baltimore, MD (10 studies), Boston, MA (5 studies), Philadelphia, PA (4 studies), and New Haven, CT (3 studies). Regarding reach, four studies were conducted during the COVID-19 pandemic. Six studies were conducted primarily in a population experiencing homelessness; two studies were conducted primarily in populations with criminal justice involvement; four studies were conducted primarily in youth or young-adult populations; three studies were conducted in rural populations. In these settings, MATUs successfully engaged vulnerable and underserved populations, delivering comprehensive care that combined harm reduction, primary care, and mental health services. These units demonstrated potential to enhance health outcomes, reduce stigma, increase treatment retention rates in marginalized populations compared to office-based programs, and tackle social determinants of health. Common challenges included patient engagement, logistical and regulatory barriers, and financial sustainability, all compounded by limited space, staffing, and resources, while homelessness, encampment removals, and the COVID-19 pandemic further disrupted care continuity (J Subst Abuse Treat 120:108149, 2021; Front Public Health 11:1154813, 2023; J Subst Use Addict Treat 159:209272, 2024; J Subst Use Addict Treat 164, 2024; Health Place 28:153-66, 2014; Addict Sci Clin Pract 18:71, 2023).<br><br>CONCLUSION: MATUs proved to be innovative and effective in addressing OUD and related issues for vulnerable populations traditionally lacking access to care. However, ongoing efforts to overcome implementation challenges and ensure sustainable funding and resources are crucial for their continued success and expansion. Future research should focus on large-scale, quantitative studies, particularly in diverse and rural settings, to better understand their long-term impact and sustainability.}, }
@article {pmid41444262, year = {2025}, author = {Wilson, JE and Gurdasani, D and Helbok, R and Ozturk, S and Fraser, DD and Filipović, SR and Peluso, MJ and Iwasaki, A and Yasuda, CL and Bocci, T and Priori, A and Altmann, D and Alwan, NA and Wesley Ely, E}, title = {COVID-19-associated neurological and psychological manifestations.}, journal = {Nature reviews. Disease primers}, volume = {11}, number = {1}, pages = {91}, pmid = {41444262}, issn = {2056-676X}, mesh = {Humans ; *COVID-19/complications/psychology/physiopathology/epidemiology ; *Nervous System Diseases/etiology/virology ; *Mental Disorders/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Anxiety/etiology ; Depression/etiology ; }, abstract = {Long COVID is an infection-associated chronic condition that typically occurs within 3 months of acute COVID-19 infection in which symptoms are intermittently or continuously present for at least 3 months. Long COVID is estimated to affect between 80 and 400 million people globally, with an incidence of 5-20% in the community and up to 50% among hospitalized patients following acute SARS-CoV-2 infection. Common neuropsychiatric and mental health symptoms of long COVID include memory deficits, executive dysfunction, anxiety, depression, recurring headaches, sleep disturbances, neuropathies, problems with taste and smell, and dizziness that accompanies erratic heart rates and severe post-exertional malaise. Underlying pathophysiological mechanisms includes SARS-CoV-2 viral persistence, herpesvirus reactivation, microbiota dysbiosis, autoimmunity, clotting and endothelial abnormalities, and chronic immune activation. Owing to the variability in the clinical presentation, management must be tailored based on a patient's presenting symptoms.}, }
@article {pmid41363223, year = {2026}, author = {Cook, KD and Guyol, GG}, title = {Early childhood education matters for child, family, and community health.}, journal = {Current opinion in pediatrics}, volume = {38}, number = {1}, pages = {9-14}, doi = {10.1097/MOP.0000000000001529}, pmid = {41363223}, issn = {1531-698X}, mesh = {Humans ; Child ; *COVID-19/epidemiology ; *Child Health ; Child, Preschool ; *Family Health ; }, abstract = {PURPOSE OF REVIEW: Strong evidence shows that early childhood education (ECE) impacts child health and wellbeing throughout the life course. Contextual factors including the rising cost of ECE and the strain of the COVID-19 pandemic on childcare arrangements have ignited national conversations about ECE. We build on existing evidence to propose a conceptual model that demonstrates mechanisms of multilevel health impacts.<br><br>RECENT FINDINGS: There is increasing recognition that ECE influences health beyond the level of the child to impact health at the levels of parent/family and community. Innovations in medical and ECE settings and cross-sector efforts can improve multilevel health outcomes by leveraging the healthcare platform to improve access to ECE, integrating mental health supports into ECE settings, and facilitating communication and data sharing between the two systems.<br><br>SUMMARY: We integrate insights from multiple early childhood disciplines, including psychology, education, and medicine to propose a model for the impacts of ECE on multilevel health outcomes. This model highlights the importance of cross-disciplinary approaches to realize the full health benefits of ECE and can inform future research and advocacy. We highlight the need for pediatricians to work across early childhood disciplines to achieve greater impact on comprehensive wellbeing.}, }
@article {pmid41312602, year = {2026}, author = {Sim, BZ and Kalil, AC and Wolfe, CR}, title = {Antiviral clinical trial design throughout the COVID pandemic: evolving endpoints and lessons learnt.}, journal = {Current opinion in infectious diseases}, volume = {39}, number = {1}, pages = {75-81}, doi = {10.1097/QCO.0000000000001165}, pmid = {41312602}, issn = {1473-6527}, mesh = {Humans ; *Antiviral Agents/therapeutic use ; SARS-CoV-2 ; *Clinical Trials as Topic/methods ; *COVID-19 Drug Treatment ; *Research Design ; COVID-19 ; Pandemics ; }, abstract = {PURPOSE OF REVIEW: Trial design during the novel coronavirus-19 (COVID-19) pandemic was stymied by significant uncertainty about the natural history of the virus, at-risk populations, and optimal patient care by investigators and clinicians alike.<br><br>RECENT FINDINGS: Three main types of trial design were invoked to address both the variable clinical disease and the evolving viral landscape, and to fit the respective health systems deploying the trials. These included adaptive trial design, platform trials, and master protocols. Strengths and challenges faced with each are discussed in more detail in the main text.<br><br>SUMMARY: Future pandemics will almost certainly continue to arise. Similarly, the landscape will continue to evolve alongside our understanding of the disease. Designing trials that remain scientifically rigorous and practical while still addressing the changing natural history of the disease continues to pose a challenge.}, }
@article {pmid41441720, year = {2025}, author = {Puchner, KP and Kondilis, E and Palantza, N and Seretis, S and Mavroudeas, S and Benos, A and Papamichail, D}, title = {Competing Theories on Global and Regional Vaccine Inequities: A Scoping Literature Review Within the Context of the COVID-19 Pandemic.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441720}, issn = {2076-393X}, abstract = {Background/Objectives: Despite global efforts, COVID-19 revealed severe spatial vaccine inequities, disproportionately affecting low- and middle-income countries (LMICs). Scholars across disciplines proposed numerous-and often competing-terms and theories to explain these disparities. In this review and within the context of the COVID-19 pandemic, we assess the usage, definition, and appropriateness of these terms and their linked theories or frameworks. Methods: We conducted a scoping review aiming to clarify key definitions, concepts, and frameworks of eight prominent terms used in the literature regarding COVID-19 global and/or regional vaccine inequities (i.e., vaccine nationalism, vaccine apartheid, vaccine colonialism, vaccine imperialism, vaccine racism, vaccine diplomacy, vaccine solidarity, and vaccine internationalism). The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines for Scoping Reviews and included papers from January 2020 to the end of October 2024. Results: We included 79 papers in our study. The majority (71%) were published in 2021-2022, with less than one-quarter authored by scholars from LMICs. Vaccine imperialism was consistently defined but rarely used, while vaccine nationalism and vaccine apartheid appeared more frequently with varied meanings. Yet, in most cases, all of these concepts identified economic interests of vaccine-producing countries as the root cause of the observed vaccine inequities. Vaccine diplomacy showed similar ambiguity, viewed by some as worsening inequities and by others as potentially mitigating them. The terms vaccine racism, vaccine colonialism, and vaccine solidarity were not explicitly identified but appear to be embedded within the definitions of other prominent terms detected. Conclusions: Across the preselected terms examined, we found numerous-and often conflicting-definitions, revealing the fragmented and competing understandings of the major drivers fueling global vaccine inequities. This lack of coherence inhibits evidence synthesis or shared theoretical progress but, most importantly, might undermine current and future efforts to address these inequities.}, }
@article {pmid41441705, year = {2025}, author = {Sun, M and Elliott, K}, title = {StealthX: A Versatile and Potent Exosome-Based Vaccine Platform for the Next Pandemic.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441705}, issn = {2076-393X}, abstract = {Exosome-based vaccines represent a transformative platform in modern vaccinology, combining nanoscale delivery, biocompatibility, and potent immunogenicity. Among these, the StealthX platform developed by Capricor, Inc. has demonstrated exceptional versatility, enabling antigen presentation at nanogram level doses without the need for adjuvants. Preclinical studies using StealthX have shown strong humoral and cellular immune responses against SARS-CoV-2 variants, including Delta and Omicron, as well as broader applications against influenza and RSV antigens. The platform's ability to accommodate multiple antigens within a single formulation addresses the challenges of viral variation and facilitates multivalent "mix-and-match" immunization strategies. This review offers an in-depth evaluation of the StealthX vaccine platform, covering the biological mechanisms underlying exosome function, the engineering approaches used to load antigens, and preclinical results demonstrated across three pivotal studies. By synthesizing current evidence, this review underscores the platform's applicability for emerging infectious diseases and explores the strategic value of multivalent exosome-based vaccines in global immunization efforts as an emerging next-generation vaccine technology.}, }
@article {pmid41441691, year = {2025}, author = {Naji, A and El Sahly, HM and Whitaker, JA}, title = {A Review of the Effects of Ipsilateral or Contralateral Vaccine Boosting on the Adaptive Immune Response.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441691}, issn = {2076-393X}, abstract = {Vaccines have been pivotal in reducing the incidence and severity of infectious diseases, improving population health, and lowering mortality rates globally. While substantial progress has been made in optimizing vaccine formulations, adjuvants, and schedules, comparatively less attention has been given to how the site of vaccination may influence immunologic outcomes. This review examines the impact of the administration of prime and booster vaccine doses in the same (ipsilateral) versus the opposite arms (contralateral) on vaccine immunogenicity. We review animal model and human studies evaluating the impact of ipsilateral versus contralateral COVID-19 and non-COVID-19 vaccine boosting on immunologic outcomes with a focus on the germinal center response, antibody production, and T cell activation. While some studies suggest that ipsilateral administration may enhance the quality of germinal center B cell responses and antibody magnitude, data across different studies have been inconsistent. Relatively few studies have compared ipsilateral versus contralateral boosting, and differences in study design and outcomes have limited the ability to draw conclusions as to whether one is superior to the other. This review highlights a noteworthy and underexplored area in vaccinology and the need for future research to clarify whether ipsilateral/contralateral boosting strategies matter. To answer this question, high-quality, randomized controlled trials evaluating different types of vaccines that consider immunologic mechanisms, capture key time points and appropriate specimens, and evaluate early and long-term immunogenicity endpoints are required.}, }
@article {pmid41441682, year = {2025}, author = {Wiblin, S and Feldman, C and MacIntyre, CR and Soulsby, N and van Buynder, P and Waterer, G}, title = {Risk Groups for Vaccine-Preventable Respiratory Infections in Children and Adults: An Overview of the Australian Environment.}, journal = {Vaccines}, volume = {13}, number = {12}, pages = {}, pmid = {41441682}, issn = {2076-393X}, abstract = {Respiratory infections are a leading cause of sickness and death in Australia. In Australia, there is a funded immunisation program for both adults and children aimed at preventing and controlling vaccine-preventable respiratory infections (VPRI), such as pneumococcal disease (PD), influenza A/B, respiratory syncytial virus (RSV) infection, and COVID-19. This narrative review outlines the current Australian adult and paediatric immunisation guidance for VPRIs. It also examines the literature that supports the current risk group recommendations, including the clinical and economic burden of VPRIs, vaccination effectiveness, and coverage. Gaps in current risk group definitions, as well as additional risk groups that could be included in vaccine recommendations, are also discussed. Further research is needed to determine the optimum age for vaccination in adults which may enable alignment of age recommendations across different VPRIs. Individuals with multiple risk factors, commonly referred to as risk stacking, are at a greater risk of developing severe disease for VPRIs. This emphasises the importance of vaccinating these individuals. More research is needed to evaluate the effectiveness of vaccines in older adults and to create more effective vaccines for high-risk paediatric groups, such as those with compromised immunity or for children who have undergone haematopoietic stem cell transplantation.}, }
@article {pmid41441346, year = {2025}, author = {Cianciulli, A and Santoro, E and Bruno, N and Quagliarella, S and Esposito, S and Manente, R and Santella, B and Ferrara, RF and Pacifico, A and Franci, G and Boccia, G}, title = {The Role of the Family and Community Nurse in Improving Quality of Life and Optimizing Home Care Post-COVID: A Systematic Review with Meta-Analysis.}, journal = {Nursing reports (Pavia, Italy)}, volume = {15}, number = {12}, pages = {}, pmid = {41441346}, issn = {2039-4403}, abstract = {Background/Objectives: The COVID-19 pandemic accelerated the shift toward community- and home-based care models. Within this transformation, Family and Community Nurses (FCNs) have become key in bridging hospital and primary care, supporting continuity, self-care, and quality of life (QoL). Despite increasing recognition, evidence on FCN-led interventions remains fragmented. This systematic review and meta-analysis aimed to synthesize evidence on the impact of FCN interventions on QoL and clinical outcomes in post-COVID and people living with chronic conditions managed in community and home settings. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Scopus, CINAHL, PsycINFO, Embase, and Cochrane Library (January 2020-November 2024). Eligible studies were randomized controlled trials evaluating FCN-led interventions. Primary outcomes were QoL (measured with validated tools) and glycemic control (HbA1c). Secondary outcomes included hospital readmissions, anxiety, depression, and self-care abilities. Risk of bias was assessed using the Cochrane RoB2 tool for randomized controlled trials. Random-effects meta-analyses were performed, with heterogeneity evaluated by I[2]. The protocol was prospectively registered in PROSPERO (CRD42024567890) before data extraction. Results: Seventy-one studies (n = 19,390) were included. Interventions comprised home visits, telehealth, patient education, and case management. Pooled analyses demonstrated significant improvement in QoL (SMD 0.34, 95% CI 0.18-0.50) and reduction in HbA1c (-0.47%, 95% CI -0.69 to -0.25). FCN interventions also reduced hospital readmissions (RR 0.74, 95% CI 0.62-0.89) and improved mental health outcomes. Most studies were judged at low to moderate risk of bias. Conclusions: FCN-led interventions significantly enhance QoL, mental health, and clinical outcomes while reducing hospital readmissions. These findings highlight the strategic importance of integrating FCNs into community-based healthcare models.}, }
@article {pmid41440751, year = {2025}, author = {Wang, J and Ma, N and Mo, G and Qin, X and Zhang, J and Yao, X and Guo, J and Sun, Z}, title = {Hazards and Health Risks of the Antibacterial Agent Triclosan to Fish: A Review.}, journal = {Journal of xenobiotics}, volume = {15}, number = {6}, pages = {}, pmid = {41440751}, issn = {2039-4713}, abstract = {Triclosan (TCS) is a widely used antimicrobial agent found in personal care products and household cleaners. While valued since the 1960s for its ability to inhibit bacterial fatty acid synthesis, its environmental persistence, ecotoxicity, and bioaccumulative potential have raised significant global concern. The increased use of disinfectants during the COVID-19 pandemic has further exacerbated its prevalence as an aquatic pollutant. In the environment, TCS is distributed through water bodies and sediments, undergoing processes such as biodegradation and photochemical degradation. Its bioaccumulation poses a substantial threat to aquatic organisms, particularly fish. A growing body of research indicates that TCS acts as an endocrine disruptor and developmental toxicant, with documented adverse effects encompassing impaired embryonic and larval development, skeletal malformations, and induction of oxidative stress, mitochondrial dysfunction, DNA damage, and inflammatory responses. Furthermore, TCS exposure is linked to reproductive toxicity, including altered sex hormone levels and diminished reproductive capacity. This review consolidates current knowledge on the chemical properties, environmental fate, biodegradation pathways, and ecotoxicological impacts of TCS, with a specific emphasis on its multifaceted health risks to fish. The synthesis aims to provide a foundation for future research, inform environmental risk assessments, and support the development of evidence-based regulatory measures.}, }
@article {pmid41440598, year = {2025}, author = {Mbeye, NM and Chipojola, R and Banda, S and Kaude, P and Mdolo, A and Nwosisi, C and Mounier-Jack, S}, title = {Integration Models for Delivering COVID-19 Vaccines Through HIV Services in Low-and Middle-Income Countries: A Scoping Review.}, journal = {Infectious disease reports}, volume = {17}, number = {6}, pages = {}, pmid = {41440598}, issn = {2036-7430}, abstract = {BACKGROUND: The Coronavirus Disease 2019 (COVID-19) remains a major global public health issue. People living with HIV (PLHIV) are among the vulnerable groups facing a higher risk of severe outcomes. Combining COVID-19 vaccination with HIV services can improve access and utilization of the vaccine among PLHIV although effective methods of delivery are yet to be ascertained. We conducted a scoping review to identify and describe models for delivering COVID-19 vaccines through HIV care services in low- and middle-income countries (LMICs).<br><br>METHODS: We used PRISMA-ScR guidelines to conduct the review. On 3rd and 4th February 2025, we searched PubMed, Web of Science, Cochrane Library, and EMBASE for studies on integrated COVID-19 vaccine delivery for PLHIV.<br><br>RESULTS: Three studies from sub-Saharan Africa reported call-back strategy, diverse partnership, and mixed service delivery models for implementing COVID-19 vaccination in HIV care services. Key strategies that were used included building capacity, generating demand, managing the supply chain, and involving stakeholders. The outcomes showed significant increases in vaccination coverage among PLHIV and reduced vaccine wastage.<br><br>CONCLUSIONS: Integrating COVID-19 vaccination into HIV services is practical and effective in LMICs. It makes use of current infrastructure, partnerships, and local innovations.}, }
@article {pmid41440526, year = {2025}, author = {László, SA and Ianoși, ES and Văsieșiu, AM and Szathmáry, M and Ianoși, MB and Rachiș, DL and Nistor, G and Jimborean, G}, title = {COVID-19 and Lung Cancer Interactions: A Literature Review.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {13}, number = {4}, pages = {}, pmid = {41440526}, issn = {2076-3271}, mesh = {Humans ; *COVID-19/epidemiology/complications/virology ; *Lung Neoplasms/epidemiology/diagnosis/virology ; SARS-CoV-2 ; Incidence ; Pandemics ; }, abstract = {This review aims to discuss the apparent reduction in pulmonary cancer incidence in the general population during and shortly after the COVID-19 pandemic from a biological and pathophysiological mechanistic point of view. While the epidemiological evidence points to a disruption in the early- and mid-stage diagnostic process, which causes a shift to late-stage lung cancer discovery with no impact on its actual prevalence, an alternative hypothesis based on the intersection of viral and cancer biology could have a real effect on lung carcinogenesis as an independent phenomenon. By weaving together population-level trends, mechanistic insights, and translational oncology, we discuss whether the pandemic-associated decline in lung cancer diagnoses reflects primarily a temporary diagnostic artifact or whether it also reveals biologically relevant intersections between SARS-CoV-2 and pulmonary oncogenesis. The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has exerted profound and multifaceted effects on global healthcare systems, altering patterns of disease detection, management, and outcomes across nearly all medical disciplines. These disruptions generated what has been termed a "diagnostic deficit", producing a backlog of undetected cancers that have only partially been recovered in subsequent years. This phenomenon, sometimes described as a "COVID-19 debt" in oncology, is thought to contribute to excess late-stage diagnoses and potentially worse medium-term survival outcomes. Beyond the disruption of medical systems, the pandemic also raised a more speculative but biologically intriguing question: could SARS-CoV-2 infection itself, through direct or indirect mechanisms, influence lung cancer biology? Our review aims to critically synthesize the evidence across seven domains to address this dual hypothesis. (1) We examine the observed effects of the pandemic on cancer incidence, highlighting global registry and health-system data; (2) we review SARS-CoV-2 infection biology, including viral entry, replication, protein functions, and treatment implications; (3) we summarize the pathogenesis of lung cancer; (4) we explore the role of immune checkpoints in tumor immune evasion, followed by (5) analyses of immune dysregulation in acute infection and (6) in long COVID; and (7) finally, we evaluate proposed oncogenic mechanisms of SARS-CoV-2, integrating molecular virology with cancer immunology. We conclude that the "diagnostic deficit" phenomenon was a reality during and immediately post-pandemic. However, a definitive answer to the questions related to the impact of the infection as an independent phenomenon would require advanced research information covering the biology of the viral infection and lung cancer oncogenesis: processes that are not currently implemented in routine clinical laboratory investigations.}, }
@article {pmid41440273, year = {2025}, author = {Fatima, M and Fatima, M and Abbas, N and Park, PG}, title = {Opportunities and Challenges in Gas Sensor Technologies for Accurate Detection of COVID-19.}, journal = {Biosensors}, volume = {15}, number = {12}, pages = {}, doi = {10.3390/bios15120792}, pmid = {41440273}, issn = {2079-6374}, support = {GCU-202502820001//Gachon University/ ; }, mesh = {Humans ; *COVID-19/diagnosis ; *Volatile Organic Compounds/analysis ; Breath Tests/methods ; SARS-CoV-2/isolation &amp; purification ; *Biosensing Techniques/methods ; Gases/analysis ; }, abstract = {Gas sensors provide versatile opportunities for detecting volatile organic compounds (VOCs) such as acetone, methanol, ethanol, propanol, isoprene, and aldehydes in exhaled breath (EB) associated with COVID-19 respiratory infections. These VOCs provide valuable information about metabolic markers linked with COVID-19. They have opened opportunities to develop sensors for COVID-19 screening based on breath analysis. These sensors have the potential to provide the rapid detection of viruses in healthcare settings. RT-PCR, as a conventionally adopted diagnostic method, has a detection limit around 10-100 RNA copies/mL, with an accuracy of around 95%. Gas sensors have demonstrated VOC detection limits at the ppm level in COVID-19 EB and have displayed a sensitivity and specificity of 98.2% and 74.3%, respectively. Multiple gas sensors combined with machine learning algorithms have the potential to enhance the specificity of VOC detection. In addition to having an accuracy similar to that of the PCR method, the VOC-based diagnosis of COVID-19 offers unique advantages in terms of non-invasive and rapid detection. This review provides an overview of state-of-the-art gas sensors developed for COVID-19 detection. Despite there being significant developments in this field, there are certain challenges that still need to be addressed-these include the impact of environmental factors, the specificity of detection, the sensing range, and precision limitations, leading to accuracy issues. Despite these existing challenges, the integration of gas sensors with machine learning methods can enhance the accuracy of the detection of COVID-19. Future research directions are proposed to validate and standardize the application of gas sensors for COVID-19 in clinical settings.}, }
@article {pmid41440051, year = {2025}, author = {Elkoury, E and Yehia, A and Caparelli, EC and Geda, YE and Ortega, D and Yamada, N and Hakhu, S and Beeman, SC and Ross, TJ and Yang, Y and Zhou, Y and Port, JD and Abulseoud, OA}, title = {Brain Volumetric Changes Post-COVID-19: A Systematic Review.}, journal = {Brain sciences}, volume = {15}, number = {12}, pages = {}, doi = {10.3390/brainsci15121255}, pmid = {41440051}, issn = {2076-3425}, abstract = {Background: The potential long-term effects of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection on the brain structure have not yet been fully elucidated. Even though existing studies have reported structural changes in the post-COVID-19 period, the results remain highly inconsistent and controversial. As such, identifying an imaging biomarker for post-COVID brains is still under investigation. This review aims to comprehensively summarize the structural MRI (sMRI) studies that focus on volumetric brain changes at least two weeks following COVID-19 infection. Methods: A systematic literature search was conducted on PubMed, SCOPUS, Web of Science, EMBASE, and Google Scholar up to 9 September 2025. Studies that utilized sMRI to assess volumetric brain changes post-COVID at greater than two weeks following infection were included. Exclusion criteria encompassed research involving pediatric or adolescent populations and imaging modalities other than sMRI. Preprints, reviews, case reports, case series and post-mortem studies were also excluded. Results: Forty-one studies satisfied the inclusion criteria and consisted of 2895 patients and 1729 healthy controls. Despite the wide variability in image acquisition protocols, data processing methods, and comorbidities between studies, multiple studies reported statistically significant volumetric reductions in the hippocampus, amygdala, thalamus, basal ganglia, nucleus accumbens and the cerebellum months to years after infection, especially in older hospitalized patients with severe COVID-19. Conclusions: The emerging literature reports long-term volume changes across various brain regions in individuals previously infected with COVID-19; however, the evidence is inconsistent. Specific imaging biomarkers following exposure to SARS-CoV-2 infection and the underlying mechanisms of these changes are yet to be identified. Future studies with harmonized imaging protocols, longitudinal designs, and integrated biomarker and clinical data are needed to define robust biomarkers and elucidate the pathophysiology of these findings.}, }
@article {pmid41439932, year = {2025}, author = {Zuñiga-Jimenez, CT and Rojas-Esguerra, DF and Muñoz-Martinez, AP and Mendoza-Guzman, DC and Daza-Arana, JE}, title = {Musculoskeletal Sequelae of Post-COVID-19 Syndrome: A Systematic Review.}, journal = {Diseases (Basel, Switzerland)}, volume = {13}, number = {12}, pages = {}, doi = {10.3390/diseases13120391}, pmid = {41439932}, issn = {2079-9721}, abstract = {Background/Objectives: COVID-19 infection is a respiratory illness that affects multiple body systems, including the musculoskeletal system. In August 2024, Colombia reported 6 million infections and a 2.2% mortality rate related to COVID-19. Post-COVID-19 syndrome (PCS) is a chronic condition occurring after the acute infection, typically characterized by fatigue, weakness, pain, and sarcopenia, impacting the patient's quality of life (QoL). This systematic review aimed to identify musculoskeletal sequelae, including peripheral muscle strength, fatigue, and QoL, in patients with PCS. Methods: We searched the PubMed, Scopus, and Web of Science databases for cross-sectional, case-control, and cohort studies focusing on musculoskeletal sequelae in patients with COVID-19 infection published between 2020 and 2025. Study quality and risk of bias were assessed using the MINORS and the ROBINS-E scales, respectively. Results: Thirteen studies (n = 5657 patients) met the eligibility criteria. Seventy-six percent of studies indicated muscle weakness as the most common sequela, primarily in older adults and individuals with comorbidities (obesity, diabetes, and chronic obstructive pulmonary disease). General fatigue (reported in 76% of the studies) significantly influenced patients' daily lives, whereas 90% of patients reported some level of deterioration in their QoL, primarily regarding mental health, bodily pain, and physical performance. Conclusions: Patients with PCS who required mechanical ventilation showed reduced muscle strength and poor physical performance, especially older adults. Inactive individuals had worse musculoskeletal sequelae, while physical activity was associated with better strength levels. Although QoL improved after 12 months, the combination of aerobic exercise with adequate nutrition is essential to promote muscle recovery, reduce fatigue, and improve overall functional capacity in post-COVID-19 patients.}, }
@article {pmid41439888, year = {2025}, author = {Gong, EJ and Bang, CS and Lee, JJ and Baik, GH}, title = {Smart Ring in Clinical Medicine: A Systematic Review.}, journal = {Biomimetics (Basel, Switzerland)}, volume = {10}, number = {12}, pages = {}, doi = {10.3390/biomimetics10120819}, pmid = {41439888}, issn = {2313-7673}, support = {RS-2023-00223501//National Research Foundation of Korea/ ; }, abstract = {BACKGROUND: Smart rings enable continuous physiological monitoring through finger-worn sensors. Despite growing consumer adoption, their clinical utility beyond sleep tracking remains unclear.<br><br>OBJECTIVES: To systematically review evidence for smart ring applications in clinical medicine, assess measurement accuracy, and evaluate clinical outcomes.<br><br>METHODS: We searched PubMed/MEDLINE, Embase, Cochrane Library, and Web of Science through 31 July 2025. Two reviewers independently screened studies and extracted data. Risk of bias was assessed using ROBINS-I and RoB 2.0.<br><br>RESULTS: From 862 citations, 107 studies met inclusion criteria including approximately 100,000 participants. Studies were equally distributed between sleep (47.7%) and non-sleep applications (52.3%). Smart rings demonstrated high accuracy: heart rate r[2] = 0.996, heart rate variability r[2] = 0.980, and sleep detection 93-96% sensitivity. Predictive capabilities included COVID-19 detection 2.75 days pre-symptom (82% sensitivity), inflammatory bowel disease flare prediction 7 weeks early (72% accuracy), and bipolar episode detection 3-7 days early (79% sensitivity). However, 65% of studies had moderate-to-high bias risk. Limitations included small samples, proprietary algorithms (89%), poor diversity reporting (35%), and declining adherence (80% at 3 months to 43% at 12 months).<br><br>CONCLUSION: Smart rings have evolved into clinical tools capable of early disease detection. However, algorithmic opacity, population homogeneity, and adherence challenges require attention before widespread implementation.}, }
@article {pmid41439194, year = {2025}, author = {Li, S and Zheng, Y and Cheng, L}, title = {Messenger RNA vaccines in the prevention of allergic diseases.}, journal = {The World Allergy Organization journal}, volume = {18}, number = {12}, pages = {101150}, pmid = {41439194}, issn = {1939-4551}, abstract = {Messenger RNA (mRNA) vaccines are composed of mRNA sequences encoding pathogens. The first coronavirus mRNA vaccine (BNT162B2, Pfizer/BioNTech), approved in the United Kingdom in 2020, had prevented approximately 20 million deaths globally within the first year of use. mRNA vaccines were initially used against tumors and infectious diseases, but recent research has also turned its attention to the prevention of allergic diseases. Here, we summarized the characteristics and outcomes of mRNA vaccines in preventing allergic diseases and analyzed their advantages over traditional inactivated vaccines and DNA vaccines. This review focused on the feasibility, potential mechanisms, and preclinical research results of prophylactic allergen mRNA vaccines in the prevention of type I hypersensitivity reactions, and preliminarily addressed the key issues in clinical trials of allergen mRNA vaccines. Allergen mRNA vaccines hold promise for preventing IgE-mediated allergic diseases, yet their potential uses warrant further clinical investigations.}, }
@article {pmid41438927, year = {2025}, author = {Cheng, AL and Barker, R and von Nordheim, D and McQueen, A}, title = {Long COVID: What is it? Who has it? What Are Treatment Resources in Missouri?.}, journal = {Missouri medicine}, volume = {122}, number = {6}, pages = {488-494}, pmid = {41438927}, issn = {0026-6620}, mesh = {Humans ; Missouri/epidemiology ; *COVID-19/epidemiology/complications/therapy ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {As we pass the five-year mark since the COVID-19 pandemic hit, the prevalence of persistent (and often disabling) symptoms from the SARS-CoV-2 virus is estimated to be on par with the prevalence of heart disease. Yet, these Long COVID symptoms can masquerade as other conditions and/or normal aging, so it is believed that Long COVID is under-diagnosed and, as a result, under-treated. Although there is not yet a true cure for Long COVID, many patients benefit substantially from rehabilitation strategies, medications, and social support resources that are available in Missouri. The purpose of this article is to review the definition and epidemiology of Long COVID, provide practical guidance for Long COVID assessment and management especially in the primary care setting, and increase awareness of regional resources for people in Missouri who are living with Long COVID and for the clinicians who are caring for them.}, }
@article {pmid41438827, year = {2025}, author = {Saraç, &#x130;A and Uzun, SU}, title = {Human metapneumovirus: an emerging public health threat and harbinger of a new pandemic.}, journal = {GMS hygiene and infection control}, volume = {20}, number = {}, pages = {Doc78}, pmid = {41438827}, issn = {2196-5226}, abstract = {Human metapneumovirus (hMPV), first identified in 2001, has increasingly been recognized as a significant cause of acute respiratory tract infections worldwide. Although often overshadowed by respiratory syncytial virus (RSV) and influenza, hMPV contributes substantially to the global burden of respiratory disease, particularly among young children, older adults, and immunocompromised populations. The COVID-19 pandemic further altered the epidemiology of respiratory viruses, disrupting established seasonal patterns and creating immunity gaps that have fueled unusual hMPV outbreaks in recent years. Despite its clinical relevance, hMPV remains underdiagnosed due to limited awareness, restricted access to reliable diagnostic tools, and frequent co-infections that obscure its contribution to disease severity. Currently, no licensed antivirals or vaccines exist, leaving supportive care as the only treatment option. Ongoing research into monoclonal antibodies, vaccine candidates, and combined RSV-hMPV preventive strategies offers promise but remains in early stages. In the context of global interconnectedness and the demonstrated capacity of respiratory viruses to cause widespread disruption, hMPV raises important concerns as a potential emerging public health threat. While unlikely to cause pandemic-scale disruption, hMPV's endemic circulation and disproportionate impact on vulnerable populations warrant its recognition as an emerging threat demanding proactive public health intervention and sustained investment in prevention strategies. This review examines hMPV's evolving role as a public health threat in the post-COVID-19 landscape, where altered epidemiological patterns and increased surveillance have highlighted its underappreciated impact.}, }
@article {pmid41438268, year = {2025}, author = {Zemp, C and Vallières, F and Broecker, F and Haroz, EEE and Kakish, I and Sheaf, G and Lee, JSY and Harrison, S and Siersbaek, R}, title = {Self-harm and suicide prevention in humanitarian and fragile contexts: A systematic scoping review.}, journal = {Global mental health (Cambridge, England)}, volume = {12}, number = {}, pages = {e145}, pmid = {41438268}, issn = {2054-4251}, abstract = {Suicide remains one of the leading causes of death globally, with growing evidence that humanitarian emergencies and fragile states, most of which unfold in low- to middle-income countries (LMICs), are associated with elevated risk of suicide. However, the few suicide-targeted interventions for use in humanitarian contexts remain both sparse and fragmented. This scoping review aims to identify and synthesise evidence from suicide and self-harm prevention interventions implemented in all types of humanitarian settings, globally, that have been evaluated for their effectiveness in improving suicide and self-harm-related outcomes. We systematically searched eight electronic databases, including two grey literature databases, and relevant organisational websites for records published through November 2024 and in any language. Screening was done using the Covidence platform, with each record independently screened by two reviewers. Among other preselected inclusion criteria, studies must have conducted a quantitative evaluation of the effectiveness of an intervention on improving suicide and self-harm-related outcomes during a humanitarian crisis to be included for data extraction. Data extraction and quality assessment were both conducted by two authors. In all, 6,209 records were screened at the title and abstract phase; 104 were included for full text screening; and 23 studies were included for data extraction. Most studies were conducted during the coronavirus disease 2019 pandemic (COVID-19), and in high-income countries. Evaluated interventions encompassed various approaches, including psychotherapeutic, practical, and pharmacological assistance, often employing multiple components. The majority targeted the general population, were delivered via remote modalities and relied on mental health specialists for their administration. Overall, 15 (65.2%) interventions were associated with statistically significant positive effects on suicide and or self-harm-related outcomes. Promising approaches include cognitive behavioural therapy-based text services, skills-building programmes, and strategies that foster supportive environments for high-risk individuals. These findings highlight both promising approaches and critical gaps in suicide prevention efforts in humanitarian settings. The limited evidence base - particularly in LMICs and with particularly at-risk populations - alongside the increasing frequency of humanitarian crises, underscores the urgent need for future implementation and associated research of suicide and self-harm prevention initiatives within humanitarian contexts.}, }
@article {pmid41437518, year = {2025}, author = {An, L and Xu, H and Fan, Q and Lu, M and Sun, D}, title = {Metabolic control of macrophages in coronavirus disease 2019.}, journal = {Virulence}, volume = {}, number = {}, pages = {2609397}, doi = {10.1080/21505594.2025.2609397}, pmid = {41437518}, issn = {2150-5608}, abstract = {In the context of COVID-19, macrophages are primarily responsible for sensing and responding to the virus, significantly influencing disease outcomes. They are involved in early pathogen recognition, immune activation, and tissue repair. Heterogeneity and phenotypic plasticity of macrophages are dynamically shaped by microenvironmental cues, including metabolites, hypoxia, and pathogen-derived signals. Notably, emerging evidence underscores that cellular metabolism, particularly in macrophages, dictates immune responses to viral infection. This metabolic-immune crosstalk critically determines COVID-19 severity, ranging from viral clearance to hyperinflammation or fibrosis. In this review, we systematically dissect how cell-intrinsic metabolic nodes and extrinsic factors modulate macrophage effector functions, while illustrating the complications associated with macrophage metabolic dysregulation in SARS-CoV-2 infection. These mechanistic insights provide a rational foundation for therapeutic strategies targeting macrophage metabolism to rebalance immune responses and mitigate COVID-19 complications.}, }
@article {pmid41436155, year = {2025}, author = {Blake, SR and Gatzoulis, M}, title = {Technology for better adult congenital heart disease care: the time is now.}, journal = {Open heart}, volume = {12}, number = {2}, pages = {}, doi = {10.1136/openhrt-2025-003766}, pmid = {41436155}, issn = {2053-3624}, mesh = {Humans ; *Heart Defects, Congenital/therapy/diagnosis ; *Telemedicine ; *COVID-19/epidemiology ; Adult ; Artificial Intelligence ; Wearable Electronic Devices ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The growing population of patients with adult congenital heart disease (ACHD) present complex lifelong care needs that traditional health systems are struggling to meet. Without innovation, gaps in access, timeliness and specialist oversight will widen. Digital health technologies, including artificial intelligence (AI), telemedicine, wearable devices and interoperable platforms offer a unique opportunity to transform care, but their potential in ACHD remain underexplored.<br><br>CURRENT DEVELOPMENTS: AI-driven prediction models show encouraging performance in mortality and event risk but require external validation and lesion-specific adaptation. Telemedicine, accelerated during the COVID-19 pandemic, has demonstrated safety and high patient satisfaction in selected cohorts, yet robust hybrid pathways are lacking. Wearables can capture rhythm, oxygen saturations and activity in real time, but consumer devices remain poorly validated for complex ACHD physiology. Data integration frameworks, such as federated learning, demonstrate global feasibility but face challenges in governance and interoperability.<br><br>FUTURE PRIORITIES: Progress in ACHD digital health will depend on three imperatives: (1) rigorous, prospective validation of digital tools in congenital populations; (2) equitable implementation, addressing digital literacy, infrastructure and reimbursement; (3) governance frameworks that embed specialist oversight, data privacy and cybersecurity from the outset.<br><br>CONCLUSION: Digital health is no longer optional in ACHD care. The field risks falling behind broader cardiovascular innovation unless patients, clinicians, technologists and policymakers commit to specialist-led integration. A decisive shift towards validated, equitable and interoperable solutions can transform ACHD management into a more predictive, personalised and preventive discipline. The aim of this viewpoint is to highlight how digital technologies could strengthen ACHD care and define priorities for future adoption.}, }
@article {pmid41433896, year = {2025}, author = {Seeher, KM}, title = {Public Health.}, journal = {Alzheimer's &amp; dementia : the journal of the Alzheimer's Association}, volume = {21 Suppl 6}, number = {Suppl 6}, pages = {e110731}, doi = {10.1002/alz70860_110731}, pmid = {41433896}, issn = {1552-5279}, mesh = {Humans ; *Public Health ; *COVID-19 ; *Global Health ; *Dementia ; SARS-CoV-2 ; }, abstract = {The Global Action Plan helps guide countries in addressing the dementia public health crisis. For several reasons, including COVID-19, action has been slowed in many countries, resulting in the World Health Assembly recently extending the Plan to 2031. This presentation will review what the Plan is and the prospects for implementation by the end of the decade.}, }
@article {pmid41432716, year = {2025}, author = {Yang, EJ and Jin, L and Jiang, HH and Lee, BG and Han, EH and Yun, CH and Na, DH}, title = {An Immunomodulatory Mushroom, Cordyceps militaris, and Its Constituents: A Review of In Vitro/In Vivo Studies and Clinical Trials.}, journal = {Phytotherapy research : PTR}, volume = {}, number = {}, pages = {}, doi = {10.1002/ptr.70144}, pmid = {41432716}, issn = {1099-1573}, abstract = {Cordyceps, known as "winter-worm summer-grass", has been used as a medicinal mushroom to boost energy levels and immune activity. Among cordyceps types, Cordyceps militaris (CM) is the most commercially useful owing to its ease of artificial cultivation for mass production. In contrast, other types, such as Ophiocordyceps sinensis, are expensive and difficult to collect. Therefore, numerous studies have explored the therapeutic potential and active constituents of CM. The therapeutic use of CM is based on its various pharmacological activities, including immunomodulatory, anti-tumor, antioxidant, anti-diabetic, anti-obesity, and neuroprotective activities, of which the immunomodulatory effects have been the most studied. CM contains active constituents such as nucleosides (cordycepin and adenosine), polysaccharides, peptides, proteins, sterols, glycolipids, and carotenoids. Recent studies show that CM extract, cordycepin, and polysaccharides exert immunomodulatory effects in response to the immune environments. They enhance innate and cell-mediated adaptive immunity not only under normal conditions but also in immunosuppressed states induced by cyclophosphamide, interleukin-4, tumor culture supernatant, methotrexate, cancer cell-line-xenografts, influenza virus, and severe acute respiratory syndrome coronavirus 2. Meanwhile, they suppress an overactivated immune system stimulated by factors such as angiotensin II ± vascular endothelial growth factors, concanavalin A, 2,4-dinitrophenyl (DNP)-serum albumin ± DNP-specific immunoglobulin E, lipopolysaccharide (LPS), lipoteichoic acid, phytohemagglutinin, phorbol myristate acetate plus calcium ionophore A23187, calcium chloride, cecal ligation and puncture ± LPS, dextran sodium sulfate, monosodium iodoacetate, ovalbumin, myelin oligodendrocyte glycoprotein 25-35, monosodium urate, and Western diet by ameliorating innate and humoral adaptive immune responses. This study reviewed recent and notable literature evaluating the immunomodulatory potentials of CM extract, cordycepin, and polysaccharides. In vitro, in vivo, and clinical trial results indicate that CM is safe for administration and shows promise for developing functional foods having various efficacies such as immunomodulation, anti-tumor, and neuroprotection.}, }
@article {pmid41432471, year = {2025}, author = {Azahar, SN and Yong, CK and Fahami, NAM and Ibrahim, IA}, title = {Pathogenesis of alcoholic fatty liver disease: Molecular and cellular changes.}, journal = {The Malaysian journal of pathology}, volume = {47}, number = {3}, pages = {377-400}, pmid = {41432471}, issn = {0126-8635}, mesh = {Humans ; *Fatty Liver, Alcoholic/pathology/metabolism/etiology ; Lipid Metabolism ; Liver/pathology/metabolism ; Oxidative Stress ; Animals ; }, abstract = {Alcohol-related liver disease (ALD) is a significant public health issue, leading to liver injuries, including fatty liver, hepatitis, and cirrhosis. The COVID-19 pandemic has exacerbated the problem by increasing alcohol abuse and hospitalisations for ALD. Since there are no approved therapies for ALD, promoting abstinence from alcohol is the primary approach. However, the mechanisms by which alcohol induces fat accumulation in the liver, the disease's initial stage, are not fully understood. This knowledge gap hampers the development of new treatments for ALD. This review aims to explore research on alcohol-induced fatty liver and compare it with metabolic-associated fatty liver disease. The goal is to merge these findings with current knowledge of ALD and hepatic lipid metabolism, including fatty acid oxidation, lipogenesis, and very-low-density lipoprotein (VLDL) secretion. Besides lipid metabolism, factors like inflammation, oxidative stress, cellular hypoxia, and autophagy also contribute to ALD's development and progression. By identifying gaps in understanding the molecular mechanisms of ALD progression, this review suggests future research directions. It emphasises how alcohol disrupts hepatic lipid metabolism, highlighting mechanisms leading to alcohol-associated fatty liver disease and other harmful effects of alcohol abuse.}, }
@article {pmid41432258, year = {2025}, author = {Zacharjasz, A and Anbari, AB}, title = {Rural COVID-19 Vaccine Decision-Making: A Qualitative Meta-Synthesis.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.70451}, pmid = {41432258}, issn = {1365-2648}, abstract = {AIMS: This qualitative meta-synthesis (QMS) aimed to develop a theoretical framework to contextualise the COVID-19 vaccine decision-making processes among rural U.S. individuals, describing complex cognitive, social, and structural influences.<br><br>DESIGN: Qualitative meta-synthesis utilising thematic synthesis and diagramming methods.<br><br>DATA SOURCES: Searches conducted across PubMed, Scopus, CINAHL, and grey literature databases between January 2020 and September 2024 identified relevant qualitative and mixed-methods studies.<br><br>REVIEW METHODS: Studies were screened against inclusion criteria: qualitative or mixed-methods design, U.S. rural adult populations, COVID-19 vaccine focus, and publication after January 2020. Twenty-one studies were selected, data extracted, coded, and analysed thematically to create a conceptual model. Quality appraisal was performed using the Critical Appraisal Skills Programme checklist.<br><br>RESULTS: Analysis yielded seven interrelated themes-Information, Beliefs, Trust, Feelings, Institutional, Community, and Culture-with 24 subthemes, highlighting dynamic interactions influencing vaccine decisions. Central factors included communication quality, media influence, institutional trust, social relationships, and cultural values. Decisions were temporal, iterative, and sensitive to evolving information and trust dynamics. Rural-specific barriers such as limited health literacy, systemic inequities, geographic isolation, and misinformation significantly shaped vaccine decisions.<br><br>CONCLUSION: This qualitative meta-synthesis provides a nuanced, rural-contextualised theoretical framework emphasising the interplay between information, trust, and social determinants in COVID-19 vaccine decision-making. Vaccine decisions among rural populations are embedded in complex sociocultural and structural contexts, evolving temporally with shifting trust and information landscapes.<br><br>IMPACT: The developed framework offers actionable insights to inform tailored public health interventions and policy strategies targeting vaccine hesitancy. Enhancing health literacy, leveraging trusted local communicators, ensuring transparency, and addressing structural inequities can effectively improve vaccine uptake and promote equitable health outcomes in rural communities.<br><br>The synthesis incorporates perspectives directly from rural community members, reflecting their lived experiences and contextual realities in vaccine decision-making processes.}, }
@article {pmid41431799, year = {2025}, author = {Amlaev, KR and Dakhkilgova, HT and Zakirova, NR and Alimov, BA}, title = {[THE FACTORS AFFECTING MENTAL HEALTH OF MIGRANTS AND WAYS OF ITS AMELIORATION].}, journal = {Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny}, volume = {33}, number = {6}, pages = {1420-1426}, doi = {10.32687/0869-866X-2025-33-6-1420-1426}, pmid = {41431799}, issn = {0869-866X}, mesh = {Humans ; *Transients and Migrants/psychology ; *Mental Health ; *COVID-19/psychology/epidemiology ; *Mental Disorders/epidemiology ; Russia/epidemiology ; }, abstract = {The article considers international experience of studying mental health of migrants. The actuality of this problem is conditioned by massive migration flow that occurred because of large number of military conflicts and desire of people to ensure better life for themselves and their descendants. The article describes the most common mental disorders among migrants, factors affecting their mental health and barriers they encounter on their way to good mental state. The impact of coronavirus infection pandemic on mental health of migrants is considered. The review indicates measures targeted to improve mental status of displaced persons, including application of participatory approach and implementation of concept of positive mental health. To maintain adequate mental health of migrants, holistic and interdisciplinary approach is required that considers ethnic and cultural characteristics of community of displaced persons.}, }
@article {pmid41431762, year = {2025}, author = {Galardo, G and Ceccarelli, C and Branda, F and Bortolani, L and Renna, R and Ciccozzi, M and d'Ettorre, G and Petramala, L and Ceccarelli, G and d'Ettorre, G}, title = {Designing Resilience for Overlapping Respiratory Epidemics: A One Health Perspective from Seasonal Influenza.}, journal = {The new microbiologica}, volume = {48}, number = {4}, pages = {293-298}, pmid = {41431762}, issn = {1121-7138}, mesh = {Humans ; *Influenza, Human/epidemiology/prevention &amp; control/diagnosis/virology ; COVID-19/epidemiology/diagnosis/prevention &amp; control ; Seasons ; Epidemics/prevention &amp; control ; *One Health ; SARS-CoV-2 ; }, abstract = {Recent European winter seasons have been characterized by the simultaneous circulation of influenza A virus, SARS-CoV-2, respiratory syncytial virus, Mycoplasma pneumoniae, and an unusual rise in group A streptococcal infections, including invasive disease. This overlap has transformed seasonal influenza from a largely predictable event into a complex clinical and epidemiological scenario where viral-bacterial interactions amplify disease severity, extend risk to previously healthy individuals, and stress both surveillance and diagnostic systems. We analyse this evolving landscape through an integrated One Health perspective, examining how local epidemiology, rapid multiplex diagnostics, adaptive antimicrobial stewardship, occupational health surveillance, and infection-prevention-oriented architectural design converge to mitigate the impact of overlapping respiratory epidemics. Such multidimensional preparedness is essential to prevent avoidable mortality, protect healthcare workers, and ensure the resilience of healthcare infrastructures facing concurrent viral and bacterial outbreaks.}, }
@article {pmid41431513, year = {2025}, author = {Mohajer-Bastami, A and Moin, S and Ahmad, S and Ahmed, A and Agarwal, A and Pouwels, S and Hammoda, M and Yang, W and Exadaktylos, AK}, title = {Establishing a Preparedness Program: Lessons From COVID-19 to Strengthen Global Strategies for Future Pandemics.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97402}, pmid = {41431513}, issn = {2168-8184}, abstract = {This study aimed to evaluate the global response to the COVID-19 pandemic, identify preparedness gaps, and propose strategies to strengthen resilience for future health crises, drawing on the natural history of SARS-CoV-2 and epidemiological models. The research team conducted a narrative review with a descriptive analysis supported by case examples and modeling. We synthesized published literature, official reports, and surveillance data, analyzing COVID-19 transmission using the epidemiological triangle model. Comparative case studies from South Korea, New Zealand, and the United Kingdom were examined to assess intervention effectiveness. National surveillance systems, outbreak response mechanisms, and public communication strategies were critically reviewed. Our findings show that disparities in testing, data transparency, and infrastructure shaped outcomes globally. Surprisingly, many high-income countries underperformed despite prior preparedness rankings. Countries implementing early lockdowns, equitable vaccine rollouts, and consistent public messaging achieved better control. However, asymptomatic transmission, weak surveillance integration, and delayed policy actions hindered containment. Vaccine inequity and fragmented data systems further limited coordinated response. Future preparedness must emphasize early interventions, sustained surveillance investment, transparent communication, and equitable access to care. Lessons from COVID-19 underscore the value of multidisciplinary response teams, international data sharing, and targeted testing strategies to mitigate the impact of future pandemics.}, }
@article {pmid41431011, year = {2025}, author = {Zhou, X and Li, MR and Sui, XH and Shan, NN}, title = {Multiple myeloma in a man with breast cancer: A case report and literature review.}, journal = {Medicine}, volume = {104}, number = {51}, pages = {e46540}, doi = {10.1097/MD.0000000000046540}, pmid = {41431011}, issn = {1536-5964}, mesh = {Humans ; Male ; *Multiple Myeloma/diagnosis/therapy/pathology ; Aged ; *Breast Neoplasms, Male/pathology/complications/therapy ; COVID-19 ; Fatal Outcome ; Bone Neoplasms/secondary/diagnosis ; Hematopoietic Stem Cell Transplantation ; Biopsy ; }, abstract = {RATIONALE: The development of multiple myeloma (MM) following male breast cancer is extremely rare and can often be mistaken for bone metastases in the early stages, potentially leading to delays in diagnosis and treatment.<br><br>PATIENT CONCERNS: In this case report, we describe a 68-year-old male patient who presented with multiple osteolytic lesions on imaging following breast cancer surgery, and was ultimately diagnosed with MM via bone marrow biopsy.<br><br>DIAGNOSES: MM.<br><br>INTERVENTIONS: After being diagnosed with MM, the patient was treated with various chemotherapy regimens, with the subsequent emergence of rare extramedullary disease necessitating an adjustment in therapy.<br><br>OUTCOMES: The patient successfully underwent autologous hematopoietic stem cell transplantation but later succumbed to a novel coronavirus infection.<br><br>LESSONS: This case highlights the diagnostic challenge of misattributing osteolytic lesions to breast cancer and underscores the importance of biopsy in patients with metastatic disease.}, }
@article {pmid41332224, year = {2026}, author = {Kranke, P and Jakobsson, J and Marin, L and Kleinberg, RL and Landoni, G and Reinoso-Barbero, F and Rossi, M and Sanders, G and Zacharowski, K}, title = {Protecting clinician autonomy and patient safety within the climate debate: the case for desflurane in modern anaesthesia.}, journal = {Current opinion in anaesthesiology}, volume = {39}, number = {1}, pages = {115-125}, pmid = {41332224}, issn = {1473-6500}, mesh = {*Desflurane/adverse effects ; Humans ; *Patient Safety ; *Anesthetics, Inhalation/adverse effects ; *Global Warming/prevention &amp; control ; *Professional Autonomy ; *Anesthesiology ; }, abstract = {PURPOSE OF REVIEW: The anaesthesia community should play a more active role in shaping sustainable healthcare practices. Current environmental measures, such as the European Commission's impending restriction on desflurane (an inhaled anaesthetic) from January 2026, risk unintended consequences for patient care and clinical autonomy.<br><br>RECENT FINDINGS: While desflurane's high global warming potential (GWP) has been the central justification, GWP is an oversimplified metric that fails to reflect the transient atmospheric behaviour of short-lived gases like desflurane compared with long-lived gases like carbon dioxide (CO 2). Recent climate modelling shows desflurane's impact on global temperature is negligible, reversible, and overstated by CO&#x2082;-equivalence comparisons. Clinically, desflurane offers significant advantages, including rapid, predictable emergence, particularly beneficial for high-risk patient groups, such as elderly, obese, paediatric, neurosurgical, and cardiac patients.<br><br>SUMMARY: Blanket restrictions undermine anaesthetists' ability to tailor care, and limit training, resilience, and preparedness in the face of drug shortages. We urge policymakers to support anaesthetic diversity and protect desflurane's availability where use is clinically justified. Sustainability efforts should focus on high-impact areas like energy use, equipment manufacturing, and waste, rather than eliminating valuable pharmacological options. Patient safety and evidence-based practice must remain central as we strive toward a more responsible, nuanced environmental approach in anaesthesia.}, }
@article {pmid41430309, year = {2025}, author = {Aladejana, OM and Ayorinde, DF}, title = {The intersection between human metapneumovirus and the respiratory microbiome.}, journal = {Virology journal}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12985-025-02872-x}, pmid = {41430309}, issn = {1743-422X}, abstract = {Human metapneumovirus is one of the viral causes of respiratory illness that can range from mild to life-threatening diseases. In December 2024, there was news about increased cases of human metapneumovirus (HMPV) in China, when 6.2% and 5.4% of positive respiratory illnesses and admissions, respectively, were linked to HMPV, surpassing adenovirus, rhinovirus, and COVID-19. There have been concerns about it becoming another epidemic, and by implication, a pandemic, especially as the world is gradually recovering from COVID-19 and its devastating impacts. Currently, there is no directly acting antiviral drug targeting HMPV, and this has left a gap in its treatment and management, especially in the young, elderly, and immunocompromised, who are prone to having severe manifestations. As the immune system is crucial in fighting and eliminating the infection, modulating the immune system directly or indirectly can treat HMPV. The lung that was initially known to be sterile is now found to house different populations of microorganisms, including bacteriome, virome, and mycobiome. The lung microbiome modulates HMPV infection. The presence of pathobionts like H. influenzae enhances HMPV infection and severity. The detection of the microbiome was made possible by the advent of cutting-edge technologies like next-generation sequencing and bioinformatics tools. The combination of Recombinase Polymerase Assay, CRISPR-Cas12a, and Fluorescence Assay has been used in the rapid detection of HMPV in China. The microbiome plays a crucial role in shaping the immune system. Exploring such can be a way of managing HMPV. Probiotics, prebiotics, and postbiotics are ways in which the microbiota can be manipulated to limit adverse drug reactions. These can be explored in HMPV diagnosis, treatment, and prevention.}, }
@article {pmid41430159, year = {2025}, author = {Xu, D and Zhang, M and Zhao, Y and Liang, W and Zhang, Y and Fang, L}, title = {Prevalence of autoantibody responses in COVID-19 patients: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12879-025-12407-y}, pmid = {41430159}, issn = {1471-2334}, }
@article {pmid41429194, year = {2025}, author = {Huang, Y and Ou, Z and Xue, X and Zhou, H and Xiao, K}, title = {Experimental and computational approaches to adaptive viral evolution: Linking molecular variation to phenotypic outcomes.}, journal = {Journal of microbiological methods}, volume = {241}, number = {}, pages = {107379}, doi = {10.1016/j.mimet.2025.107379}, pmid = {41429194}, issn = {1872-8359}, abstract = {Viruses pose a persistent global health threat due to their high mutation rates and rapid evolutionary capacity, which drive zoonotic spillover, vaccine escape, and drug resistance. Even single amino acid substitutions might impact viral invasion, receptor binding, immune evasion, or transmissibility, as illustrated by recent influenza, SARS-CoV-2 and other emerging viruses' outbreaks. Understanding these processes requires linking molecular variation to phenotypic consequences. This review summarizes five experimental and computational technologies-pseudovirus systems, minigenome assays, display systems, deep mutational scanning (DMS), and in silico modeling-that together form an iterative framework for studying viral adaptation. A representative integration of DMS with reverse genetics has validated computationally predicted escape mutations and revealed trade-offs between binding and replication that conventional assays could not capture. We discuss each approach's strengths and limitations, highlighting how their coordinated use supports mechanism-based evaluation and data-driven design of vaccines and antiviral strategies.}, }
@article {pmid41428129, year = {2025}, author = {Zafar, S and Andlib, Z and Fareed, Z and Rehman, MA}, title = {Food Security and Environmental Pollution: Policy Directions in the Face of COVID19.}, journal = {Food and environmental virology}, volume = {18}, number = {1}, pages = {2}, pmid = {41428129}, issn = {1867-0342}, support = {22BJY145//Project name: Research on the blocking mechanism of the risk of large-scale return to poverty by "two types of households" in rural tourism areas. . National Social Science Foundation project/ ; }, mesh = {*COVID-19/epidemiology/economics ; Humans ; *Food Security ; *Environmental Pollution ; Climate Change ; SARS-CoV-2 ; Carbon Dioxide/analysis ; Pandemics ; *Food Supply ; }, abstract = {Even before the COVID-19 pandemic, many countries were experiencing rising levels of acute food insecurity due to many factors, for instance, natural disasters, extreme weather and climate events and socioeconomic conditions. Subsequently, COVID-19 led to substantial and pervasive increases in global food insecurity, impacting vulnerable households worldwide. Owing to these facts, the first empirical study intends to investigate the empirical relationship between COVID-19, environmental pollution, and food shortage. We employ rolling window multiple correlation analysis on worldwide daily data of COVID-19 cases, carbon emissions, and food shortage news index from 22nd January 2020 to 29th November 2021. The results reveal a significant correlation between bivariate and multivariate cases over time. In bivariate cases, we find asymmetric but insignificant correlations between COVID-19 vs. food security and food security vs. CO2 emissions, except for a significant interconnection between COVID-19 vs. CO2 emissions at different periods. In the trivariate case, CO2 emissions and COVID-19 significantly and positively correlated to the food shortage index. This study provides policymakers with critical insights into the global food scarcity crisis driven by COVID-19 and climate change.}, }
@article {pmid41427721, year = {2025}, author = {Sun, Y and Wong, L-YR and Chang, TL}, title = {ACE2-independent entry factors for SARS-CoV-2 infection and immune activation.}, journal = {mBio}, volume = {}, number = {}, pages = {e0189724}, doi = {10.1128/mbio.01897-24}, pmid = {41427721}, issn = {2150-7511}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), remains a major public health threat, particularly in vulnerable populations. SARS-CoV-2 spike proteins interact with the human angiotensin-converting enzyme 2 (ACE2) receptor, together with accessory molecules that facilitate viral entry, through its spike receptor-binding domain (RBD). Although ACE2 is the primary receptor required for viral replication, its expression patterns do not fully correlate with viral distribution or tissue pathology. Moreover, SARS-CoV-2 has been shown to infect cells and tissues lacking detectable ACE2 expression. Viral entry via ACE2-independent pathways may also confer resistance to some monoclonal antibodies (Abs) targeting the spike RBD that block ACE2-mediated binding. These observations highlight the potential significance of ACE2-independent entry factors in SARS-CoV-2 infection, particularly in vaccinated individuals with Abs directed against ACE2-dependent viral entry. In this review, we discuss the emerging roles of ACE2-independent entry factors in SARS-CoV-2 infection and the immune responses. These factors include CD147, AXL, CD169/Siglec-1, CD209L, CD209, CLEC4G, ASGR1, LDLRAD3, TMEM30A, TMEM106B, transferrin receptor 1, GPR78, integrin α5β1, KREMEN1, LFA-1, and CD4. While ACE2 remains central to viral replication, ACE2-independent entry appears sufficient to elicit immune responses. Therefore, future investigations are warranted to elucidate the roles of ACE2-independent mechanisms in immune-mediated pathology and viral evolution, independent of immune pressure targeting ACE2-mediated entry in previously infected or vaccinated individuals.}, }
@article {pmid41427009, year = {2025}, author = {Zhu, Y and Yang, W and Li, N and Yang, J and Yang, J and Zheng, Y and Chen, W and Yang, Y and Liu, Y and Zhao, Y}, title = {Comparative Effectiveness of Non-Pharmacological Interventions for Postpartum Depression and Anxiety: A Network Meta-Analysis.}, journal = {Neuropsychiatric disease and treatment}, volume = {21}, number = {}, pages = {2817-2834}, pmid = {41427009}, issn = {1176-6328}, abstract = {BACKGROUND: Postpartum depression (PPD), a prevalent perinatal mood disorder characterized by persistent depressive and anxiety symptoms, significantly impacts maternal-infant health. The COVID-19 pandemic has further increased the global burden of PPD, emphasizing the need for effective and accessible interventions. Although non-pharmacological interventions are widely used, their comparative efficacy remains uncertain.<br><br>METHODS: We searched the Cochrane Library, Web of Science, EMBASE, PubMed, Scopus, CNKI, VIP Database, and Wanfang Database (inception to September 1, 2024) for randomized controlled trials (RCTs). Interventions included acupuncture (ACU), exercise (EXE), psychotherapy (PSY), exercise combined with psychotherapy (ECP), and music therapy (MT). Primary (depression) and secondary (anxiety) outcomes were pooled using mean differences (MD) with 95% credible intervals (CrI). Risk of bias was assessed via Cochrane RoB2. (PROSPERO: CRD42020166801).<br><br>RESULTS: Thirty-five RCTs were included (n=4047). Meta-analyses for depressive symptoms (5 interventions, n=4047) showed a statistically significant improvement in the non-pharmacological intervention group compared with the control group (standard care, no intervention, or placebo et al), particularly for the ECP (95% CrI -2.3 to -0.85), followed by ACU (95% CrI -1.8 to -0.44) and EXE (95% CrI -1.7 to -0.48). Similarly, for anxiety symptoms (5 interventions, n=863), the overall effect of the non-pharmacological interventions was superior to that of the control group, with ECP again being the most effective modality (95% CrI -2.3 to -0.18), followed by EXE (95% CrI -2.0 to -0.0021) and ACU (95% CrI -0.96 to -0.052).<br><br>CONCLUSION: This study demonstrates the promise of non-pharmacological interventions, particularly exercise, acupuncture, and ECP, for alleviating PPD symptoms, positioning ECP as a potential first-line intervention for mild to moderate cases.}, }
@article {pmid41426687, year = {2025}, author = {Al-Otaibi, FMS and Alotaibi, MT and Altamimi, N and Abu-Dawas, S and Yaqinuddin, A and Alkattan, K}, title = {Social isolation and anxiety disorders during COVID-19: a systematic review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1688239}, pmid = {41426687}, issn = {2296-2565}, mesh = {Humans ; *Social Isolation/psychology ; *COVID-19/psychology/epidemiology ; *Anxiety Disorders/epidemiology/psychology ; Adult ; SARS-CoV-2 ; Pandemics ; Male ; Anxiety ; Female ; Loneliness/psychology ; }, abstract = {BACKGROUND: This systematic review examines the relationship between prolonged social isolation during the COVID-19 pandemic and anxiety levels in adults, with specific focus on social anxiety. It highlights that enforced distancing measures like lockdowns and reduced social contact significantly contributed to a global rise in psychological distress and anxiety disorders.<br><br>OBJECTIVE: To synthesize recent evidence on how social isolation influenced anxiety levels in the general adult population during the COVID-19 pandemic.<br><br>METHODOLOGY: This study followed a qualitative systematic review design. Relevant literature was identified through searches in databases including PubMed, MEDLINE, Web of Science, SCOPUS, and others, using combinations of MeSH terms and keywords. Data extraction and quality assessment followed the PRISMA guidelines and used the Downs and Black Checklist to evaluate methodological quality.<br><br>RESULTS: Seven studies were included, with a total of 3,014 participants. Findings revealed a consistent positive association between social isolation and anxiety. Perceived isolation was a stronger predictor of anxiety than objective isolation. Older adults showed higher vulnerability when isolated or lacking social support. Students and young adults also experienced elevated anxiety, especially when living alone or facing COVID-related stressors.<br><br>CONCLUSION: Social isolation during the pandemic significantly contributed to increased anxiety symptoms across global adult populations. Public health efforts should target loneliness and promote sustainable social connectedness to mitigate long-term psychological consequences.}, }
@article {pmid41426668, year = {2025}, author = {Ding, M}, title = {A critical review of Chinese vaccine enterprises in the global aid market: evolution, drivers, and structural constraints.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1692140}, pmid = {41426668}, issn = {2296-2565}, mesh = {Humans ; China ; *COVID-19/prevention &amp; control/epidemiology ; *COVID-19 Vaccines/economics/supply &amp; distribution ; *Global Health ; *International Cooperation ; SARS-CoV-2 ; *Drug Industry/organization &amp; administration ; Pandemics ; }, abstract = {The Chinese government has assumed an increasingly prominent role in global health governance in recent years, yet the engagement of Chinese enterprises remains underexplored. Existing studies have largely focused on Beijing's major initiatives during the COVID-19 pandemic, overlooking the evolving role of Chinese enterprises as non-state actors. This article provides a comprehensive review of the participation of Chinese vaccine companies in the global aid market, with particular attention to their changing roles, underlying motivations, and persistent challenges as latecomers from the Global South. Drawing on around 80 industry and policy documents, publicly available datasets, and 10 semi-structured interviews with industry and government stakeholders, this study uses documentary synthesis and thematic analysis to show that COVID-19 marked a critical turning point, accelerating Chinese vaccine manufacturers' international engagement while exposing persistent structural barriers. Unlike earlier studies, this review shows that Chinese vaccine enterprises' engagement in the global aid market is shaped not only by strategic market ambitions and alignment with national public health priorities, but also by enduring structural constraints such as geopolitical tensions, institutional mistrust, talent shortages, and reputational vulnerabilities. By situating Chinese enterprises within broader debates on non-state actors in global health, the study advances existing literature and offers policy-relevant insights to strengthen their capacity and influence in promoting equitable vaccine access.}, }
@article {pmid41425583, year = {2025}, author = {Chen, H and Gu, Y and Song, L and Si, L}, title = {Next-generation vaccines against bacterial pathogens: mRNA and beyond.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1709794}, pmid = {41425583}, issn = {1664-3224}, mesh = {Humans ; Animals ; *Bacterial Vaccines/immunology ; COVID-19/immunology/prevention &amp; control ; Vaccine Development ; mRNA Vaccines/immunology ; SARS-CoV-2/immunology ; *Bacterial Infections/immunology/prevention &amp; control ; RNA, Messenger/immunology ; Mycobacterium tuberculosis/immunology ; Nanoparticles ; Vaccines, Synthetic/immunology ; }, abstract = {The global rise of multidrug-resistant (MDR) bacterial infections has exacerbated the need for effective vaccines to prevent these hard-to-treat pathogens. Traditional vaccine approaches have achieved tremendous successes but often fall short for pathogens like Mycobacterium tuberculosis (TB), which evades host immunity through complex mechanisms, and for multidrug-resistant ESKAPE bacteria, where antibiotic resistance and antigenic variability complicate effective vaccine development. The COVID-19 pandemic spurred unprecedented advances in vaccine technology - particularly mRNA vaccines - reviving interest in novel platforms for bacterial diseases. Here we review next-generation vaccine strategies, focusing on nucleic acid-based platforms such as mRNA, DNA, and self-amplifying RNA (saRNA), as well as viral vector vaccines. We also examine nanoparticle technologies that serve as delivery systems or adjuvant platforms across these approaches. We discuss the unique opportunities of mRNA vaccines to induce both robust antibody and T-cell responses required for intracellular infections like TB, as well as the challenges of antigen discovery and delivery (e.g. lipid nanoparticles). Each platform's mechanism, immunogenic profile, current development status, and challenges are analyzed, including comparative insights. We highlight recent progress such as mRNA vaccine candidates against TB entering clinical trials and saRNA prototypes protecting against plague in animals. Finally, we provide a perspective on the future of vaccine strategies to combat antimicrobial resistance (AMR) - emphasizing the integration of multiple platforms, global collaborative efforts, regulatory pathways, and the translational hurdles that must be overcome to bring these next-generation vaccines from bench to bedside.}, }
@article {pmid41424988, year = {2025}, author = {Pourshaban, M and Allahbakhshian, A and Purabdollah, M}, title = {Mapping the Contributing Factors to Missed Nursing Care in Hospital Settings During a Global Health Crisis: A Systematic Scoping Review.}, journal = {Journal of nursing management}, volume = {2025}, number = {}, pages = {7343469}, pmid = {41424988}, issn = {1365-2834}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; Global Health ; *Nursing Care/standards/statistics &amp; numerical data ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Little foreknowledge and preparation exist for health-related crises, and they do not match the magnitude of the problem. During the COVID-19 pandemic, nursing care in some countries faced more challenges. One of these challenges was missed nursing care. This scoping review aims to identify and map the factors influencing missed nursing care in hospital settings during the COVID-19 pandemic in studies conducted in developed and developing countries.<br><br>METHODS: A scoping review was conducted according to methodology recommended by the Joanna Briggs Institute (JBI). We searched five databases-PubMed, Scopus, CINAHL, ProQuest, and Web of Science-as well as the Google Scholar search engine, from December 2019 to July 2025. Keywords of the study were selected according to the Medical Subject Headings (MeSH) and previous research. We included studies in hospital wards that examined missed nursing care and related concepts, specifically those whose data collection periods occurred during the COVID-19 pandemic. Language restrictions were not applied. The factors were derived inductively, considering conceptual similarities, relevance to the core themes, and similarities in meaning, including aspects related to the missed nursing care model, the developed model derived from it related to the factors considered for missed nursing care, and emerging challenges introduced by COVID-19. Findings were reported following the PRISMA-ScR.<br><br>FINDINGS: From the 1966 studies, we included 57 articles in the final review. Among them, 50 were cross-sectional, four were qualitative, two were mixed, and one was quasiexperimental. They were conducted mainly in Iran and the hospital units. Four main themes and nine subthemes emerged (1) work environment (structure, work climate), (2) nurse characteristics (individual and professional, personal), (3) workflow characteristics (intensity, predictability, risk), (4) country (developed, developing). Although the lack of human resources was reported in most studies, it was not the most significant contributing factor.<br><br>CONCLUSION: These findings can inform the development of strategies to address underlying factors affecting workflow, such as nurses' attitudes and the work environment, thereby enhancing adaptability to future global health crises and serving as a crucial policy foundation for mitigating the missed nursing care during health emergencies.<br><br>PRACTICAL IMPLICATIONS: These findings not only complement other global research exploring the reasons behind missed cares in nursing but also offer a framework for understanding and anticipating reported instances of missed care, enabling targeted interventions to address them effectively.}, }
@article {pmid41424893, year = {2025}, author = {Bhat, HM and Nazir, R and Kashoo, ZA}, title = {Rising Threats of Viral Infections: Exploring Probiotics as Antiviral Agents.}, journal = {Indian journal of microbiology}, volume = {65}, number = {4}, pages = {1781-1798}, pmid = {41424893}, issn = {0046-8991}, abstract = {Viral infections are the most common etiological agents behind a wide range of human illnesses, with significant and widespread effects on human health. Vaccines have been developed to combat viral infectious diseases in various ways. However, the high rate of mutation in viruses, specifically RNA viruses, makes vaccines and medications for viral infectious diseases ineffective. Meanwhile, published research continues to offer insight into the efficacy of probiotics as antiviral agents. Various clinical findings reveal those specific probiotic strains aid in the prevention of viral and bacterial infections. Probiotics have been used to prevent and treat common viral infections such as rotavirus, coronavirus, hepatitis, human papillomavirus, human immunodeficiency virus, and herpes simplex viruses etc. The studies compiled in this review demonstrate the value of probiotics in the treatment and prevention of several viral infections using in vitro and in vivo trials in both experimental animals and humans and also provide perspectives on probiotics' probable antiviral mechanisms. Although the initial findings are promising, the current research is limited by small sample sizes, short study durations, and a lack of diversity in population groups. Consequently, further research with larger, more diverse cohorts and extended follow-up periods is necessary to thoroughly assess and confirm the effectiveness of this probiotic treatment against these severe infectious diseases.}, }
@article {pmid41424145, year = {2026}, author = {Tang, P and Xiao, R and Xiao, W and Wen, T and Li, Y and Lu, B and Yang, X}, title = {The impact of the COVID-19 pandemic on osteoporotic fractures: a systematic review and meta-analysis.}, journal = {Annals of medicine}, volume = {58}, number = {1}, pages = {2604391}, doi = {10.1080/07853890.2025.2604391}, pmid = {41424145}, issn = {1365-2060}, mesh = {Humans ; *COVID-19/epidemiology ; *Osteoporotic Fractures/epidemiology ; Incidence ; SARS-CoV-2 ; Male ; Female ; Pandemics ; Spinal Fractures/epidemiology ; Hip Fractures/epidemiology ; }, abstract = {BACKGROUND: Recent reports suggest that the COVID-19 pandemic and associated lockdowns may have influenced the epidemiology of osteoporotic fractures, but results vary across regions and fracture types. The aim of this study was to provide evidence-based insights into the impact of the pandemic on osteoporotic fracture incidence.<br><br>METHODS: We searched four databases (PubMed, Embase, Cochrane Library, and Web of Science) up to August 2025 for observational or retrospective studies comparing osteoporotic fracture incidence during the COVID-19 pandemic (2020) with the pre-pandemic period (2019). The primary outcome of interest was the change in fracture incidence, analysed using risk ratios (RR) with 95% confidence intervals (CI) in Review Manager 5.4. Subgroup analyses were performed by sex, geographic region, and fracture type.<br><br>RESULTS: Nine studies meeting the inclusion criteria were analysed. Overall, "all types" of osteoporotic fractures showed a significant decrease during the pandemic (RR = 0.85, 95% CI 0.80-0.91, p&#x2009;<&#x2009;0.0001). Specifically, forearm fractures decreased significantly (RR = 0.87, 95% CI 0.79-0.96, p&#x2009;=&#x2009;0.002). However, for the most clinically significant fractures, no statistically significant global change was found for hip fractures (RR = 0.93, 95% CI 0.76-1.15, p&#x2009;=&#x2009;0.14) or vertebral fractures (RR = 1.35, 95% CI 0.85-2.15, p&#x2009;=&#x2009;0.20). In regional subgroup analysis, hip fracture incidence decreased significantly in South America (RR = 0.79, p&#x2009;=&#x2009;0.0004) and in both males and females, but no significant change was observed in Europe (RR = 0.92, 95% CI 0.81-1.04, p&#x2009;=&#x2009;0.17).<br><br>CONCLUSION: During the COVID-19 pandemic, there was a decrease in the incidence of minor fractures, such as those of the forearm, likely due to reduced outdoor activity. However, the incidence of major osteoporotic fractures (hip and vertebral) remained stable globally, with significant reductions observed only in specific regions like South America.}, }
@article {pmid41424056, year = {2025}, author = {Vereijken, FR and Frielink, N and Jahoda, A and Embregts, PJCM}, title = {Continued Involvement: A Scoping Review on Family Members' Needs and Experiences Collaborating With Support Staff for Relatives With Intellectual Disabilities Living Outside the Family Home.}, journal = {Journal of intellectual disability research : JIDR}, volume = {}, number = {}, pages = {}, doi = {10.1111/jir.70074}, pmid = {41424056}, issn = {1365-2788}, support = {329561//Ministerie van Volksgezondheid, Welzijn en Sport/ ; }, abstract = {BACKGROUND: Family members' involvement in the care for their relative often continues after their relative has moved out of the family home. However, little is known about the needs of family members when collaborating specifically with support staff caring for their relative. This scoping review provides an overview of existing literature to inform future research.<br><br>METHOD: The review was conducted in accordance with the PRISMA for Scoping Review statement. Seven databases were systematically searched in April 2022 (with a final update in May 2025). Studies that were published in English in peer-reviewed journals and examined the needs and experiences of family members collaborating with support staff in residential care settings were considered for inclusion. The Mixed Methods Appraisal Tool was used to assess risk of bias and a thematic synthesis was conducted to analyse the data.<br><br>RESULTS: Ten articles met the inclusion criteria. Four studies focused on family members' experiences following a relative's transition from institutional or hospital settings, one study on sibling-staff collaboration, one on the roles of adult siblings, one exploring family experiences during the COVID-19 pandemic, one on parental perceptions of communication, one on family experiences postabuse inquiry and one focused on collaboration within hospital settings. The studies involved relatives with severe (n&#x2009;=&#x2009;1), mild, severe and profound (n&#x2009;=&#x2009;1), severe to profound (n&#x2009;=&#x2009;1) or profound intellectual disabilities (n&#x2009;=&#x2009;3). Four did not mention the level of intellectual disability. The synthesis yielded four analytical themes: (1) complexities in building personal relationships amidst changing contexts (n&#x2009;=&#x2009;8), (2) navigating how to address unmet needs and the vulnerability it exposes (n&#x2009;=&#x2009;3), (3) a desire for partnership and recognition (n&#x2009;=&#x2009;10) and (4) a desire for staff to uphold their relative's quality of life (n&#x2009;=&#x2009;10).<br><br>DISCUSSION: This review highlights key areas for future research, including how family characteristics, disability severity and living arrangement can influence needs and experiences when collaborating with support staff. Additionally, further insight is needed on what impacts the dynamic nature of family-staff relationships. Lastly, understanding the views and experiences of support staff regarding family involvement is important, as it can aid the development of collaboration that is sensitive to their specific needs.}, }
@article {pmid41423992, year = {2026}, author = {Failla, KR and Pelletier, LR and Poeltler, DM}, title = {Newly Licensed Nurse Retention: What a 5-Year Review of Data Tells Us.}, journal = {Nursing administration quarterly}, volume = {50}, number = {1}, pages = {3-8}, pmid = {41423992}, issn = {1550-5103}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; *Personnel Turnover/statistics &amp; numerical data ; *Nurses/supply &amp; distribution ; Job Satisfaction ; United States ; }, abstract = {Although many articles address retention, few define the concept. There is a need for all health care organizations to adopt a standard definition in order to make accurate comparisons. This organization provides a definition of retention, measures pre-COVID and post-COVID retention, and uses psychometrically tested tools to measure the effectiveness of an accredited Nurse Residency Program. Characteristics of nurses who stay and nurses who leave are provided. Evidence-based retention strategies and opportunities for improvement are discussed, as all health care organizations and nurse leaders desire to have a return on their investment of enculturating newly licensed nurses.}, }
@article {pmid41423526, year = {2025}, author = {Veronese, N and Barratt, J and Coemans, E and Dayananda, P and Del Riccio, M and Fulop, T and Gabutti, G and Gravenstein, S and Hiligsmann, M and Hummers, E and Kassianos, G and Macchia, F and Manzoni, P and Martin, FC and Michel, JP and Morandi, A and Ory, J and Pattyn, J and Peetermans, E and Polidori, MC and Riccò, M and Sieber, CC and Torres, A and van Essen, GA and Maggi, S}, title = {Infectious diseases, infection control, vaccines and long-term care: an European interdisciplinary Council on ageing consensus document.}, journal = {Aging clinical and experimental research}, volume = {}, number = {}, pages = {}, doi = {10.1007/s40520-025-03271-6}, pmid = {41423526}, issn = {1720-8319}, abstract = {The accelerating ageing of populations worldwide presents profound challenges for public health, particularly within long-term care facilities (LTCFs). Older adults, often burdened by multimorbidity, frailty, and immunosenescence, are highly vulnerable to vaccine-preventable diseases such as influenza, pneumococcal pneumonia, COVID-19, respiratory syncytial virus (RSV), pertussis, and herpes zoster (HZ). Despite the availability of effective vaccines, immunization coverage in LTCFs remains inadequate, hindered by fragmented national policies, insufficient mandates, and systemic neglect of adult vaccination. In many settings, vaccination uptake is not even systematically monitored, leaving policymakers and clinicians without reliable data to identify gaps or measure progress. The COVID-19 pandemic underscored these vulnerabilities, temporarily spurring emergency vaccination efforts but failing to establish sustainable, life-course immunization frameworks. This consensus document, developed by the European Interdisciplinary Council on Ageing (EICA) following the San Servolo (Venice, Italy) 2025 meeting, synthesizes evidence on intrinsic and environmental infection risk factors in LTCFs, the health and economic burden of infections, and the persistent gaps in vaccine uptake among both residents and staff. We highlight the cost-effectiveness of preventive interventions, the critical role of non-pharmacological infection control measures, and the need to address antimicrobial resistance through integrated vaccination strategies. The Council emphasizes that routine adult vaccination must become a structural element of care planning for ageing populations, supported by digital registries, systematic assessments at LTC admission, co-administration strategies, and robust staff engagement. Stronger global and national policy leadership is urgently needed to align LTCF immunization with life-course approaches and primary healthcare integration. Protecting frail older adults from infectious diseases is not only a clinical necessity but also a societal obligation-central to safeguarding dignity, resilience, and healthy ageing in Europe and beyond.}, }
@article {pmid41422470, year = {2025}, author = {Taha, MK and Weil-Olivier, C and Leng, S and Dinleyici, EC and Yezli, S}, title = {Meningococcal Disease in Older Adults: Challenges in Diagnosis and Management.}, journal = {Infectious diseases and therapy}, volume = {}, number = {}, pages = {}, pmid = {41422470}, issn = {2193-8229}, abstract = {Invasive meningococcal disease (IMD) in older adults frequently presents with atypical clinical manifestations, including bacteremic pneumonia, often without classical meningeal signs or sepsis, which presents clinicians with diagnostic challenges, and may delay treatment, which contributes to the high mortality observed in older adults. Within the broader resurgence of IMD observed since relaxation of quarantine measures introduced to mitigate the impact of the COVID-19 pandemic, there has been a notable increase in reporting of such atypical cases. The aim of this review is to summarize epidemiological, diagnostic, and treatment aspects of non-meningeal forms of IMD in older patients, with a focus on meningococcal pneumonia. By convention, laboratory confirmation requires N. meningitidis detection by culture, polymerase chain reaction (PCR), or antigen detection. In most cases, presentation of meningococcal pneumonia is similar to that of other forms of community-acquired pneumonia, and cerebrospinal fluid sampling may be non-informative. This places a premium on early blood culture for N. meningitidis, allied with testing of respiratory samples (e.g., broncho-alveolar washes). Many cases are linked to isolates of serogroups Y and W. When confirmed, treatment with third-generation cephalosporins is generally preferred. Chemoprophylaxis and vaccination of close contacts is essential for controlling onward meningococcal disease transmission and prevention of further cases.}, }
@article {pmid41422110, year = {2025}, author = {Baichoo, S and Oladeji, O and Villareal, L and Diakabana, H and Okekunle, AP and Marivate, V and Kaggwa, F and Nsoesie, EO}, title = {Scoping review of artificial intelligence via mobile technology and social media for health in Africa.}, journal = {Nature communications}, volume = {16}, number = {1}, pages = {11288}, pmid = {41422110}, issn = {2041-1723}, mesh = {Humans ; Africa/epidemiology ; *Social Media ; *Artificial Intelligence ; *Cell Phone ; COVID-19/epidemiology ; Machine Learning ; Malaria/epidemiology ; SARS-CoV-2 ; }, abstract = {The combination of mobile technologies and social media with Artificial Intelligence (AI) opens new opportunities for multi-modal data generation, analysis, and inference for various health applications. To investigate how these tools are being used for health applications in Africa, we conduct a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. We screen 469 articles and synthesize 116. We include 29 studies documenting the use of a broad range of advanced and straightforward machine-learning techniques to study infectious and chronic diseases such as COVID-19 (4 studies, 13.8%), malaria (5, 17.2%), and cervical cancer (2, 6.9%). Countries with high internet and mobile phone penetration have higher representation. Based on identified gaps, we make research and policy recommendations to enhance the contribution of these tools in advancing health in Africa. These include investing in studies on chronic diseases and implementing frameworks to address geographic inequity.}, }
@article {pmid41421733, year = {2025}, author = {Duggan, MR and Chatila, ZK and Auber, LA and Silberberg, E and Fernandez, JR and Walker, KA and Schultek, NM}, title = {Can the COVID-19 pandemic advance neuroinfectious research?.}, journal = {Brain, behavior, and immunity}, volume = {132}, number = {}, pages = {106233}, doi = {10.1016/j.bbi.2025.106233}, pmid = {41421733}, issn = {1090-2139}, abstract = {Investments in SARS-CoV-2 research provide a unique opportunity to explore how microbes may contribute to neurological conditions, an area of investigation that has been chronically underfunded. As exemplified by HIV/AIDS funding, crisis-driven research can yield broader biomedical advances, including spillover effects that address unanticipated and unmet medical needs. Leveraging newly established SARS-CoV-2 funding opportunities to study immune crosstalk and genetic predispositions could reveal therapeutic pathways and biomarkers for individuals who are vulnerable to infection-related dementia risk and neuropsychiatric symptoms. Despite the vast consequences of SARS-CoV-2, research investments following this pandemic may have long lasting benefits for other scientific endeavors, including insights for microbial contributions to neurodegenerative disease.}, }
@article {pmid41418929, year = {2025}, author = {Liao, ZX and Tseng, SJ}, title = {Evaluating the potential of mRNA technology for cytokine production and delivery in antitumor therapy.}, journal = {Drug discovery today}, volume = {}, number = {}, pages = {104590}, doi = {10.1016/j.drudis.2025.104590}, pmid = {41418929}, issn = {1878-5832}, abstract = {Tumors evolve in tandem with their tumor microenvironment (TME), often creating an immunosuppressive state that hinders anticancer responses. Whereas antitumor immunostimulating cytokines can reverse this suppression and trigger effective immunity, their systemic administration causes severe toxicity, limiting their clinical use. mRNA technology, recognized as a medical breakthrough highlighted by COVID-19 vaccines, offers a promising approach. This review posits that local delivery of mRNA-encoded antitumor cytokines to the TME enables targeted, in situ production, maximizing antitumor effects while minimizing systemic toxicity.}, }
@article {pmid41418501, year = {2025}, author = {Krahé, B}, title = {Situational risk factors for intimate partner violence.}, journal = {Current opinion in psychology}, volume = {68}, number = {}, pages = {102228}, doi = {10.1016/j.copsyc.2025.102228}, pmid = {41418501}, issn = {2352-2518}, abstract = {Intimate partner violence (IPV) is a worldwide problem with a wide range of negative effects, and a broad literature has identified risk factors at the societal, relationship, interpersonal, and individual level associated with relatively stable differences in the likelihood of IPV. In addition, risk factors for IPV may be located within a given situation, promoting the use of violence by one or both partners. Based on two influential theories of aggression, the General Aggression Model and I[3] theory, this article presents evidence on five situational risk factors for IPV: alcohol use, provocation and jealousy, acute stress, the Covid-19 pandemic, and the presence of firearms, and outlines implications for prevention.}, }
@article {pmid41418272, year = {2025}, author = {Carmona Pestaña, A and Herrera-Peco, I and Jiménez-Gómez, B and Suárez-Llevat, C}, title = {Internet Memes as Drivers of Health Narratives and Infodemics: Integrative Review.}, journal = {JMIR infodemiology}, volume = {5}, number = {}, pages = {e77029}, pmid = {41418272}, issn = {2564-1891}, mesh = {Humans ; *COVID-19/epidemiology ; *Social Media ; *Narration ; *Health Communication/methods ; *Internet ; SARS-CoV-2 ; Pandemics ; Communication ; }, abstract = {BACKGROUND: Digital media memes have emerged as influential tools in health communication, particularly during the COVID-19 pandemic. While they offer opportunities for emotional engagement and community resilience, they also act as vectors for health misinformation, contributing to the global infodemic. Despite growing interest in their communicative power, the role of memes in shaping public perception and misinformation diffusion remains underexplored in infodemiology.<br><br>OBJECTIVE: This integrative review aims to analyze how memes influence emotional, behavioral, and ideological responses to health crises, and to examine their dual role as both contributors to and potential mitigators of infodemics. The paper also explores strategies for integrating memes into public health campaigns and infodemic management.<br><br>METHODS: A comprehensive literature search was conducted across 3 major databases (MEDLINE, Scopus, and Web of Science), identifying a total of 386 records. Following duplicate removal and eligibility screening, 14 peer-reviewed studies published between 2020 and 2025 were included. An integrative narrative approach was used to synthesize evidence on social media behavior, misinformation dynamics, and digital health campaigns. The analysis was grounded in infodemiological and infoveillance frameworks as established by Eysenbach, incorporating insights from psychology, media studies, and public health.<br><br>RESULTS: Memes function as emotionally salient and visually potent carriers of health-related narratives. While they can simplify complex messages and foster adaptive humor during crises, they are also susceptible to distortion, particularly in echo chambers and conspiracy communities. Findings reveal that misinformation-laden memes often leverage humor and disgust to bypass critical thinking, and their viral potential is linked to emotional intensity. However, memes have also been successfully integrated into prebunking strategies, increasing engagement and reducing susceptibility to false claims when culturally tailored. The review identifies key mechanisms that enhance or hinder the infodemiological value of memes, including political orientation, digital literacy, and narrative framing.<br><br>CONCLUSIONS: Memes are a double-edged sword in the context of infodemics. Their integration into infodemic surveillance and digital health campaigns requires a nuanced understanding of their emotional, cultural, and epistemic effects. Public health institutions should incorporate meme analysis into real-time infoveillance systems, apply evidence-based meme formats in prebunking efforts, and foster digital literacy that enables critical meme consumption. Future infodemiology research should further explore the long-term behavioral impacts of memetic misinformation and the scalability of meme-based interventions.}, }
@article {pmid41424476, year = {2024}, author = {Dhir, S and Karim, N and Berka, H and Shatkin, J}, title = {Pharmacological management of pediatric insomnia.}, journal = {Frontiers in sleep}, volume = {3}, number = {}, pages = {1389052}, pmid = {41424476}, issn = {2813-2890}, abstract = {Insomnia is the most commonly reported sleep disorder among children and adolescents, impacting their cognitive, emotional, behavioral, and physical development. The prevalence of insomnia generally increases with age, often persisting into adulthood if unaddressed. Insomnia is exceedingly common among those with developmental disabilities and is frequently comorbid with a great range of psychiatric diagnoses. The COVID-19 pandemic has only increased the prevalence of insomnia among children and adolescents. Health care providers are routinely called upon to treat insomnia in the pediatric population. Psychoeducation and behavioral interventions, especially cognitive behavioral therapy for insomnia (CBT-I), remain the first line treatments, given empirical evidence for their efficacy and success in relapse prevention. However, medications are frequently employed in clinical practice, despite the fact that no medications are approved by the Food and Drug Administration (FDA) for the treatment of pediatric insomnia. This review was designed to educate and support practitioners who are treating children and adolescents who struggle with insomnia. A thorough narrative review was completed to identify all published medication studies of pediatric insomnia; the identified studies are described and then graded into four categories according to the strength of the evidence supporting their use, side effect profiles, co-morbidities, and overall risk vs. benefit of each pharmacological treatment. This review will help practitioners in making clinical decisions for their pediatric patients who suffer with insomnia.}, }
@article {pmid41417766, year = {2025}, author = {Silveira, LC and Santos, KF and Campos, JS and Assunção, LP and Santos, RS and Reis, AAS}, title = {Association of genetic variants with the progression of COVID-19 symptoms in diabetic patients: a systematic review and in silico protein interaction analysis.}, journal = {Brazilian journal of biology = Revista brasleira de biologia}, volume = {85}, number = {}, pages = {e297127}, doi = {10.1590/1519-6984.297127}, pmid = {41417766}, issn = {1678-4375}, mesh = {Humans ; *COVID-19/genetics ; *Diabetes Mellitus/genetics ; *Genetic Variation/genetics ; Angiotensin-Converting Enzyme 2/genetics ; SARS-CoV-2 ; Genetic Predisposition to Disease ; Disease Progression ; Risk Factors ; Computer Simulation ; }, abstract = {Diabetes mellitus is a global public health issue and, at the onset of the COVID-19 pandemic, was identified as a risk factor associated with high morbidity and mortality in cases of acute respiratory infection caused by the SARS-CoV-2 coronavirus. This study investigated genetic variants in diabetic patients with COVID-19 through a systematic analysis of the PubMed/NCBI, EMBASE, Web of Science, SCOPUS, and Virtual Health Library databases, with the protocol registered on the PROSPERO platform (registration number CRD42020181311). Fifteen genetic variants were associated with five specific genes in symptomatic diabetic patients with COVID-19. Inheritance models, diabetic individuals carrying the heterozygous genotype TC (VDR rs4516035) showed ~10-15-fold higher odds of symptomatic COVID-19. Protein-protein interaction (PPI) analysis showed that the proteins ACE, ACE2, IL-6, and IL-17 exhibited strong predicted interactions with each other, as well as with insulin and the TMPRSS2 protease. Limitations include small number of eligible studies, heterogeneity in populations and outcome definitions. These preliminary findings highlight the need for further studies to understand better the relationship between the identified genetic variants and the progression of COVID-19 in diabetic patients.}, }
@article {pmid41417528, year = {2025}, author = {Miquilussi, PA and Aguiar, TV and Cruz, PLD and Duca, AP and Ribeiro, M and Araújo, CM and Santos, RS and Schroder, AGD and Crippa, ACS}, title = {Impact of SARS-Cov-2 exposure during pregnancy on child neurodevelopment: systematic review and meta-analysis.}, journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo}, volume = {43}, number = {}, pages = {e2025094}, pmid = {41417528}, issn = {1984-0462}, mesh = {Humans ; Pregnancy ; *COVID-19/complications ; Female ; *Pregnancy Complications, Infectious ; *Prenatal Exposure Delayed Effects/epidemiology ; *Neurodevelopmental Disorders/virology/etiology/epidemiology ; Infant ; SARS-CoV-2 ; *Child Development ; Child, Preschool ; Infant, Newborn ; }, abstract = {OBJECTIVE: The objective of this study was to investigate the impact of intrauterine exposure to SARS-CoV-2 on neurodevelopment in children up to 2 years of age.<br><br>DATA SOURCE: A combination of keywords and truncations was adapted for five electronic databases: Excerpta Medica Database (EMBASE), Latin American and Caribbean Literature in Health Sciences (LILACS), PubMed/Medline, Scopus, and Web of Science. Additionally, gray literature sources were consulted, including the American Speech-Language-Hearing Association (ASHA), Google Scholar, and ProQuest Dissertations and Theses. The quality of evidence was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist. A random-effects meta-analysis was performed to evaluate the primary outcome using R in R Studio version 1.2.1335 (RStudio Inc., Boston, USA). Study weights were calculated using the Mantel-Haenszel method, and variance, expressed by Tau2 values, employed the DerSimonian-Laird estimator. The Freeman-Tukey double arcsine transformation was applied to approximate a normal data distribution, and 95% confidence intervals were calculated for each meta-analysis.<br><br>DATA SYNTHESIS: Nine articles were included in the qualitative synthesis and eight in the quantitative analysis. There was no statistically significant difference in neurodevelopment between infants exposed and unexposed to SARS-CoV-2 during pregnancy [RR=5.10; 95%CI 0.36-71.85; I2=91%]. However, for the "fine motor" domain, the exposed group had a 2.38 times higher risk of deficit [95%CI 1.22-4.68] compared to the non-exposed group, with low heterogeneity in the analysis (I2=0%).<br><br>CONCLUSIONS: Exposure to the SARS-CoV-2 virus during the gestational period is not associated with neurodevelopmental delay up to 2 years of age, although it has been linked to an increased risk of delayed fine motor development. However, this evidence remains uncertain due to the limited number of studies on the topic and the heterogeneity of methodologies.}, }
@article {pmid41417317, year = {2025}, author = {Oliveira, AM and Cartøgenes, AD and Berni, LC and Amaral, LMB and Machado, RL and Oliveira, RCS}, title = {Impacts of COVID-19 on pediatric patients with congenital heart disease: a small systematic and integrative literature review.}, journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo}, volume = {43}, number = {}, pages = {e2025073}, pmid = {41417317}, issn = {1984-0462}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Heart Defects, Congenital/complications/therapy ; Child ; }, abstract = {OBJECTIVE: The objective of this study was to compile primary studies to understand the impacts of COVID-19 on pediatric patients with congenital heart disease.<br><br>DATA SOURCE: A systematic review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) method, with searches conducted in the PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), and Scientific Electronic Library Online (SciELO) databases. Studies published in the last 5 years, open access, and addressing the research question, "What are the main impacts of COVID-19 on pediatric patients with congenital heart disease?" were included. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) and the Joanna Briggs Institute (JBI) tools.<br><br>DATA SYNTHESIS: A total of 377 articles were identified, of which 12 met the inclusion criteria. The NOS tool indicated that two of the eight cohort studies had a risk of bias and lower methodological quality. The JBI tool revealed that three of the four cross-sectional studies had a low risk of bias and good methodological quality. The integrative analysis highlighted three main impacts of COVID-19 on these patients: difficulties in follow-up and treatment, reduced physical activity due to social distancing, and postponement of procedures and surgeries. Infected patients experienced increased complications and hospitalizations, but without a significant change in mortality.<br><br>CONCLUSIONS: The COVID-19 pandemic significantly affected the health and management of congenital heart disease, leading to clinical complications and worsening follow-up. Further primary and secondary studies are needed to strengthen the evidence and improve patient management.}, }
@article {pmid41020593, year = {2025}, author = {Boardman, SA and Hetherington, C and Hughes, T and Cook, C and Galea, I and Hilton, O and Solomon, T and Luster, AD and Allan, S and Kurt-Jones, E and Forth, J and Patabendige, A and Egbe, FN and Dunai, C and Michael, BD}, title = {Viral Infection and the Blood-Brain Barrier: Molecular Research Insights and Therapies.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {6}, pages = {1273-1282}, doi = {10.1093/infdis/jiaf455}, pmid = {41020593}, issn = {1537-6613}, mesh = {*Blood-Brain Barrier/virology/physiopathology/pathology ; Humans ; COVID-19 ; *Virus Diseases/virology/therapy ; Animals ; SARS-CoV-2 ; }, abstract = {The blood-brain barrier (BBB) protects the brain from pathogenic microorganisms. Neurologic complications from viral infections, including herpes simplex virus, varicella zoster virus, HIV, Japanese encephalitis virus, and SARS-CoV-2, are linked to BBB dysfunction and loss of barrier integrity. Increased BBB permeability associated with viral infections can occur through several mechanisms, such as direct neurotropism, Trojan horse mechanisms, or systemic infection and inflammation. Viruses cause direct and indirect immune-mediated damage. Understanding these neuroimmune mechanisms is critical to establish therapeutic strategies to protect BBB function. This review describes the effect of viral infection on the BBB, clinical methods to assess BBB integrity, and clinical management approaches to address viral-induced BBB damage.}, }
@article {pmid40854466, year = {2026}, author = {Visentin, A and Nazeri, A and Peñalvo, JL and Gorska, A and Davis, RJ and Flett, RL and Simensen, VC and Langeland, N and Gaday, Q and Mirandola, M and Mazzotta, V and Luong Nguyen, LB and Mothe, B and Van Dijck, C and Meyerhans, A and Boesecke, C and Giaquinto, C and Judd, A and Tacconelli, E}, title = {Lessons from the European mpox outbreak: strengthening cohort research for future pandemic preparedness.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {32}, number = {1}, pages = {62-69}, doi = {10.1016/j.cmi.2025.08.019}, pmid = {40854466}, issn = {1469-0691}, mesh = {Humans ; Europe/epidemiology ; *COVID-19/epidemiology/prevention &amp; control ; Cohort Studies ; *Disease Outbreaks/prevention &amp; control ; *Pandemics/prevention &amp; control ; SARS-CoV-2 ; Pandemic Preparedness ; }, abstract = {BACKGROUND: Well-designed cohort studies are crucial for pandemic preparedness, informing evidence-based infection prevention and treatment strategies.<br><br>OBJECTIVES: Following the 2022 mpox outbreak in Europe, this scoping review critically evaluates the design, implementation, and characteristics of cohort studies focusing on mpox. The aim is to inform recommendations for the Cohort Coordination Board and the COordination MEchanism for Cohorts and Trials (CoMeCT) to enhance cohort study research and improve preparedness.<br><br>SOURCES: A comprehensive literature search was conducted in PubMed, Scopus, ClinicalTrials.gov, the European Union Clinical Trials Register, and the European Clinical Research Infrastructure Network (ECRIN) metadata repository up to December 2024.<br><br>CONTENT: Forty-nine cohorts were identified, encompassing 10 728 individuals with primary or breakthrough mpox and 34 010 individuals without mpox (vaccinated and unvaccinated). The majority of cohorts collected data prospectively (30, 63%) and were multicentre (25, 52%). The primary aims were the natural history of mpox (31, 65%); effectiveness of vaccination (15, 31%); and treatment (2, 4%). The most frequent target population was individuals at increased risk of sexually transmitted infection (18, 38%). Follow-up of participants varied widely among cohorts. Significant data heterogeneity, stemming from the inconsistent use of standardized data dictionaries, impeded data sharing and meta-analyses. Under-representation of vulnerable populations and limited biobanking further compounded these challenges.<br><br>IMPLICATIONS: This review underscores critical gaps in the research response during the mpox outbreak. Based on these findings, we propose the following recommendations: (1) establishing and maintaining "ever-warm" cohorts of high-risk individuals during inter-epidemic periods to enable rapid data collection during future outbreaks; (2) promoting data interoperability through the development and adoption of standardized data collection tools and ontologies; (3) improving the quality of study reporting through strict adherence to relevant guidelines; and (4) strengthening European and global coordination through the establishment of collaborative research networks. Sustained investment in research infrastructure is essential for a more effective, equitable, and timely public health response to future outbreaks.}, }
@article {pmid34289925, year = {2022}, author = {Majid, U and Hussain, SAS and Wasim, A and Farhana, N and Saadat, P}, title = {A Systematic Map of Non-Clinical Evidence Syntheses Published Globally on COVID-19.}, journal = {Disaster medicine and public health preparedness}, volume = {16}, number = {6}, pages = {2659-2664}, pmid = {34289925}, issn = {1938-744X}, abstract = {STUDY OBJECTIVE: Evidence syntheses perform rigorous investigations of the primary literature and they have played a vital role in generating evidence-based recommendations for governments worldwide during the Covid-19 pandemic. However, there has not yet been an attempt to organize them by topic and other characteristics. This study performed a systematic mapping exercise of non-clinical evidence syntheses pertaining to Covid-19.<br><br>METHODS: This study conducted a systematic search on December 5, 2020 across 10 databases and servers: CINAHL (EBSCO Information Services, Ipswich, Massachusetts, United States), Embase (Elsevier, Aalborg, Denmark), Global Health (EBSCO Information Services, Ipswich, Massachusetts, United States), Healthstar (NICHSR and AHA, Bethesda, United States), MEDLINE (NLM, Bethesda, United States), PsychINFO (APA, Washington, DC, United States), Web of Science (Clarivate Analytics, London, UK), Research Square (Research Square, Durham, North Carolina), MEDRxiv (Cold Spring Harbor Laboratory, New York, United States), and PROSPERO (NIHR, York, United Kingdom). Only full evidence syntheses published in a peer-reviewed journal or preprint server were included.<br><br>RESULTS: This study classified all evidence syntheses in the following topics: health service delivery (n = 280), prevention and behavior (n = 201), mental health (n = 140), social epidemiology (n = 31), economy (n = 22), and environment (n = 19). This study provides a comprehensive resource of all evidence syntheses categorized according to topic.<br><br>CONCLUSIONS: This study proposes the following research priorities: governance, the impact of Covid-19 on different populations, the effectiveness of prevention and control methods across contexts, mental health, and vaccine hesitancy.}, }
@article {pmid41416803, year = {2025}, author = {Kumari, S and Banerjee, A}, title = {Extracellular vesicles: the double-edged sword in viral infections.}, journal = {mBio}, volume = {}, number = {}, pages = {e0331625}, doi = {10.1128/mbio.03316-25}, pmid = {41416803}, issn = {2150-7511}, abstract = {Extracellular vesicles (EVs) are lipid-bound nanocarriers released by various eukaryotic cells and found in diverse bodily fluids. EVs have transitioned from being considered cellular waste disposers to significant players in intercellular communication and signaling. These EVs carry signature cargos of infected cells and thus can be helpful as biomarkers or prognostic markers for infectious diseases. Viruses can manipulate the EV biogenesis machinery in their own dissemination. EVs released from virus-infected cells can carry immune modulatory molecules, thus contributing to disease progression. This comprehensive review collates the information on the impact of EVs on viral infection and disease progression.}, }
@article {pmid41416679, year = {2025}, author = {Tao, X and Zhang, Z and Liang, L and Xu, S and Du, X and Ren, Z and Yu, X}, title = {Temporal patterns of suicidal ideation prevalence during the COVID-19 pandemic: a systematic review and meta-analysis of cross-sectional and longitudinal studies.}, journal = {Epidemiology and psychiatric sciences}, volume = {34}, number = {}, pages = {e61}, doi = {10.1017/S2045796025100358}, pmid = {41416679}, issn = {2045-7979}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Suicidal Ideation ; Cross-Sectional Studies ; Prevalence ; Longitudinal Studies ; Pandemics ; SARS-CoV-2 ; }, abstract = {AIMS: Although extensive research has been conducted on the impact of the COVID-19 pandemic on global mental health, a systematic synthesis of the cross-time dynamics of suicidal ideation (SI) remains lacking. This study aims to systematically synthesise the global aggregated prevalence of SI before and after the pandemic, investigate the potential association between pandemic exposure and the SI risk through meta-regression analysis of longitudinal studies, and explore key moderating factors.<br><br>METHODS: A systematic search was conducted in Web of Science, PubMed, PsycINFO and ProQuest databases up to August 2025. Observational studies were included if they employed cross-sectional or longitudinal designs and reported the prevalence of SI before and after the pandemic across global regions.<br><br>RESULTS: The analysis included 354 cross-sectional studies (N = 8,247,875) and 27 longitudinal studies. In cross-sectional studies, the pooled prevalence of SI was 13.20% [95% CI 12.06%-14.42%]. Pre-pandemic prevalence was 12.52% [95% CI 8.46%-18.14%], and post-pandemic prevalence was 13.24% [95% CI 12.07%-14.50%], with no significant difference. Meta-regression analysis identified three moderators. Specifically, larger sample sizes (n) were associated with lower prevalence (&#x3b2; = -0.232, P < 0.0001); higher study quality predicted lower prevalence (&#x3b2; = -0.278, P < 0.001); and studies on adults reported significantly lower prevalence than adolescents (&#x3b2; = -0.366, P < 0.05). Conversely, time progression during the pandemic, development level, geographical area, gender and measurement method did not show significant independent effects. Interaction analyses also found no significant moderating effect of economic development level or geographical area on the temporal trend of SI prevalence. Longitudinal analysis found no significant increase in prevalence from the pre-pandemic to the post-pandemic period (P = 0.101). However, a small but significant increase occurred between early and late stages within the pandemic (&#x3b2; = 0.265, P = 0.021). Subgroup analyses showed no significant moderation of these temporal changes.<br><br>CONCLUSIONS: The COVID-19 pandemic's impact on SI was dynamic. While no significant prevalence change was found between pre- and post-pandemic periods, a significant increase occurred as the crisis progressed. This deteriorating trend was more pronounced in adolescents, identifying them as a key vulnerable group. Methodologically, findings were moderated by the measurement instrument, study quality and sample size, with evidence suggesting potential small-study effects. These findings underscore the need for robust mental health surveillance and targeted interventions for at-risk populations during prolonged public health crises.The protocol was registered on PROSPERO (CRD42024603151).}, }
@article {pmid41416347, year = {2025}, author = {Shokri-Afra, H and Saber Jeyvan, F and Barartabar, Z and Khanicheragh, P and Yousefi Abdolmaleki, E and Ilbeigi, D and Musavi, H and Malekzadegan, Y}, title = {Targeting SIRT1: A Potential Strategy for Combating Severe COVID-19.}, journal = {BioMed research international}, volume = {2025}, number = {}, pages = {9507417}, pmid = {41416347}, issn = {2314-6141}, mesh = {*Sirtuin 1/metabolism ; Humans ; *COVID-19/immunology/virology ; *SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; Angiotensin-Converting Enzyme 2/metabolism ; Resveratrol/pharmacology/therapeutic use ; Antiviral Agents/therapeutic use/pharmacology ; Virus Internalization/drug effects ; }, abstract = {Sirtuin 1 (SIRT1) is a crucial regulator of cellular processes, including inflammation, metabolism, and stress responses, playing a significant role in the body's defense mechanisms. During SARS-CoV-2 infection, SIRT1 plays a crucial role in modulating the immune response. This protein helps to enhance the antiviral response through deacetylating key transcription factors and regulating proinflammatory cytokines, thereby reducing the cytokine storm (an overwhelming immune response) associated with severe COVID-19 cases. SIRT1 influences the expression of angiotensin-converting enzyme 2 (ACE2), the primary receptor for SARS-CoV-2, thereby potentially mitigating viral entry and replication. Natural activators of SIRT1, such as resveratrol, have been shown to enhance its activity, offering promising avenues for therapeutic interventions aimed at bolstering the immune response during COVID-19. Understanding the multifaceted role of SIRT1 in human defense mechanisms against SARS-CoV-2 could pave the way for innovative strategies to manage COVID-19 and similar viral infections, emphasizing the importance of SIRT1 as a potential target for future therapeutic approaches.}, }
@article {pmid41415646, year = {2025}, author = {Choi, CH}, title = {[The Journey of the Clinical Practice Guideline Committee Towards Evidence-Based Radiology: Commemorating the 80th Anniversary of the Korean Society of Radiology].}, journal = {Journal of the Korean Society of Radiology}, volume = {86}, number = {6}, pages = {874-881}, pmid = {41415646}, issn = {2951-0805}, abstract = {In the field of radiology, clinical practice guidelines (CPGs) have been established as a core tool for ensuring consistency in clinical diagnosis and patient safety. In 2012, aligning with the global emphasis on evidence-based medicine that emerged in the early 2000s, the CPG Committee of the Korean Society of Radiology was founded, with the aim of establishing or revising various guidelines across radiology and related medical fields. Since then, the Committee has developed and disseminated diverse CPGs to ensure the appropriateness of radiological examinations and to minimize radiation exposure. This report reviews the Committee's major achievements over the past decade, including the development of justification guidelines, support for subspecialty-led creation of guidelines, safety protocols for contrast media, rapid guidelines for COVID-19 imaging, and integration with clinical decision support systems. Through active collaboration with government agencies and academic institutions, the Committee has enhanced the scientific rigor and clinical relevance of its guidelines. Furthermore, the launch of an online archive has improved accessibility and utilization. Looking forward, the Committee aims to establish AI-integrated guideline frameworks and expand globally through international cooperation and alignment with national health policies.}, }
@article {pmid41415584, year = {2025}, author = {Kvandova, M and Balis, P and Kalocayova, B and Vlkovicova, J and Dobrodenkova, S and Puzserova, A}, title = {Cardiovascular damage and comorbidities related to long COVID: pathomechanisms, prevention, and therapy.}, journal = {Frontiers in cardiovascular medicine}, volume = {12}, number = {}, pages = {1671951}, pmid = {41415584}, issn = {2297-055X}, abstract = {Long COVID (LC) is a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection-associated chronic condition and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems, including cardiovascular. Extensive literature supports an association between SARS-CoV-2 infection and cardiovascular complications and increased cardiovascular risk after infection. The cardiovascular sequelae after SARS-CoV-2 infection have not yet been comprehensively characterized. A growing body of evidence suggests that endothelial dysfunction is a central mechanism in COVID-19 and has also been identified as a key pathogenic mechanism in LC. Although considerable progress has been made in characterizing the epidemiology, clinical course, and biology of LC, many questions remain unanswered. The incomplete understanding of the pathomechanisms of LC has hampered the development of targeted therapies to date. Further research and data are needed to develop effective therapeutic and preventive tools. Based on current literature this review aims to provide an up-to-date overview of the pathomechanisms affecting the cardiovascular system and the potential role of selected micronutrients, vitamins and minerals, and flavonoids as preventive and therapeutic strategies in LC.}, }
@article {pmid41415293, year = {2025}, author = {Murugan, AK and Alzahrani, AS}, title = {COVID-19 vaccine-induced autoimmune hyperthyroidism: Graves' disease.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1699210}, pmid = {41415293}, issn = {1664-3224}, mesh = {Humans ; *Graves Disease/immunology/etiology ; *COVID-19 Vaccines/adverse effects/immunology ; *SARS-CoV-2/immunology ; *COVID-19/prevention &amp; control/immunology ; Autoantibodies/immunology ; Autoimmunity ; }, abstract = {Graves' disease (GD) is an autoimmune disorder that results in hyperthyroidism, in which the immune system mistakenly targets the thyroid gland, causing it to produce excessive amounts of thyroid hormones. Genetic predisposition, environmental factors such as infections and stress, disruptions in the gut microbiome, excessive iodine intake, and epigenetic changes have all been implicated in the development of GD. The recent pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posed a serious global health crisis. The emergence of COVID-19 vaccines has been pivotal in combating the viral infection and its spread. However, reports of rare adverse events, including the development of autoimmune disorders such as GD following vaccination, have raised concerns. Autoimmune factors play a critical role in the pathogenesis of GD, particularly through the production of autoantibodies targeting the thyroid gland. In this review, reported cases are critically analyzed to elucidate commonalities and potential triggers for the development of this autoimmune disorder, highlighting the vital role of autoimmune mechanisms in inducing GD. We also discuss the molecular mechanisms underlying vaccine-induced autoimmunity, including antigen presentation, bystander activation, molecular mimicry, and the induction of inflammatory factors following vaccination. Understanding these mechanisms in COVID-19 vaccine-induced GD could enhance patient care and guide vaccination policies.}, }
@article {pmid41412274, year = {2025}, author = {Zheng, W and Chen, W and Hutvagner, G and Rangel-Sanchez, L and Deng, W}, title = {Advancements in breast cancer mRNA vaccines: Current development and future prospects.}, journal = {Biochimica et biophysica acta. Reviews on cancer}, volume = {1881}, number = {1}, pages = {189515}, doi = {10.1016/j.bbcan.2025.189515}, pmid = {41412274}, issn = {1879-2561}, abstract = {Messenger RNA (mRNA) vaccines have become a transformative approach in immunotherapy and have attracted significant attention owing to their unprecedented success in controlling COVID-19. With their ability to flexibly and specifically encode tumour-associated antigens, along with their favorable safety profiles and scalable manufacturing, mRNA vaccines represent a highly promising platform for cancer treatment. Breast cancer is a heterogeneous disease and many of its subtypes are immunologically cold tumours, which has limited the progress of immunotherapy in this field. Recent studies have highlighted the potential of mRNA vaccines to reshape the tumour immune microenvironment in breast cancer. These vaccines can enhance antigen presentation, activate T cell responses, and convert immunologically cold tumours into immune-active ones. This review provides a comprehensive overview of recent advances in mRNA vaccine development for breast cancer with a focus on antigen selection, mRNA design, and delivery strategies. It also examines findings from both preclinical and clinical studies as well as recent progress in industrial development. Finally, we discuss the current challenges hindering the clinical translation and ethical considerations of mRNA vaccine technology and propose future directions to advance mRNA vaccine-based therapies for breast cancer.}, }
@article {pmid41411704, year = {2025}, author = {Thomm, E and Bauer, J and Bromme, R}, title = {The role of expert pertinence for epistemic trust during the COVID-19 pandemic and beyond.}, journal = {Current opinion in psychology}, volume = {68}, number = {}, pages = {102233}, doi = {10.1016/j.copsyc.2025.102233}, pmid = {41411704}, issn = {2352-2518}, abstract = {The COVID-19 pandemic spotlighted the critical role of scientific expertise in epistemic trust. Diverse experts entered the public arena and became visible in debates, confronting non-experts with the question of whom to trust-especially when experts contradicted each other, changed recommendations, or were intermingled with unreliable voices. This article highlights the pertinence of scientific expertise (i.e., the alignment between a source's expertise and the claims it advances) as key factor for epistemic trust. While judgments of expertise are recognized as essential, little is known about how non-experts assess its pertinence. More research is needed to examine non-experts' skills to assess the pertinence of expertise and how these skills can be enhanced through education and science communication.}, }
@article {pmid41410086, year = {2025}, author = {Abdollahimohammad, A and Rahnama, M and Miri, K and Ildarabadi, EH}, title = {Community Health Nurses' Experiences During the COVID-19 Pandemic: A Systematic Review.}, journal = {Public health nursing (Boston, Mass.)}, volume = {}, number = {}, pages = {}, doi = {10.1111/phn.70055}, pmid = {41410086}, issn = {1525-1446}, abstract = {BACKGROUND: Community health nurses (CHNs) played a key role in pandemic crisis management, yet their specific experiences remain poorly documented. This study aims to identify the experiences of CHNs during the COVID-19 pandemic.<br><br>METHOD: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant articles were searched in PubMed, Web of Science, and Scopus in 2024. Two independent researchers reviewed titles and abstracts to identify eligible studies based on the inclusion criteria. Data synthesis employed the method of Lizardo et&#xa0;al. Nine articles were included.<br><br>RESULTS: Four themes were extracted: (1) awareness and preparation of CHNs, (2) facilitators, (3) various challenges in playing the role of CHNs (including moral dilemmas, organizational challenges, and occupational challenges), and (4) procedural changes and the use of technology.<br><br>CONCLUSION: Despite facing numerous challenges, CHNs played a crucial role in enhancing public knowledge and performance to control the pandemic. Comprehensive cooperation and support between health and non-health systems are essential for improving community health preparedness. It is suggested that health system managers use the results of this study to inform their service delivery planning.}, }
@article {pmid41130317, year = {2025}, author = {Chavez, E and Williams, BA and Beitelshees, M and Gorecki, G and True, JM}, title = {Enhancing pandemic preparedness through effective national policies: A global perspective.}, journal = {Drug discovery today}, volume = {30}, number = {12}, pages = {104506}, doi = {10.1016/j.drudis.2025.104506}, pmid = {41130317}, issn = {1878-5832}, mesh = {Humans ; *Pandemics/prevention &amp; control ; *Health Policy ; Global Health ; Delivery of Health Care/organization &amp; administration ; COVID-19/epidemiology/prevention &amp; control ; Pandemic Preparedness ; }, abstract = {The ongoing risk of global pandemics underscores the need for governments to adopt policies that support robust healthcare systems and effective preparedness strategies. We conducted a narrative literature review of the pandemic preparedness policies of 15 countries, spanning multiple geographic regions and high-income to lower-middle-income categories, focusing on crucial aspects of pandemic preparedness, such as R&amp;D, manufacturing capacities, healthcare infrastructure and health system resilience. Through this review, we identify policies and strategies that are pragmatic, executable and adaptable to diverse national contexts, offering an adaptable framework to mitigate future pandemics while maintaining routine healthcare services. This holistic approach offers practical guidance for national and global stakeholders seeking to strengthen preparedness and ensure continuity of care during future health emergencies.}, }
@article {pmid41410053, year = {2025}, author = {Sundler Björkman, L and Eswaran, H and Grover, SP}, title = {Therapeutic Potential of C1-Inhibitor in Vascular Diseases and Beyond.}, journal = {Arteriosclerosis, thrombosis, and vascular biology}, volume = {}, number = {}, pages = {}, doi = {10.1161/ATVBAHA.125.323743}, pmid = {41410053}, issn = {1524-4636}, abstract = {C1INH (C1-inhibitor) is a multifunctional SERPIN (serine protease inhibitor) that functions as a major negative regulator of the complement, coagulation, and kallikrein-kinin systems. C1INH products were originally developed for the treatment of hereditary angioedema associated with C1INH deficiency. A growing body of literature indicates that C1INH products may find utility in the management of several other disease states. In this review, we detail the key biological activities of C1INH and consider the pathophysiological role of C1INH targets in many conditions. The therapeutic potential of exogenous C1INH is highlighted in the settings of thromboembolism, ischemia-reperfusion injury, sepsis, transplantation, and coronavirus disease 2019.}, }
@article {pmid41409950, year = {2025}, author = {Piszka, M and Kwapien, E and Brasse, P and Staszkiewicz, K and Zerdka, J and Staszkiewicz, KK and Bartkowski, J and Czarnecki, F and Kubicka, M}, title = {The Impact of Screen Time on the Health of the Pediatric Population: Short- and Long-Term Consequences for Lifestyle, Ophthalmology, and Mental Health.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e96944}, pmid = {41409950}, issn = {2168-8184}, abstract = {This review analyzes extensive scientific data linking screen time to a wide range of health problems in the pediatric population and divides them into short-term and long-term health effects. Excessive exposure to screen media negatively affects many aspects of the health of children and adolescents. We can observe negative effects that translate into patients' lifestyles as well as ophthalmological and mental health problems. After analyzing the studies, the most common short-term consequences, such as obesity, sleep disorders, and dry eye syndrome, were identified. Many studies have highlighted the impact of particularly long periods of screen time, more than 3-4 hours. The health consequences that manifest themselves later include hypertension, cardiovascular disease, and myopia. This impact also extends to mental health, where there is a clear correlation between long screen time and a higher incidence of anxiety, depression, and behavioral problems. Evidence indicates an increase in children's screen time since the COVID-19 pandemic. Due to the continuing high level of screen time, associated not only with entertainment but also with the transfer of certain activities to an online format, despite the end of the pandemic, public health interventions and educational strategies are urgently needed to mitigate these negative effects and promote a healthy lifestyle among children, which will translate into the health of the entire population in the future.}, }
@article {pmid41409701, year = {2025}, author = {Qi, X}, title = {A systematic review of global COVID-19 vaccine PPPs: drivers and barriers to governance alignment.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1727808}, pmid = {41409701}, issn = {2296-2565}, mesh = {Humans ; *COVID-19 Vaccines/supply &amp; distribution ; *COVID-19/prevention &amp; control ; *Public-Private Sector Partnerships/organization &amp; administration ; Global Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Public-private partnerships (PPPs) have emerged as a prominent governance model for vaccine equity in the COVID-19 vaccine supply chain. Previous studies focus on evaluating PPP's performance, lacking multi-dimensional analysis on the drivers and barriers that shape public and private actors' willingness to participate in PPPs.<br><br>METHOD: Following the PRISMA 2020 guidelines, a systematic review using the Web of Science (WoS) database was conducted to identify empirical factors influencing stakeholders' preference for PPPs and the alignment between sectors was explored by qualitative content analysis.<br><br>RESULTS: Three main categories of private sector drivers were identified, including regulatory facilitation, financial incentives and reputational incentives. While four sets of barriers emerged, including the political environment, economic and logistic constraints, and the contractual obligations. For the public sector, motivations centered on ethical considerations, national interest protection, and institutional advantages, while participation was also constrained by vaccine nationalism and administrative lag. The analysis demonstrates the degree of alignment and misalignment among these governance factors.<br><br>CONCLUSION: Based on the analysis of factors, this study proposes the Governance Alignment Framework (GAF) as a conceptual tool to pair the profits of different sectors and guide governments and public sectors to improve the developmental-steering capacities to better align private incentives with public value during the pandemic.}, }
@article {pmid41409541, year = {2025}, author = {Hu, X and Wang, Z and Wang, S and Sun, H and Feng, N and Li, E and Xia, X and Hu, G and Yan, F and Li, B}, title = {Next-Generation Vaccines for Co-Circulating PEDV and TGEV: Integrating Nucleic Acid Platforms, Mucosal Delivery, and AI-Driven Antigen Design.}, journal = {Transboundary and emerging diseases}, volume = {2025}, number = {}, pages = {2014296}, pmid = {41409541}, issn = {1865-1682}, mesh = {Animals ; *Viral Vaccines/immunology ; *Transmissible gastroenteritis virus/immunology ; *Porcine epidemic diarrhea virus/immunology ; Swine ; *Gastroenteritis, Transmissible, of Swine/prevention &amp; control/virology ; *Artificial Intelligence ; Vaccine Development ; *Coronavirus Infections/prevention &amp; control/veterinary ; *Swine Diseases/prevention &amp; control/virology ; Antigens, Viral/immunology ; }, abstract = {Porcine epidemic diarrhea virus (PEDV) and transmissible gastroenteritis virus (TGEV) are causative agents of acute enteric diseases in pigs and have a high contagion potential. These coronaviruses (CoVs) impose substantial economic losses on global pork production, particularly affecting lactating piglets where coinfections occur. Although traditional vaccines offer partial protection, their efficacy is increasingly challenged by the continuous emergence of mutated strains of PEDV and TGEV. This underscores the demand for novel vaccines with improved protective efficacy and cost-effectiveness. Emerging vaccine technologies, such as nucleic acid vaccines, genetically engineered subunit vaccines, and live vector vaccines, have received widespread attention because of their advantages in terms of safety, stability, targeted delivery, economy, and ease of use. This review summarizes recent advances in PEDV and TGEV vaccine development, highlighting both their potential and limitations. More importantly, we prospect novel techniques that may supplement the status gaps and lead to breakthroughs in blocking the transmission of these CoVs. Notable research priorities encompass mucosal immunity mechanisms, vertical transmission prevention strategies, and computational immunogen design leveraging artificial intelligence (AI). Overall, a deeper understanding of the pathogens coupled with technological advances is expected to accelerate the control of and effective response to pathogenic CoVs, thereby safeguarding the stability of animal husbandry.}, }
@article {pmid41409040, year = {2025}, author = {Cao, L and Min, J and Yu, M and Zhang, Z and Yuan, D and Chen, D}, title = {Key Clinical Frontiers of mRNA Loaded Lipid Nanoparticles in Cancer Vaccines.}, journal = {International journal of nanomedicine}, volume = {20}, number = {}, pages = {14935-14953}, pmid = {41409040}, issn = {1178-2013}, mesh = {Humans ; *Cancer Vaccines/administration &amp; dosage/immunology ; *Nanoparticles/chemistry ; *RNA, Messenger/administration &amp; dosage/immunology ; *Lipids/chemistry ; COVID-19 Vaccines/immunology ; *Neoplasms/therapy/immunology ; COVID-19/prevention &amp; control ; Animals ; SARS-CoV-2/immunology ; mRNA Vaccines ; Liposomes ; }, abstract = {Cancer vaccines are promising, but clinical translation is constrained by inefficient antigen delivery and suboptimal immune activation. Lipid nanoparticles (LNPs)-validated for potency and safety in COVID-19 mRNA vaccines-offer a versatile, scalable, and immunogenic platform. Key barriers persist: precise targeting of tumors or lymphoid tissues, efficient intracellular mRNA release, and the immunosuppressive tumor microenvironment. This review synthesizes design principles for mRNA-loaded LNPs, emphasizing lipid chemistry, organ-selective biodistribution, and nano-engineering strategies that strengthen antigen presentation and T-cell priming. We also examine combination approaches with checkpoint blockade, chemotherapy-induced immunogenic cell death, and molecular adjuvants. Clinically, signals of efficacy are emerging-most notably the KEYNOTE-942 study, in which mRNA-4157 combined with pembrolizumab showed a sustained improvement in recurrence-free survival at 5 years compared with pembrolizumab alone-highlighting both the potential and the remaining questions for this modality. Finally, we outline manufacturing and regulatory considerations and map future directions-including thermostable formulations, self-amplifying RNA, and AI-guided lipid discovery-to address translational bottlenecks and expand global access to LNP-based cancer vaccines.}, }
@article {pmid41408601, year = {2025}, author = {Edward, M and Owoicho, AW}, title = {Leprosy elimination: are we winning the fight or losing focus?.}, journal = {Annals of medicine}, volume = {57}, number = {1}, pages = {2604389}, doi = {10.1080/07853890.2025.2604389}, pmid = {41408601}, issn = {1365-2060}, mesh = {Humans ; *Leprosy/epidemiology/prevention &amp; control/drug therapy/diagnosis ; *Disease Eradication/methods ; COVID-19/epidemiology ; Leprostatic Agents/therapeutic use ; Global Health ; Social Stigma ; India/epidemiology ; Nigeria/epidemiology ; World Health Organization ; Brazil/epidemiology ; SARS-CoV-2 ; Prevalence ; }, abstract = {Despite decades of significant global efforts, leprosy remains persistent a public health challenge, with approximately two million people living with leprosy-related disabilities. This article traces the history of leprosy control, highlights the transformative impact of multidrug therapy (MDT), and warns against the risks of waning global attention. The World Health Organization's (WHO)'s 1991 elimination target-defined as prevalence below 1 case per 10,000 population-drove a campaign that treated over 13 million cases by 2020. However, this statistical success has fostered a false narrative of eradication, leading to reduced funding, political will, and research investment. This article argues that this premature complacency threatens sustainable leprosy control. Persistent stigma, weak health systems, antimicrobial resistance (AMR), and disparities in gender and child diagnosis. The COVID-19 pandemic exacerbated these issues, causing a 35.9% drop in case detection in the Americas in 2020. We present evidence from in Brazil, India, and Nigeria where community health agents and local leaders have improved early detection and reduced stigma. The risk of losing focus is greatest for marginalized communities, where the disease continues to thrive unnoticed. We conclude that sustaining progress requires a renewed commitment beyond statistical targets, emphasizing continuous surveillance, community-led initiatives, and a focus on social justice and innovative tools like post-exposure prophylaxis (PEP) and AI-based diagnostics to ensure that the gains made are not reversed.}, }
@article {pmid41408488, year = {2025}, author = {Almanaa, TN and Al-Kuraishy, HM and Al-Gareeb, AI and Abdelnaby, MA and Alexiou, A and Papadakis, M and Abo-ElFetoh, IE and Batiha, GE}, title = {SARS-CoV-2 infection and gut-lung axis: the potential role of rifaximin.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41408488}, issn = {1568-5608}, abstract = {Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to global effects. COVID-19 causes pulmonary and extra-pulmonary manifestations. One of the most common extra-pulmonary manifestations is gastrointestinal (GI) manifestation. Enteric COVID-19 triggers changes in the diversity of gut microbiota (dysbiosis). Dysbiosis of gut flora increases gut permeability, resulting in secondary bacterial infections, systemic inflammation, and injury of the peripheral organs. Dysbiosis may affect the immune system and pulmonary response to the SARS-CoV-2 invasion, suggesting a link between the lungs and gut through the gut-lung axis. Intestinal inflammation caused by SARS-CoV-2 infection induces leaky gut with subsequent transmission of toxins and antigens to the systemic circulation, causing further worsening of the septic condition in COVID-19 patients. Therefore, the anti-inflammatory agents' interruption of the gut-lung axis may reduce respiratory complications due to intestinal inflammation in COVID-19. Rifaximin (RXM) is a semi-synthetic antibacterial drug derived from natural rifamycin that acts locally within GI by inhibiting bacterial RNA polymerase and reducing the bacterial population and associated intestinal inflammation. RXM inhibits bacterial adherence to the intestinal epithelial lining and translocation across this GI lining. RXM has anti-inflammatory effects by inhibiting the release of pro-inflammatory cytokines and modulating the gut pregnane X receptor (PXR). RXM acts as a prebiotic in maintaining the growth of gut microbiota and may prevent the development of COVID-19-induced dysbiosis. Therefore, RXM could be effective in managing COVID-19 and associated inflammatory complications. Therefore, this review aims to discuss the potential role of RXM in managing COVID-19.}, }
@article {pmid41408194, year = {2025}, author = {Bosquet, A and Affo, C and Happe, F and Helfer, H and Versini, E and Mahé, I}, title = {COVID-19 treatment of hospital patients worldwide at the onset of the pandemic in 2020: a systematic review.}, journal = {BMC infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12879-025-12368-2}, pmid = {41408194}, issn = {1471-2334}, abstract = {In early 2020, no drug had proven efficacy to treat COVID-19 in-patients. This work aimed to describe COVID-19 treatment for in-patients worldwide until June, 2020. A PubMed search was performed with the terms "retrospective observational study", "hospital", "treatment" and "COVID" to identify English-written studies describing treatments given to adult in-patients before June 30, 2020. The identified reports were analyzed, with data extracted regarding patient characteristics and treatments across continents and countries. Overall, 178 studies involving 181,510 patients in 28 countries were analyzed, including 484 patients from Africa, 36,840 from Asia, 69,088 from Europa and 68,524 from North America. The most prescribed drugs were hydroxychloroquine (64.3%, i.e. 41.9% of all patients), corticosteroids (31.0%, i.e. 21.0%) and lopinavir/ritonavir (30.8%, i.e. 12.0%). Corticosteroids was used worldwide with similar rates in Asia, Europe and North America. Hydroxychloroquine dominated prescriptions in Africa, Europe and North America. Asia exhibited unique features: less frequent hydroxychloroquine use, higher oseltamivir use and exclusive use of umifenovir. In Europe, repurposed drugs prescription was the highest in Spain and Italy. Our study is not an exhaustive review of the literature on COVID-19 treatment of in-patients early in 2020 but is the first one to provide a comprehensive overview of COVID-19 treatment modalities in such a broad range of countries worldwide. Our work reveals high prescription rates but also heterogeneity across continents and countries in the treatment of COVID-19 in-patients worldwide. These findings emphasize the critical role of international collaboration in generating and disseminating reliable information for managing emerging diseases.}, }
@article {pmid41408029, year = {2025}, author = {Pérez Palacios, AF and Medina Parra, JA and Córdoba Velasco, DS and Zona Rubio, DC and Alves, IA and Aragón Novoa, DM}, title = {New Strategies to Improve Drug Solubility and Its Impact on Bioavailability: A Patent Review (2015-2024).}, journal = {AAPS PharmSciTech}, volume = {27}, number = {1}, pages = {57}, pmid = {41408029}, issn = {1530-9932}, mesh = {Solubility ; Biological Availability ; *Patents as Topic ; Humans ; Pharmaceutical Preparations/chemistry/metabolism ; Drug Delivery Systems/methods ; Animals ; Chemistry, Pharmaceutical/methods ; Drug Development/methods ; Particle Size ; }, abstract = {Poor aqueous solubility is a major barrier in drug development, affecting dissolution, absorption, and systemic bioavailability. Nearly 40% of approved drugs and up to 90% of new chemical entities face this limitation, resulting in therapeutic inefficacy and costly clinical development. This study reviewed patents published between 2015 and 2024 that describe technological strategies to enhance drug solubility and bioavailability, aiming to identify innovation trends and their pharmaceutical impact. A structured search was conducted in the Espacenet database using the keywords "bioavailability" and "solubility" under the IPC code A61K. From 98,111 initial results, duplicates, language restrictions, and patents related to cosmetics, nutrition, or veterinary products were excluded, yielding 29 eligible documents. Extracted data included applicant country, therapeutic indication, BCS classification, formulation approach, manufacturing method, and available in vivo pharmacokinetic results. Descriptive analysis was performed using R software. China led patent registrations (55%), followed by the USA (17%). Patent filings increased steadily from 2016-2020, decreased during the COVID-19 pandemic, and recovered after 2021. Most drugs belonged to BCS Class II (76%), reflecting high permeability but poor solubility. The main strategies included particle size reduction, solid dispersions, self-emulsifying drug delivery systems, cyclodextrin inclusion complexes, and advanced crystallization techniques. When reported, pharmacokinetic data showed significant improvements in Cmax and AUC; however, only 58% of patents included in vivo studies. Overall, patents reveal robust innovation aimed at overcoming solubility challenges.}, }
@article {pmid41297150, year = {2026}, author = {Mora-Theuer, EA and Naughton, A and Cankardas, S and Sammut-Scerri, C and Grylli, C and Pantazidou, A and Pivoriene, J and Loiseau, M and Kariene, B and Schöggl, J and Tagiyeva, N and Quantin, C}, title = {Impact of COVID-19 pandemic on characteristics, extent, and trends in child maltreatment in 34 Euro-CAN COST Action Countries: a scoping review of the literature.}, journal = {Child abuse &amp; neglect}, volume = {171}, number = {}, pages = {107810}, doi = {10.1016/j.chiabu.2025.107810}, pmid = {41297150}, issn = {1873-7757}, mesh = {Humans ; *Child Abuse/statistics &amp; numerical data/trends ; *COVID-19/epidemiology ; Child ; Europe/epidemiology ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: The COVID-19 pandemic intensified known risk factors for child maltreatment (CM). Yet, globally inconsistent trends were reported. Little is known about CM trends across Europe, given varying surveillance systems.<br><br>OBJECTIVE: This scoping review systematically examined evidence on CM trends during the pandemic in 34 European countries in the COST Action Euro-CAN network.<br><br>PARTICIPANTS AND SETTING: CM (physical, sexual, psychological abuse, neglect, and online harms) across various settings (population, healthcare, social care including NGOs, child protection services, judicial/police).<br><br>METHODS: We searched PubMed, EMBASE, PsycINFO, Scopus, Web of Science, OPENGREY, and Google Scholar (January 2020-November 2024). Eligible studies included primary research and systematic or narrative reviews. Two reviewers independently screened and extracted data. Findings were synthesized narratively by CM type, sector, country, and study design, and reported following the PRISMA-ScR.<br><br>RESULTS: Of 4658 records screened, 87 records were included (72 primary research, 15 reviews). Most studies used quantitative methods (n&#xa0;=&#xa0;64, 89&#xa0;%) and reported healthcare and population-based data. Physical abuse was the most frequently reported type (n&#xa0;=&#xa0;42, 58&#xa0;%). Results were mixed, showing increase, decrease, or no change in CM. The most consistent signal was an increase in physical abuse identified in French hospital datasets. Qualitative studies highlighted concerns about children's safety during school closures and changes in referral patterns.<br><br>CONCLUSION: This is the first comprehensive review of CM trends in Europe during the pandemic, covering the longest timeframe. Fragmented evidence reflects heterogeneous definitions, reliance on institutional data and underrepresentation of vulnerable groups. Findings stress for harmonised definitions and resilient surveillance systems.}, }
@article {pmid40387694, year = {2026}, author = {Weix, NM and Shake, HM and Duran Saavedra, AF and Clingan, HE and Hernandez, VC and Johnson, GM and Hansen, AD and Collins, DM and Pryor, LE and Kitchens, R and Armstead, A and Hilton, C}, title = {Cognitive Interventions and Rehabilitation to Address Long-COVID Symptoms: A Systematic Review.}, journal = {OTJR : occupation, participation and health}, volume = {46}, number = {1}, pages = {74-95}, pmid = {40387694}, issn = {1938-2383}, mesh = {Humans ; *COVID-19/rehabilitation/complications/psychology ; *Cognitive Behavioral Therapy/methods ; *Occupational Therapy/methods ; SARS-CoV-2 ; *Cognitive Dysfunction/rehabilitation ; Quality of Life ; }, abstract = {Long COVID symptoms include cognitive and physical deficits impacting one's functional performance and quality of life. Limited evidence examines the use of cognitive interventions provided by occupational therapists in treating long COVID symptoms among adults. This systematic review summarizes existing studies on cognitive interventions and rehabilitation to treat long COVID symptoms and discusses their potential use within the scope of occupational therapy practice. We identified literature from 2021 to 2023 through searches of MEDLINE, CINAHL, PsycINFO, Cochrane Trials, and Scopus databases. Nineteen articles met inclusion criteria and were categorized into five types of intervention: (a) cognitive training, (b) cognitive behavioral therapy, (c) neurostimulation, (d) neurostimulation combined with cognitive training, and (e) multi-component rehabilitation programs. Strong evidence supports cognitive training, moderate supports cognitive behavioral training and low-level evidence supports other interventions provided by occupational therapists to target long COVID cognitive symptoms in adults.}, }
@article {pmid41407606, year = {2025}, author = {Ouksel, H}, title = {[Long covid pulmonary rehabilitation].}, journal = {Revue des maladies respiratoires}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.rmr.2025.12.001}, pmid = {41407606}, issn = {1776-2588}, abstract = {While the SARS-CoV-2 pandemic has left a lasting impression, the long-term effects of this virus, such as persistent symptoms or long COVID, remain unclear. However, recommendations from learned societies for improving these symptoms exist and are being applied by a number of respiratory rehabilitation centers. In this paper, we provide a summary of the specificities of long COVID care in the context of respiratory rehabilitation, particularly as regards respiratory symptoms, fatigue, cognitive disorders, and cardiovascular symptoms and, more specifically, vegetative dysautonomia. The key elements of support are Therapeutic Patient Education (TPE) and activity management and fractionated exercise (PACING). While the effects of respiratory rehabilitation are highly promising, with potential improvement in symptoms and exercise capacity, the level of evidence remains low to moderate. Structured and coordinated multidisciplinary work is of paramount importance as a means of providing for these individuals the best possible support on their road to recovery. Further studies are needed to improve the level of evidence on the effectiveness of rehabilitation in cases of long COVID.}, }
@article {pmid41407484, year = {2025}, author = {Wilson, JC and Liu, KY and Mittelman, E and Bareke, P and Shleifer, E and Howard, R}, title = {Brain fog with long covid and chemotherapy: systematic review and meta-analysis.}, journal = {BMJ mental health}, volume = {28}, number = {1}, pages = {}, doi = {10.1136/bmjment-2025-301969}, pmid = {41407484}, issn = {2755-9734}, mesh = {Humans ; *COVID-19/complications/psychology ; *Antineoplastic Agents/adverse effects ; *Neoplasms/drug therapy ; SARS-CoV-2 ; *Cognitive Dysfunction/etiology ; }, abstract = {QUESTION: What are the cognitive, functional and affective characteristics of brain fog in individuals with long covid and following chemotherapy, and how are these features assessed across studies?<br><br>STUDY SELECTION AND ANALYSIS: In March 2024, we conducted a systematic review and meta-analysis of peer-reviewed studies assessing cognition, function or mood in adults (&#x2265;18 years) with brain fog after COVID-19 or chemotherapy. PubMed, Embase and Web of Science were searched systematically according to eligibility criteria to March 2024, with an update in May 2025. Random-effects meta-analyses using the 'dmetar' package (V.0.0.9000) in R V.4.3.1 were performed for studies comparing individuals with and without brain fog. Bias was assessed using the National Institutes of Health Study Quality Assessment Tools.<br><br>FINDINGS: Of 3077 records screened, 65 studies met inclusion criteria: 40 investigated brain fog in long covid and 25 in chemotherapy populations. Considerable variation in assessment tools was observed. Montreal Cognitive Assessment was the most common cognitive test in long covid studies; Functional Assessment of Cancer Therapy-Cognitive Function was most used in chemotherapy studies. Nine long covid studies were eligible for meta-analysis. Compared with controls, individuals with brain fog had significantly lower cognitive performance (Hedge's g=-0.63, 95%&#x2009;CI -1.15 to -0.12), higher fatigue (Hedge's g=2.64, 95%&#x2009;CI 0.41 to 4.86) and more depressive symptoms (Hedge's g=1.48, 95%&#x2009;CI 0.40 to 2.55). Heterogeneity was high (I[2]>70%). No chemotherapy studies were appropriate for meta-analysis, preventing direct comparison of brain fog features between long covid and chemotherapy groups.<br><br>CONCLUSIONS: Brain fog in long covid and chemotherapy populations is associated with cognitive complaints, fatigue and mood disturbance, though assessment methods differ widely. To improve comparability and clinical understanding, we propose adoption of consistent tools and definitions in future studies. This will be a crucial step in generating findings that can be meaningfully compared across populations.<br><br>PROSPERO REGISTRATION NUMBER: CRD42024520549.}, }
@article {pmid41406849, year = {2025}, author = {Asokan, S and Choudekar, A and Jagadeesan, A and Sm, R and Ali, A and Napte, SU and Selvam, SA and Verma, G and Das, P and Beniwal, N and Radhamanalan, G and Vijayan, S and Rajeswary, D and Jacob, T}, title = {Molecular diagnostics in clinical microbiology: Advances, applications, and future directions.}, journal = {Diagnostic microbiology and infectious disease}, volume = {114}, number = {3}, pages = {117223}, doi = {10.1016/j.diagmicrobio.2025.117223}, pmid = {41406849}, issn = {1879-0070}, abstract = {Molecular diagnostics have transformed clinical microbiology by enabling rapid, accurate, and highly sensitive detection of infectious agents, significantly improving patient outcomes and public health response. Over the past decade, advances in polymerase chain reaction (PCR), next-generation sequencing (NGS), digital PCR, isothermal amplification, and CRISPR-based assays have enhanced pathogen identification, antimicrobial resistance profiling, and outbreak investigation. These technologies have been instrumental in detecting and monitoring emerging and re-emerging viral pathogens such as SARS-CoV-2, Nipah, Zika, H5N1 avian influenza, Mpox, Ebola, Marburg, and MERS-CoV. Molecular diagnostics also play a critical role in antimicrobial resistance surveillance and hospital infection control by enabling high-resolution tracking of resistance genes and pathogen transmission dynamics. Despite these achievements, challenges remain regarding implementation costs, technical expertise, infrastructure, and the need for global standardization. Future directions focus on developing cost-effective, point-of-care molecular platforms, integrating artificial intelligence and bioinformatics for enhanced interpretation, and applying these technologies within One Health and environmental surveillance frameworks. These innovations will be pivotal for early outbreak detection, real-time data-driven decision-making, and equitable access to advanced diagnostics worldwide. Ultimately, molecular diagnostics are poised to remain the cornerstone of precision medicine and infectious disease control in the era of global health challenges.}, }
@article {pmid41406676, year = {2025}, author = {Ward, J and Gressani, O and Kim, S and Hens, N and Edmunds, WJ}, title = {The epidemiology of pathogens with pandemic potential: A review of key parameters and clustering analysis.}, journal = {Epidemics}, volume = {54}, number = {}, pages = {100882}, doi = {10.1016/j.epidem.2025.100882}, pmid = {41406676}, issn = {1878-0067}, abstract = {INTRODUCTION: In the light of the COVID-19 pandemic many countries are trying to widen their pandemic planning from its traditional focus on influenza. However, it is impossible to draw up detailed plans for every pathogen with epidemic potential. We set out to try to simplify this process by reviewing the epidemiology of a range of pathogens with pandemic potential and seeing whether they fall into groups with shared epidemiological traits.<br><br>METHODS: We reviewed the epidemiological characteristics of 19 different pathogens with pandemic potential (those on the WHO priority list of pathogens, different strains of influenza and Mpox). We extracted data on key parameters (reproduction number serial interval, proportion of presymptomatic transmission, case fatality risk and transmission route) and applied an unsupervised learning algorithm. This combined Monte Carlo sampling with ensemble clustering to classify pathogens into distinct epidemiological archetypes based on their shared characteristics.<br><br>RESULTS: From 154 articles we extracted 302 epidemiological parameter estimates. The clustering algorithms categorise these pathogens into six archetypes (1) highly transmissible Coronaviruses, (2) moderately transmissible Coronaviruses, (3) high-severity contact and zoonotic pathogens, (4) Influenza viruses (5) MERS-CoV-like and (6) MPV-like.<br><br>CONCLUSION: Unsupervised learning on epidemiological data can be used to define distinct pathogen archetypes. This method offers a valuable framework to allocate emerging and novel pathogens into defined groups to evaluate common approaches for their control.}, }
@article {pmid41405828, year = {2025}, author = {Constantin, M and Barbu, I and Vrancianu, CO and Chifiriuc, MC and Pitică, IM and Casangiu, A and Ruță, SM and Bleotu, C}, title = {Retroviral Remnants in the Human Genome: Classification, Integration and Regulation.}, journal = {Molecular diagnosis &amp; therapy}, volume = {}, number = {}, pages = {}, pmid = {41405828}, issn = {1179-2000}, support = {CNFIS-FDI-2025-F-0364//UB Research Nexus: Transforming Research through Innovation, Digitalization and Exploration at the University of Bucharest/ ; Component C9/Investment no. 8 (I8) - contract CF 68//Ministry of Research, Innovation and Digitalization through the National Recovery and Resilience Plan (PNRR) of Romania, Pillar III/ ; PNRR-III-C9-2023 (I8)- CF 53 - 760231/28.12.2023//Design and Implementation of Base-Relief DNA Origami: A multilevel approach to DNA Nanotechnology/ ; project no. 23020101//The core program within the National Research Development and Innovation Plan, 2022-2027', carried out with the support of the Ministry of Research, Innovation and Digitalization (MCID/ ; Contract no. 7N from 3 January 2023//The core program within the National Research Development and Innovation Plan, 2022-2027', carried out with the support of the Ministry of Research, Innovation and Digitalization (MCID/ ; }, abstract = {Human endogenous retroviruses (HERVs) are remnants of ancient retroviral infections constituting nearly 8% of the human genome. Far from being inert genetic fossils, HERVs have co-evolved with their hosts, acquiring regulatory and functional roles that influence development, immunity and disease. In this comprehensive review, we examine the origin, evolutionary dynamics and structural diversity of HERVs, emphasising their integration, genomic organisation and mosaic recombination patterns. We further highlight how epigenetic modifications, intracellular factors such as transcriptional regulators, hormones and cytokines, and environmental influences regulate HERV expression. By synthesising current evidence linking HERV activity to immune modulation, tumourigenesis, autoimmunity and neurodegenerative processes, we provide an integrated perspective on their dual role as drivers of pathology and contributors to normal physiology. Our analysis underscores that HERVs are not only markers of past infections but also active genomic elements with potential clinical implications, from biomarker discovery to novel therapeutic targets, making their systematic investigation timely and highly relevant.}, }
@article {pmid41405805, year = {2025}, author = {Blair, HA}, title = {Sublingual Cyclobenzaprine: First Approval.}, journal = {Clinical drug investigation}, volume = {}, number = {}, pages = {}, pmid = {41405805}, issn = {1179-1918}, abstract = {TONMYA[™] is a sublingual eutectic formulation of cyclobenzaprine being developed by Tonix Pharmaceuticals for the treatment of various conditions, including fibromyalgia, post-traumatic stress disorder (PTSD), acute stress disorder, major depressive disorder, post-acute COVID-19 syndrome, alcohol use disorder, and agitation in Alzheimer's disease. The sublingual formulation was designed for rapid transmucosal absorption to produce diurnal variation in peak-to-trough drug concentrations, making it suitable for long-term bedtime use. On 15 August 2025, sublingual cyclobenzaprine was approved for the treatment of fibromyalgia in adults in the USA. This article summarizes the milestones in the development of sublingual cyclobenzaprine leading to this first approval for fibromyalgia.}, }
@article {pmid41405643, year = {2025}, author = {Nawrooz, MS and Taher, WM and Alwan, M and Jawad, M and Mushtaq, H and Allela, OQB}, title = {The role of low-density lipoprotein receptors in emerging and reemerging viruses: a review with examples from human metapneumovirus and beyond.}, journal = {Archives of microbiology}, volume = {208}, number = {1}, pages = {79}, pmid = {41405643}, issn = {1432-072X}, mesh = {Humans ; *Receptors, LDL/metabolism ; *Metapneumovirus/physiology ; *Communicable Diseases, Emerging/virology ; *Paramyxoviridae Infections/virology/metabolism ; Animals ; Virus Replication ; Virus Internalization ; SARS-CoV-2 ; Antiviral Agents/pharmacology ; }, abstract = {The frequency of new and re-emerging viral infections is rising, driven by shifts in environmental conditions and altered interactions between hosts, vectors, and pathogens. New treatments may be developed through a better understanding of the molecular processes underlying viral replication. The low-density lipoprotein receptor (LDLR) serves as a critical entry portal for a diverse range of infectious agents, facilitating the initiation and perpetuation of their infection cycles. Furthermore, numerous viruses, such as the dengue virus and the hepatitis C virus (HCV), depend on host cholesterol (CHO) for replication and spread. Consequently, targeting the LDLR with pharmacological agents presents a promising therapeutic strategy for a broad spectrum of viral infections, including those caused by human immunodeficiency virus (HIV), HCV, and severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). In addition, human metapneumovirus (HMPV) is a leading cause of respiratory infections in young children, underscoring the need for effective treatments. This research investigates the role of the LDLR in HMPV and other emerging viruses. A key finding is that HMPV infection depends on LDLR-mediated pathways, as evidenced by the rapid recovery observed after exogenous CHO administration. Therefore, understanding the mechanism of LDLR in viral entry and replication is crucial and presents a promising avenue for developing novel antiviral therapies.}, }
@article {pmid41405551, year = {2025}, author = {Wang, L and Lin, C and Chuai, Y and Zhang, Q and Qin, S and Luo, Z and Li, Y}, title = {Home-used coronavirus sensors powered by isothermal amplification.}, journal = {Journal of materials chemistry. B}, volume = {}, number = {}, pages = {}, doi = {10.1039/d5tb01673h}, pmid = {41405551}, issn = {2050-7518}, abstract = {The global pandemic caused by coronaviruses, particularly SARS-CoV-2, has highlighted the urgent need for biosensing platforms that enable early and self-administered viral detection. Home-used biosensors enable rapid, accurate, and highly sensitive detection in home settings, reducing the probability of cross-infection while circumventing the temporal, financial, and operational constraints of conventional hospital-based workflows. However, they face limitations in sensitivity. Isothermal nucleic acid amplification strategies under constant or ambient temperature conditions present a transformative solution, leveraging mild reaction conditions and operational simplicity to advance household-compatible diagnostics. In recent years, a variety of innovative at-home sensors with advanced performance have been developed based on different isothermal amplification strategies, including loop-mediated isothermal amplification, clustered regularly interspaced short palindromic repeats, hybridization chain reaction, catalytic hairpin assembly, entropy-driven circuit and so on. Mainly taking the novel coronavirus as an example, this review systematically summarized the latest progress in the construction and application of household coronavirus sensors from three aspects: the targets of detection, the signal amplification strategies, and the biosensing platforms (fluorescence, Raman spectroscopy, surface plasmon resonance, colorimetry, and electrochemistry), as well as emphasized their advantages and challenges. We further delineate persistent challenges and future trajectories for enhancing the accessibility, accuracy, and multiplexing capacity of decentralized diagnostic platforms.}, }
@article {pmid41405493, year = {2025}, author = {McTavish, C and McGillis Hall, L and Price, S and Visekruna, S and Blain, A}, title = {Worsening Shortages, Mass Departures, Intolerable Working Conditions: A Media Analysis of Canada's Nursing Workforce Crisis.}, journal = {International nursing review}, volume = {72}, number = {4}, pages = {e70140}, doi = {10.1111/inr.70140}, pmid = {41405493}, issn = {1466-7657}, support = {WI2 179956/CAPMC/CIHR/Canada ; }, mesh = {Humans ; *COVID-19/epidemiology/nursing ; Canada/epidemiology ; *Mass Media/statistics &amp; numerical data ; Pandemics ; Health Policy ; *Nursing Staff/supply &amp; distribution ; SARS-CoV-2 ; Working Conditions ; }, abstract = {AIM: To explore the nature and content of Canadian media coverage surrounding the COVID-19 pandemic by wave - spanning from 2020 to 2024, identifying health policy and system responses that emerged as strategies in retaining the nursing workforce.<br><br>BACKGROUND: COVID-19 was an unprecedented health crisis impacting healthcare delivery and the healthcare workforce globally. It caused tremendous turbulence and strain, testing system capacity due to staff shortages, resource limitations and issues accommodating high volumes and acuity levels of patients. Across Canada, the pandemic resulted in mobilization of policy and system responses to address workforce challenges that emerged.<br><br>METHODS: A qualitative content analysis was conducted of online media coverage from nursing organizations and government websites published from January 2020 to March 2024, as well as newspaper articles from the Canadian Newsstream database.<br><br>RESULTS: Synthesized findings were categorized according to waves of the pandemic, highlighting key themes surrounding system and policy responses that emerged. Government investments to increase wages, educate additional staff and enhance protection for workers were among the measures employed.<br><br>DISCUSSION: This review captures the evolution and progression of the health crisis, its impact on the nursing workforce and associated responses. Workforce development and retention were emphasized through measures to enhance mental health and wellness, improve protection for workers and address safe staffing practices.<br><br>CONCLUSION: Nurses played a pivotal role throughout the global pandemic. Multiple system and policy responses were identified as key facets in strengthening, supporting and sustaining the nursing workforce.<br><br>Measures implemented illustrate the instrumental role that stakeholders, including the government and nursing organizations, play in building capacity and prioritizing efforts to protect nurses and enhance preparedness for future outbreaks.}, }
@article {pmid41404505, year = {2025}, author = {Islam, MS and Monir, SB and Haque, N and Vabna, MA and Fan, J and Li, Y and Nime, I and Feroz, F and Acharjee, M and Pan, F}, title = {Immunometabolic crossroads: infections as bidirectional modulators in diabetes and metabolic syndromes.}, journal = {Frontiers in endocrinology}, volume = {16}, number = {}, pages = {1710157}, pmid = {41404505}, issn = {1664-2392}, mesh = {Humans ; *Metabolic Syndrome/immunology/metabolism ; *Diabetes Mellitus/immunology/metabolism ; Animals ; COVID-19/immunology ; *Infections/immunology/metabolism/complications ; Inflammation/immunology/metabolism ; Insulin Resistance ; }, abstract = {Diabetes and metabolic disorders represent a global health crisis driven by complex interactions between metabolic, immune, and microbial networks. Beyond their metabolic derangements- hyperglycemia, insulin resistance, and low-grade systemic inflammation-these disorders are now recognized to exist at an immunometabolic interface profoundly influenced by infectious agent The bidirectional relationship between infections and metabolic dysregulation highlighting how acute and chronic infections contribute to insulin resistance, β-cell dysfunction, and systemic inflammation, while metabolic dysregulation impairs immune competence, predisposing individuals to recurrent and severe infections. Pathogens such as Helicobacter pylori Staphylococcus aureus, Escherichia coli, SARS-CoV-2, and hepatitis viruses, alter host metabolic signaling through inflammatory, mitochondrial, and hormonal pathways, reshaping glucose and lipid homeostasis. In turn, diabetic immune impairment amplifies susceptibility to pneumonia, urinary tract infections, and chronic wound infections, reinforcing a pathogenic feedback loop. Emerging therapeutic strategies including nanotechnology enabled, therapeutics, gene, and stem cell based interventions and next-generation incretin agonists- including tirzepatide and CagriSem offer promising avenues to restore both metabolic balance and immune resilience. Additionally, foundational strategies such as lifestyle modifications, medical nutrition therapy, and vaccination remain essential components of disease control. Understanding infections as dynamic modulators of metabolic homeostasis reframes diabetes not merely as an endocrine disorder, but as a systemic immunometabolic disease. This review synthesizes current evidence on infection induced metabolic syndrome, immune impairments, and innovative therapeutic strategies to guide future precision interventions at the infection-metabolism interface.}, }
@article {pmid41404126, year = {2025}, author = {Serradell, L and Fretta, A and Nachbar, J and Dreyfus, J and Garofalo, D and Lucini, A and Mather, S and Esposito, D and Chabanon, AL and Bauchau, V and Sellers, S}, title = {The use of observed-to-expected analyses as a signal detection tool in COVID-19 vaccine safety surveillance: lessons learned from an industry perspective.}, journal = {Frontiers in drug safety and regulation}, volume = {5}, number = {}, pages = {1650992}, pmid = {41404126}, issn = {2674-0869}, abstract = {During the pandemic, the accelerated review and authorization of coronavirus disease 19 (COVID-19) vaccines by regulatory authorities elicited the need for rapid and thorough worldwide signal detection and evaluation. To meet this need, the European Medicines Agency and other health authorities expected that, in addition to routine signal detection, COVID-19 vaccine manufacturers should leverage observed-to-expected (O/E) analyses unconventionally as a quantitative method for signal detection of adverse events of special interest (AESIs). The objective of O/E analyses in vaccine signal detection was to determine if AESIs were occurring at a higher-than-expected rate in the vaccinated population in comparison with an unexposed population. The use of O/E was intended to mitigate the challenge of analyzing large volumes of individual case safety reports (ICSRs) received over a very short period following mass vaccination campaigns. The "Beyond COVID-19 Monitoring Excellence" (BeCOME) initiative, a non-competitive voluntary initiative launched in 2022 by COVID-19 vaccine Marketing Authorization Holders (MAHs) and key stakeholders, was established to align systems, enhance processes, and foster innovation in post-marketing vaccine monitoring, building on lessons from the pandemic. A dedicated working group was created to review and share MAHs' experience on O/E analyses used as an additional tool for signal detection during the COVID-19 pandemic. This review presents the industry perspective on using O/E analyses for COVID-19 vaccine signal detection, including challenges and limitations encountered, and proposes best practices for future improvement. Despite the priority and resources devoted to O/E analyses, no de novo signals resulting in the identification of safety concerns were detected using this methodology during the COVID-19 pandemic. O/E analyses are most useful when source data are accurate and there is a high level of confidence in the assumptions and parameters used. In the context of the COVID-19 pandemic, confidence in certain assumptions and parameters was low, limiting the value of O/E analyses in signal detection. Nevertheless, O/E analyses applied for signal refinement, as traditionally used, proved to be useful. Industry experiences support maintaining O/E analyses as a tool for signal refinement and standardizing methodological approaches as much as possible to enhance its future application and comparability across stakeholders.}, }
@article {pmid41403919, year = {2026}, author = {Regmi, A and Sami, A and Baral, S and Niraula, BB and Jain, VK and Iyengar, KP}, title = {Temporal onset and steroid-associated risk in post-COVID hip avascular necrosis: A systematic review and pooled analysis.}, journal = {Journal of orthopaedics}, volume = {72}, number = {}, pages = {304-311}, pmid = {41403919}, issn = {0972-978X}, abstract = {BACKGROUND: Avascular necrosis (AVN) of the hip has emerged as a post-COVID musculoskeletal complication, likely driven by corticosteroid therapy and virus-induced microvascular injury. This study systematically reviews published evidence on post-COVID AVN, analyzing pooled data on latency, cumulative steroid dose, staging, and management outcomes.<br><br>METHODS: A systematic review and pooled analysis were conducted following PRISMA guidelines. PubMed, Embase and Scopus, were searched up to June 2024 using predefined keywords. Studies reporting AVN of the hip following confirmed COVID-19 infection were included. Quantitative pooling of latency (days from infection to AVN diagnosis) and cumulative steroid dose (mg prednisolone equivalent) was performed using a random-effects model.<br><br>RESULTS: Seventeen studies encompassing 209 patients (313 hips) were included. The mean age was 43.7&#xa0;&#xb1;&#xa0;16.2 years, with a male predominance. Pooled analysis showed a mean latency of 126.48 days (95&#xa0;% CI: 95.5-157.46) from COVID-19 infection to AVN onset and a mean cumulative steroid dose of 1198.44&#xa0;mg (95&#xa0;% CI: 860.99-1535.88). Most cases presented at Ficat-Arlet stages II-III. Core decompression and bisphosphonate therapy were effective in early stages, while total hip arthroplasty was required for advanced disease.<br><br>CONCLUSION: Post-COVID AVN of the hip is a delayed yet potentially preventable sequela associated with corticosteroid exposure and COVID-related vascular injury. The mean latency of 126 days from infection to AVN onset and an average cumulative corticosteroid exposure of 1198&#xa0;mg prednisolone equivalent underscores the delayed yet dose-dependent nature of this condition.}, }
@article {pmid41403560, year = {2025}, author = {Dandachi, I and Aljabr, W}, title = {MERS-COV in the Middle East, a one health concept approach.}, journal = {One health (Amsterdam, Netherlands)}, volume = {21}, number = {}, pages = {101282}, pmid = {41403560}, issn = {2352-7714}, abstract = {The MERS-COV virus is a zoonotic coronavirus that emerged in 2012 in KSA and caused viral illness with a case fatality rate up to 35 %. Over a decade later, the virus is still evolving and circulating. The aim of this review is to discuss the current epidemiology of MERS-COV both in humans and animals, during and post the COVID-19 pandemic. We have found that MERS-COV is still evolving in camels with new lineages being detected in Saudi Arabia. Although the number of human cases has decreased, there is a gradual resurgence in the number of cases. Furthermore, many cases are being reported without exposure to camels and/or raw products, nor contact with known human cases. This necessitates global efforts in the surveillance of asymptomatic carriers in the community, role of unknown animal reservoirs in the virus spread if any, as well as extensive genomic surveillance of the virus. This is in order to unveil and assess the genetic changes that the virus is undergoing and their according effect on the viral fitness, tropism, and virulence. These efforts are crucial for potential future pandemic preparedness, understanding the modes of transmission, as well as drug and vaccine development for MERS-COV.}, }
@article {pmid41402837, year = {2025}, author = {Syam, N and Abbas, MZ}, title = {From proposal to compromise: the TRIPS waiver debate and the crisis of WTO decision-making.}, journal = {Globalization and health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12992-025-01176-7}, pmid = {41402837}, issn = {1744-8603}, abstract = {The Marrakesh Agreement, which established the World Trade Organization (WTO), permits WTO member countries to jointly decide to temporarily suspend certain obligations under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS Agreement). The TRIPS Decision adopted at the 12th WTO Ministerial Conference in June 2022, following 20 months of extended negotiations during the COVID-19 pandemic, approved only a limited portion of the waiver proposal originally submitted by India and South Africa. Since the Decision was adopted, WTO members have faced a deadlock over whether to extend its scope to include COVID-19 diagnostics and therapeutics, despite being required by the Decision to reach a conclusion on this issue within six months. This paper re-examines the discussions surrounding the potential expansion of the Decision and argues that including COVID-19 diagnostics and therapeutics within its scope was both appropriate and necessary. In addition, the paper proposes ways to make effective use of TRIPS flexibilities during a pandemic, so that developing countries are not left dependent on unpredictable waiver negotiations. The paper also outlines possible approaches for reforming the waiver decision-making process, aiming to ensure that such decisions are made promptly and efficiently, without prolonged negotiations during times of emergency.Clinical trial number Not applicable.}, }
@article {pmid41401799, year = {2025}, author = {Monteiro, H and Oliveira, M and Martinho, R and Martins, C}, title = {Managing Data in Screening Programs: Challenges and Solutions.}, journal = {Acta medica portuguesa}, volume = {}, number = {}, pages = {}, doi = {10.20344/amp.23363}, pmid = {41401799}, issn = {1646-0758}, abstract = {Population-based screening programs are vital public health initiatives that enable the early detection of diseases, significantly reducing both morbidity and healthcare costs. As these programs expand, the management of the extensive data they generate becomes increasingly complex, highlighting the need for structured digital solutions. This narrative review article presents a pragmatic framework aimed at clarifying big data analytics tailored to the needs and practices of healthcare professionals and administrators, focusing on effective integration into routine screening workflows. To achieve effective data utilization, the process begins with systematic archiving, which involves cloud-based storage solutions capable of securely maintaining various data formats in compliance with regulatory standards, thus ensuring long-term accessibility and continuity. Subsequent real-time processing of screening data facilitates rapid decision-making and patient management by providing immediate validation and analysis, essential for maintaining the responsiveness of screening services. Transformation processes play a critical role in converting diverse data inputs into standardized, consistent formats, enabling seamless communication and exchange among multiple healthcare systems. Integration further builds upon this standardization, merging data from different healthcare providers and diagnostic centers into centralized analytical platforms. This unified approach enables comprehensive patient monitoring and supports predictive modeling for early identification of at-risk individuals. Advanced analytics, particularly process mining and predictive techniques, reveal inefficiencies within screening workflows, highlighting areas needing improvement. These methods help healthcare managers to streamline operations, optimize resources, and enhance overall program performance. Real-time visualization tools provide administrators with continuous, practical insights into operational dynamics, despite existing challenges related to data governance and system interoperability. This article illustrates these concepts through concrete examples from the colorectal cancer screening program in Northern Portugal and the response to the COVID-19 pandemic. The colorectal cancer screening scenario demonstrates how structured data management significantly boosts operational efficiency and healthcare accessibility. Meanwhile, the COVID-19 experience highlights the importance of having flexible digital infrastructures capable of quickly adapting to unexpected crises. Finally, ongoing investments in digital infrastructure, professional training, and comprehensive data governance are crucial for sustaining these improvements. This review provides clear, actionable knowledge to support healthcare professionals in adopting big data analytics effectively within preventive healthcare programs.}, }
@article {pmid41395986, year = {2026}, author = {He, Z and Liu, M and Xie, Q and Lu, H and Guo, C}, title = {Autophagy and ubiquitination in important swine viral infections: Host defense and viral antagonism.}, journal = {Virulence}, volume = {17}, number = {1}, pages = {2605370}, doi = {10.1080/21505594.2025.2605370}, pmid = {41395986}, issn = {2150-5608}, mesh = {Animals ; *Autophagy ; Swine ; *Ubiquitination ; Porcine epidemic diarrhea virus/immunology ; *Host-Pathogen Interactions ; *Swine Diseases/virology/immunology ; African Swine Fever Virus/immunology ; Porcine respiratory and reproductive syndrome virus/immunology ; Virus Diseases/veterinary ; Immune Evasion ; }, abstract = {Swine viral infections continue to impose major economic and animal-health burdens worldwide, with pathogens such as porcine epidemic diarrhea virus (PEDV), African swine fever virus (ASFV), and porcine reproductive and respiratory syndrome virus (PRRSV) causing recurrent outbreaks. Autophagy and ubiquitination are central degradative pathways that act as double-edged swords, serving both host defense and viral exploitation. In this narrative review, we synthesize recent advances showing how these pathogens manipulate ubiquitin - autophagy circuits while host cells counteract through selective autophagy. We propose an autophagy - metabolism - immunity triad that positions autophagy as a hub linking infection, metabolic reprogramming, and immune evasion. This integrated framework moves beyond the traditional view of autophagy as strictly antiviral or pro-viral. Deciphering how viruses hijack ubiquitin - autophagy axes reveals actionable therapeutic targets and translational opportunities for antivirals, adjuvants, and metabolic interventions to reduce the burden of swine viral diseases.}, }
@article {pmid41117600, year = {2025}, author = {Batac, ALR and Marks, M and Tucker, JD and Peeling, R&#x174;}, title = {Syphilis self-testing and implications for syphilis control and prevention.}, journal = {Journal of clinical microbiology}, volume = {63}, number = {12}, pages = {e0098225}, doi = {10.1128/jcm.00982-25}, pmid = {41117600}, issn = {1098-660X}, mesh = {Humans ; *Syphilis/diagnosis/prevention &amp; control/epidemiology ; *Self-Testing ; COVID-19 ; *Syphilis Serodiagnosis/methods ; }, abstract = {The incidence of syphilis has risen dramatically in many regions despite the availability of affordable facility-based testing and curative treatment. The recent approval of over-the-counter syphilis self-tests (SSTs) represents an important advance for expanding diagnostic access and disease control and prevention. Evidence demonstrates that SSTs are accurate, usable, and acceptable. However, as with HIV and COVID-19 self-testing, implementation challenges remain, including ensuring equitable access, supporting vulnerable groups, securing linkage to care, and maintaining quality assurance.}, }
@article {pmid40536568, year = {2025}, author = {Li, L and Zhao, C and Hou, S}, title = {Efficacy and safety of imatinib in patients with COVID-19: a systematic review and meta-analysis.}, journal = {Wiener klinische Wochenschrift}, volume = {137}, number = {23-24}, pages = {778-786}, pmid = {40536568}, issn = {1613-7671}, mesh = {Humans ; *Imatinib Mesylate/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; COVID-19/mortality ; Treatment Outcome ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To inform treatment decisions in clinical practice, we conducted a meta-analysis to evaluate the efficacy and safety of imatinib in patients with COVID-19.<br><br>METHODS: A&#xa0;comprehensive systematic search was conducted across multiple electronic databases to identify relevant randomized controlled trials (RCTs) comparing imatinib with placebo in patients with COVID-19. A&#xa0;meta-analysis was performed using Review Manager software version&#xa0;5.3 and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.<br><br>RESULTS: The analysis included 4&#xa0;studies with a&#xa0;total of 717 patients. The risk ratio (RR) for 28-day mortality in the imatinib group compared to the placebo group was 0.79 (95% confidence interval. CI 0.51-1.21; p&#x202f;=&#x2009;0.28). There were no statistically significant differences in the duration of oxygen supplementation (MD&#x202f;=&#x2009;-0.13, 95% CI -2.57-2.31; p&#x202f;=&#x2009;0.92) or the number of ventilator-free days (MD&#x202f;=&#x2009;4.71, 95% CI -6.97-16.38; p&#x202f;=&#x2009;0.43). Imatinib treatment did not significantly reduce the duration of hospital or intensive care unit (ICU) stay. Additionally, there was no significant difference between imatinib and placebo in the risk of any adverse events (AEs) or serious AEs.<br><br>CONCLUSION: Imatinib did not significantly improve clinical outcomes in patients with COVID-19. Future research should consider subgroup analyses based on the biological heterogeneity of COVID-19-associated acute respiratory distress syndrome (ARDS) or the concurrent use of interleukin&#xa0;6 (IL-6) receptor inhibitors to identify patient populations that may benefit from imatinib treatment.}, }
@article {pmid34423546, year = {2021}, author = {Hamad, N and Ananda-Rajah, M and Gilroy, N and MacIntyre, R and Gottlieb, D and Ritchie, D and Harrison, S and Kennedy, G and Watson, AM and Greenwood, M and Doocey, R and Perera, T and Spencer, A and Wong, E and O'Brien, T and Shaw, P and Conyers, R and Milliken, S and Bardy, P and Larsen, S and Ho, PJ and Lai, H and Bajel, A and Butler, J and Tiley, C and D'Rozario, J and Johnston, A and Cochrane, T and Mills, T and Irving, I and Pullon, H and Purtill, D}, title = {Australia and New Zealand Transplant and Cellular Therapies COVID-19 vaccination consensus position statement.}, journal = {Internal medicine journal}, volume = {51}, number = {8}, pages = {1321-1323}, pmid = {34423546}, issn = {1445-5994}, mesh = {Adult ; Australia/epidemiology ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines ; Child ; Consensus ; Humans ; New Zealand/epidemiology ; Prospective Studies ; *Transplant Recipients ; Vaccination ; }, abstract = {Australia and New Zealand have achieved excellent community control of COVID-19 infection. In light of the imminent COVID-19 vaccination roll out in both countries, representatives of all adult and paediatric allogeneic bone marrow transplant and cellular therapy (TCT) centres as well as representatives from autologous transplant only centres in Australia and New Zealand collaborated with infectious diseases specialists with expertise in TCT on this consensus position statement regarding COVID-19 vaccination in TCT patients in Australia and New Zealand. It is our recommendation that TCT patients, should have expedited access to high-efficacy COVID-19 vaccines given that these patients are at high risk of morbidity and mortality from COVID-19 infection. We also recommend prioritising vaccination of TCT healthcare workers and household members of TCT patients. Vaccination should not replace other public health measures in TCT patients given the effectiveness of COVID-19 vaccination in TCT patients is unknown. Furthermore, given the limited available data, prospective collection of safety and efficacy data of COVID-19 vaccination in this patient group is a priority.}, }
@article {pmid34399446, year = {2021}, author = {Ku, CR and Jung, KY and Ahn, CH and Moon, JS and Lee, JH and Kim, EH and Kwon, H and Kim, HK and Suh, S and Hong, S and Ha, J and Roh, E and Kim, JH and Kim, MK and , }, title = {COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society.}, journal = {Endocrinology and metabolism (Seoul, Korea)}, volume = {36}, number = {4}, pages = {757-765}, pmid = {34399446}, issn = {2093-5978}, mesh = {COVID-19/epidemiology/immunology/*prevention &amp; control ; COVID-19 Vaccines/administration &amp; dosage/adverse effects/*standards ; *Endocrine System Diseases/epidemiology/immunology ; Endocrinologists/*standards ; Humans ; Practice Guidelines as Topic/standards ; Republic of Korea/epidemiology ; Societies, Medical/*standards ; Vaccination/*standards ; }, abstract = {Since the first outbreak of coronavirus disease 2019 (COVID-19), ongoing efforts have been made to discover an efficacious vaccine against COVID-19 to combat the pandemic. In most countries, both mRNA and DNA vaccines have been administered, and their side effects have also been reported. The clinical course of COVID-19 and the effects of vaccination against COVID-19 are both influenced by patients' health status and involve a systemic physiological response. In view of the systemic function of endocrine hormones, endocrine disorders themselves and the therapeutics used to treat them can influence the outcomes of vaccination for COVID-19. However, there are very limited data to support the development of clinical guidelines for patients with specific medical backgrounds based on large clinical trials. In the current severe circumstances of the COVID-19 pandemic, position statements made by clinical specialists are essential to provide appropriate recommendations based on both medical evidence and clinical experiences. As endocrinologists, we would like to present the medical background of COVID-19 vaccination, as well as precautions to prevent the side effects of COVID-19 vaccination in patients with specific endocrine disorders, including adrenal insufficiency, diabetes mellitus, osteoporosis, autoimmune thyroid disease, hypogonadism, and pituitary disorders.}, }
@article {pmid34310563, year = {2021}, author = {Caldarola, P and Murrone, A and Roncon, L and Di Pasquale, G and Tavazzi, L and Amodeo, V and Aspromonte, N and Cipriani, M and Di Lenarda, A and Domenicucci, S and Francese, GM and Imazio, M and Scotto di Uccio, F and Urbinati, S and Valente, S and Gulizia, MM and Colivicchi, F and Gabrielli, D}, title = {[ANMCO Position paper: Reorganization of cardiology in the era of the COVID-19 pandemic].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {22}, number = {8}, pages = {610-619}, doi = {10.1714/3641.36216}, pmid = {34310563}, issn = {1972-6481}, mesh = {*COVID-19 ; Cardiology/*organization &amp; administration ; Cardiovascular Diseases/therapy ; Delivery of Health Care/*organization &amp; administration ; Health Personnel/organization &amp; administration ; Humans ; Italy ; National Health Programs/organization &amp; administration ; }, abstract = {The COVID-19 pandemic represents an unprecedented event that has brought deep changes in hospital facilities with reshaping of the health system organization, revealing inadequacies of current hospital and local health systems. When the COVID-19 emergency will end, further evaluation of the national health system, new organization of acute wards, and a further evolution of the entire health system will be needed to improve care during the chronic phase of disease. Therefore, new standards for healthcare personnel, more efficient organization of hospital facilities for patients with acute illnesses, improvement of technological approaches, and better integration between hospital and territorial services should be pursued. With experience derived from the COVID-19 pandemic, new models, paradigms, interventional approaches, values and priorities should be suggested and implemented.}, }
@article {pmid34227785, year = {2021}, author = {Gnanaraj, JP and Anne, PS and Majella, CM and Durairaj, P and Edwin, R and Kannan, K and Ramachandran, V and Jeyabalan, N and Mohanan, N and Krishnan, S and Somasundaram, S}, title = {Antithrombotic Therapy in COVID-19 - A Scientific Position Statement by Heart Disease Management Program, National Health Mission, Government of Tamil Nadu.}, journal = {The Journal of the Association of Physicians of India}, volume = {69}, number = {1}, pages = {82-87}, pmid = {34227785}, issn = {0004-5772}, mesh = {*COVID-19 ; Disease Management ; *Fibrinolytic Agents ; Government ; Humans ; India ; National Health Programs ; SARS-CoV-2 ; }, }
@article {pmid34212511, year = {2021}, author = {Butsch, WS and Hajduk, A and Cardel, MI and Donahoo, WT and Kyle, TK and Stanford, FC and Zeltser, LM and Kotz, CM and Jastreboff, AM}, title = {COVID-19 vaccines are effective in people with obesity: A position statement from The Obesity Society.}, journal = {Obesity (Silver Spring, Md.)}, volume = {29}, number = {10}, pages = {1575-1579}, pmid = {34212511}, issn = {1930-739X}, support = {P30 DK040561/DK/NIDDK NIH HHS/United States ; UL1 TR001863/TR/NCATS NIH HHS/United States ; I01 BX003004/BX/BLRD VA/United States ; P30 DK045735/DK/NIDDK NIH HHS/United States ; I01 BX003687/BX/BLRD VA/United States ; }, mesh = {Adolescent ; Adult ; Aged ; COVID-19/*immunology/*prevention &amp; control/virology ; COVID-19 Vaccines/*immunology ; Clinical Trials as Topic ; Humans ; Middle Aged ; Obesity/*immunology ; SARS-CoV-2/*immunology ; *Societies, Medical ; Young Adult ; }, abstract = {The position statement is issued by The Obesity Society in response to published literature, as well as inquiries made to the Society by patients, providers, Society members, policy makers, and others regarding the efficacy of vaccines in persons with obesity against SARS-CoV-2, the virus that causes COVID-19. The Obesity Society has critically evaluated data from published peer-reviewed literature and briefing documents from Emergency Use Authorization applications submitted by Pfizer-BioNTech, Moderna, and Johnson &amp; Johnson. We conclude that these vaccines are highly efficacious, and their efficacy is not significantly different in people with and without obesity, based on scientific evidence available at the time of publication. The Obesity Society believes there is no definitive way to determine which of these three COVID-19 vaccines is "best" for any weight subpopulation (because of differences in the trial design and outcome measures in the phase 3 trials, elapsed time between doses, and regional differences in the presence of SARS-CoV-2 variants [e.g., South Africa B.1.351 in Johnson &amp; Johnson trial]). All three trials have demonstrated high efficacy against COVID-19-associated hospitalization and death. Therefore, The Obesity Society encourages adults with obesity ≥18 years (≥16 years for Pfizer-BioNTech) to undergo vaccination with any one of the currently available vaccines authorized for emergency use by the US Food and Drug Administration as soon as they are able.}, }
@article {pmid34180546, year = {2022}, author = {Korath, ADJ and Janda, J and Untersmayr, E and Sokolowska, M and Feleszko, W and Agache, I and Adel Seida, A and Hartmann, K and Jensen-Jarolim, E and Pali-Schöll, I}, title = {One Health: EAACI Position Paper on coronaviruses at the human-animal interface, with a specific focus on comparative and zoonotic aspects of SARS-CoV-2.}, journal = {Allergy}, volume = {77}, number = {1}, pages = {55-71}, pmid = {34180546}, issn = {1398-9995}, support = {//European Academy of Allergy and Clinical Immunology (EAACI)/ ; }, mesh = {Animals ; *COVID-19 ; Humans ; *One Health ; Pandemics ; Quality of Life ; SARS-CoV-2 ; }, abstract = {The latest outbreak of a coronavirus disease in 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evolved into a worldwide pandemic with massive effects on health, quality of life, and economy. Given the short period of time since the outbreak, there are several knowledge gaps on the comparative and zoonotic aspects of this new virus. Within the One Health concept, the current EAACI position paper dwells into the current knowledge on SARS-CoV-2's receptors, symptoms, transmission routes for human and animals living in close vicinity to each other, usefulness of animal models to study this disease and management options to avoid intra- and interspecies transmission. Similar pandemics might appear unexpectedly and more frequently in the near future due to climate change, consumption of exotic foods and drinks, globe-trotter travel possibilities, the growing world population, the decreasing production space, declining room for wildlife and free-ranging animals, and the changed lifestyle including living very close to animals. Therefore, both the society and the health authorities need to be aware and well prepared for similar future situations, and research needs to focus on prevention and fast development of treatment options (medications, vaccines).}, }
@article {pmid34170086, year = {2021}, author = {Richter, D and Guasti, L and Koehler, F and Squizzato, A and Nistri, S and Christodorescu, R and Dievart, F and Gaudio, G and Asteggiano, R and Ferrini, M}, title = {Late phase of COVID-19 pandemic in General Cardiology. A position paper of the ESC Council for Cardiology Practice.}, journal = {ESC heart failure}, volume = {8}, number = {5}, pages = {3483-3494}, pmid = {34170086}, issn = {2055-5822}, mesh = {*COVID-19/complications ; *Cardiology ; Humans ; Pandemics ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {Cardiovascular (CV) engagement in coronavirus disease 2019 (COVID-19) is a huge determinant of prognosis during the acute phase of the disease. However, little is known about the potential chronic implications of the late phase of COVID-19 and about the appropriate approach to these patients. Heart failure, type 1 and type 2 myocardial infarction, arrhythmias, myocarditis, pulmonary fibrosis, and thrombosis have been shown to be related to severe acute respiratory syndrome coronavirus 2 infection, and a 'long COVID-19' illness has been recognized with fatigue, chest pain, and dyspnoea among the most frequent symptoms reported after discharge from hospital. This paper focuses on some open questions that cardiologists are going to face during the next months in a general cardiology outpatient clinic, in particular how to evaluate a 'post-COVID' patient during follow-up of CV complications of the acute phase and how to manage new CV symptoms that could be the consequence, at least in part, of heart/vessels and/or lung involvement of the previous virus infection. Present symptoms and signs, history of previous CV disease (both preceding COVID-19 and occurring during viral infection), and specific laboratory and imaging measurements during the acute phase may be of interest in focusing on how to approach the clinical evaluation of a post-COVID patient and how to integrate in our standard of care the new information on COVID-19, possibly in a multidisciplinary view. Dealing with the increased COVID-associated CV risk burden and becoming acquainted with potential new e-cardiology approaches aimed at integrating the cardiology practice are relevant new challenges brought by severe acute respiratory syndrome coronavirus 2 infection and its sequelae.}, }
@article {pmid34155756, year = {2021}, author = {Kanjanapan, Y and Blinman, P and Underhill, C and Karikios, D and Segelov, E and Yip, D}, title = {Medical Oncology Group of Australia position statement: COVID-19 vaccination in patients with solid tumours.}, journal = {Internal medicine journal}, volume = {51}, number = {6}, pages = {955-959}, pmid = {34155756}, issn = {1445-5994}, mesh = {Australia/epidemiology ; *COVID-19 ; COVID-19 Vaccines ; Humans ; Medical Oncology ; *Neoplasms/epidemiology/therapy ; SARS-CoV-2 ; Vaccination ; }, abstract = {People with cancer are vulnerable to increased morbidity and mortality from the coronavirus disease 2019 (COVID-19). COVID-19 vaccination is key to protecting the population of people with cancer from adverse outcomes of SARS-CoV-2 infection. The Medical Oncology Group of Australia aimed to address the considerations around COVID-19 vaccination in people with cancer, in particular, safety and efficacy of vaccination. The assessment of patients with generalised allergic reaction to anti-cancer therapy containing vaccine components and practical implementation of vaccination of people on active anti-cancer therapy are also discussed.}, }
@article {pmid34142284, year = {2022}, author = {Testino, G and Vignoli, T and Patussi, V and Allosio, P and Amendola, MF and Aricò, S and Baselice, A and Balbinot, P and Campanile, V and Fanucchi, T and Greco, G and Macciò, L and Meneguzzi, C and Mioni, D and Palmieri, VO and Parisi, M and Renzetti, D and Rossin, R and Gandin, C and Bottaro, LC and Bernardi, M and Addolorato, G and Lungaro, L and Zoli, G and Scafato, E and Caputo, F}, title = {Alcohol-Related Liver Disease in the Covid-19 Era: Position Paper of the Italian Society on Alcohol (SIA).}, journal = {Digestive diseases and sciences}, volume = {67}, number = {6}, pages = {1975-1986}, pmid = {34142284}, issn = {1573-2568}, mesh = {*Alcoholism/complications/epidemiology/therapy ; *COVID-19 ; Communicable Disease Control ; Humans ; *Liver Diseases, Alcoholic/epidemiology/therapy ; Pandemics ; }, abstract = {BACKGROUND: Coronavirus Disease 2019 (COVID-19), firstly reported in China last November 2019, became a global pandemic. It has been shown that periods of isolation may induce a spike in alcohol use disorder (AUD). In addition, alcohol-related liver disease (ALD) is the most common consequence of excessive alcohol consumption worldwide. Moreover, liver impairment has also been reported as a common manifestation of COVID-19.<br><br>AIMS: The aim of our position paper was to consider some critical issues regarding the management of ALD in patients with AUD in the era of COVID-19.<br><br>METHODS: A panel of experts of the Italian Society of Alcohology (SIA) met via "conference calls" during the lockdown period to draft the SIA's criteria for the management of ALD in patients with COVID-19 as follows: (a) liver injury in patients with ALD and COVID-19 infection; (b) toxicity to the liver of the drugs currently tested to treat COVID-19 and the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) reorganization of the management of compensated and decompensated ALD and liver transplantation in the COVID-19 era.<br><br>RESULTS AND CONCLUSIONS: The COVID-19 pandemic has rapidly carried us toward a new governance scenario of AUD and ALD which necessarily requires an in-depth review of the management of these diseases with a new safe approach (management of out-patients and in-patients following new rules of safety, telemedicine, telehealth, call meetings with clinicians, nurses, patients, and caregivers) without losing the therapeutic efficacy of multidisciplinary treatment.}, }
@article {pmid34133609, year = {2021}, author = {Colombo, CSSS and Leitão, MB and Avanza Junior, AC and Borges, SF and Silveira, ADD and Braga, F and Camarozano, AC and Kopiler, DA and Lazzoli, JK and Freitas, OGA and Grossman, GB and Milani, M and Nunes, MB and Ritt, LEF and Sellera, CAC and Ghorayeb, N}, title = {Position Statement on Post-COVID-19 Cardiovascular Preparticipation Screening: Guidance for Returning to Physical Exercise and Sports - 2020.}, journal = {Arquivos brasileiros de cardiologia}, volume = {116}, number = {6}, pages = {1213-1226}, pmid = {34133609}, issn = {1678-4170}, mesh = {*COVID-19 ; *Cardiovascular Diseases/diagnosis/prevention &amp; control ; Death, Sudden, Cardiac/prevention &amp; control ; Exercise ; Humans ; Mass Screening ; Physical Examination ; SARS-CoV-2 ; *Sports ; *Sports Medicine ; }, }
@article {pmid34100388, year = {2021}, author = {Alqahtani, SA and Barry, M and Memish, Z and Hashim, A and Alfares, MA and Alghamdi, SA and Al-Hamoudi, WK and Al-Judaibi, B and Alhazzani, W and Al-Tawfiq, JA and Abaalkhail, F}, title = {Use of COVID-19 vaccines in patients with liver disease and post-liver transplantation: Position statement of the Saudi association for the study of liver diseases and transplantation.}, journal = {Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association}, volume = {27}, number = {4}, pages = {201-207}, pmid = {34100388}, issn = {1998-4049}, mesh = {BNT162 Vaccine ; *COVID-19 ; COVID-19 Vaccines ; ChAdOx1 nCoV-19 ; Humans ; *Liver Diseases ; *Liver Transplantation ; SARS-CoV-2 ; Saudi Arabia ; }, abstract = {Patients with chronic liver disease (CLD) and liver transplant recipients are at increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19). Although several studies demonstrated the safety and efficacy of COVID-19 vaccines in the general population, data in CLD patients and liver transplant recipients are lacking. Two COVID-19 vaccines were approved by the Saudi Food and Drug Authority and rolled out to several million recipients in Saudi Arabia. These vaccines are mRNA-based vaccine BNT162b2 from Pfizer/BioNTech and adenovirus-based AZD1222 from Oxford/AstraZeneca from three manufacturing sites (EU Nodes, Serum Institute of India, and South Korea Bio). The Saudi Association for the Study of Liver diseases and Transplantation (SASLT) has reviewed the available evidence and issued interim recommendations for COVID-19 vaccination in CLD and liver transplant recipients. Since there is no evidence contradicting the safety and immunogenicity of the currently approved COVID-19 vaccines in patients with CLD and hepatobiliary cancer and liver transplant recipients, the SASLT recommends vaccination in those patient populations. CLD and hepatobiliary cancer patients and liver transplant recipients should be prioritized depending on the risk factors for severe COVID-19. In transplant recipients, the optimal timing of vaccination remains unknown; however, immunization is recommended after the initial immunosuppression phase. Patients with CLD and liver transplant candidates or recipients should be closely monitored after COVID-19 vaccination. These patient populations should be included in future clinical trials to provide further evidence on the efficacy and safety of COVID-19 vaccines.}, }
@article {pmid34059190, year = {2021}, author = {Prati, D and Fiorin, F and Berti, P and De Silvestro, G and Accorsi, P and Ostuni, A and , }, title = {Position paper on the use of COVID-19 convalescent plasma: an update.}, journal = {Blood transfusion = Trasfusione del sangue}, volume = {19}, number = {4}, pages = {277-280}, pmid = {34059190}, issn = {2385-2070}, mesh = {COVID-19/blood/*therapy ; *Consensus ; Humans ; Immunization, Passive/standards ; Inpatients ; Italy ; Meta-Analysis as Topic ; Randomized Controlled Trials as Topic ; Treatment Outcome ; COVID-19 Serotherapy ; }, }
@article {pmid34052501, year = {2021}, author = {Al-Motlaq, M and Neill, S and Foster, MJ and Coyne, I and Houghton, D and Angelhoff, C and Rising-Holmström, M and Majamanda, M}, title = {Position Statement of the International Network for Child and Family Centered Care: Child and Family Centred Care during the COVID19 Pandemic.}, journal = {Journal of pediatric nursing}, volume = {61}, number = {}, pages = {140-143}, pmid = {34052501}, issn = {1532-8449}, mesh = {*COVID-19 ; Child ; Family ; Humans ; Pandemics ; Patient-Centered Care ; SARS-CoV-2 ; }, abstract = {It is the position of the International Network for Child and Family Centered Care (INCFCC) that COVID19 restrictions pose tremendous challenges for the health care team in their efforts to provide child and family centered care (CFCC). COVID-19 restrictions impact on the family's right to be presernt with their ill child and to contribute to the caring process. A limited number of articles have discussed challenges about the successful delivery of CFCC during the COVID-19 pandemic. Based on current literature, the INCFCC stresses the need for continuous facilitation implementation of child and family centred care as, it is essential for children's physical and psychological wellbeing. Furthermore we believe that the families' presence and participation holds more benefits than risks to the health of children, their families, and the health care team.}, }
@article {pmid34048585, year = {2021}, author = {Bean, MK and Adams, EL and Buscemi, J and Ford, S and Wischenka, D and Behrman, P and Wilson, DK and Gladstone, TRG and Fitzgibbon, ML}, title = {Society of Behavioral Medicine (SBM) Position Statement: increase access to mental health services due to COVID-19-related parent and family stress.}, journal = {Translational behavioral medicine}, volume = {11}, number = {8}, pages = {1635-1637}, pmid = {34048585}, issn = {1613-9860}, support = {T32 CA093423/CA/NCI NIH HHS/United States ; 2T32CA093423//National Cancer Institute at the National Institutes of Health/ ; 2T32 CA093423/NH/NIH HHS/United States ; }, mesh = {*Behavioral Medicine ; *COVID-19 ; Child ; Humans ; *Mental Health Services ; Parents ; SARS-CoV-2 ; United States/epidemiology ; }, abstract = {COVID-19 has caused drastic increases in family stress contributing to deleterious social and emotional ramifications. Before COVID-19, millions of Americans lacked access to mental health resources, and now in the midst of a global pandemic, resources are more limited in times of greater need. In March 2020, the Coronavirus Aid, Relief, and Economic Security (CARES) Act provided funding for mental health reforms; yet many barriers remained to receiving sufficient care. In February 2021, the Society of Behavioral Medicine recommended federal legislators expand Community Behavioral Healthcare Centers, increase funding for Federally Qualified Healthcare Centers and School Based Health Centers, incentivize providers to accept Medicaid, and institute more statewide licensing flexibilities to expand the reach of mental health care. In March 2021, the American Rescue Plan was signed into law and provided an additional ~$4 billion in funding for community mental health services, implementing substance abuse prevention and treatment programs, increasing the behavioral health workforce, promoting behavioral telehealth within primary care, increasing school-based mental health services, implementing suicide prevention programs, and improving services for traumatized families. This significant investment in parents and children's mental health is a tremendous step in the right direction and provides reassurance that relief is underway. Ongoing surveillance of the programmatic and clinical outcomes that result from these new policy reforms will be important for identifying areas that may need continual support as our nation recovers from COVID-19.}, }
@article {pmid34047035, year = {2021}, author = {McCaughan, G and Di Ciaccio, P and Ananda-Rajah, M and Gilroy, N and MacIntyre, R and Teh, B and Weinkove, R and Curnow, J and Szer, J and Enjeti, AK and Ross, DM and Mulligan, S and Trotman, J and Dickinson, M and Quach, H and Choi, P and Polizzotto, MN and Tam, CS and Ho, PJ and Ku, M and Gregory, G and Gangatharan, S and Hapgood, G and Cochrane, T and Cheah, C and Gibbs, S and Wei, A and Johnston, A and Greenwood, M and Prince, HM and Latimer, M and Berkahn, L and Wight, J and Armytage, T and Hamad, N}, title = {COVID-19 vaccination in haematology patients: an Australian and New Zealand consensus position statement.}, journal = {Internal medicine journal}, volume = {51}, number = {5}, pages = {763-768}, pmid = {34047035}, issn = {1445-5994}, mesh = {Australia/epidemiology ; *COVID-19 ; COVID-19 Vaccines ; Consensus ; *Hematology ; Humans ; New Zealand/epidemiology ; Prospective Studies ; SARS-CoV-2 ; Vaccination ; }, abstract = {Australia and New Zealand have achieved excellent community control of COVID-19 infection. In light of the imminent COVID-19 vaccination roll out in both countries, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 vaccination in patients with haematological disorders. It is our recommendation that patients with haematological malignancies, and some benign haematological disorders, should have expedited access to high-efficacy COVID-19 vaccines, given that these patients are at high risk of morbidity and mortality from COVID-19 infection. Vaccination should not replace other public health measures in these patients, given that the effectiveness of COVID-19 vaccination, specifically in patients with haematological malignancies, is not known. Given the limited available data, prospective collection of safety and efficacy data of COVID-19 vaccination in this patient group is a priority.}, }
@article {pmid34030157, year = {2021}, author = {Exten, C and Pinto, CN and Gaynor, AM and Meyerson, B and Griner, SB and Van Der Pol, B and , }, title = {Direct-to-Consumer Sexually Transmitted Infection Testing Services: A Position Statement from the American Sexually Transmitted Diseases Association.}, journal = {Sexually transmitted diseases}, volume = {48}, number = {11}, pages = {e155-e159}, pmid = {34030157}, issn = {1537-4521}, mesh = {*COVID-19 ; Humans ; Pandemics ; SARS-CoV-2 ; *Sexually Transmitted Diseases/diagnosis/epidemiology ; Specimen Handling ; United States/epidemiology ; }, abstract = {Direct-to-consumer test services have gained popularity for sexually transmitted infections in recent years, with substantially increased use as a result of the SARS-CoV-2 (CoVID-19) global pandemic. This method of access has been variously known as "self-testing," "home testing," and "direct access testing." Although these online services may be offered through different mechanisms, here we focus on those that are consumer-driven and require self-collected samples, and sample shipment to a centralized laboratory without involvement of health care providers and/or local health departments. We provide the American Sexually Transmitted Diseases Association's position on utilization of these services and recommendations for both consumers and health care providers.}, }
@article {pmid33976449, year = {2020}, author = {Awuku, YA and Jibril, AT and Bockarie, AS and Duah, A and Tachi, K and Agyei-Nkansah, A and Afihene, MY}, title = {Gastroenterology practice in the COVID-19 era: Ghana Association for the Study of Liver and Digestive Diseases (GASLIDD) position statement.}, journal = {Ghana medical journal}, volume = {54}, number = {4 Suppl}, pages = {104-106}, pmid = {33976449}, issn = {2616-163X}, mesh = {COVID-19/*prevention &amp; control ; Endoscopy, Gastrointestinal/*standards ; Gastroenterology/*standards ; Ghana ; Humans ; Infection Control/*standards ; *Practice Guidelines as Topic ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {UNLABELLED: The COVID-19 pandemic has impacted healthcare negatively across the globe. The practice of gastroenterology has been affected especially gastrointestinal (GI) endoscopy which is considered high risk for transmission of the virus. As a community of practitioners there is the need to share information and make evidence-based statements to guide GI practice in Ghana. This GASLIDD position statement based on the growing and rapidly evolving body of knowledge is to provide up to date information on the COVID-19 disease and guidance for the practice of gastroenterology in Ghana and beyond. It is to help the GI community of practice to maintain the highest level of health delivery and safety for our patients, staff, community and GI practitioners.<br><br>FUNDING: Self-funded.}, }
@article {pmid33960979, year = {2021}, author = {Indolfi, C and Barillà, F and Basso, C and Ciccone, MM and Curcio, A and Mancone, M and Mercuro, G and Muscoli, S and Nodari, S and Pedrinelli, R and Romeo, F and Sinagra, G and Filardi, PP}, title = {[Position paper of the Italian Society of Cardiology (SIC) on COVID-19 vaccine priority in patients with cardiovascular diseases].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {22}, number = {5}, pages = {363-375}, doi = {10.1714/3592.35745}, pmid = {33960979}, issn = {1972-6481}, mesh = {Age Factors ; Animals ; COVID-19/epidemiology/mortality/*prevention &amp; control ; COVID-19 Vaccines/*administration &amp; dosage ; Cardiology ; Cardiovascular Diseases/*complications ; *Consensus ; Coronary Disease/complications ; Disease Vectors ; Heart Failure/complications ; Heart Transplantation ; Heart Valve Diseases/complications ; Humans ; Hypertension, Pulmonary/complications ; Italy/epidemiology ; Prognosis ; Renal Insufficiency/complications ; SARS-CoV-2/immunology ; Societies, Medical ; Vaccines, Synthetic/administration &amp; dosage ; mRNA Vaccines ; }, abstract = {In over a year, the COVID-19 pandemic caused 2.69 million deaths and 122 million infections. Social isolation and distancing measures have been the only prevention available for months. Scientific research has done a great deal of work, developing in a few months safe and effective vaccines against COVID-19. In the European Union, nowadays, four vaccines have been authorized for use: Pfizer-BioNTech, Moderna, ChAdOx1 (AstraZeneca/Oxford), Janssen (Johnson &amp; Johnson), and three others are currently under rolling review.Vaccine allocation policy is crucial to optimize the advantage of treatment preferring people with the highest risk of contagion. These days the priority in the vaccination program is of particular importance since it has become clear that the number of vaccines is not sufficient for the entire Italian population in the short term. Cardiovascular diseases are frequently associated with severe COVID-19 infections, leading to the worst prognosis. The elderly population suffering from cardiovascular diseases is, therefore, to be considered a particularly vulnerable population. However, age cannot be considered the only discriminating factor because in the young-adult population suffering from severe forms of heart disease, the prognosis, if affected by COVID-19, is particularly ominous and these patients should have priority access to the vaccination program. The aim of this position paper is to establish a consensus on a priority in the vaccination of COVID-19 among subjects suffering from different cardiovascular diseases.}, }
@article {pmid33941488, year = {2021}, author = {Russo, FP and Piano, S and Bruno, R and Burra, P and Puoti, M and Masarone, M and Montagnese, S and Ponziani, FR and Petta, S and Aghemo, A and , }, title = {Italian association for the study of the liver position statement on SARS-CoV2 vaccination.}, journal = {Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver}, volume = {53}, number = {6}, pages = {677-681}, pmid = {33941488}, issn = {1878-3562}, mesh = {*COVID-19/epidemiology/prevention &amp; control ; *COVID-19 Vaccines/classification/pharmacology ; Humans ; *Immunization Programs/methods/organization &amp; administration ; Immunosuppressive Agents/therapeutic use ; Italy/epidemiology ; *Liver Diseases/immunology/therapy ; Liver Transplantation ; Patient Safety ; Patient Selection ; Risk Adjustment/*methods ; Risk Assessment ; SARS-CoV-2/immunology ; Transplant Recipients ; Treatment Outcome ; }, abstract = {The vaccination campaign against Sars-CoV-2 commenced in Italy at the end of December 2020. The first ones to receive the immunization against the virus were the health workers and the residents of nursing homes, following which the vaccine would be available for the entire population, beginning with the most vulnerable individuals. SARS-CoV2 vaccines have been demonstrated to be safe for the general population, although no data for patients with liver diseases or those having undergone liver transplantation are available so far. The present position statement AISF is an attempt to suggest, based on the published data on the impact of Sars-Cov-2 infection in patients with chronic liver disease, a possible priority for vaccination for this category of patients.}, }
@article {pmid33909805, year = {2021}, author = {Queiroz, NSF and Teixeira, FV and Freire, CCF and Motta, MP and Vasconcellos, MAM and Chebli, LA and Saad-Hossne, R and , }, title = {BRAZILIAN IBD STUDY GROUP POSITION STATEMENT ON SARS-COV2 VACCINATION.}, journal = {Arquivos de gastroenterologia}, volume = {58}, number = {1}, pages = {1-4}, doi = {10.1590/S0004-2803.202100000-02}, pmid = {33909805}, issn = {1678-4219}, mesh = {Brazil ; *COVID-19 ; COVID-19 Vaccines ; Humans ; *Inflammatory Bowel Diseases ; Pandemics ; RNA, Viral ; SARS-CoV-2 ; Vaccination ; }, abstract = {Mass vaccination offers the best strategy to fight against COVID-19 pandemic, and SARS-CoV2 vaccines are being approved in several countries for emergency use. In Brazil, vaccine approval is expected in the next few days, however potential concerns exist regarding vaccine recommendations for specific populations, such as patients with inflammatory bowel disease (IBD). To address these questions, the Brazilian IBD Study Group (GEDIIB) provides this practical advice with key recommendations about the COVID-19 vaccines in IBD population.}, }
@article {pmid33861837, year = {2020}, author = {Álvarez Z, P and Larios G, G and Toro R, L and Acevedo A, V and Arancibia G, F and Cárdenas M, L and Fernández C, C}, title = {[Recommendation for the recognition, management and follow up of cardiovascular compromise in patients with Pediatric Multisystemic Inflammatory Syndrome associated with COVID-19 (PIMS-CT). Position statement of Chilean Scientific Societies].}, journal = {Revista chilena de pediatria}, volume = {91}, number = {6}, pages = {982-990}, doi = {10.32641/rchped.vi91i6.3215}, pmid = {33861837}, issn = {0717-6228}, mesh = {Biomarkers/metabolism ; COVID-19/diagnosis/physiopathology/*therapy ; Cardiovascular Diseases/diagnosis/therapy/*virology ; Child ; Chile ; Humans ; Mucocutaneous Lymph Node Syndrome/therapy/virology ; Patient Care Team/organization &amp; administration ; Shock/therapy/virology ; Systemic Inflammatory Response Syndrome/diagnosis/physiopathology/*therapy ; }, abstract = {Since the onset of the SARS-CoV-2 pandemic, the pediatric population has been less affected by the disease both in frequency and severity. However, since April cases of variable presentation and severity characterized by inflammatory phenomena that affect multiple organs have been reported, a condition called Multisystem Inflammatory Syndrome in Children (MIS-C). The literature has reported frequent cardiac involvement, up to 80%. This is characterized by myocardial injury with a significant increase of biomarkers such as serum troponins I and T, BNP, or NT-ProBNP coupled with varying degrees of ventricular dysfunction, pericarditis, valvulitis, and arrhythmias. Coronary compromise has also been described, which can occur in up to 23% of cases, and ranges from dila tations to aneurysms. Inpatient and outpatient cardiology follow-up has been systematized based on the clinical phenotypes such as myocardial injury (myocarditis, valvulitis, pericarditis), shock (usua lly vasoplegic), Kawasaki disease-type manifestations, and those MIS-C that do not comply with the clinic of the previous three. This last group represents the main challenge in the short-, medium- and long-term follow-up, therefore, it is necessary a multidisciplinary team for managing these patients. Considering the high frequency of cardiac compromise in MIS-C, and the importance of reaching a consensus regarding its management and follow-up, we present these recommendations according to the current state of knowledge regarding this recently described pathology.}, }
@article {pmid33839767, year = {2021}, author = {Badimon, L and Robinson, EL and Jusic, A and Carpusca, I and deWindt, LJ and Emanueli, C and Ferdinandy, P and Gu, W and Gyöngyösi, M and Hackl, M and Karaduzovic-Hadziabdic, K and Lustrek, M and Martelli, F and Nham, E and Potočnjak, I and Satagopam, V and Schneider, R and Thum, T and Devaux, Y}, title = {Cardiovascular RNA markers and artificial intelligence may improve COVID-19 outcome: a position paper from the EU-CardioRNA COST Action CA17129.}, journal = {Cardiovascular research}, volume = {117}, number = {8}, pages = {1823-1840}, pmid = {33839767}, issn = {1755-3245}, support = {CH/15/1/31199/BHF_/British Heart Foundation/United Kingdom ; RG/20/9/35101/BHF_/British Heart Foundation/United Kingdom ; }, mesh = {Artificial Intelligence/*economics ; Biomarkers/*analysis ; COVID-19/*diagnosis ; Cardiovascular Diseases/diagnosis/genetics ; Cardiovascular System/virology ; Humans ; Quality of Life ; RNA/*genetics ; SARS-CoV-2/pathogenicity ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has been as unprecedented as unexpected, affecting more than 105 million people worldwide as of 8 February 2020 and causing more than 2.3 million deaths according to the World Health Organization (WHO). Not only affecting the lungs but also provoking acute respiratory distress, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is able to infect multiple cell types including cardiac and vascular cells. Hence a significant proportion of infected patients develop cardiac events, such as arrhythmias and heart failure. Patients with cardiovascular comorbidities are at highest risk of cardiac death. To face the pandemic and limit its burden, health authorities have launched several fast-track calls for research projects aiming to develop rapid strategies to combat the disease, as well as longer-term projects to prepare for the future. Biomarkers have the possibility to aid in clinical decision-making and tailoring healthcare in order to improve patient quality of life. The biomarker potential of circulating RNAs has been recognized in several disease conditions, including cardiovascular disease. RNA biomarkers may be useful in the current COVID-19 situation. The discovery, validation, and marketing of novel biomarkers, including RNA biomarkers, require multi-centre studies by large and interdisciplinary collaborative networks, involving both the academia and the industry. Here, members of the EU-CardioRNA COST Action CA17129 summarize the current knowledge about the strain that COVID-19 places on the cardiovascular system and discuss how RNA biomarkers can aid to limit this burden. They present the benefits and challenges of the discovery of novel RNA biomarkers, the need for networking efforts, and the added value of artificial intelligence to achieve reliable advances.}, }
@article {pmid33820898, year = {2021}, author = {Rodrigues, AM and Romeu, JC and Canas da Silva, J and Tavares-Costa, J and Faustino, A and Vaz, C and Pereira da Silva, JA and Canhão, H}, title = {Osteoporosis management during the COVID-19 pandemic - Position paper.}, journal = {Acta reumatologica portuguesa}, volume = {46}, number = {1}, pages = {55-57}, pmid = {33820898}, issn = {2184-8777}, mesh = {*COVID-19 ; Humans ; Osteoporosis/*therapy ; }, abstract = {COVID-19 pandemic significantly increased the already large number of victims of osteoporosis in Portugal. Osteoporosis outpatient clinics were either closed or had limited presential appointments. Many hospitals reduced orthopaedic services to make space for patients with COVID-19. In addition, the volunteer or forced sedentarism, as imposed by the pandemic, increased the risk of falls and fractures drastically. It urges to intensify the current efforts to improve the management of bone health and to prioritize fragility fracture care and prevention. This paper addresses the challenges in osteoporosis management during the COVID-19 pandemic and provides guidance on osteoporosis management. This position paper is a joint initiative of several health professionals and patients dedicated to osteoporosis.}, }
@article {pmid33780557, year = {2021}, author = {Arenbergerova, M and Lallas, A and Nagore, E and Rudnicka, L and Forsea, AM and Pasek, M and Meier, F and Peris, K and Olah, J and Posch, C}, title = {Position statement of the EADV Melanoma Task Force on recommendations for the management of cutaneous melanoma patients during COVID-19.}, journal = {Journal of the European Academy of Dermatology and Venereology : JEADV}, volume = {35}, number = {7}, pages = {e427-e428}, pmid = {33780557}, issn = {1468-3083}, support = {PROGRES Q28//Charles University, Prague, Czech Republic/ ; }, mesh = {*COVID-19 ; Humans ; *Melanoma/therapy ; SARS-CoV-2 ; *Skin Neoplasms/therapy ; }, }
@article {pmid33752263, year = {2021}, author = {Ring, J and Worm, M and Wollenberg, A and Thyssen, JP and Jakob, T and Klimek, L and Bangert, C and Barbarot, S and Bieber, T and de Bruin-Weller, MS and Chernyshov, PV and Christen-Zaech, S and Cork, M and Darsow, U and Flohr, C and Fölster-Holst, R and Gelmetti, C and Gieler, U and Gutermuth, J and Heratizadeh, A and Hijnen, DJ and von Kobyletzki, LB and Kunz, B and Paul, C and De Raeve, L and Seneschal, J and Simon, D and Spuls, PI and Stalder, JF and Svensson, A and Szalai, Z and Taieb, A and Torrelo, A and Trzeciak, M and Vestergaard, C and Werfel, T and Weidinger, S and Deleuran, M}, title = {Risk of severe allergic reactions to COVID-19 vaccines among patients with allergic skin diseases - practical recommendations. A position statement of ETFAD with external experts.}, journal = {Journal of the European Academy of Dermatology and Venereology : JEADV}, volume = {35}, number = {6}, pages = {e362-e365}, pmid = {33752263}, issn = {1468-3083}, mesh = {*Anaphylaxis ; *COVID-19 ; COVID-19 Vaccines ; *Dermatitis, Atopic/prevention &amp; control ; Humans ; SARS-CoV-2 ; *Vaccines ; }, }
@article {pmid33642133, year = {2021}, author = {Tarazona-Santabalbina, FJ and Cuadra, L and Cancio, JM and Carbonell, FR and Garrote, JMP and Casas-Herrero, &#xc1; and Martínez-Velilla, N and Serra-Rexach, JA and Formiga, F}, title = {VitaminD supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology.}, journal = {Revista espanola de geriatria y gerontologia}, volume = {56}, number = {3}, pages = {177-182}, pmid = {33642133}, issn = {1578-1747}, mesh = {Aged ; COVID-19/complications/immunology/prevention &amp; control/*therapy ; *Cytokine Release Syndrome/prevention &amp; control ; *Dietary Supplements ; *Geriatrics ; Humans ; Receptors, Calcitriol/metabolism ; Societies, Medical ; Spain ; Vitamin D/*administration &amp; dosage/immunology ; Vitamin D Deficiency/complications/*therapy ; Vitamins/*administration &amp; dosage/immunology ; }, abstract = {The coronavirus disease 2019 (COVID-19) produces severe respiratory symptoms such as bilateral pneumonia associated to a high morbidity and mortality, especially in patients of advanced age. Vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and dysregulation of the immune system. Vitamin D in modulates immune function too. Vitamin D receptor (VDR) is expressed by most immune cells, including B and T lymphocytes, monocytes, macrophages, and dendritic cells and the signalling of vitamin D and VDR together has an anti-inflammatory effect. Some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19 because vitamin D plays an important role as a modulator of immunocompetence. Over the last few months, some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm. Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients. Vitamin D should be administered daily until adequate levels are achieved due to vitamin D behaves as a negative acute phase reactant (APR). Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults, authors consider it is necessary to standardize the use in clinical practice. These recommendations advice supplement vitamin D in a protocoled fashion based on expert opinions, level of evidence 5.}, }
@article {pmid33533553, year = {2021}, author = {Beecker, J and Papp, KA and Dutz, J and Vender, RB and Gniadecki, R and Cooper, C and Gisondi, P and Gooderham, M and Hong, CH and Kirchhof, MG and Lynde, CW and Maari, C and Poulin, Y and Puig, L}, title = {Position statement for a pragmatic approach to immunotherapeutics in patients with inflammatory skin diseases during the coronavirus disease 2019 pandemic and beyond.}, journal = {Journal of the European Academy of Dermatology and Venereology : JEADV}, volume = {35}, number = {4}, pages = {797-806}, pmid = {33533553}, issn = {1468-3083}, mesh = {COVID-19/complications/*epidemiology/therapy ; Dermatitis/*therapy ; Humans ; *Immunotherapy ; Practice Patterns, Physicians' ; Risk Assessment ; }, abstract = {Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2, a novel RNA virus that was declared a global pandemic on 11 March 2020. The efficiency of infection with SARS-CoV-2 is reflected by its rapid global spread. The SARS-CoV-2 pandemic has implications for patients with inflammatory skin diseases on systemic immunotherapy who may be at increased risk of infection or more severe infection. This position paper is a focused examination of current evidence considering the mechanisms of action of immunotherapeutic drugs in relation to immune response to SARS-CoV-2. We aim to provide practical guidance for dermatologists managing patients with inflammatory skin conditions on systemic therapies during the current pandemic and beyond. Considering the limited and rapidly evolving evidence, mechanisms of action of therapies, and current knowledge of SARS-CoV-2 infection, we propose that systemic immunotherapy can be continued, with special considerations for at risk patients or those presenting with symptoms.}, }
@article {pmid33518409, year = {2021}, author = {Zimmerman, E and Martins, NN and Verheijen, RHM and Mahmood, T}, title = {EBCOG position statement - Simulation-based training for obstetrics and gynaecology during the COVID-19 pandemic.}, journal = {European journal of obstetrics, gynecology, and reproductive biology}, volume = {258}, number = {}, pages = {457-458}, pmid = {33518409}, issn = {1872-7654}, mesh = {COVID-19/epidemiology ; Curriculum ; Female ; Gynecology/*education ; Humans ; Obstetrics/*education ; Pandemics ; Pregnancy ; SARS-CoV-2 ; Simulation Training/*standards ; }, abstract = {The specialty of Obstetrics and Gynaecology has been on the forefront of introducing simulation in post graduate education for the past two decades. Simulation training is known to enhance psychomotor skills and is considered an important step in the transition from classroom learning to clinical practice. Training on simulators allows trainees to acquire basic skills before getting involved in day to day care in real life situations. Clinical circumstances around the COVID 19 pandemic have highlighted the key importance of simulation training in delivering post graduate curriculum.}, }
@article {pmid33495916, year = {2021}, author = {Torres-Naranjo, F and De la Peña-Rodríguez, P and López-Cervantes, RE and Morales-Torres, J and Morales-Vargas, J and Gutiérrez-Hermosillo, H and Guzmán-Rico, AC and González-Mendoza, RG and Rueda Plata, PN and Flores Castro, M and Celis Gonzalez, C and Espinosa Morales, R and Quintero Hernández, S and López-Taylor, JR}, title = {Joint position statement on management of patient with osteoporosis during COVID-19 contingency from the AMMOM, CONAMEGER, FELAEN, FEMECOG, FEMECOT, and ICAAFYD.}, journal = {Archives of osteoporosis}, volume = {16}, number = {1}, pages = {18}, pmid = {33495916}, issn = {1862-3514}, mesh = {Aged ; *COVID-19 ; Humans ; *Medicine ; *Orthopedics ; *Osteoporosis/epidemiology/therapy ; Pandemics ; SARS-CoV-2 ; *Traumatology ; }, abstract = {UNLABELLED: Infection by SARS-Cov-2 (COVID-19) has affected practically all the world. This joint position statement of Latin American Medical Societies provides an updated guide for the prevention, diagnosis, and treatment of osteoporotic patients in the face of possible clinical scenarios posed by the COVID-19 health crisis.<br><br>BACKGROUND: Infection by SARS-Cov-2 (COVID-19) has affected practically all the world. Characterized by high contagiousness, significative morbidity, and mortality in a segment of those infected, it has overwhelmed health services and forced to redirect resources to the emergency while impacting the attention of acute non-COVID-19 and many chronic conditions.<br><br>OBJECTIVE: The objective of this study is to provide an updated guide for the prevention, diagnosis, and treatment of osteoporotic patients in the face of possible clinical scenarios posed by the COVID-19 health crisis.<br><br>METHODS: A task force, of bone specialists with a wide range of disciplines in the field of osteoporosis and fragility fracture, was convened with the representation of several professional associations, namely, the Mexican Association of Bone and Mineral Metabolism (AMMOM), the National College of Geriatric Medicine (CONAMEGER), the Latin American Federation of Endocrinology (FELAEN), the Mexican Federation of Colleges of Obstetrics and Gynecology (FEMECOG), the Mexican Federation of Colleges of Orthopedics and Traumatology (FEMECOT), and the Institute of Applied Sciences for Physical Activity and Sports of the University of Guadalajara (ICAAFYD). Clinical evidence was collated, and an evidence report was rapidly generated and disseminated. After finding the gaps in the available evidence, a consensus opinion of experts was made. The resulting draft was reviewed and modified accordingly, in 4 rounds, by the participants.<br><br>RESULTS: The task force approved the initial guidance statements, with moderate and high consensus. These were combined, resulting in the final guidance statements on the (1) evaluation of fracture risk; (2) stratification of risk priorities; (3) indications of bone density scans and lab tests; (4) initiation and continuation of pharmacologic therapy; (5) interruptions of therapy; (6) treatment of patients with incident fracture; (7) physical therapy and fall prevention; and (8) nutritional interventions.<br><br>CONCLUSION: These guidance statements are provided to promote optimal care to patients at risk for osteoporosis and fracture, during the current COVID-19 pandemic. However, given the low level of available evidence and the rapidly evolving literature, this guidance is presented as a "living document" and future updates are anticipated.}, }
@article {pmid33419600, year = {2021}, author = {White, SJ and Barello, S and Cao di San Marco, E and Colombo, C and Eeckman, E and Gilligan, C and Graffigna, G and Jirasevijinda, T and Mosconi, P and Mullan, J and Rehman, SU and Rubinelli, S and Vegni, E and Krystallidou, D}, title = {Critical observations on and suggested ways forward for healthcare communication during COVID-19: pEACH position paper.}, journal = {Patient education and counseling}, volume = {104}, number = {2}, pages = {217-222}, pmid = {33419600}, issn = {1873-5134}, mesh = {*COVID-19 ; *Health Communication ; Health Literacy ; Health Personnel/*psychology ; Health Promotion/*methods ; Humans ; Pandemics ; *Public Health Practice ; *SARS-CoV-2 ; *Telemedicine ; Uncertainty ; }, abstract = {OBJECTIVE: Communication in healthcare has influenced and been influenced by the COVID-19 pandemic. In this position paper, we share observations based on the latest available evidence and experiential knowledge that have emerged during the pandemic, with a specific focus on policy and practice.<br><br>METHODS: This is a position paper that presents observations relating to policy and practice in communication in healthcare related to COVID-19.<br><br>RESULTS: Through our critical observations as experts in the field of healthcare communication, we share our stance how healthcare communication has occured during the pandemic and suggest possible ways of improving policy and professional practice. We make recommendations for policy makers, healthcare providers, and communication experts while also highlighting areas that merit further investigation regarding healthcare communication in times of healthcare crises.<br><br>CONCLUSION: We have witnessed an upheaval of healthcare practice and the development of policy on-the-run. To ensure that policy and practice are evidence-based, person-centred, more inclusive and equitable, we advocate for critical reflection on this symbiotic relationship between COVID-19 and the central role of communication in healthcare.<br><br>PRACTICE IMPLICATIONS: This paper provides a summary of the key areas for development in communication in healthcare during COVID-19. It offers recommendations for improvement and a call to review policies and practice to build resilience and inclusive and equitable responsiveness in communication in healthcare.}, }
@article {pmid33416050, year = {2021}, author = {Chieffo, A and Tarantini, G and Naber, CK and Barbato, E and Roffi, M and Stefanini, GG and Buchanan, GL and Buszman, P and Moreno, R and Zawiślak, B and Cayla, G and Danenberg, H and Da Silveira, JAB and Nef, H and James, SK and Mauri Ferre, J and Voskuil, M and Witt, N and Windecker, S and Baumbach, A and Dudek, D}, title = {Performing elective cardiac invasive procedures during the COVID-19 outbreak: a position statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI).}, journal = {EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology}, volume = {16}, number = {14}, pages = {1177-1186}, pmid = {33416050}, issn = {1969-6213}, mesh = {*COVID-19 ; *Cardiovascular Surgical Procedures ; *Elective Surgical Procedures ; Humans ; Masks ; *Pandemics ; Personal Protective Equipment ; SARS-CoV-2 ; }, abstract = {The rearrangement of healthcare services required to face the coronavirus disease 2019 (COVID-19) pandemic led to a drastic reduction in elective cardiac invasive procedures. We are already facing a "second wave" of infections and we might be dealing during the next months with a "third wave" and subsequently new waves. Therefore, during the different waves of the COVID-19 pandemic we have to face the problems of how to perform elective cardiac invasive procedures in non-COVID patients and which patients/procedures should be prioritised. In this context, the interplay between the pandemic stage, the availability of healthcare resources and the priority of specific cardiac disorders is crucial. Clear pathways for "hot" or presumed "hot" patients and "cold" patients are mandatory in each hospital. Depending on the local testing capacity and intensity of transmission in the area, healthcare facilities may test patients for SARS-CoV-2 infection before the interventional procedure, regardless of risk assessment for COVID-19. Pre-hospital testing should always be conducted in the presence of symptoms suggestive of SARS-CoV-2 infection. In cases of confirmed or suspected COVID-19 positive patients, full personal protective equipment using FFP 2/N95 masks, eye protection, gowning and gloves is indicated during cardiac interventions for healthcare workers. When patients have tested negative for COVID-19, medical masks may be sufficient. Indeed, individual patients should themselves wear medical masks during cardiac interventions and outpatient visits.}, }
@article {pmid33378789, year = {2021}, author = {Klimek, L and Jutel, M and Akdis, CA and Bousquet, J and Akdis, M and Torres, MJ and Agache, I and Canonica, GW and Del Giacco, S and O'Mahony, L and Shamji, MH and Schwarze, J and Untersmayr, E and Ring, J and Bedbrook, A and Worm, M and Zuberbier, T and Knol, E and Hoffmann-Sommergruber, K and Chivato, T}, title = {ARIA-EAACI statement on severe allergic reactions to COVID-19 vaccines - An EAACI-ARIA Position Paper.}, journal = {Allergy}, volume = {76}, number = {6}, pages = {1624-1628}, doi = {10.1111/all.14726}, pmid = {33378789}, issn = {1398-9995}, mesh = {BNT162 Vaccine ; *COVID-19 ; COVID-19 Vaccines ; Humans ; SARS-CoV-2 ; *Vaccines/adverse effects ; }, abstract = {Further to the approval of the Coronavirus disease 2019 (COVID-19) vaccine BNT162b2, several severe anaphylaxis cases occured within the first few days of public vaccination. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and there are raising concerns that severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerge. To minimize the risk of severe allergic reactions in vaccinated individuals, it is urgently required to understand the specific nature of the reported severe allergic reactions, including the background medical history of the individuals affected and the mechanisms involved. To achieve this goal, all clinical and laboratory information should be collected and reported. Mild and moderate allergic patients should not be excluded from the vaccine as this could have a significant impact on reaching the goal of population immunity. Healthcare practitioners vaccinating against COVID-19 are required to be sufficiently prepared to recognize and treat anaphylaxis properly with the ability to administer adrenaline. Further to vaccine administration, a mandatory observation period of at least 15 minutes should be followed for all individuals. The current data have not shown any higher risk for patients suffering from allergic rhinitis or asthma, and this message should be clearly stated by physicians to enable our patients to trust the vaccine. More than 30% of the population suffers from allergic diseases and the benefit of the vaccination clearly outweighs the risk of severe COVID-19 development.}, }
@article {pmid33372938, year = {2020}, author = {Corona, T and Castañón-González, JA and Clark-Peralta, P and García-Peña, C and Guevara-Guzmán, R and Domínguez-Cherit, G and Halabe-Cherem, J and López-Cervantes, M and Macias-Hernández, A and Rodríguez-Violante, M and Santillán-Doherty, P and Anda, GV and Guinzberg, AL}, title = {Position paper: Impact on medical and health personnel in the SARS-CoV-2 pandemic.}, journal = {Gaceta medica de Mexico}, volume = {156}, number = {5}, pages = {478-480}, doi = {10.24875/GMM.M20000432}, pmid = {33372938}, issn = {0016-3813}, mesh = {COVID-19/*prevention &amp; control/*transmission ; *Health Personnel ; Humans ; Infectious Disease Transmission, Patient-to-Professional/*prevention &amp; control ; Practice Guidelines as Topic ; }, }
@article {pmid33359375, year = {2021}, author = {Mussini, C and Falcone, M and Nozza, S and Sagnelli, C and Parrella, R and Meschiari, M and Petrosillo, N and Mastroianni, C and Cascio, A and Iaria, C and Galli, M and Chirianni, A and Sagnelli, E and Iacobello, C and Di Perri, G and Mazzotta, F and Carosi, G and Tinelli, M and Grossi, P and Armignacco, O and Portelli, V and Andreoni, M and Tavio, M and , }, title = {Therapeutic strategies for severe COVID-19: a position paper from the Italian Society of Infectious and Tropical Diseases (SIMIT).}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {27}, number = {3}, pages = {389-395}, pmid = {33359375}, issn = {1469-0691}, mesh = {COVID-19/diagnosis/epidemiology/therapy ; Humans ; Italy/epidemiology ; *Practice Guidelines as Topic ; Randomized Controlled Trials as Topic ; SARS-CoV-2/isolation &amp; purification ; Societies, Medical/*standards ; Standard of Care ; *COVID-19 Drug Treatment ; }, abstract = {SCOPE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become pandemic, reaching almost one million death worldwide. At present standard treatment for coronavirus disease 2019 (COVID-19) is not well defined because the evidence, either from randomized or observational studies, with conflicting results, has led to rapid changes in treatment guidelines. Our aim was to narratively summarize the available literature on the management of COVID-19 in order to combine current evidence and interpretation of the data by experts who are treating patients in the frontline setting.<br><br>METHODS: The panel conducted a detailed review of the literature and eventual press releases from randomized clinical trials for each possible available treatment. Inductive PubMed search waws performed for publications relevant to the topic, including all clinical trials conducted. The result was a flowchart with treatment indications for patients with COVID-19.<br><br>IMPLICATIONS: After 6&#xa0;months of a pandemic situation and before a possible second coronavirus wave descends on Europe, it is important to evaluate which drugs proved to be effective while also considering that results from many randomized clinical trials are still awaited. Indeed, among treatments for COVID-19, only glucocorticoids have resulted in an association with a significant decrease in mortality in published randomized controlled trials. New therapeutic strategies are urgently needed.}, }
@article {pmid33313664, year = {2021}, author = {Diller, GP and Gatzoulis, MA and Broberg, CS and Aboulhosn, J and Brida, M and Schwerzmann, M and Chessa, M and Kovacs, AH and Roos-Hesselink, J}, title = {Coronavirus disease 2019 in adults with congenital heart disease: a position paper from the ESC working group of adult congenital heart disease, and the International Society for Adult Congenital Heart Disease.}, journal = {European heart journal}, volume = {42}, number = {19}, pages = {1858-1865}, pmid = {33313664}, issn = {1522-9645}, mesh = {Adult ; *COVID-19 ; *Cardiovascular Diseases ; *Heart Defects, Congenital/complications/epidemiology/therapy ; Humans ; Pandemics ; SARS-CoV-2 ; }, abstract = {We are witnessing an unparalleled pandemic caused by the novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated with coronavirus disease 2019 (COVID-19). Current data show that SARS-CoV-2 results in mild flu-like symptoms in the majority of healthy and young patients affected. Nevertheless, the severity of COVID-19 respiratory syndrome and the risk of adverse or catastrophic outcomes are increased in patients with pre-existing cardiovascular disease. Patients with adult congenital heart disease (ACHD)-by definition-have underlying cardiovascular disease. Many patients with ACHD are also afflicted with residual haemodynamic lesions such as valve dysfunction, diminished ventricular function, arrhythmias or cyanosis, have extracardiac comorbidities, and face additional challenges regarding pregnancy. Currently, there are emerging data of the effect of COVID-19 on ACHD patients, but many aspects, especially risk stratification and treatment considerations, remain unclear. In this article, we aim to discuss the broad impact of COVID-19 on ACHD patients, focusing specifically on pathophysiology, risk stratification for work, self-isolation, hospitalization, impact on pregnancy, psychosocial health, and longer-term implications for the provision of ACHD care.}, }
@article {pmid33295471, year = {2020}, author = {Marques-Santos, C and Avila, WS and Carvalho, RCM and Lucena, AJG and Freire, CMV and Alexandre, ERG and Campanharo, FF and Rivera, MAMR and Costa, MENC and Castro, ML}, title = {Position Statement on COVID-19 and Pregnancy in Women with Heart Disease Department of Women Cardiology of the Brazilian Society of Cardiology - 2020.}, journal = {Arquivos brasileiros de cardiologia}, volume = {115}, number = {5}, pages = {975-986}, pmid = {33295471}, issn = {1678-4170}, mesh = {Brazil ; *COVID-19 ; *Cardiology ; Female ; *Heart Diseases ; Humans ; Pandemics ; Practice Guidelines as Topic ; Pregnancy ; *Pregnancy Complications, Neoplastic ; SARS-CoV-2 ; Societies, Medical ; }, }
@article {pmid33178656, year = {2020}, author = {Bhaskar, S and Bradley, S and Chattu, VK and Adisesh, A and Nurtazina, A and Kyrykbayeva, S and Sakhamuri, S and Yaya, S and Sunil, T and Thomas, P and Mucci, V and Moguilner, S and Israel-Korn, S and Alacapa, J and Mishra, A and Pandya, S and Schroeder, S and Atreja, A and Banach, M and Ray, D}, title = {Telemedicine Across the Globe-Position Paper From the COVID-19 Pandemic Health System Resilience PROGRAM (REPROGRAM) International Consortium (Part 1).}, journal = {Frontiers in public health}, volume = {8}, number = {}, pages = {556720}, pmid = {33178656}, issn = {2296-2565}, mesh = {*COVID-19 ; Humans ; Pandemics/prevention &amp; control ; Public Health ; SARS-CoV-2 ; *Telemedicine ; }, abstract = {Coronavirus disease 2019 (COVID-19) has accelerated the adoption of telemedicine globally. The current consortium critically examines the telemedicine frameworks, identifies gaps in its implementation and investigates the changes in telemedicine framework/s during COVID-19 across the globe. Streamlining of global public health preparedness framework that is interoperable and allow for collaboration and sharing of resources, in which telemedicine is an integral part of the public health response during outbreaks such as COVID-19, should be pursued. With adequate reinforcement, telemedicine has the potential to act as the "safety-net" of our public health response to an outbreak. Our focus on telemedicine must shift to the developing and under-developing nations, which carry a disproportionate burden of vulnerable communities who are at risk due to COVID-19.}, }
@article {pmid33123943, year = {2021}, author = {Defrancesco, M and Bancher, C and Dal-Bianco, P and Hinterhuber, H and Schmidt, R and Struhal, W and Ransmayr, G and Stögmann, E and Marksteiner, J}, title = {[Position paper of the Austrian Alzheimer Association (Österreichische Alzheimer Gesellschaft, ÖAG) : Effects of the COVID-19 pandemic in Austria on people with dementia and their care environment-problem areas, recommendations, and strategies].}, journal = {Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater}, volume = {35}, number = {1}, pages = {35-47}, pmid = {33123943}, issn = {2194-1327}, mesh = {Aged ; Aged, 80 and over ; *Alzheimer Disease/therapy ; Austria ; *COVID-19/epidemiology ; Communicable Disease Control ; *Dementia/therapy ; Humans ; *Pandemics ; Practice Guidelines as Topic ; SARS-CoV-2 ; }, abstract = {Older adults are particularly affected by the current COVID-19 (SARS-CoV-2) pandemic. The risk of dying from COVID-19 increases with age and is often associated with pre-existing health conditions. Globally, more than 50 million-in Austria currently approximately 140,000 people-suffer from dementia. The co-occurrence of dementia as a "pandemic of old age" together with the COVID-19 pandemic has a double impact on persons living with dementia and their caregivers. The COVID-19 pandemic poses major challenges for individuals with dementia and their caregivers: (1) People with dementia have limited access to information on COVID-19, may have difficulties with protective measures such as wearing masks and in remembering safety regulations. (2) People with dementia live alone or with their family, or are institutionalized. To reduce the chance of infection among older people in nursing homes, Austrian local authorities have banned visitors to nursing homes and long-term care facilities and implemented strict social-distancing measures. As a result, older people lost face-to-face contact with their family members, became isolated and social activities stopped. Consequently, anxiety, stress and serious concerns about infections among staff in nursing homes increased and they developed signs of exhaustion and burnout during the full lockdown of the facilities. Thus, due to the emerging COVID-19 crisis, the Austrian Alzheimer Association (Österreichische Alzheimer Gesellschaft, ÖAG) and international societies developed recommendations to support people living with dementia and their caregivers on various issues of physical and mental health.}, }
@article {pmid33075144, year = {2021}, author = {Klimek, L and Jutel, M and Bousquet, J and Agache, I and Akdis, CA and Hox, V and Gevaert, P and Tomazic, PV and Rondon, C and Cingi, C and Toppila-Salmi, S and Karavelia, A and Bozkurt, B and Förster-Ruhrmann, U and Becker, S and Chaker, AM and Wollenberg, B and Mösges, R and Huppertz, T and Hagemann, J and Bachert, C and Fokkens, W}, title = {Management of patients with chronic rhinosinusitis during the COVID-19 pandemic-An EAACI position paper.}, journal = {Allergy}, volume = {76}, number = {3}, pages = {677-688}, doi = {10.1111/all.14629}, pmid = {33075144}, issn = {1398-9995}, mesh = {Adrenal Cortex Hormones/administration &amp; dosage ; Asthma/drug therapy ; Biological Products/therapeutic use ; COVID-19/*epidemiology ; Chronic Disease ; Humans ; Nasal Polyps/drug therapy ; Rhinitis/*drug therapy ; *SARS-CoV-2 ; Sinusitis/*drug therapy ; }, abstract = {BACKGROUND: Chronic rhinosinusitis is regarded as a chronic airway disease. According to WHO recommendations, it may be a risk factor for COVID-19 patients. In most CRSwNP cases, the inflammatory changes affecting the nasal and paranasal mucous membranes are type-2 (T2) inflammation endotypes.<br><br>METHODS: The current knowledge on COVID-19 and on treatment options for CRS was analyzed by a literature search in Medline, Pubmed, international guidelines, the Cochrane Library and the Internet.<br><br>RESULTS: Based on international literature, on current recommendations by WHO and other international organizations as well as on previous experience, a panel of experts from EAACI and ARIA provided recommendations for the treatment of CRS during the COVID-19 pandemic.<br><br>CONCLUSION: Intranasal corticosteroids remain the standard treatment for CRS in patients with SARS-CoV-2 infection. Surgical treatments should be reduced to a minimum and surgery preserved for patients with local complications and for those with no other treatment options. Systemic corticosteroids should be avoided. Treatment with biologics can be continued with careful monitoring in noninfected patients and should be temporarily interrupted during the course of the COVID-19 infection.}, }
@article {pmid33027040, year = {2020}, author = {Bossuyt, X and Damoiseaux, J and Rasmussen, N and van Paassen, P and Hellmich, B and Baslund, B and Blockmans, D and Vermeersch, P and Lopez-Hoyos, M and Vercammen, M and Barret, E and Hammar, F and Leinfelder, U and Mahler, M and Olschowka, N and Roggenbuck, D and Schlumberger, W and Walker, R and Rönnelid, J and Cohen Tervaert, JW and Csernok, E and Fierz, W and , }, title = {Harmonization of antineutrophil cytoplasmic antibodies (ANCA) testing by reporting test result-specific likelihood ratios: position paper.}, journal = {Clinical chemistry and laboratory medicine}, volume = {59}, number = {2}, pages = {e35-e39}, doi = {10.1515/cclm-2020-1178}, pmid = {33027040}, issn = {1437-4331}, mesh = {Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/blood/*diagnosis/immunology ; Antibodies, Antineutrophil Cytoplasmic/*blood ; Calibration ; Data Interpretation, Statistical ; Diagnosis, Differential ; Humans ; Immunoassay/methods/*standards ; Likelihood Functions ; Myeloblastin/immunology ; Peroxidase/immunology ; Reference Standards ; Sensitivity and Specificity ; }, }
@article {pmid33014958, year = {2020}, author = {Bhaskar, S and Bradley, S and Chattu, VK and Adisesh, A and Nurtazina, A and Kyrykbayeva, S and Sakhamuri, S and Moguilner, S and Pandya, S and Schroeder, S and Banach, M and Ray, D}, title = {Telemedicine as the New Outpatient Clinic Gone Digital: Position Paper From the Pandemic Health System REsilience PROGRAM (REPROGRAM) International Consortium (Part 2).}, journal = {Frontiers in public health}, volume = {8}, number = {}, pages = {410}, pmid = {33014958}, issn = {2296-2565}, mesh = {*Ambulatory Care Facilities ; COVID-19/*prevention &amp; control ; Health Personnel ; Humans ; Pandemics ; Physical Distancing ; Telemedicine/*trends ; Videoconferencing ; }, abstract = {Technology has acted as a great enabler of patient continuity through remote consultation, ongoing monitoring, and patient education using telephone and videoconferencing in the coronavirus disease 2019 (COVID-19) era. The devastating impact of COVID-19 is bound to prevail beyond its current reign. The vulnerable sections of our community, including the elderly, those from lower socioeconomic backgrounds, those with multiple comorbidities, and immunocompromised patients, endure a relatively higher burden of a pandemic such as COVID-19. The rapid adoption of different technologies across countries, driven by the need to provide continued medical care in the era of social distancing, has catalyzed the penetration of telemedicine. Limiting the exposure of patients, healthcare workers, and systems is critical in controlling the viral spread. Telemedicine offers an opportunity to improve health systems delivery, access, and efficiency. This article critically examines the current telemedicine landscape and challenges in its adoption, toward remote/tele-delivery of care, across various medical specialties. The current consortium provides a roadmap and/or framework, along with recommendations, for telemedicine uptake and implementation in clinical practice during and beyond COVID-19.}, }
@article {pmid32945570, year = {2020}, author = {Bryant, PA and Rogers, BA and Cowan, R and Bowen, AC and Pollard, J and , }, title = {Planning and clinical role of acute medical home care services for COVID-19: consensus position statement by the Hospital-in-the-Home Society Australasia.}, journal = {Internal medicine journal}, volume = {50}, number = {10}, pages = {1267-1271}, pmid = {32945570}, issn = {1445-5994}, mesh = {Australasia/epidemiology ; Betacoronavirus ; COVID-19 ; Communication ; Coronavirus Infections/*epidemiology/*therapy ; Equipment and Supplies, Hospital/supply &amp; distribution ; Health Workforce/organization &amp; administration ; Home Care Services/*organization &amp; administration ; Humans ; Infection Control/organization &amp; administration ; Occupational Exposure/prevention &amp; control ; Pandemics ; Patient-Centered Care/organization &amp; administration ; Pneumonia, Viral/*epidemiology/*therapy ; SARS-CoV-2 ; Workload ; }, abstract = {During a pandemic when hospitals are stretched and patients need isolation, the role of hospital-in-the-home (HITH) providing acute medical care at home has never been more relevant. We aimed to define and address the challenges to acute home care services posed by the COVID-19 pandemic. Planning for service operation involves staffing, equipment availability and cleaning, upskilling in telehealth and communication. Planning for clinical care involves maximising cohorts of patients without COVID-19 and new clinical pathways for patients with COVID-19. The risk of SARS-CoV-2 transmission, specific COVID-19 clinical pathways and the well-being of patients and staff should be addressed in advance.}, }
@article {pmid32941344, year = {2020}, author = {Oliva, A and Caputo, M and Grassi, S and Vetrugno, G and Marazza, M and Ponzanelli, G and Cauda, R and Scambia, G and Forti, G and Bellantone, R and Pascali, VL}, title = {Liability of Health Care Professionals and Institutions During COVID-19 Pandemic in Italy: Symposium Proceedings and Position Statement.}, journal = {Journal of patient safety}, volume = {16}, number = {4}, pages = {e299-e302}, pmid = {32941344}, issn = {1549-8425}, mesh = {Betacoronavirus/isolation &amp; purification ; COVID-19 ; Coronavirus Infections/epidemiology ; Health Personnel/*legislation &amp; jurisprudence ; Humans ; Italy/epidemiology ; *Legislation, Hospital ; *Liability, Legal ; Pandemics/*legislation &amp; jurisprudence ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; }, abstract = {BACKGROUND: On May 12, 2020, a symposium titled "Liability of healthcare professionals and institutions during COVID-19 pandemic" was held in Italy with the participation of national experts in malpractice law, hospital management, legal medicine, and clinical risk management. The symposium's rationale was the highly likely inflation of criminal and civil proceedings concerning alleged errors committed by health care professionals and decision makers during the COVID-19 pandemic. Its aim was to identify and discuss the main issues of legal and medicolegal interest and thus to find solid solutions in the spirit of preparedness planning.<br><br>METHODS: There were 5 main points of discussion: (A) how to judge errors committed during the pandemic because of the application of protocols and therapies based on no or weak evidence of efficacy, (B) whether hospital managers can be considered liable for infected health care professionals who were not given adequate personal protective equipment, (C) whether health care professionals and institutions can be considered liable for cases of infected inpatients who claim that the infection was transmitted in a hospital setting, (D) whether health care institutions and hospital managers can be considered liable for the hotspots in long-term care facilities/care homes, and (E) whether health care institutions and hospital managers can be considered liable for the worsening of chronic diseases.<br><br>RESULTS AND CONCLUSION: Limitation of the liability to the cases of gross negligence (with an explicit definition of this term), a no-fault system with statal indemnities for infected cases, and a rigorous methodology for the expert witnesses were proposed as key interventions for successfully facing future proceedings.}, }
@article {pmid32933562, year = {2020}, author = {Villani, A and Bozzola, E and Staiano, A and Agostiniani, R and Del Vecchio, A and Zamperini, N and Marino, F and Vecchio, D and Corsello, G}, title = {Facial masks in children: the position statement of the Italian pediatric society.}, journal = {Italian journal of pediatrics}, volume = {46}, number = {1}, pages = {132}, pmid = {32933562}, issn = {1824-7288}, mesh = {*Betacoronavirus ; COVID-19 ; Child ; *Consensus ; Coronavirus Infections/epidemiology/*transmission ; Disease Transmission, Infectious/*prevention &amp; control ; Equipment Design ; Humans ; Infection Control/*organization &amp; administration ; Masks/standards/*supply &amp; distribution ; Pandemics ; Pneumonia, Viral/epidemiology/*transmission ; SARS-CoV-2 ; }, abstract = {Facial masks may be one of the most cost-effective strategies to prevent the diffusion of COVID 19 infection. Nevertheless, fake news are spreading, alerting parents on dangerous side effects in children, such as hypercapnia, hypoxia, gut dysbiosis and immune system weakness. Aim of the Italian Pediatric Society statement is to face misconception towards the use of face masks and to spread scientific trustable information.}, }
@article {pmid32890777, year = {2020}, author = {Greenspan, H and San José Estépar, R and Niessen, WJ and Siegel, E and Nielsen, M}, title = {Position paper on COVID-19 imaging and AI: From the clinical needs and technological challenges to initial AI solutions at the lab and national level towards a new era for AI in healthcare.}, journal = {Medical image analysis}, volume = {66}, number = {}, pages = {101800}, pmid = {32890777}, issn = {1361-8423}, support = {R01 HL149877/HL/NHLBI NIH HHS/United States ; R21 HL140422/HL/NHLBI NIH HHS/United States ; }, mesh = {Algorithms ; Artificial Intelligence/*trends ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/*diagnostic imaging ; Diagnostic Imaging/*methods ; Humans ; Pandemics ; Pneumonia, Viral/*diagnostic imaging ; SARS-CoV-2 ; }, abstract = {In this position paper, we provide a collection of views on the role of AI in the COVID-19 pandemic, from clinical requirements to the design of AI-based systems, to the translation of the developed tools to the clinic. We highlight key factors in designing system solutions - per specific task; as well as design issues in managing the disease at the national level. We focus on three specific use-cases for which AI systems can be built: early disease detection, management in a hospital setting, and building patient-specific predictive models that require the combination of imaging with additional clinical data. Infrastructure considerations and population modeling in two European countries will be described. This pandemic has made the practical and scientific challenges of making AI solutions very explicit. A discussion concludes this paper, with a list of challenges facing the community in the AI road ahead.}, }
@article {pmid32882035, year = {2020}, author = {Rutkowski, JL and Camm, DP and El Chaar, E}, title = {AAID White Paper: Management of the Dental Implant Patient During the COVID-19 Pandemic and Beyond.}, journal = {The Journal of oral implantology}, volume = {46}, number = {5}, pages = {454-466}, doi = {10.1563/aaid-joi-D-20-00316}, pmid = {32882035}, issn = {0160-6972}, mesh = {*Betacoronavirus ; *COVID-19 ; *Dental Implants ; Humans ; Pandemics ; United States ; }, abstract = {The scientific community's understanding of how the SARS-CoV-2 virus is transmitted and how to best mitigate its spread is improving daily. To help protect patients from acquiring COVID-19 from a dental office nosocomial infection, many state or local governments have classified dental treatments as "nonessential" and have paused routine dental care. Dentists have been instructed to perform only procedures designated as emergencies. Unfortunately, there is not a good understanding of what a dental emergency is among governmental leaders. What a government agency may perceive as an elective procedure may be seen as "essential" by the dental clinician responsible for maintaining the oral health of the patient. Each dental specialty understands the effects delayed care has on a patient's oral and systemic health. Dentistry has made extensive progress in improving oral health through prevention of the dental emergency. The dental profession must work together to prevent the reversal of the progress dentistry and patients have made. This American Academy of Implant Dentistry (AAID) White Paper discusses what COVID-19 is and how it impacts dental treatments, presents guidelines for dentistry in general and for dental implant related treatments, specifically. Recommendations for implant dentistry include the following: (1) what constitutes a dental implant related emergency, (2) how patients should be screened and triaged, (3) what personal protective equipment is necessary, (4) how operatories should be equipped, (5) what equipment should be used, and (6) what, when, and how procedures can be performed. This paper is intended to provide guidance for the dental implant practice so patients and dental health care providers can be safe, and offices can remain open and viable during the pandemic.}, }
@article {pmid32876200, year = {2020}, author = {Soeiro, AM and Leal, TCAT and Pereira, MP and Lima, EG and Figueiredo, ACBDS and Petriz, JLF and Precoma, DB and Serrano, CV}, title = {Position Statement on the Use of Antiplatelet Agents and Anticoagulants in Patients Infected with the New Coronavirus (COVID-19) - 2020.}, journal = {Arquivos brasileiros de cardiologia}, volume = {115}, number = {2}, pages = {292-301}, pmid = {32876200}, issn = {1678-4170}, mesh = {Anticoagulants/*therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/*drug therapy ; Humans ; Pandemics ; Platelet Aggregation Inhibitors/*therapeutic use ; Pneumonia, Viral/*drug therapy ; SARS-CoV-2 ; }, }
@article {pmid32871013, year = {2020}, author = {Noel, JM and Jackson, CW}, title = {ASHP Therapeutic Position Statement on the Use of Antipsychotic Medications in the Treatment of Adults with Schizophrenia and Schizoaffective Disorder.}, journal = {American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists}, volume = {77}, number = {24}, pages = {2114-2132}, doi = {10.1093/ajhp/zxaa303}, pmid = {32871013}, issn = {1535-2900}, mesh = {Adult ; Antipsychotic Agents/*administration &amp; dosage/adverse effects ; Humans ; Psychotic Disorders/*drug therapy ; Schizophrenia/*drug therapy ; Societies, Pharmaceutical ; United States ; }, abstract = {In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.}, }
@article {pmid32825892, year = {2020}, author = {Vora, A and Arora, VK and Behera, D and Tripathy, SK}, title = {White paper on Ivermectin as a potential therapy for COVID-19.}, journal = {The Indian journal of tuberculosis}, volume = {67}, number = {3}, pages = {448-451}, pmid = {32825892}, issn = {0019-5707}, mesh = {Antiparasitic Agents/therapeutic use ; *Betacoronavirus ; COVID-19 ; Coronavirus Infections/*drug therapy ; Humans ; Ivermectin/*therapeutic use ; Pandemics ; Pneumonia, Viral/*drug therapy ; Risk Factors ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {A group of senior doctors with vast clinical experience met on 19th July'20 under the aegis of Academy of Advanced Medical Education. The panel looked at Ivermectin, one of the old molecule and evaluated it's use in COVID 19 (Novel Coronavirus Disease 2019) management. After critical panel discussion, all the attending doctors came to a conclusion that Ivermectin can be a potential molecule for prophylaxis and treatment of people infected with Coronavirus, owing to its anti-viral properties coupled with effective cost, availability and good tolerability and safety.}, }
@article {pmid32823368, year = {2020}, author = {Pfaar, O and Klimek, L and Worm, M and Bergmann, KC and Bieber, T and Buhl, R and Buters, J and Darsow, U and Keil, T and Kleine-Tebbe, J and Lau, S and Maurer, M and Merk, H and Mösges, R and Saloga, J and Staubach, P and Stute, P and Rabe, K and Rabe, U and Vogelmeier, C and Biedermann, T and Jung, K and Schlenter, W and Ring, J and Chaker, A and Wehrmann, W and Becker, S and Mülleneisen, N and Nemat, K and Czech, W and Wrede, H and Brehler, R and Fuchs, T and Tomazic, PV and Aberer, W and Fink-Wagner, A and Horak, F and Wöhrl, S and Niederberger-Leppin, V and Pali-Schöll, I and Pohl, W and Roller-Wirnsberger, R and Spranger, O and Valenta, R and Akdis, M and Akdis, C and Hoffmann-Sommergruber, K and Jutel, M and Matricardi, P and Spertini, F and Khaltaev, N and Michel, JP and Nicod, L and Schmid-Grendelmeier, P and Hamelmann, E and Jakob, T and Werfel, T and Wagenmann, M and Taube, C and Gerstlauer, M and Vogelberg, C and Bousquet, J and Zuberbier, T}, title = {[Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI-AeDA-GPA-DGAKI Position Paper (Pocket-Guide)].}, journal = {Laryngo- rhino- otologie}, volume = {99}, number = {10}, pages = {676-679}, doi = {10.1055/a-1170-8426}, pmid = {32823368}, issn = {1438-8685}, mesh = {*Betacoronavirus ; COVID-19 ; *Coronavirus Infections ; Desensitization, Immunologic ; Humans ; *Pandemics ; *Pneumonia, Viral ; SARS-CoV-2 ; }, }
@article {pmid32754159, year = {2020}, author = {Bhaskar, S and Sinha, A and Banach, M and Mittoo, S and Weissert, R and Kass, JS and Rajagopal, S and Pai, AR and Kutty, S}, title = {Cytokine Storm in COVID-19-Immunopathological Mechanisms, Clinical Considerations, and Therapeutic Approaches: The REPROGRAM Consortium Position Paper.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {1648}, pmid = {32754159}, issn = {1664-3224}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Adrenal Cortex Hormones/therapeutic use ; Angiotensin-Converting Enzyme 2 ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Betacoronavirus/*immunology ; CD4-CD8 Ratio ; CD4-Positive T-Lymphocytes/immunology ; CD8-Positive T-Lymphocytes/immunology ; COVID-19 ; Clinical Decision-Making/methods ; Coronavirus Infections/blood/*drug therapy/*immunology/mortality ; Critical Care/*methods ; Critical Illness ; Cytokines/*blood ; Endothelial Cells/metabolism ; Female ; Humans ; Immunocompromised Host ; Interleukin-6/antagonists &amp; inhibitors ; Janus Kinase Inhibitors/therapeutic use ; Male ; Pandemics ; Peptidyl-Dipeptidase A/metabolism ; Pneumonia, Viral/blood/*drug therapy/*immunology/mortality ; SARS-CoV-2 ; Sex Factors ; Thrombosis ; }, abstract = {Cytokine storm is an acute hyperinflammatory response that may be responsible for critical illness in many conditions including viral infections, cancer, sepsis, and multi-organ failure. The phenomenon has been implicated in critically ill patients infected with SARS-CoV-2, the novel coronavirus implicated in COVID-19. Critically ill COVID-19 patients experiencing cytokine storm are believed to have a worse prognosis and increased fatality rate. In SARS-CoV-2 infected patients, cytokine storm appears important to the pathogenesis of several severe manifestations of COVID-19: acute respiratory distress syndrome, thromboembolic diseases such as acute ischemic strokes caused by large vessel occlusion and myocardial infarction, encephalitis, acute kidney injury, and vasculitis (Kawasaki-like syndrome in children and renal vasculitis in adult). Understanding the pathogenesis of cytokine storm will help unravel not only risk factors for the condition but also therapeutic strategies to modulate the immune response and deliver improved outcomes in COVID-19 patients at high risk for severe disease. In this article, we present an overview of the cytokine storm and its implications in COVID-19 settings and identify potential pathways or biomarkers that could be targeted for therapy. Leveraging expert opinion, emerging evidence, and a case-based approach, this position paper provides critical insights on cytokine storm from both a prognostic and therapeutic standpoint.}, }
@article {pmid32748068, year = {2020}, author = {Stolbach, A and Mazer-Amirshahi, M and Schwarz, ES and Juurlink, D and Wiegand, TJ and Nelson, LS}, title = {ACMT Position Statement: Caring for Patients with Opioid Use Disorder during Coronavirus Disease Pandemic.}, journal = {Journal of medical toxicology : official journal of the American College of Medical Toxicology}, volume = {16}, number = {4}, pages = {484-486}, pmid = {32748068}, issn = {1937-6995}, mesh = {*Betacoronavirus ; COVID-19 ; Coronavirus Infections/*epidemiology ; Health Services Accessibility ; Humans ; Opioid-Related Disorders/*therapy ; Pandemics ; Pneumonia, Viral/*epidemiology ; SARS-CoV-2 ; Toxicology ; }, }
@article {pmid32740024, year = {2020}, author = {Maculotti, D and Spena, PR and Villa, G}, title = {POSITION STATEMENT ON CARE OF OSTOMY PATIENTS DURING COVID-19 PANDEMIC.}, journal = {Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates}, volume = {43}, number = {4}, pages = {324-326}, doi = {10.1097/SGA.0000000000000539}, pmid = {32740024}, issn = {1538-9766}, mesh = {Ambulatory Care ; *Betacoronavirus ; COVID-19 ; Coronavirus Infections/*epidemiology/prevention &amp; control/transmission ; Hospitalization ; Humans ; Infection Control/*organization &amp; administration ; *Ostomy ; Pandemics/prevention &amp; control ; Patient Selection ; Pneumonia, Viral/*epidemiology/prevention &amp; control/transmission ; SARS-CoV-2 ; }, }
@article {pmid32732509, year = {2020}, author = {Moore, TA}, title = {Overview of the Care of Mothers and Newborns With COVID-19; Joint Position Statement.}, journal = {Advances in neonatal care : official journal of the National Association of Neonatal Nurses}, volume = {20}, number = {4}, pages = {268}, pmid = {32732509}, issn = {1536-0911}, mesh = {American Nurses' Association ; Betacoronavirus ; COVID-19 ; *Coronavirus Infections/epidemiology/prevention &amp; control ; *Evidence-Based Nursing/methods/trends ; Female ; Humans ; Infant, Newborn ; Infection Control/organization &amp; administration ; *Neonatal Nursing/organization &amp; administration/standards ; Organizational Innovation ; *Pandemics/prevention &amp; control ; *Pneumonia, Viral/epidemiology/prevention &amp; control ; *Postnatal Care/methods/organization &amp; administration/trends ; SARS-CoV-2 ; United States ; }, }
@article {pmid32719884, year = {2020}, author = {Gutenbrunner, C and Stokes, EK and Dreinhöfer, K and Monsbakken, J and Clarke, S and Côté, P and Urseau, I and Constantine, D and Tardif, C and Balakrishna, V and Nugraha, B}, title = {Why Rehabilitation must have priority during and after the COVID-19-pandemic: A position statement of the Global Rehabilitation Alliance.}, journal = {Journal of rehabilitation medicine}, volume = {52}, number = {7}, pages = {jrm00081}, doi = {10.2340/16501977-2713}, pmid = {32719884}, issn = {1651-2081}, mesh = {*Betacoronavirus ; COVID-19 ; Coronavirus Infections/prevention &amp; control/*rehabilitation ; Global Health ; Health Services Accessibility/standards ; Humans ; Infection Control/standards ; Pandemics/prevention &amp; control ; Pneumonia, Viral/prevention &amp; control/*rehabilitation ; SARS-CoV-2 ; }, abstract = {COVID-19 has become a pandemic with strong influence on health systems. In many cases it leads to a disruption of rehabilitation service provision. On the other hand, rehabilitation must be an integral part of COVID-19 management. Rehabilitation for COVID-19 should start from acute and early post-acute care and needs to be continued in the post-acute and long-term rehabilitation phase. Of course, it should follow specific safety protocol. Additionally, rehabilitation must be kept available for all other people who are in need. From the perspective of health system, the Global Rehabilitation Alliance urges decision makers to ensure that rehabilitation services will be available for all patients with COVID-19 in the acute, post-acute and long-term phase. Additionally, it must be ensured that all other persons with rehabilitation need have access to rehabilitation services. Rehabilitation services must be equipped with personal protection equipment and follow strict hygiene measures. In particular, rehabilitation must be accessible for vulnerable populations. For that reason, rehabilitation must be kept a health priority during the COVID-19 pandemic and given adequate financial resources. Last but not least, scientific studies should be performed to clarify the impact of the pandemic on rehabilitation services as well as on the needs for rehabilitation of COVID-19 patients.}, }
@article {pmid32694078, year = {2020}, author = {Vivas, D and Roldán, V and Esteve-Pastor, MA and Roldán, I and Tello-Montoliu, A and Ruiz-Nodar, JM and Cosín-Sales, J and Gámez, JM and Consuegra, L and Ferreiro, JL and Marín, F and , }, title = {Recommendations on antithrombotic treatment during the COVID-19 pandemic. Position statement of the Working Group on Cardiovascular Thrombosis of the Spanish Society of Cardiology.}, journal = {Revista espanola de cardiologia (English ed.)}, volume = {73}, number = {9}, pages = {749-757}, pmid = {32694078}, issn = {1885-5857}, mesh = {*Betacoronavirus ; COVID-19 ; Cardiology ; Coronavirus Infections/*drug therapy ; Fibrinolytic Agents/*therapeutic use ; Humans ; Pandemics ; Patient Selection ; Pneumonia, Viral/*drug therapy ; SARS-CoV-2 ; Societies, Medical ; Spain ; COVID-19 Drug Treatment ; }, abstract = {The new coronavirus SARS-CoV-2, which gives rise to the highly contagious COVID-19 disease, has caused a pandemic that is overwhelming health care systems worldwide. Affected patients have been reported to have a heightened inflammatory state that increases their thrombotic risk. However, there is very scarce information on the management of thrombotic risk, coagulation disorders, and anticoagulant therapy. In addition, the situation has also greatly influenced usual care in patients not infected with COVID-19. This article by the Working Group on Cardiovascular Thrombosis of the Spanish Society of Cardiology aims to summarize the available information and to provide a practical approach to the management of antithrombotic therapy.}, }
@article {pmid32675009, year = {2020}, author = {Torlone, E and Festa, C and Formoso, G and Scavini, M and Sculli, MA and Succurro, E and Sciacca, L and Di Bartolo, P and Purrello, F and Lapolla, A}, title = {Italian recommendations for the diagnosis of gestational diabetes during COVID-19 pandemic: Position statement of the Italian Association of Clinical Diabetologists (AMD) and the Italian Diabetes Society (SID), diabetes, and pregnancy study group.}, journal = {Nutrition, metabolism, and cardiovascular diseases : NMCD}, volume = {30}, number = {9}, pages = {1418-1422}, pmid = {32675009}, issn = {1590-3729}, mesh = {*Betacoronavirus ; Blood Glucose/analysis ; COVID-19 ; Coronavirus Infections/*epidemiology ; Diabetes, Gestational/*diagnosis ; Female ; Glucose Tolerance Test ; Humans ; Italy ; Pandemics ; Pneumonia, Viral/*epidemiology ; Pregnancy ; SARS-CoV-2 ; }, abstract = {AIM: In response to the COVID-19 pandemic, there is a need for substantial changes in the procedures for accessing healthcare services. Even in the current pandemic, we should not reduce our attention towards the diagnosis and treatment of GDM. The purpose of this document is to provide a temporary guide for GDM screening, replacing the current guidelines when it is not possible to implement standard GDM screening because of an unfavorable risk/benefit ratio for pregnant women or when usual laboratory facilities are not available.<br><br>DATA SYNTHESIS: At the first visit during pregnancy, we must exclude the presence of "Overt diabetes" in all women. The criteria for the diagnosis of overt diabetes are either fasting plasma glucose &#x2265;126&#xa0;mg/dL, or random plasma glucose &#x2265;200&#xa0;mg/dL, or glycated hemoglobin &#x2265;6.5%. When the screening procedure (OGTT) cannot be safely performed, the diagnosis of GDM is acceptable if fasting plasma glucose is&#xa0;&#x2265;&#xa0;92&#xa0;mg/dL.&#xa0;In order to consider the impaired fasting glucose as an acceptable surrogate for the diagnosis of GDM, the fasting glucose measurement should be performed within the recommended time windows for the risk level (high or medium risk).<br><br>CONCLUSIONS: The changes to the screening procedure for GDM reported below are specifically produced in response to the health emergency of the COVID-19 pandemic. Therefore, these recommended changes should cease to be in effect and should be replaced by current national guidelines when the healthcare authorities declare the end of this emergency.}, }
@article {pmid32674177, year = {2020}, author = {Kolditz, M and Dellweg, D and Geerdes-Fenge, H and Lepper, PM and Schaberg, T and Ewig, S and Pfeifer, M and Bauer, T}, title = {[Treatment with Dexamethasone in Patients with COVID-19 - A Position Paper of the German Respiratory Society (DGP)].}, journal = {Pneumologie (Stuttgart, Germany)}, volume = {74}, number = {8}, pages = {493-495}, pmid = {32674177}, issn = {1438-8790}, mesh = {Anti-Inflammatory Agents/*therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus/*isolation &amp; purification ; Coronavirus Infections/diagnosis/*drug therapy ; Dexamethasone/*therapeutic use ; Germany ; Humans ; *Pandemics ; Pneumonia, Viral/diagnosis/*drug therapy ; *Practice Guidelines as Topic ; SARS-CoV-2 ; Societies, Medical ; Treatment Outcome ; COVID-19 Drug Treatment ; }, }
@article {pmid32643767, year = {2020}, author = {Gralnek, IM and Hassan, C and Beilenhoff, U and Antonelli, G and Ebigbo, A and Pellisé, M and Arvanitakis, M and Bhandari, P and Bisschops, R and Van Hooft, JE and Kaminski, MF and Triantafyllou, K and Webster, G and Voiosu, AM and Pohl, H and Dunkley, I and Fehrke, B and Gazic, M and Gjergek, T and Maasen, S and Waagenes, W and de Pater, M and Ponchon, T and Siersema, PD and Messmann, H and Dinis-Ribeiro, M}, title = {ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: An update on guidance during the post-lockdown phase and selected results from a membership survey.}, journal = {Endoscopy}, volume = {52}, number = {10}, pages = {891-898}, pmid = {32643767}, issn = {1438-8812}, mesh = {Humans ; Betacoronavirus ; *Coronavirus Infections ; COVID-19 ; *Endoscopy, Gastrointestinal ; *Pandemics ; *Pneumonia, Viral ; SARS-CoV-2 ; Surveys and Questionnaires ; }, }
@article {pmid32638902, year = {2020}, author = {Guimarães, HP and Timerman, S and Rodrigues, RDR and Corrêa, TD and Schubert, DUC and Freitas, AP and Rea Neto, &#xc1; and Polastri, TF and Vane, MF and Couto, TB and Brandão, ACA and Giannetti, NS and Timerman, T and Hajjar, LA and Bacal, F and Lopes, MACQ}, title = {Position Statement: Cardiopulmonary Resuscitation of Patients with Confirmed or Suspected COVID-19 - 2020.}, journal = {Arquivos brasileiros de cardiologia}, volume = {114}, number = {6}, pages = {1078-1087}, pmid = {32638902}, issn = {1678-4170}, mesh = {Advisory Committees ; Betacoronavirus ; Brazil/epidemiology ; COVID-19 ; Cardiopulmonary Resuscitation/methods/*standards ; *Coronavirus ; Coronavirus Infections/diagnosis/epidemiology/*therapy ; Humans ; *Pandemics ; Pneumonia, Viral/diagnosis/epidemiology/*therapy ; *Practice Guidelines as Topic ; SARS-CoV-2 ; Societies, Medical ; United States ; }, abstract = {Care for patients with cardiac arrest in the context of the coronavirus disease 2019 (COVID-19) pandemic has several unique aspects that warrant particular attention. This joint position statement by the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Society of Cardiology (SBC), Brazilian Association of Intensive Care Medicine (AMIB), and Brazilian Society of Anesthesiology (SBA), all official societies representing the corresponding medical specialties affiliated with the Brazilian Medical Association (AMB), provides recommendations to guide health care workers in the current context of limited robust evidence, aiming to maximize the protection of staff and patients alike. It is essential that full aerosol precautions, which include wearing appropriate personal protective equipment, be followed during resuscitation. It is also imperative that potential causes of cardiac arrest of particular interest in this patient population, especially hypoxia, cardiac arrhythmias associated with QT prolongation, and myocarditis, be considered and addressed. An advanced invasive airway device should be placed early. Use of HEPA filters at the bag-valve interface is mandatory. Management of cardiac arrest occurring during mechanical ventilation or during prone positioning demands particular ventilator settings and rescuer positioning for chest compressions which deviate from standard cardiopulmonary resuscitation techniques. Apart from these logistical issues, care should otherwise follow national and international protocols and guidelines, namely the 2015 International Liaison Committee on Resuscitation (ILCOR) and 2019 American Heart Association (AHA) guidelines and the 2019 Update to the Brazilian Society of Cardiology Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Guideline.}, }
@article {pmid32623686, year = {2020}, author = {Stier, C and Lopez-Nava, G and Neto, MG and Thompson, CC and Campos, J and Khoursheed, M and Lakdawala, M and Ramos, A and Abu Dayyeh, BK}, title = {IFSO Endoscopy Committee Position Statement on the Practice of Bariatric Endoscopy During the COVID-19 Pandemic.}, journal = {Obesity surgery}, volume = {30}, number = {11}, pages = {4179-4186}, pmid = {32623686}, issn = {1708-0428}, mesh = {*Bariatrics ; *Betacoronavirus ; COVID-19 ; Coronavirus Infections/epidemiology/*prevention &amp; control/transmission ; *Endoscopy ; Humans ; Infection Control/*organization &amp; administration ; Obesity, Morbid/*surgery ; Pandemics/*prevention &amp; control ; Patient Selection ; Pneumonia, Viral/epidemiology/*prevention &amp; control/transmission ; Practice Guidelines as Topic ; SARS-CoV-2 ; }, abstract = {COVID-19 (Coronavirus disease 2019) caused by SARS-CoV-2 has become a global pandemic. Obesity is a risk factor for severe disease, and the practice of endoscopy poses special challenges and risks of SARS-CoV-2 transmission to patients and providers given the evolving role of the gastrointestinal tract in viral transmission and aerosol generation during endoscopic procedures. It is therefore necessary to distinguish between urgent interventions that cannot be postponed despite the risks during the pandemic and, in contrast, purely elective interventions that could be deferred in order to minimize transmission risks during a time of infection surge and limited access. Semi-urgent bariatric procedures have an intermediate position. Since the chronological course of the pandemic is still unpredictable, these interventions were defined according to whether or not they should be performed within a nominal 8-week period. In this position statement, the IFSO Endoscopy Committee offers guidance on navigating bariatric endoscopic procedures in patients with obesity during the COVID-19 pandemic, in the hope of mitigating the risk of SARS-CoV-2 transmission to vulnerable patients and healthcare workers. These recommendations may evolve as the pandemic progresses.}, }
@article {pmid32620315, year = {2020}, author = {Miranda-Zazueta, G and González-Regueiro, JA and García-Juárez, I and Moctezuma-Velázquez, C and López-Díaz, FJ and Pérez-González, B and Uscanga-Domínguez, LF and Peláez-Luna, M}, title = {Pharmacologic management of patients with hepatic and pancreatic diseases that involve immunosuppressive therapies. Position statement within the framework of the SARS-CoV-2 (COVID-19) pandemic.}, journal = {Revista de gastroenterologia de Mexico (English)}, volume = {85}, number = {3}, pages = {312-320}, pmid = {32620315}, issn = {2255-534X}, mesh = {COVID-19 ; Coronavirus Infections/*complications ; Humans ; Immunosuppressive Agents/*adverse effects/*therapeutic use ; Liver Diseases/complications/*drug therapy ; Liver Transplantation ; Pancreas Transplantation ; Pancreatic Diseases/complications/*drug therapy ; *Pandemics ; Pneumonia, Viral/*complications ; }, abstract = {The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) virus. COVID-19 affected more than 6million persons worldwide in fewer than 4 months, after the report of the first cases in China in December 2019. The relation of the disease caused by SARS-Cov-2 to immunosuppressive treatment used in different gastrointestinal disorders is uncertain, resulting in debate with regard to suspending immunosuppressive therapy to improve infection outcome. Said suspension implies the inherent risk for graft rejection or autoimmune disease exacerbation that can potentially worsen the course of the infection. Based on the presently available evidence, a treatment stance has been established for patients with gastrointestinal diseases that require immunosuppressive therapy.}, }
@article {pmid32617893, year = {2020}, author = {Farmer, BM and Cole, JB and Olives, TD and Farrell, NM and Rao, R and Nelson, LS and Mazer-Amirshahi, M and Stolbach, AI}, title = {ACMT Position Statement: Medication Administration and Safety During the Response to COVID-19 Pandemic.}, journal = {Journal of medical toxicology : official journal of the American College of Medical Toxicology}, volume = {16}, number = {4}, pages = {481-483}, pmid = {32617893}, issn = {1937-6995}, mesh = {*Betacoronavirus ; COVID-19 ; Coronavirus Infections/drug therapy/*epidemiology/prevention &amp; control ; Health Personnel/education ; Humans ; Pandemics/prevention &amp; control ; Personal Protective Equipment ; Pneumonia, Viral/drug therapy/*epidemiology/prevention &amp; control ; SARS-CoV-2 ; Toxicology ; }, }
@article {pmid32613918, year = {2020}, author = {Geneid, A and Nawka, T and Schindler, A and Oguz, H and Chrobok, V and Calcinoni, O and Am Zehnhoff-Dinnesen, A and Neumann, K and Farahat, M and Abou-Elsaad, T and Moerman, M and Chavez, E and Fishman, J and Yazaki, R and Arnold, B and Frajkova, Z and Graf, S and Pflug, C and Drsata, J and Desuter, G and Samuelsson, C and Tedla, M and Costello, D and Sjögren, E and Hess, M and Kinnari, T and Rubin, J}, title = {Union of the European Phoniatricians' position statement on the exit strategy of phoniatric and laryngological services: staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020).}, journal = {The Journal of laryngology and otology}, volume = {134}, number = {8}, pages = {661-664}, pmid = {32613918}, issn = {1748-5460}, mesh = {Audiology/*methods/standards ; Betacoronavirus/*isolation &amp; purification ; COVID-19 ; Child ; Child, Preschool ; Coronavirus Infections/epidemiology/*prevention &amp; control/virology ; Deglutition Disorders/diagnosis/surgery/virology ; Europe/epidemiology ; Humans ; Mandatory Testing/standards ; Otolaryngology/*methods/standards ; Pandemics/*prevention &amp; control ; Pediatrics/standards ; Personal Protective Equipment/standards/supply &amp; distribution ; Pneumonia, Viral/epidemiology/*prevention &amp; control/virology ; Practice Guidelines as Topic ; SARS-CoV-2 ; Societies, Medical/organization &amp; administration ; Voice Disorders/diagnosis/surgery/virology ; }, abstract = {BACKGROUND: The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services.<br><br>OBJECTIVES: This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures.<br><br>CONCLUSION: As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.}, }
@article {pmid32601022, year = {2020}, author = {Parsonage, WA and Cullen, L and Brieger, D and Hillis, GS and Nasis, A and Dwyer, N and Wahi, S and Lo, S and Than, M and Kerr, A and Devlin, G and Chew, DK}, title = {CSANZ Position Statement on the Evaluation of Patients Presenting With Suspected Acute Coronary Syndromes During the COVID-19 Pandemic.}, journal = {Heart, lung &amp; circulation}, volume = {29}, number = {7}, pages = {e105-e110}, pmid = {32601022}, issn = {1444-2892}, mesh = {*Acute Coronary Syndrome/diagnosis/epidemiology/therapy ; Australia/epidemiology ; Betacoronavirus ; COVID-19 ; *Cardiology/methods/organization &amp; administration/trends ; *Communicable Disease Control/methods/organization &amp; administration ; Consensus ; *Coronavirus Infections/epidemiology/prevention &amp; control ; Humans ; Infection Control/*organization &amp; administration ; New Zealand/epidemiology ; *Pandemics/prevention &amp; control ; Patient Care Management/*methods ; *Pneumonia, Viral/epidemiology/prevention &amp; control ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {A pandemic of Coronavirus-19 disease was declared by the World Health Organization on March 11, 2020. The pandemic is expected to place unprecedented demand on health service delivery. This position statement has been developed by the Cardiac Society of Australia and New Zealand to assist clinicians to continue to deliver rapid and safe evaluation of patients presenting with suspected acute cardiac syndrome at this time. The position statement complements, and should be read in conjunction with, the National Heart Foundation of Australia &amp; Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Management of Acute Coronary Syndromes 2016: Section 2 'Assessment of Possible Cardiac Chest Pain'.}, }
@article {pmid32574446, year = {2020}, author = {}, title = {UHMS Position Statement: Hyperbaric Oxygen (HBO2) for COVID-19 Patients.}, journal = {Undersea &amp; hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc}, volume = {47}, number = {2}, pages = {297-298}, pmid = {32574446}, issn = {1066-2936}, mesh = {*Betacoronavirus ; COVID-19 ; Clinical Trials as Topic ; Coronavirus Infections/complications/*therapy ; Humans ; *Hyperbaric Oxygenation/adverse effects/methods ; Hypoxia/etiology/therapy ; Pandemics ; Pneumonia/etiology/therapy ; Pneumonia, Viral/complications/*therapy ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {There have been numerous recent inquiries regarding use of hyperbaric oxygen (HBO2) for patients with COVID-19. Questions have been raised pertinent to two possible mechanisms for HBO2 in this clinical context. The UHMS Hyperbaric Oxygen Therapy Committee, UHMS Executive Committee, with collaborative input from multiple senior UHMS members and researchers have drafted this position statement.}, }
@article {pmid32548994, year = {2020}, author = {Mureddu, GF and Ambrosetti, M and Venturini, E and La Rovere, MT and Mazza, A and Pedretti, R and Sarullo, F and Fattirolli, F and Faggiano, P and Giallauria, F and Vigorito, C and Angelino, E and Brazzo, S and Ruzzolini, M}, title = {Cardiac rehabilitation activities during the COVID-19 pandemic in Italy. Position Paper of the AICPR (Italian Association of Clinical Cardiology, Prevention and Rehabilitation).}, journal = {Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace}, volume = {90}, number = {2}, pages = {}, doi = {10.4081/monaldi.2020.1439}, pmid = {32548994}, issn = {2532-5264}, mesh = {Acute Coronary Syndrome/rehabilitation ; COVID-19 ; Cardiac Rehabilitation/psychology/*standards ; Cardiotonic Agents/adverse effects/therapeutic use ; Coronavirus Infections/*epidemiology ; Exercise ; Female ; Heart Failure/rehabilitation ; Humans ; Italy/epidemiology ; Male ; Nutrition Therapy ; Pandemics ; Pneumonia, Viral/*epidemiology ; Thromboembolism/rehabilitation ; }, abstract = {The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units. The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.}, }
@article {pmid32541561, year = {2020}, author = {Zidan, A and Alabbad, S and Ali, T and Nizami, I and Haberal, M and Tokat, Y and Kamel, R and Said, H and Abdelaal, A and Elsharkawy, M and El Fouly, A and Sayed, H and Al-Mousawi, M and AlGhonaim, M and Broering, D}, title = {Position Statement of Transplant Activity in the Middle East in Era of COVID-19 Pandemic.}, journal = {Transplantation}, volume = {104}, number = {11}, pages = {2205-2207}, pmid = {32541561}, issn = {1534-6080}, mesh = {Betacoronavirus ; COVID-19 ; Coronavirus Infections/*epidemiology ; Delivery of Health Care/*standards ; Humans ; Middle East ; Organ Transplantation/statistics &amp; numerical data/*trends ; Pandemics ; Pneumonia, Viral/*epidemiology ; SARS-CoV-2 ; }, }
@article {pmid32537929, year = {2020}, author = {Hamad, N and Gottlieb, D and Ritchie, D and Kennedy, G and Watson, AM and Greenwood, M and Doocey, R and Perera, T and Spencer, A and Wong, E and O'Brien, T and Shaw, P and Conyers, R and Cole, T and Milliken, S and Bardy, P and Larsen, S and Lai, H and Butler, A and Fraser, C and Bajel, A and Butler, J and Kerridge, I and Purtill, D}, title = {Bone Marrow Transplant Society of Australia and New Zealand COVID-19 consensus position statement.}, journal = {Internal medicine journal}, volume = {50}, number = {6}, pages = {774-775}, doi = {10.1111/imj.14867}, pmid = {32537929}, issn = {1445-5994}, mesh = {Australia ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/*methods/statistics &amp; numerical data ; Comorbidity ; *Consensus ; Coronavirus Infections/*diagnosis/physiopathology/therapy/virology ; Cryopreservation ; Hematopoietic Stem Cell Transplantation/*methods ; Humans ; Leukemia/physiopathology/*therapy ; New Zealand ; Pandemics ; Pneumonia, Viral/*diagnosis/physiopathology/therapy/virology ; Practice Guidelines as Topic ; Triage ; }, }
@article {pmid32531110, year = {2021}, author = {Pfaar, O and Klimek, L and Jutel, M and Akdis, CA and Bousquet, J and Breiteneder, H and Chinthrajah, S and Diamant, Z and Eiwegger, T and Fokkens, WJ and Fritsch, HW and Nadeau, KC and O'Hehir, RE and O'Mahony, L and Rief, W and Sampath, V and Schedlowski, M and Torres, MJ and Traidl-Hoffmann, C and Wang, Y and Zhang, L and Bonini, M and Brehler, R and Brough, HA and Chivato, T and Del Giacco, SR and Dramburg, S and Gawlik, R and Gelincik, A and Hoffmann-Sommergruber, K and Hox, V and Knol, EF and Lauerma, A and Matricardi, PM and Mortz, CG and Ollert, M and Palomares, O and Riggioni, C and Schwarze, J and Skypala, I and Untersmayr, E and Walusiak-Skorupa, J and Ansotegui, IJ and Bachert, C and Bedbrook, A and Bosnic-Anticevich, S and Brussino, L and Canonica, GW and Cardona, V and Carreiro-Martins, P and Cruz, AA and Czarlewski, W and Fonseca, JA and Gotua, M and Haahtela, T and Ivancevich, JC and Kuna, P and Kvedariene, V and Larenas-Linnemann, DE and Abdul Latiff, AH and Mäkelä, M and Morais-Almeida, M and Mullol, J and Naclerio, R and Ohta, K and Okamoto, Y and Onorato, GL and Papadopoulos, NG and Patella, V and Regateiro, FS and Samoliński, B and Suppli Ulrik, C and Toppila-Salmi, S and Valiulis, A and Ventura, MT and Yorgancioglu, A and Zuberbier, T and Agache, I}, title = {COVID-19 pandemic: Practical considerations on the organization of an allergy clinic-An EAACI/ARIA Position Paper.}, journal = {Allergy}, volume = {76}, number = {3}, pages = {648-676}, pmid = {32531110}, issn = {1398-9995}, mesh = {Allergists ; COVID-19/*epidemiology/prevention &amp; control ; Health Personnel ; Humans ; Hypersensitivity/diagnosis/*therapy ; Information Technology ; Patient Care Team ; *SARS-CoV-2 ; Triage ; }, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic infectious disease transmitted by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). Allergists and other healthcare providers (HCPs) in the field of allergies and associated airway diseases are on the front line, taking care of patients potentially infected with SARS-CoV-2. Hence, strategies and practices to minimize risks of infection for both HCPs and treated patients have to be developed and followed by allergy clinics.<br><br>METHOD: The scientific information on COVID-19 was analysed by a literature search in MEDLINE, PubMed, the National and International Guidelines from the European Academy of Allergy and Clinical Immunology (EAACI), the Cochrane Library, and the internet.<br><br>RESULTS: Based on the diagnostic and treatment standards developed by EAACI, on international information regarding COVID-19, on guidelines of the World Health Organization (WHO) and other international organizations, and on previous experience, a panel of experts including clinicians, psychologists, IT experts, and basic scientists along with EAACI and the "Allergic Rhinitis and its Impact on Asthma (ARIA)" initiative have developed recommendations for the optimal management of allergy clinics during the current COVID-19 pandemic. These recommendations are grouped into nine sections on different relevant aspects for the care of patients with allergies.<br><br>CONCLUSIONS: This international Position Paper provides recommendations on operational plans and procedures to maintain high standards in the daily clinical care of allergic patients while ensuring the necessary safety measures in the current COVID-19 pandemic.}, }
@article {pmid32513287, year = {2020}, author = {Campanile, FC and Podda, M and Arezzo, A and Botteri, E and Sartori, A and Guerrieri, M and Cassinotti, E and Muttillo, I and Pisano, M and Brachet Contul, R and D'Ambrosio, G and Cuccurullo, D and Bergamini, C and Allaix, ME and Caracino, V and Petz, WL and Milone, M and Silecchia, G and Anania, G and Agrusa, A and Di Saverio, S and Casarano, S and Cicala, C and Narilli, P and Federici, S and Carlini, M and Paganini, A and Bianchi, PP and Salaj, A and Mazzari, A and Meniconi, RL and Puzziello, A and Terrosu, G and De Simone, B and Coccolini, F and Catena, F and Agresta, F}, title = {Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement.}, journal = {World journal of emergency surgery : WJES}, volume = {15}, number = {1}, pages = {38}, pmid = {32513287}, issn = {1749-7922}, mesh = {Betacoronavirus ; COVID-19 ; Cholecystectomy/methods/*standards ; Cholecystitis, Acute/*surgery/virology ; Coronavirus Infections/*complications/virology ; Humans ; Infection Control/*standards ; Pandemics ; Pneumonia, Viral/*complications/virology ; *Practice Guidelines as Topic ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {Following the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level.We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have.}, }
@article {pmid32501145, year = {2020}, author = {Linnemann, B and Bauersachs, R and Grebe, M and Klamroth, R and Müller, O and Schellong, S and Lichtenberg, M}, title = {Venous thromboembolism in patients with COVID-19 (SARS-CoV-2 infection) - a position paper of the German Society of Angiology (DGA).}, journal = {VASA. Zeitschrift fur Gefasskrankheiten}, volume = {49}, number = {4}, pages = {259-263}, doi = {10.1024/0301-1526/a000885}, pmid = {32501145}, issn = {0301-1526}, mesh = {Anticoagulants/*administration &amp; dosage ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/*complications ; Humans ; Pandemics ; Pneumonia, Viral/*complications ; SARS-CoV-2 ; *Venous Thromboembolism ; }, abstract = {As observed in other infections with a systemic inflammatory response, severe COVID-19 is associated with hypercoagulability and a prothrombotic state. Currently, there is growing evidence that pulmonary embolism and thrombosis contribute to adverse outcomes and increased mortality in critically ill patients with COVID-19. The optimal thromboprophylactic regimen for patients with COVID-19 is not known. Whereas pharmacologic thromboprophylaxis is generally recommended for all hospitalized COVID-19 patients, adequate dosing of anticoagulants remains a controversial issue. Therefore, we summarize current evidence from the available literature and, on behalf of the German Society of Angiology (DGA), we aim to provide advice to establish an improved and more uniform strategy for thromboprophylaxis in patients with COVID-19.}, }
@article {pmid32500283, year = {2020}, author = {Stolbach, AI and Mazer-Amirshahi, M and Marino, R and Nelson, LS and Sugarman, J}, title = {ACMT Position Statement: Off-Label Prescribing during COVID-19 Pandemic.}, journal = {Journal of medical toxicology : official journal of the American College of Medical Toxicology}, volume = {16}, number = {3}, pages = {342-345}, pmid = {32500283}, issn = {1937-6995}, mesh = {Betacoronavirus/drug effects ; COVID-19 ; Coronavirus Infections/*drug therapy ; Emergency Medical Services/*standards ; Humans ; Off-Label Use/*standards/*statistics &amp; numerical data ; Pandemics ; Pneumonia, Viral/*drug therapy ; *Practice Guidelines as Topic ; SARS-CoV-2 ; United States ; United States Food and Drug Administration ; }, }
@article {pmid32489251, year = {2020}, author = {Ahmed, S and Barbera, L and Bartlett, SJ and Bebb, DG and Brundage, M and Bryan, S and Cheung, WY and Coburn, N and Crump, T and Cuthbertson, L and Howell, D and Klassen, AF and Leduc, S and Li, M and Mayo, NE and McKinnon, G and Olson, R and Pink, J and Robinson, JW and Santana, MJ and Sawatzky, R and Moxam, RS and Sinclair, S and Servidio-Italiano, F and Temple, W}, title = {A catalyst for transforming health systems and person-centred care: Canadian national position statement on patient-reported outcomes.}, journal = {Current oncology (Toronto, Ont.)}, volume = {27}, number = {2}, pages = {90-99}, pmid = {32489251}, issn = {1718-7729}, mesh = {Canada ; Delivery of Health Care/methods/standards/*statistics &amp; numerical data ; Humans ; Medical Oncology/methods/standards/*statistics &amp; numerical data ; Neoplasms/diagnosis/*therapy ; *Patient Reported Outcome Measures ; Patient-Centered Care/methods/standards/*statistics &amp; numerical data ; Quality of Life ; }, abstract = {BACKGROUND: Patient-reported outcomes (pros) are essential to capture the patient's perspective and to influence care. Although pros and pro measures are known to have many important benefits, they are not consistently being used and there is there no Canadian pros oversight. The Position Statement presented here is the first step toward supporting the implementation of pros in the Canadian health care setting.<br><br>METHODS: The Canadian pros National Steering Committee drafted position statements, which were submitted for stakeholder feedback before, during, and after the first National Canadian Patient Reported Outcomes (canpros) scientific conference, 14-15 November 2019 in Calgary, Alberta. In addition to the stakeholder feedback cycle, a patient advocate group submitted a section to capture the patient voice.<br><br>RESULTS: The canpros Position Statement is an outcome of the 2019 canpros scientific conference, with an oncology focus. The Position Statement is categorized into 6 sections covering 4 theme areas: Patient and Families, Health Policy, Clinical Implementation, and Research. The patient voice perfectly mirrors the recommendations that the experts reached by consensus and provides an overriding impetus for the use of pros in health care.<br><br>CONCLUSIONS: Although our vision of pros transforming the health care system to be more patient-centred is still aspirational, the Position Statement presented here takes a first step toward providing recommendations in key areas to align Canadian efforts. The Position Statement is directed toward a health policy audience; future iterations will target other audiences, including researchers, clinicians, and patients. Our intent is that future versions will broaden the focus to include chronic diseases beyond cancer.}, }
@article {pmid32487434, year = {2020}, author = {Lal, S and Van Gossum, A and Joly, F and Bozzetti, F and Cuerda, C and Lamprecht, G and Mundi, MS and Staun, M and Szczepanek, K and Wanten, G and Wheatley, C and Pironi, L and , }, title = {Considerations for the management of home parenteral nutrition during the SARS-CoV-2 pandemic: A position paper from the Home Artificial Nutrition and Chronic Intestinal Failure Special Interest Group of ESPEN.}, journal = {Clinical nutrition (Edinburgh, Scotland)}, volume = {39}, number = {7}, pages = {1988-1991}, pmid = {32487434}, issn = {1532-1983}, mesh = {Betacoronavirus ; COVID-19 ; Chronic Disease ; *Coronavirus Infections/complications/therapy ; Hospitalization ; Humans ; *Intestinal Diseases/complications/therapy ; *Pandemics ; *Parenteral Nutrition, Home ; *Pneumonia, Viral/complications/therapy ; Practice Guidelines as Topic ; SARS-CoV-2 ; }, abstract = {The management of patients with chronic intestinal failure requiring home parenteral nutrition has been and will continue to be impaired during the SARS-CoV-2 pandemic. Multidisciplinary intestinal failure teams may have to adapt their clinical approaches to home care, outpatient care as well as hospital admission and discharge in order to keep this vulnerable group of patients as safe and well as possible during the unprecedented challenges that countries are facing during the pandemic. Equally, it is important that expert advice from intestinal failure teams is available when home parenteral nutrition (HPN)-dependent patients require admission with SARS-CoV-2 infection. The Home Artificial Nutrition &amp; Chronic Intestinal Failure Special Interest Group of the European Society for Clinical Nutrition and Metabolism (ESPEN) has developed a position paper to outline areas for intestinal failure teams to consider when managing patients with chronic intestinal failure during the SARS-CoV-2 pandemic.}, }
@article {pmid32473781, year = {2020}, author = {Nicholls, SJ and Nelson, M and Astley, C and Briffa, T and Brown, A and Clark, R and Colquhoun, D and Gallagher, R and Hare, DL and Inglis, S and Jelinek, M and O'Neil, A and Tirimacco, R and Vale, M and Redfern, J}, title = {Optimising Secondary Prevention and Cardiac Rehabilitation for Atherosclerotic Cardiovascular Disease During the COVID-19 Pandemic: A Position Statement From the Cardiac Society of Australia and New Zealand (CSANZ).}, journal = {Heart, lung &amp; circulation}, volume = {29}, number = {7}, pages = {e99-e104}, pmid = {32473781}, issn = {1444-2892}, mesh = {Australia/epidemiology ; Betacoronavirus ; COVID-19 ; *Cardiac Rehabilitation/methods/trends ; *Cardiology/methods/organization &amp; administration/trends ; *Cardiovascular Diseases/complications/epidemiology/prevention &amp; control ; Consensus ; *Coronavirus Infections/epidemiology/prevention &amp; control ; Delivery of Health Care/organization &amp; administration ; Humans ; Infection Control/*organization &amp; administration ; New Zealand/epidemiology ; *Pandemics/prevention &amp; control ; *Pneumonia, Viral/epidemiology/prevention &amp; control ; SARS-CoV-2 ; *Secondary Prevention/methods/organization &amp; administration ; Societies, Medical ; }, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has introduced a major disruption to the delivery of routine health care across the world. This provides challenges for the use of secondary prevention measures in patients with established atherosclerotic cardiovascular disease (CVD). The aim of this Position Statement is to review the implications for effective delivery of secondary prevention strategies during the COVID-19 pandemic.<br><br>CHALLENGES: The COVID-19 pandemic has introduced limitations for many patients to access standard health services such as visits to health care professionals, medications, imaging and blood tests as well as attendance at cardiac rehabilitation. In addition, the pandemic is having an impact on lifestyle habits and mental health. Taken together, this has the potential to adversely impact the ability of practitioners and patients to adhere to treatment guidelines for the prevention of recurrent cardiovascular events.<br><br>RECOMMENDATIONS: Every effort should be made to deliver safe, ongoing access to health care professionals and the use of evidenced based therapies in individuals with CVD. An increase in use of a range of electronic health platforms has the potential to transform secondary prevention. Integrating research programs that evaluate the utility of these approaches may provide important insights into how to develop more optimal approaches to secondary prevention beyond the pandemic.}, }
@article {pmid32467031, year = {2020}, author = {Wahi, S and Thomas, L and Stanton, T and Taylor, A and Mahadevan, D and Evans, G and Playford, D and To, A and Davis, M and Anderson, B and Buckley, B}, title = {CSANZ Imaging Council Position Statement on Echocardiography Services During the COVID-19 Pandemic.}, journal = {Heart, lung &amp; circulation}, volume = {29}, number = {6}, pages = {e78-e83}, pmid = {32467031}, issn = {1444-2892}, mesh = {Australia/epidemiology ; *Betacoronavirus ; COVID-19 ; Cardiology ; *Coronavirus Infections/diagnostic imaging/epidemiology ; Delivery of Health Care/*standards ; Echocardiography/*standards ; Humans ; New Zealand/epidemiology ; *Pandemics ; *Pneumonia, Viral/diagnostic imaging/epidemiology ; Positron-Emission Tomography/*standards ; Risk Assessment ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {This Cardiac Society of Australia and New Zealand (CSANZ) Imaging Council Position Statement aims to guide local, regional and national clinical practice, and facilitate resource and echocardiographic service planning appropriately during the current COVID-19 global pandemic. General considerations include workforce arrangements and contingency plans, patient risk assessment for COVID-19 and level of care (personal protective equipment) for staff. Both outpatient and inpatient settings are addressed, including specific considerations in the in-patient setting including scanning protocols, screening modalities and indications for echocardiograms in the context of COVID-19 infection.}, }
@article {pmid32451232, year = {2020}, author = {Kumar, S and Haqqani, H and Wynn, G and Pathak, RK and Lipton, J and Mahajan, R and Sanders, P and Healey, S and Wilsmore, B and Mariani, JA and Thomas, SP and Weerasooriya, R and McGavigan, A and Gould, PA and Weatherley, P and Saad, N and Cowan, M and Turnbull, S and Trivic, I and Wong, M and Tonchev, I and Morton, JB and Skinner, JR and Pflaumer, A and McGuire, M and Kistler, P and Kalman, JM and , }, title = {Position Statement on the Management of Cardiac Electrophysiology and Cardiac Implantable Electronic Devices in Australia During the COVID-19 Pandemic: A Living Document.}, journal = {Heart, lung &amp; circulation}, volume = {29}, number = {6}, pages = {e57-e68}, pmid = {32451232}, issn = {1444-2892}, mesh = {Australia/epidemiology ; *Betacoronavirus ; COVID-19 ; *Coronavirus Infections/epidemiology/physiopathology/therapy ; *Defibrillators, Implantable ; *Electrophysiologic Techniques, Cardiac ; Humans ; *Pandemics ; *Pneumonia, Viral/epidemiology/physiopathology/therapy ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic poses a significant stress on health resources in Australia. The Heart Rhythm Council of the Cardiac Society of Australia and New Zealand aims to provide a framework for efficient resource utilisation balanced with competing risks when appropriately treating patients with cardiac arrhythmias. This document provides practical recommendations for the electrophysiology (EP) and cardiac implantable electronic devices (CIED) services in Australia. The document will be updated regularly as new evidence and knowledge is gained with time.}, }
@article {pmid32425181, year = {2020}, author = {Bonalumi, G and Di Mauro, M and Garatti, A and Barili, F and Parolari, A and Gerosa, G}, title = {[COVID-19 outbreak and Cardiac Surgery: position paper from the COVID-SICCH Task Force of the Italian Society for Cardiac Surgery].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {21}, number = {6}, pages = {396-400}, doi = {10.1714/3359.33320}, pmid = {32425181}, issn = {1972-6481}, mesh = {COVID-19 ; Cardiovascular Surgical Procedures/methods/*standards ; Coronavirus Infections/*complications ; Humans ; Italy ; Pandemics ; Pneumonia, Viral/*complications ; *Practice Guidelines as Topic ; Risk Assessment ; Societies, Medical ; }, }
@article {pmid32418875, year = {2020}, author = {Lal, S and Hayward, CS and De Pasquale, C and Kaye, D and Javorsky, G and Bergin, P and Atherton, JJ and Ilton, MK and Weintraub, RG and Nair, P and Rudas, M and Dembo, L and Doughty, RN and Kumarasinghe, G and Juergens, C and Bannon, PG and Bart, NK and Chow, CK and Lattimore, JD and Kritharides, L and Totaro, R and Macdonald, PS}, title = {COVID-19 and Acute Heart Failure: Screening the Critically Ill - A Position Statement of the Cardiac Society of Australia and New Zealand (CSANZ).}, journal = {Heart, lung &amp; circulation}, volume = {29}, number = {7}, pages = {e94-e98}, pmid = {32418875}, issn = {1444-2892}, mesh = {Australia/epidemiology ; Betacoronavirus ; COVID-19 ; *Cardiology/methods/organization &amp; administration/trends ; Consensus ; *Coronavirus Infections/epidemiology/prevention &amp; control ; Critical Illness/therapy ; *Heart Failure/diagnosis/etiology/therapy ; Humans ; *Infection Control/methods/organization &amp; administration ; *Myocarditis/complications/virology ; New Zealand/epidemiology ; *Pandemics/prevention &amp; control ; Patient Care Management/*methods ; *Pneumonia, Viral/epidemiology/prevention &amp; control ; Risk Adjustment/methods ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {Up to one-third of COVID-19 patients admitted to intensive care develop an acute cardiomyopathy, which may represent myocarditis or stress cardiomyopathy. Further, while mortality in older patients with COVID-19 appears related to multi-organ failure complicating acute respiratory distress syndrome (ARDS), the cause of death in younger patients may be related to acute heart failure. Cardiac involvement needs to be considered early on in critically ill COVID-19 patients, and even after the acute respiratory phase is passing. This Statement presents a screening algorithm to better identify COVID-19 patients at risk for severe heart failure and circulatory collapse, while balancing the need to protect health care workers and preserve personal protective equipment (PPE). The significance of serum troponin levels and the role of telemetry and targeted transthoracic echocardiography (TTE) in patient investigation and management are addressed, as are fundamental considerations in the management of acute heart failure in COVID-19 patients.}, }
@article {pmid32418120, year = {2020}, author = {Mazer-Amirshahi, M and Fox, ER and Farmer, BM and Stolbach, AI}, title = {ACMT Position Statement: Medication Shortages During Coronavirus Disease Pandemic.}, journal = {Journal of medical toxicology : official journal of the American College of Medical Toxicology}, volume = {16}, number = {3}, pages = {346-348}, pmid = {32418120}, issn = {1937-6995}, mesh = {Antiviral Agents/*supply &amp; distribution/*therapeutic use ; Betacoronavirus/drug effects ; COVID-19 ; Coronavirus Infections/*drug therapy ; Humans ; Medication Systems, Hospital/*standards/*statistics &amp; numerical data ; Pandemics ; Pneumonia, Viral/*drug therapy ; *Practice Guidelines as Topic ; SARS-CoV-2 ; }, }
@article {pmid32414880, year = {2020}, author = {Rubin, MA and Bonnie, RJ and Epstein, L and Hemphill, C and Kirschen, M and Lewis, A and Suarez, JI and , }, title = {AAN position statement: The COVID-19 pandemic and the ethical duties of the neurologist.}, journal = {Neurology}, volume = {95}, number = {4}, pages = {167-172}, doi = {10.1212/WNL.0000000000009744}, pmid = {32414880}, issn = {1526-632X}, mesh = {COVID-19 ; Coronavirus Infections/complications/*therapy ; Health Resources ; Humans ; Nervous System Diseases/complications ; Neurologists/*ethics ; Neurology/education/*ethics ; Pandemics/*ethics ; Pneumonia, Viral/complications/*therapy ; Referral and Consultation ; Societies, Medical ; Telemedicine ; }, abstract = {Patients, clinicians, and hospitals have undergone monumental changes during the coronavirus disease 2019 (COVID-19) pandemic. This crisis has forced us to consider the obligations that we neurologists have to our individual patients as well as the greater community. By returning to our fundamental understanding of these duties, we can ensure that we are providing the most ethically appropriate contingency and crisis care possible. We recommend specific adaptations to both the inpatient and outpatient settings, as well as changes to medical and trainee education. Furthermore, we explore the daunting but potentially necessary implementation of scare resource allocation protocols. As the pandemic evolves, we will need to adapt continuously to these rapidly changing circumstances and consider both national and regional standards and variation.}, }
@article {pmid32404302, year = {2020}, author = {Chieffo, A and Stefanini, GG and Price, S and Barbato, E and Tarantini, G and Karam, N and Moreno, R and Buchanan, GL and Gilard, M and Halvorsen, S and Huber, K and James, S and Neumann, FJ and Möllmann, H and Roffi, M and Tavazzi, G and Ferré, JM and Windecker, S and Dudek, D and Baumbach, A}, title = {EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes during the COVID-19 pandemic.}, journal = {EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology}, volume = {16}, number = {3}, pages = {233-246}, doi = {10.4244/EIJY20M05_01}, pmid = {32404302}, issn = {1969-6213}, mesh = {Acute Coronary Syndrome/*therapy ; Algorithms ; Betacoronavirus ; COVID-19 ; Cardiology/*standards ; *Coronavirus Infections ; Europe ; Humans ; *Pandemics ; *Pneumonia, Viral ; SARS-CoV-2 ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to healthcare worldwide. The infection can be life threatening and require intensive care treatment. The transmission of the disease poses a risk to both patients and healthcare workers. The number of patients requiring hospital admission and intensive care may overwhelm health systems and negatively affect standard care for patients presenting with conditions needing emergency interventions. This position statements aims to assist cardiologists in the invasive management of acute coronary syndrome (ACS) patients in the context of the COVID-19 pandemic. To that end, we assembled a panel of interventional cardiologists and acute cardiac care specialists appointed by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the Acute Cardiovascular Care Association (ACVC) and included the experience from the first and worst affected areas in Europe. Modified diagnostic and treatment algorithms are proposed to adapt evidence-based protocols for this unprecedented challenge. Various clinical scenarios, as well as management algorithms for patients with a diagnosed or suspected COVID-19 infection, presenting with ST- and non-ST-segment elevation ACS are described. In addition, we address the need for re-organization of ACS networks, with redistribution of hub and spoke hospitals, as well as for in-hospital reorganization of emergency rooms and cardiac units, with examples coming from multiple European countries. Furthermore, we provide a guidance to reorganization of catheterization laboratories and, importantly, measures for protection of healthcare providers involved with invasive procedures.}, }
@article {pmid32381517, year = {2020}, author = {Klein, JD and Koletzko, B and El-Shabrawi, MH and Hadjipanayis, A and Thacker, N and Bhutta, Z}, title = {Promoting and supporting children's health and healthcare during COVID-19 - International Paediatric Association Position Statement.}, journal = {Archives of disease in childhood}, volume = {105}, number = {7}, pages = {620-624}, doi = {10.1136/archdischild-2020-319370}, pmid = {32381517}, issn = {1468-2044}, mesh = {Adolescent ; Betacoronavirus/*pathogenicity ; COVID-19 ; Child ; *Child Health ; Child, Preschool ; Consensus ; Coronavirus Infections/*prevention &amp; control ; Health Promotion/*organization &amp; administration ; Humans ; Infant ; Infant, Newborn ; Pandemics/*prevention &amp; control ; *Pediatrics ; Pneumonia, Viral/*prevention &amp; control ; Practice Guidelines as Topic ; *Public Health ; SARS-CoV-2 ; World Health Organization ; }, }
@article {pmid32374440, year = {2020}, author = {Farrell, TW and Ferrante, LE and Brown, T and Francis, L and Widera, E and Rhodes, R and Rosen, T and Hwang, U and Witt, LJ and Thothala, N and Liu, SW and Vitale, CA and Braun, UK and Stephens, C and Saliba, D}, title = {AGS Position Statement: Resource Allocation Strategies and Age-Related Considerations in the COVID-19 Era and Beyond.}, journal = {Journal of the American Geriatrics Society}, volume = {68}, number = {6}, pages = {1136-1142}, pmid = {32374440}, issn = {1532-5415}, support = {K76 AG054862/AG/NIA NIH HHS/United States ; K76 AG054866/AG/NIA NIH HHS/United States ; K76 AG057023/AG/NIA NIH HHS/United States ; UL1 TR001863/TR/NCATS NIH HHS/United States ; }, mesh = {Aged ; Aged, 80 and over ; *Betacoronavirus ; COVID-19 ; *Coronavirus Infections ; Female ; Geriatrics/*standards ; Health Care Rationing/*standards ; *Health Planning Guidelines ; Humans ; Male ; *Pandemics ; *Pneumonia, Viral ; SARS-CoV-2 ; United States/epidemiology ; }, abstract = {Coronavirus disease 2019 (COVID-19) continues to impact older adults disproportionately, from severe illness and hospitalization to increased mortality risk. Concurrently, concerns about potential shortages of healthcare professionals and health supplies to address these needs have focused attention on how resources are ultimately allocated and used. Some strategies misguidedly use age as an arbitrary criterion, inappropriately disfavoring older adults. This statement represents the official policy position of the American Geriatrics Society (AGS). It is intended to inform stakeholders including hospitals, health systems, and policymakers about ethical considerations to consider when developing strategies for allocating scarce resources during an emergency involving older adults. Members of the AGS Ethics Committee collaborated with interprofessional experts in ethics, law, nursing, and medicine (including geriatrics, palliative care, emergency medicine, and pulmonology/critical care) to conduct a structured literature review and examine relevant reports. The resulting recommendations defend a particular view of distributive justice that maximizes relevant clinical factors and deemphasizes or eliminates factors placing arbitrary, disproportionate weight on advanced age. The AGS positions include (1) avoiding age per se as a means for excluding anyone from care; (2) assessing comorbidities and considering the disparate impact of social determinants of health; (3) encouraging decision makers to focus primarily on potential short-term (not long-term) outcomes; (4) avoiding ancillary criteria such as "life-years saved" and "long-term predicted life expectancy" that might disadvantage older people; (5) forming and staffing triage committees tasked with allocating scarce resources; (6) developing institutional resource allocation strategies that are transparent and applied uniformly; and (7) facilitating appropriate advance care planning. The statement includes recommendations that should be immediately implemented to address resource allocation strategies during COVID-19, aligning with AGS positions. The statement also includes recommendations for post-pandemic review. Such review would support revised strategies to ensure that governments and institutions have equitable emergency resource allocation strategies, avoid future discriminatory language and practice, and have appropriate guidance to develop national frameworks for emergent resource allocation decisions. J Am Geriatr Soc 68:1136-1142, 2020.}, }
@article {pmid32371055, year = {2020}, author = {Lavinsky, J and Kosugi, EM and Baptistella, E and Roithmann, R and Dolci, E and Ribeiro, TK and Rossini, B and Romano, FR and Maunsell, RCK and Mitre, EI and Imamura, R and Hachiya, A and Chone, CT and Watanabe, LMN and Fornazieri, MA and Lessa, MM and Sant'Anna, GD}, title = {An update on COVID-19 for the otorhinolaryngologist - a Brazilian Association of Otolaryngology and Cervicofacial Surgery (ABORL-CCF) Position Statement.}, journal = {Brazilian journal of otorhinolaryngology}, volume = {86}, number = {3}, pages = {273-280}, pmid = {32371055}, issn = {1808-8686}, mesh = {*Betacoronavirus ; COVID-19 ; Coronavirus Infections/*prevention &amp; control ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention &amp; control ; Otolaryngology/*standards ; Pandemics/*prevention &amp; control ; Personal Protective Equipment/*standards ; Pneumonia, Viral/*prevention &amp; control ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {INTRODUCTION: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients.<br><br>METHODS: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19.<br><br>RESULTS: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period.<br><br>CONCLUSIONS: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.}, }
@article {pmid32323287, year = {2020}, author = {Pfeifer, M and Ewig, S and Voshaar, T and Randerath, W and Bauer, T and Geiseler, J and Dellweg, D and Westhoff, M and Windisch, W and Schönhofer, B and Kluge, S and Lepper, PM}, title = {[Position Paper for the State of the Art Application of Respiratory Support in Patients with COVID-19 - German Respiratory Society].}, journal = {Pneumologie (Stuttgart, Germany)}, volume = {74}, number = {6}, pages = {337-357}, pmid = {32323287}, issn = {1438-8790}, mesh = {Berlin ; Betacoronavirus ; COVID-19 ; *Continuous Positive Airway Pressure/standards ; Coronavirus Infections/complications/epidemiology ; Humans ; Intubation, Intratracheal ; Lung/physiopathology/virology ; Noninvasive Ventilation/*methods ; Pandemics ; Pneumonia, Viral/complications/epidemiology ; *Positive-Pressure Respiration ; *Practice Guidelines as Topic ; Pulmonary Edema/etiology/*therapy ; Respiratory Distress Syndrome/etiology/*therapy ; Respiratory Insufficiency/prevention &amp; control/*therapy ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {Against the background of the pandemic caused by infection with the SARS-CoV-2, the German Society for Pneumology and Respiratory Medicine (DGP e.V.), in cooperation with other associations, has designated a team of experts in order to answer the currently pressing questions about therapy strategies in dealing with COVID-19 patients suffering from acute respiratory insufficiency (ARI).The position paper is based on the current knowledge that is evolving daily. Many of the published and cited studies require further review, also because many of them did not undergo standard review processes.Therefore, this position paper is also subject to a continuous review process and will be further developed in cooperation with the other professional societies.This position paper is structured into the following five topics:1. Pathophysiology of acute respiratory insufficiency in patients without immunity infected with SARS-CoV-22. Temporal course and prognosis of acute respiratory insufficiency during the course of the disease3. Oxygen insufflation, high-flow oxygen, non-invasive ventilation and invasive ventilation with special consideration of infectious aerosol formation4. Non-invasive ventilation in ARI5. Supply continuum for the treatment of ARIKey points have been highlighted as core statements and significant observations. Regarding the pathophysiological aspects of acute respiratory insufficiency (ARI), the pulmonary infection with SARS-CoV-2 COVID-19 runs through three phases: early infection, pulmonary manifestation and severe hyperinflammatory phase.There are differences between advanced COVID-19-induced lung damage and those changes seen in Acute Respiratory Distress Syndromes (ARDS) as defined by the Berlin criteria. In a pathophysiologically plausible - but currently not yet histopathologically substantiated - model, two types (L-type and H-type) are distinguished, which correspond to an early and late phase. This distinction can be taken into consideration in the differential instrumentation in the therapy of ARI.The assessment of the extent of ARI should be carried out by an arterial or capillary blood gas analysis under room air conditions and must include the calculation of the oxygen supply (measured from the variables of oxygen saturation, the Hb value, the corrected values of the Hüfner number and the cardiac output). In principle, aerosols can cause transmission of infectious viral particles. Open systems or leakage systems (so-called vented masks) can prevent the release of respirable particles. Procedures in which the invasive ventilation system must be opened, and endotracheal intubation must be carried out are associated with an increased risk of infection.The protection of personnel with personal protective equipment should have very high priority because fear of contagion must not be a primary reason for intubation. If the specifications for protective equipment (eye protection, FFP2 or FFP-3 mask, gown) are adhered to, inhalation therapy, nasal high-flow (NHF) therapy, CPAP therapy or NIV can be carried out according to the current state of knowledge without increased risk of infection to the staff. A significant proportion of patients with respiratory failure presents with relevant hypoxemia, often also caused by a high inspiratory oxygen fraction (FiO2) including NHF, and this hypoxemia cannot be not completely corrected. In this situation, CPAP/NIV therapy can be administered under use of a mouth and nose mask or a respiratory helmet as therapy escalation, as long as the criteria for endotracheal intubation are not fulfilled.In acute hypoxemic respiratory insufficiency, NIV should be performed in an intensive care unit or in a comparable unit by personnel with appropriate expertise. Under CPAP/NIV, a patient can deteriorate rapidly. For this reason, continuous monitoring with readiness to carry out intubation must be ensured at all times. If CPAP/NIV leads to further progression of ARI, intubation and subsequent invasive ventilation should be carried out without delay if no DNI order is in place.In the case of patients in whom invasive ventilation, after exhausting all guideline-based measures, is not sufficient, extracorporeal membrane oxygenation procedure (ECMO) should be considered to ensure sufficient oxygen supply and to remove CO2.}, }
@article {pmid32320138, year = {2021}, author = {Sadeghipour, P and Talasaz, AH and Eslami, V and Geraiely, B and Vojdanparast, M and Sedaghat, M and Moosavi, AF and Alipour-Parsa, S and Aminian, B and Firouzi, A and Ghaffari, S and Ghasemi, M and Saleh, DK and Khosravi, A and Kojuri, J and Noohi, F and Pourhosseini, H and Salarifar, M and Salehi, MR and Sezavar, H and Shabestari, M and Soleimani, A and Tabarsi, P and Parsa, AFZ and Abdi, S}, title = {Management of ST-segment-elevation myocardial infarction during the coronavirus disease 2019 (COVID-19) outbreak: Iranian"247" National Committee's position paper on primary percutaneous coronary intervention.}, journal = {Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography &amp; Interventions}, volume = {97}, number = {3}, pages = {E346-E351}, pmid = {32320138}, issn = {1522-726X}, mesh = {Algorithms ; COVID-19/*epidemiology/*prevention &amp; control/transmission ; Humans ; Infection Control/*organization &amp; administration ; Iran/epidemiology ; *Percutaneous Coronary Intervention ; ST Elevation Myocardial Infarction/*therapy ; }, abstract = {World Health Organization has designated coronavirus disease 2019 (COVID-19) as a pandemic. During the past several weeks, a considerable burden has been imposed on the Iranian's healthcare system. The present document reviewed the latest evidence and expert opinion regarding the management of ST-segment-elevation myocardial infarction during the outbreak of COVID-19 and outlines a practical algorithm for it.}, }
@article {pmid32311380, year = {2020}, author = {Maillard, JY and Bloomfield, SF and Courvalin, P and Essack, SY and Gandra, S and Gerba, CP and Rubino, JR and Scott, EA}, title = {Reducing antibiotic prescribing and addressing the global problem of antibiotic resistance by targeted hygiene in the home and everyday life settings: A position paper.}, journal = {American journal of infection control}, volume = {48}, number = {9}, pages = {1090-1099}, pmid = {32311380}, issn = {1527-3296}, mesh = {Anti-Bacterial Agents/*adverse effects ; Bacterial Infections/drug therapy ; *Drug Resistance, Bacterial ; Global Health/*standards ; Humans ; Hygiene/*standards ; Prescription Drug Overuse/*prevention &amp; control ; Sanitation/standards ; }, abstract = {Antimicrobial resistance (AMR) continues to threaten global health. Although global and national AMR action plans are in place, infection prevention and control is primarily discussed in the context of health care facilities with home and everyday life settings barely addressed. As seen with the recent global SARS-CoV-2 pandemic, everyday hygiene measures can play an important role in containing the threat from infectious microorganisms. This position paper has been developed following a meeting of global experts in London, 2019. It presents evidence that home and community settings are important for infection transmission and also the acquisition and spread of AMR. It also demonstrates that the targeted hygiene approach offers a framework for maximizing protection against colonization and infections, thereby reducing antibiotic prescribing and minimizing selection pressure for the development of antibiotic resistance. If combined with the provision of clean water and sanitation, targeted hygiene can reduce the circulation of resistant bacteria in homes and communities, regardless of a country's Human Development Index (overall social and economic development). Achieving a reduction of AMR strains in health care settings requires a mirrored reduction in the community. The authors call upon national and international policy makers, health agencies, and health care professionals to further recognize the importance of targeted hygiene in the home and everyday life settings for preventing and controlling infection, in a unified quest to tackle AMR.}, }
@article {pmid32243317, year = {2020}, author = {Garcia-Castrillo, L and Petrino, R and Leach, R and Dodt, C and Behringer, W and Khoury, A and Sabbe, M}, title = {European Society For Emergency Medicine position paper on emergency medical systems' response to COVID-19.}, journal = {European journal of emergency medicine : official journal of the European Society for Emergency Medicine}, volume = {27}, number = {3}, pages = {174-177}, pmid = {32243317}, issn = {1473-5695}, mesh = {Betacoronavirus ; COVID-19 ; Coronavirus Infections/*diagnosis/*therapy ; Emergency Medicine/*standards ; Emergency Service, Hospital/*organization &amp; administration ; Humans ; Infection Control ; Pandemics ; Patient Isolation ; Personal Protective Equipment/supply &amp; distribution ; Pneumonia, Viral/*diagnosis/*therapy ; SARS-CoV-2 ; Triage ; }, abstract = {The 2019 novel coronavirus acute respiratory epidemic is creating a stressed situation in all the health systems of the affected countries. Emergency medical systems and specifically the emergency departments as the front line of the health systems are suffering from overload and severe working conditions, the risk of contagion and transmission of the health professionals adds a substantial burden to their daily work. Under the perspective of European Society For Emergency Medicine, the recommendations provided by the health authorities are reviewed focus on the emergency department's activity.}, }
@article {pmid32223063, year = {2020}, author = {Tarantini, G and Fraccaro, C and Chieffo, A and Marchese, A and Tarantino, FF and Rigattieri, S and Limbruno, U and Mauro, C and La Manna, A and Castiglioni, B and Longoni, M and Berti, S and Greco, F and Musumeci, G and Esposito, G and , }, title = {Italian Society of Interventional Cardiology (GISE) position paper for Cath lab-specific preparedness recommendations for healthcare providers in case of suspected, probable or confirmed cases of COVID-19.}, journal = {Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography &amp; Interventions}, volume = {96}, number = {4}, pages = {839-843}, pmid = {32223063}, issn = {1522-726X}, mesh = {*Betacoronavirus ; COVID-19 ; *Cardiac Catheterization ; Clinical Protocols ; Coronavirus Infections/epidemiology/*prevention &amp; control/transmission ; Humans ; Infection Control/*organization &amp; administration ; Italy ; Pandemics/*prevention &amp; control ; Pneumonia, Viral/epidemiology/*prevention &amp; control/transmission ; Practice Guidelines as Topic ; SARS-CoV-2 ; Societies, Medical ; }, abstract = {COVID-19 pandemic raised the issue to guarantee the proper level of care to patients with acute cardiovascular diseases and concomitant suspected or confirmed COVID-19 and, in the meantime safety and protection of healthcare providers. The aim of this position paper is to provide standards to healthcare facilities and healthcare providers on infection prevention and control measures during the management of suspected and confirmed cases of 2019-nCoV infection accessing in cath-lab. The document represents the view of the Italian Society of Interventional Cardiology (GISE), and it is based on recommendations from the main World and European Health Organizations (WHO, and ECDC) as well as from the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI).}, }
@article {pmid32207189, year = {2020}, author = {Poon, LC and Abramowicz, JS and Dall'Asta, A and Sande, R and Ter Haar, G and Maršal, K and Brezinka, C and Miloro, P and Basseal, J and Westerway, SC and Abu-Rustum, RS and Lees, C}, title = {ISUOG Safety Committee Position Statement on safe performance of obstetric and gynecological scans and equipment cleaning in context of COVID-19.}, journal = {Ultrasound in obstetrics &amp; gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology}, volume = {55}, number = {5}, pages = {709-712}, doi = {10.1002/uog.22027}, pmid = {32207189}, issn = {1469-0705}, mesh = {*Betacoronavirus ; COVID-19 ; *Coronavirus Infections/prevention &amp; control/transmission ; *Diagnostic Techniques, Obstetrical and Gynecological/standards ; Equipment Safety/*standards ; Female ; Genital Diseases, Female/diagnosis ; Humans ; *Hygiene/standards ; *Pandemics/prevention &amp; control ; *Pneumonia, Viral/prevention &amp; control/transmission ; Pregnancy ; SARS-CoV-2 ; Societies, Medical ; }, }
@article {pmid41401760, year = {2025}, author = {Blanco, J and Ferreras, M and Cosido, O}, title = {Predictive modeling of hospital emergency department demand using artificial intelligence: A systematic review.}, journal = {International journal of medical informatics}, volume = {207}, number = {}, pages = {106215}, doi = {10.1016/j.ijmedinf.2025.106215}, pmid = {41401760}, issn = {1872-8243}, abstract = {BACKGROUND: Accurately forecasting patient arrivals in hospital emergency departments (EDs) is critical for hospital capacity and planning and clinical decision-making. Artificial intelligence (AI), particularly machine learning (ML) and deep learning (DL), has shown promising performance over traditional time series approaches. However, the extent to which these models are validated and generalizable remains uncertain.<br><br>OBJECTIVE: To systematically review the literature on predictive models for hospital ED demand forecasting, focusing on algorithms used, internal and external variables, validation strategies and limitations pre- and post-pandemic developments.<br><br>METHODS: A systematic literature review (SLR) was conducted following PRISMA guidelines. Five databases (PubMed, IEEE, Springer, ScienceDirect, ACM) were searched for peer-reviewed articles published between January 2019 and July 2025. Eligible studies applied predictive algorithms - excluding those focused on COVID-19 - to forecast ED visits. Extracted data included modeling approaches, feature types, evaluation metrics, and validation methods.<br><br>RESULTS: Eleven studies met the inclusion criteria. Classical models such as ARIMA and SARIMA remain in use, but ML (e.g., XGBoost, Random Forest) and DL (e.g., LSTM, CNN) showed higher predictive accuracy, especially with high-dimensional, nonlinear data. Incorporating external variables-such as weather (temperature, humidity, wind), air quality, and calendar events-consistently improved performance. Common metrics included Mean Absolute Error (MAE), Root Mean Squared Error (RMSE), and Mean Absolute Percentage Error (MAPE), with MAPE ranging from 3&#xa0;% to 18&#xa0;%. Few studies performed external validation, and only a minority employed explainable AI methods (e.g., SHAP) to address interpretability.<br><br>CONCLUSIONS: AI-based models offer strong potential for ED demand forecasting, particularly when integrating environmental and temporal features. However, limited external validation and lack of interpretability remain significant barriers to clinical adoption. Future research should prioritize multicenter validation, standardized evaluation, and explainable AI to support reliable, transparent, and scalable use in hospital emergency departments.}, }
@article {pmid41401413, year = {2025}, author = {Miranda Quintero, J and Celis-Amórtegui, M and Arturo Rojas, MC and Mendoza Rosado, L and Grillo-Ardila, CF and Grillo-Ardila, EK and Ramírez-Mosquera, JJ and Lovera, LA and Ramírez-Mosquera, MJ}, title = {[Consenso de expertos en torno a la vacunación como estrategia de prevención primaria para la mujer que se encuentra en edad reproductiva, gestando o en la edad adulta].}, journal = {Revista colombiana de obstetricia y ginecologia}, volume = {76}, number = {2}, pages = {}, doi = {10.18597/rcog.4310}, pmid = {41401413}, issn = {2463-0225}, mesh = {Humans ; Female ; Pregnancy ; *Vaccination/methods ; Adult ; Colombia ; *Primary Prevention/methods ; Young Adult ; Consensus ; *Vaccines/administration &amp; dosage ; }, abstract = {OBJETIVO: generar recomendaciones para la vacunación de la mujer, en las diferentes etapas de su vida, a fin de disminuir la posible variabilidad de su uso actual en Colombia. Materiales y métodos: el grupo desarrollador estuvo conformado por profesionales pertenecientes al área de la salud. Todos los participantes declararon por escrito sus conflictos de interés. Se formularon preguntas clínicas contestables, se hizo la graduación de los desenlaces y la pesquisa de la información se realizó en Medline/PubMed, Embase y Lilacs. La búsqueda también abarcó fuentes de literatura gris y se actualizó el 14 de mayo de 2024 sin restricciones por fecha o idioma. Se implementó la metodología GRADE (Grading of Recommendations Assessment, Development and Evaluation) para establecer la calidad de la evidencia y la fuerza de la recomendación. En virtud de las limitaciones de los estudios recuperados, y especialmente cuando se trató de limitaciones en la aplicabilidad de la evidencia, se acudió a la opinión de expertos. Se realizó consenso formal acorde con la metodología RAND/UCLA (RAND Corporation/Universidad de California en Los Ángeles). Previo a la publicación, el documento fue objeto de revisión por pares.<br><br>RESULTADOS: se desarrollaron las siguientes recomendaciones: &#x2022; El grupo desarrollador sugiere que las mujeres no inmunes a las paperas, sarampi&#xf3;n o rubeola (p. ej., IgG negativo) sean vacunadas durante el periodo preconcepcional. Calidad de la evidencia: baja &#x2a01;&#x2a01;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere que todas las mujeres en periodo preconcepcional se vacunen contra la varicela si no tienen inmunidad natural confirmada (p. ej., anticuerpos IgG negativo para el virus varicela z&#xf3;ster). Calidad de la evidencia: muy baja &#x2a01;&#x25ef;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere que las mujeres que viven en regiones end&#xe9;micas para fiebre amarilla se vacunen durante el periodo preconcepcional si no han sido previamente inmunizadas. Calidad de la evidencia: muy baja &#x2a01;&#x25ef;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere vacunar adolescentes y adultas j&#xf3;venes con la vacuna para el virus del papiloma humano (VPH), de 3 dosis (0,2 y 6 meses) con el fin de reducir la incidencia y mortalidad por c&#xe1;ncer cervical. Calidad de evidencia: moderada &#x2a01;&#x2a01;&#x2a01;&#x25ef; &#x2022; El grupo desarrollador sugiere que las mujeres gestantes sean inmunizadas contra el t&#xe9;tano, la difteria y la tos ferina durante la gestaci&#xf3;n, con el objetivo de reducir el riesgo de infecci&#xf3;n en la madre y el neonato. Calidad de la evidencia: baja &#x2a01;&#x2a01;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere la vacunaci&#xf3;n contra la influenza a cualquier edad gestacional, con el objetivo de reducir el riesgo de infecci&#xf3;n en la madre y el neonato hasta los seis meses de edad. Calidad de la evidencia: muy baja &#x2a01;&#x25ef;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere la vacunaci&#xf3;n materna frente al COVID-19 a cualquier edad gestacional, con el objetivo de reducir el riesgo de hospitalizaci&#xf3;n y muerte de la madre y el neonato durante los primeros cuatro meses de vida. Calidad de la evidencia: muy baja &#x2a01;&#x25ef;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere la vacunaci&#xf3;n contra el virus sincitial respiratorio (VSR) en mujeres gestantes, con el objetivo de reducir el riesgo de hospitalizaci&#xf3;n en el neonato. Calidad de la evidencia: muy baja &#x2a01;&#x25ef;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el herpes z&#xf3;ster, con el fin de reducir la morbilidad asociada a esta condici&#xf3;n. Calidad de la evidencia: moderada &#x2a01;&#x2a01;&#x2a01;&#x25ef; &#x2022; El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra la influenza a fin de reducir la incidencia de infecci&#xf3;n respiratoria aguda (IRA). Calidad de la evidencia: moderada &#x2a01;&#x2a01;&#x2a01;&#x25ef; &#x2022; El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el neumococo a fin de reducir la incidencia de neumon&#xed;a y enfermedad neumoc&#xf3;cica invasora. Calidad de la evidencia: baja &#x2a01;&#x2a01;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere que la mujer adulta mayor se vacune contra el VSR a fin de reducir la incidencia de infecci&#xf3;n respiratoria aguda e infecci&#xf3;n respiratoria del tracto inferior. Calidad de la evidencia: baja &#x2a01;&#x2a01;&#x25ef;&#x25ef; &#x2022; El grupo desarrollador sugiere que la mujer adulta mayor que vive en regiones end&#xe9;micas para fiebre amarilla se vacune si no ha sido previamente inmunizada. Calidad de la evidencia: muy baja &#x2a01;&#x25ef;&#x25ef;&#x25ef; Conclusiones: se recomienda la vacunaci&#xf3;n como estrategia de prevenci&#xf3;n primaria a lo largo de las diferentes etapas de la vida en la mujer. Dada la calidad de la evidencia y las serias limitaciones en la aplicabilidad de algunos estudios, especialmente en mujeres gestantes, se requieren m&#xe1;s investigaciones que eval&#xfa;en la seguridad y la efectividad de esta intervenci&#xf3;n en esta etapa de la vida.}, }
@article {pmid41401334, year = {2025}, author = {Gabor, M and Schlosserova, A and Korchynska, OO}, title = {Vaccination in pregnancy: a systematic review of current evidence.}, journal = {Wiadomosci lekarskie (Warsaw, Poland : 1960)}, volume = {78}, number = {10}, pages = {2142-2146}, doi = {10.36740/WLek/213601}, pmid = {41401334}, issn = {0043-5147}, mesh = {Humans ; Pregnancy ; Female ; *COVID-19/prevention &amp; control ; *Influenza, Human/prevention &amp; control ; *Pregnancy Complications, Infectious/prevention &amp; control ; *Vaccination ; *Influenza Vaccines/administration &amp; dosage ; *COVID-19 Vaccines/administration &amp; dosage ; *Whooping Cough/prevention &amp; control ; *Pertussis Vaccine ; }, abstract = {OBJECTIVE: Aim: To summarize current recommendations and the state of knowledge on vaccination of pregnant women against influenza, pertussis, and Covid-19, and to highlight evidence on the efficacy and safety of vaccination during pregnancy.<br><br>PATIENTS AND METHODS: Materials and Methods: A systematic literature review of studies published between 2014 and 2024 in the PubMed, Science Direct, Google Scholar, and NCBI databases was conducted. Of the total number of 31 studies found, 10 that met our required conditions were included. The inclusion criteria were peer-reviewed articles dealing with vaccination during pregnancy. Data selection and extraction were performed in accordance with PRISMA recommendations.<br><br>CONCLUSION: Conclusions: Vaccination of pregnant women appears to be a safe and effective way to protect mothers and their offspring. Emphasis should be placed on raising awareness and education in clinical practice.}, }
@article {pmid41399268, year = {2025}, author = {Fedorchenko, Y and Zimba, O}, title = {Ethical Use of Artificial Intelligence for Processing Medical Images.}, journal = {Journal of Korean medical science}, volume = {40}, number = {48}, pages = {e341}, doi = {10.3346/jkms.2025.40.e341}, pmid = {41399268}, issn = {1598-6357}, mesh = {Humans ; *Artificial Intelligence/ethics ; *Image Processing, Computer-Assisted/ethics ; *Diagnostic Imaging/ethics ; COVID-19 ; Algorithms ; Deep Learning ; SARS-CoV-2 ; }, abstract = {Artificial intelligence (AI) tools employ prompts and algorithms to perform tasks that typically require human expertise, hypothesis formulation, and critical evaluation. AI enables rapid analysis of complex imaging data, automates segmentation and lesion detection, and supports real-time image-guided interventions. Deep learning architectures (CNNs, RNNs, U-Net, and transformer-based models) facilitate advanced image classification, reconstruction, and interpretation, achieving clinical accuracies above 90% in multiple domains, including coronavirus disease 2019, oncology, and rheumatology. Generative AI platforms (MedGAN, StyleGAN, CycleGAN, SinGAN-Seg) further support synthetic image creation and dataset augmentation, mitigating data scarcity while preserving patient privacy. However, the integration of AI in healthcare presents significant ethical challenges. Key concerns include algorithmic bias, patient privacy, transparency, accountability, and equitable access. Biases-such as annotation, automation, confirmation, demographic, and feedback-loop bias-can compromise diagnostic reliability and patient outcomes. Ethical deployment requires rigorous data governance, informed consent, anonymization, standardized validation frameworks, human oversight, and regulatory compliance. Maintaining interpretability and transparency of AI outputs is essential for clinical decision-making, while professional training and AI literacy are critical to mitigate overreliance and ensure patient safety.}, }
@article {pmid41398580, year = {2025}, author = {Manarte, R and Henriques, MR}, title = {From exceptionalism to universal testing: an historical review of HIV testing in Portugal.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {4251}, pmid = {41398580}, issn = {1471-2458}, mesh = {Portugal/epidemiology ; Humans ; *HIV Infections/diagnosis ; *HIV Testing/history ; *Health Policy ; History, 20th Century ; History, 21st Century ; *Mass Screening/history ; *Universal Health Care ; }, abstract = {INTRODUCTION: Portugal has made significant progress over the last 40 years in the response against the Human Immunodeficiency Virus (HIV) infection and the Acquired Immunodeficiency Syndrome (AIDS). However, as of 2021, it remained one of the three Western European countries with the highest rates of new HIV infections and AIDS cases. Initially shaped by HIV exceptionalism, Portugal began transitioning to a universal testing strategy in 2011. This study provides a historical and policy review of the evolution of HIV testing in Portugal, focusing on alignment with international guidelines and national implementation outcomes.<br><br>METHODS: We conducted a narrative policy review covering the period from 1998 to 2024. Our analysis drew on scientific literature, national health plans, surveillance reports, and international guidelines. Documents were selected through structured searches in multiple academic databases and government repositories using relevant Portuguese and English search terms. Thematically coded findings were mapped chronologically and assessed against evolving WHO and CDC recommendations.<br><br>RESULTS: Portugal gradually moved from a targeted testing approach to a more comprehensive, universal strategy. Key policy shifts occurred in 2011 and 2017, accompanied by an expansion of testing modalities, including self-testing and community-based testing. Despite these developments, implementation has been uneven. The lack of standardized protocols, limited integration into primary healthcare, and regional disparities tied to a contract-based health system have contributed to inconsistent service delivery. Additionally, testing uptake among older adults, migrants, and other key populations remains suboptimal. The COVID-19 pandemic temporarily disrupted testing services but also accelerated the use of self-testing strategies.<br><br>DISCUSSION: Portugal's experience illustrates the challenges of operationalizing universal HIV testing within a hybrid public-private healthcare system. Although policies increasingly reflect international best practices, structural barriers continue to hinder equitable implementation.<br><br>CONCLUSION: To close existing testing gaps, Portugal must strengthen implementation by standardizing procedures, improve disaggregated data collection in monitoring systems, and ensure greater integration of HIV testing in primary healthcare. Enhanced outreach to underserved populations will be critical to achieving national and international HIV prevention targets. This paper offers a historical and policy perspective to inform more equitable and effective national testing strategies.}, }
@article {pmid41398527, year = {2025}, author = {Maleki, F and Hosseinpour, M and Pashaei, MR and Aghdam, ME and Bahardoust, M and Delpisheh, A}, title = {Body mass index in children with newly diagnosed celiac disease: A systematic review and meta-analysis.}, journal = {European journal of pediatrics}, volume = {185}, number = {1}, pages = {18}, pmid = {41398527}, issn = {1432-1076}, mesh = {Humans ; *Celiac Disease/diagnosis/complications/diet therapy/epidemiology ; *Body Mass Index ; Child ; *Thinness/epidemiology ; Prevalence ; Diet, Gluten-Free ; *Pediatric Obesity/epidemiology ; Child, Preschool ; }, abstract = {UNLABELLED: Clinical manifestations of celiac disease (CeD) in children are often associated with malabsorption, malnutrition, and underweight. Recent evidence suggests an increased prevalence in normal-weight and obese children. Under-recognition of patients with normal or high BMI can lead to delayed diagnosis and serious complications. The present study aimed to determine the BMI status of children with CeD at diagnosis and before gluten-free diet (GFD). A systematic review and meta-analysis was conducted following the PRISMA and MOOSE guidelines and after PROSPERO registration (CRD42023390243). The information sources, including PubMed, Scopus, and Web of Science, were systematically searched through 30 September 2025 to identify relevant articles. The study's eligibility criteria included observational studies, such as retrospective, cross-sectional, and prospective designs, with participants whose CeD diagnosis was confirmed by a gastroenterologist and who reported BMI data at the time of diagnosis. Heterogeneity among studies was assessed using the I[2] statistic. Funnel plots and Egger's test were also used to examine publication bias. The risk of bias of studies was assessed using the Newcastle-Ottawa (NOS) scale. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to determine the certainty of the evidence. Overall, 32 studies including 14,169 children with CeD were investigated. The pooled prevalence of underweight and overweight/obesity at diagnosis was 15.3% (10.8-20.4%) and 10.5% (5.7-16.4%), respectively. Subgroup analysis by WHO region revealed a marked heterogeneity (I[2] > 90%), with the highest prevalence of underweight observed in the Eastern Mediterranean Region (EMRO) (31.9%). On the other hand, the highest prevalence of overweight/obesity was observed in the European Region (EURO) (12.0%) and the Western Pacific Region (WPRO) (21.4%). A key finding was a significant difference across World Bank income groups; underweight prevalence was nearly four times higher in low- and middle-income countries (LMICs), 35.48 (24.29, 47.51), compared with high-income countries, 9.58 (6.88, 12.63). The certainty of the evidence for all pooled prevalence estimates was rated as very low due to serious inconsistency and imprecision.<br><br>CONCLUSIONS: &#xa0;The prevalence of normal weight and overweight/obesity in children with celiac disease at diagnosis was higher than that of underweight, mainly in high-income countries. This finding challenges the traditional belief about the CeD and emphasizes its diagnosis in children with suspicious symptoms, regardless of their BMI status. This approach will lead to earlier diagnosis, improving clinical outcomes and quality of life for patients in the long term.<br><br>WHAT IS KNOWN: &#x2022; The clinical presentation of celiac disease is evolving, and its association with underweight is inconsistent. &#x2022; The structural effects of COVID-19 on the developing brain remain poorly understood due to limited pediatric imaging studies.<br><br>WHAT IS NEW: &#x2022; This is the first meta-analysis focused exclusively on children, revealing that the majority (70.2%) present with a normal BMI at diagnosis. &#x2022; The clinical inconsistency in BMI presentation is strongly linked to income levels; underweight prevalence is nearly four times higher in LMICs (35.5%) than in high-income countries (9.6%).}, }
@article {pmid41397515, year = {2025}, author = {Chen, P and Prosser, M and Phillips, B and Ellison CEng, P and Rangan, A}, title = {Accuracy and Reliability of Remote Shoulder Motion Capturing Methods: A Systematic Review and Meta-Analysis.}, journal = {Journal of shoulder and elbow surgery}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jse.2025.11.007}, pmid = {41397515}, issn = {1532-6500}, abstract = {BACKGROUND: The COVID-19 pandemic accelerated the demand for remote assessment tools in rehabilitation, especially the need for accurate and reliable technologies to measure shoulder range of motion (ROM) outside of clinical environments. Emerging tools such as smartphone apps, wearable sensors, and markerless motion capture systems are increasingly being adopted, yet their accuracy and reliability compared to reference standards remains unclear.<br><br>OBJECTIVE: To systematically evaluate the accuracy and reliability of existing remote shoulder ROM measurement technologies, quantify measurement bias, and assess their agreement with reference standards.<br><br>METHODS: A systematic review and meta-analysis was conducted on 26 studies evaluating remote ROM measurement tools. Pooled mean bias (in degrees) was calculated as the primary effect size for agreement, with reliability assessed using intraclass correlation coefficients (ICCs). Subgroup analyses were performed by motion type, technology category, population health status, and data acquisition method. Risk of bias was assessed using the QUADAS-2 tool.<br><br>RESULTS: Remote measurement methods showed a small but consistent overestimation of ROM compared to reference standards (pooled mean bias = 2.63&#xb0;, 95% CI: 1.52&#xb0;, 3.74&#xb0;), particularly in flexion, internal rotation, and external rotation. No significant bias was observed in abduction or extension. Both IMU and non-IMU technologies demonstrated comparable levels of overestimation. Pathological populations exhibited greater variability (bias = 4.33&#xb0; vs. 2.37&#xb0; in healthy subjects). Self-measurements showed lower and non-significant bias compared to assessor-guided methods. Reliability was generally high, especially for test-retest assessments (ICCs > 0.90), though more variable in inter-rater and pathological settings.<br><br>CONCLUSION: Remote shoulder ROM measurement technologies tend to slightly overestimate joint angles but remain within clinically acceptable limits. These tools are reliable for tracking ROM trends and suitable for remote monitoring in clinical and research settings. However, increased variability in pathological populations warrants caution. Broader validation in diverse patient cohorts is needed to strengthen clinical implementation.}, }
@article {pmid41397310, year = {2025}, author = {Cho, AH and Cho, SY and Kim, S and Lee, S}, title = {Targeting emerging viruses with phage display-driven engineered antibodies: Bridging molecular design and clinical application.}, journal = {Molecular aspects of medicine}, volume = {107}, number = {}, pages = {101441}, doi = {10.1016/j.mam.2025.101441}, pmid = {41397310}, issn = {1872-9452}, abstract = {Phage display (PD) is a powerful platform that accelerates the discovery and engineering of therapeutic antibodies across diverse diseases, including emerging and re-emerging viral infections. The COVID-19 pandemic highlighted the urgency for rapid and adaptable antibody development against highly mutable pathogens, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). PD technology enables the rapid and high-throughput identification, optimization, and efficient reformatting of virus-neutralizing antibodies, yielding fully PD-derived antibodies and reformatted derivatives from PD fragments without requiring convalescent samples or animal immunization. This approach supports a proactive and scalable strategy for pandemic preparedness. This review provides a comprehensive overview of PD-derived therapeutic antibodies targeting infectious diseases, focusing on approved agents and candidates in clinical or preclinical development for SARS-CoV-2. We highlight recent case studies, including our own, showing the successful application of PD in generating potent neutralizing and multispecific antibody formats. These offer functional advantages such as enhanced breadth and affinity while also serving as versatile molecular tools for elucidating viral pathogenesis and immune evasion mechanisms. Despite PD's technological strengths, the clinical advancement of PD-derived candidates has been influenced by external circumstances associated with the evolving pandemic landscape, highlighting the need to strategically leverage PD's strengths to accelerate translational outcomes in future outbreaks. This review offers a well-rounded viewpoint on PD, outlining its applications, addressing its challenges, and incorporating emerging innovations into PD workflows. These advances position PD-derived candidates as a strategic, versatile, and rapid-response platform that bridges molecular insights with clinical translation, offering a robust framework for addressing current and future infectious disease challenges.}, }
@article {pmid33909785, year = {2021}, author = {Beck, ALS and Barberato, SH and Almeida, ALC and Grau, CRPC and Lopes, MMU and Lima, RSL and Cerci, RJ and Albricker, ACL and Barros, FS and Oliveira, AJ and Lira Filho, EB and Miglioranza, MH and Vieira, MLC and Pena, JLB and Strabelli, TMV and Bihan, DCSL and Tsutsui, JM and Rochitte, CE}, title = {Position Statement on Indications and the Safe Reintroduction of Cardiovascular Imaging Methods in the COVID-19 Scenario - 2021.}, journal = {Arquivos brasileiros de cardiologia}, volume = {116}, number = {3}, pages = {659-678}, pmid = {33909785}, issn = {1678-4170}, mesh = {Humans ; *Cardiovascular System ; *COVID-19 ; SARS-CoV-2 ; Societies, Medical ; }, }
@article {pmid32472377, year = {2020}, author = {Ganau, M and Netuka, D and Broekman, M and Zoia, C and Tsianaka, E and Schwake, M and Balak, N and Sekhar, A and Ridwan, S and Clusmann, H and , }, title = {Neurosurgeons and the fight with COVID-19: a position statement from the EANS Individual Membership Committee.}, journal = {Acta neurochirurgica}, volume = {162}, number = {8}, pages = {1777-1782}, pmid = {32472377}, issn = {0942-0940}, mesh = {Humans ; *Access to Information ; Betacoronavirus ; *Communication ; *Coronavirus Infections/epidemiology ; COVID-19 ; Europe/epidemiology ; Neurosurgeons ; Neurosurgery ; Pandemics ; *Personal Protective Equipment ; *Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Societies, Medical ; *Stress, Psychological ; }, }
@article {pmid32407899, year = {2020}, author = {Lavoué, V and Akladios, C and Gladieff, L and Classe, JM and Lécuru, F and Collinet, P}, title = {Onco-gynecologic surgery in the COVID-19 era: Risks and precautions-A position paper from FRANCOGYN, SCGP, SFCO, and SFOG.}, journal = {Journal of gynecology obstetrics and human reproduction}, volume = {49}, number = {7}, pages = {101787}, pmid = {32407899}, issn = {2468-7847}, mesh = {Female ; Humans ; Anesthesiologists ; Antineoplastic Agents/therapeutic use ; *Betacoronavirus ; Consensus ; *Coronavirus Infections/epidemiology/prevention &amp; control/transmission ; COVID-19 ; France/epidemiology ; *Genital Neoplasms, Female/diagnosis/therapy ; *Gynecologic Surgical Procedures ; *Occupational Diseases/prevention &amp; control ; *Pandemics/prevention &amp; control ; Personal Protective Equipment ; *Pneumonia, Viral/epidemiology/prevention &amp; control/transmission ; Preoperative Care/methods ; SARS-CoV-2 ; *Societies, Medical ; Surgeons ; Telemedicine ; Withholding Treatment ; }, }
@article {pmid41394882, year = {2025}, author = {Padilla-Blanco, M and García-García, T and Grigas, J and López-Ayllón, BD and Garrido, JJ and Oliva, MA and Montoya, M}, title = {Hidden players of COVID-19: the evolving roles of SARS-CoV-2 accessory proteins.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1726698}, pmid = {41394882}, issn = {1664-3224}, mesh = {Humans ; *SARS-CoV-2/immunology/genetics ; *COVID-19/immunology/virology ; Host-Pathogen Interactions/immunology ; Interferon Type I/immunology/metabolism ; Animals ; *Viral Regulatory and Accessory Proteins/immunology/genetics/metabolism ; Viral Proteins/immunology ; }, abstract = {SARS-CoV-2 accessory proteins (APs), particularly ORF3a and ORF9b, have emerged as key modulators of host-pathogen interaction and potential contributors to long COVID. Of the 13 predicted APs, only nine are expressed during infection - termed Infection-related APs - while the remaining are classified as Putative APs. Despite this distinction, extensive gene overlap among APs underscores the remarkable adaptability of SARS-CoV-2 viral genome. This review delves into the diverse roles of the original Wuhan APs and their Omicron counterparts in shaping host immunity, with an emphasis on their ability to suppress type I interferon (IFN-I) signalling, modulate cellular metabolism, and trigger inflammatory/apoptotic pathways. By integrating immunopathological insights with evolutionary dynamics and structural perspectives, this review provides a comprehensive understanding of the mechanism underlying Omicron's reduced pathogenicity and highlights promising, yet unexplored, therapeutic targets within the SARS-CoV-2 accessory proteome.}, }
@article {pmid41394849, year = {2025}, author = {Gabig-Cimińska, M}, title = {Dysregulated TFEB-autophagy-lysosome pathway links acute COVID-19 immunopathology to Long COVID sequelae.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1708364}, pmid = {41394849}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/pathology/complications ; *Lysosomes/immunology/metabolism ; *Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/metabolism/immunology ; *Autophagy/immunology ; *SARS-CoV-2/immunology ; Animals ; Signal Transduction/immunology ; Immunity, Innate ; }, abstract = {SARS-CoV-2 disrupts cellular homeostasis, including the autophagy-lysosome pathway (ALP), a critical component of innate immunity and viral clearance. By subverting autophagy, SARS-CoV-2 proteins such as ORF3a, ORF7a, and NSP6 inhibit autophagosome-lysosome (APG-L) fusion, generating "incomplete autophagy" that permits viral persistence and drives hyperinflammation. Transcription factor EB (TFEB), a master regulator of lysosomal biogenesis and autophagy, has emerged as a central player in the host response to coronavirus infection. TFEB orchestrates the expression of genes required for lysosomal function and autophagic flux while also shaping immune processes, including cytokine production, interferon-stimulated gene expression, and inflammasome clearance. This mini review synthesizes current knowledge on the TFEB-ALP axis in COVID-19 pathogenesis, highlighting its influence on acute immunopathology and its potential contribution to post-acute sequelae (Long COVID). Restoring TFEB activity and autophagic flux may counteract SARS-CoV-2 evasion strategies and restrain aberrant inflammatory responses. Harnessing the TFEB-autophagy pathway as a host-directed therapeutic strategy could help rebalance immune homeostasis, limit tissue damage during acute infection, and mitigate persistent inflammatory sequelae in Long COVID.}, }
@article {pmid41392909, year = {2025}, author = {Pandey, V and Sen, D and Rathee, S and Soni, S and Mishra, S and Jain, SK and Patil, UK}, title = {Unlocking Toll-Like Receptors: Targeting Therapeutics for Respiratory Tract Infections and Inflammatory Disorders.}, journal = {Recent advances in inflammation &amp; allergy drug discovery}, volume = {19}, number = {3}, pages = {303-315}, doi = {10.2174/0127722708329138240926073013}, pmid = {41392909}, issn = {2772-2716}, mesh = {Humans ; *Toll-Like Receptors/immunology/metabolism/antagonists &amp; inhibitors ; COVID-19/immunology ; *Respiratory Tract Infections/drug therapy/immunology ; *Inflammation/drug therapy/immunology ; *COVID-19 Drug Treatment ; Animals ; SARS-CoV-2 ; Signal Transduction/drug effects ; Immunity, Innate/drug effects ; }, abstract = {The Toll-like Receptors (TLRs) family has significantly enhanced the understanding of innate immune responses by identifying and responding to various microbes or host-derived organisms. TLRs contribute to these responses by increasing the levels of cytokines, interleukins, and other inflammatory mediators through multiple pathways. Located both intracellularly and on the surface of various cells and tissues, including vascular smooth muscles (VSMs) and myocardium cells, TLRs play distinct roles in innate immune activation, such as recognizing pathogen-associated molecular patterns (PAMPs) and activating downstream signaling pathways. In the context of COVID-19, TLRs are critically involved in the pathophysiology by mediating excessive inflammatory responses that exacerbate disease severity, influencing both the acute phase and long-term outcomes. It has been observed that inflammatory diseases such as atherosclerosis, viral myocarditis, and other comorbidities associated with the spread of COVID-19 have increased, although the exact mechanisms remain not fully understood. Nonetheless, there is evidence of TLR-mediated increased pro-inflammatory signaling by different mechanisms in these diseases. This review explains the role of TLRs in various inflammatory diseases related to COVID-19, including viral myocarditis, acute lung infections, and atherosclerosis. Furthermore, the review discusses various herbal drugs, such as Platycodon grandiflorum, Acanthopanax senticosus, Scutellaria baicalensis Georgi, and Engelhardia roxburghiana, and their mechanisms of action on TLRs, including NF-κB, MyD88-dependent, MyD88-independent pathways, and Plasmacytoid DCs. Enhanced clarity on TLRs' specific contributions to COVID-19 pathophysiology and stronger evidence supporting herbal interventions targeting TLRs could improve the impact and applicability of these findings in clinical settings.}, }
@article {pmid41392882, year = {2025}, author = {de Bruin, O and Maisonneuve, E and Hurley, E and Nordeng, HME and Bérard, A and Sheehy, O and Kaul, P and Shinde, MU and Cosgrove, A and Lyons, JG and Messenger-Jones, E and Kempner, ME and Toh, S and Hua, W and Hernández-Muñoz, JJ and Sahin, L and Cesta, CE and Hägg, D and Gini, R and Paoletti, O and Poblador-Plou, B and Jordan, S and Rodríguez-Bernal, CL and Sánchez-Sáez, F and Lassalle, R and Bernard, MA and Ahmadizar, F and Favre, G and Panchaud, A and Bloemenkamp, KWM and Plueschke, K and de Vries, C and Siiskonen, SJ and Sturkenboom, MCJM and , }, title = {Adverse outcomes among pregnant women with COVID-19 according to hospitalization status: A prospective individual participant data meta-analysis in Europe and North America.}, journal = {International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics}, volume = {}, number = {}, pages = {}, doi = {10.1002/ijgo.70694}, pmid = {41392882}, issn = {1879-3479}, support = {//European Medicines Agency/ ; /CAPMC/CIHR/Canada ; //Canada Foundation for Innovation/ ; /FD/FDA HHS/United States ; }, abstract = {BACKGROUND: Understanding the varied impact of COVID-19 severity on pregnancy outcomes is crucial for informed clinical management and targeted interventions.<br><br>OBJECTIVE: To evaluate the impact of COVID-19 on pregnancy outcomes, distinguishing between pregnant women managed in primary care and those requiring hospitalization.<br><br>SEARCH STRATEGY: Regulatory authorities actively promoted global cooperation on COVID-19's impact during pregnancy. Data were obtained through these regulatory bodies and direct researcher communication rather than through systematic searches.<br><br>SELECTION CRITERIA: Data sources required secondary population-based data to identify pregnancies with COVID-19, along with hospitalization, diagnostic and medication codes. Eligibility for the meta-analysis was determined through protocol evaluation and researcher consultations.<br><br>DATA COLLECTION AND ANALYSIS: PRISMA-IPD and Cochrane guidelines for prospective meta-analysis were followed. Protocols and definitions were standardized across sources, and a common R script was developed. Initially, crude and adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated to assess adverse outcomes in pregnant women with and without COVID-19 in each data source. Estimates were stratified by trimester at infection and hospitalization status. Subsequently, data were pooled using a random-effects meta-analysis.<br><br>MAIN RESULTS: Data from 10 sources across seven countries contributed to the meta-analysis, including 86&#x2009;210 pregnant women diagnosed with COVID-19, of whom 4.4% were hospitalized. Non-hospitalized pregnant women with COVID-19 had no increased risks of adverse outcomes compared to pregnant women without COVID-19. However, hospitalized women with COVID-19 in each trimester had higher risks of cesarean section, preterm birth, and LBW compared to pregnant women without COVID-19. Hospitalization due to COVID-19 in the third trimester was associated with increased risk of stillbirth (aRR 5.90, 95% CI: 2.22-15.71, I[2]&#x2009;=&#x2009;0%). First-trimester hospitalizations due to COVID-19 did not show heightened risks of GDM (aRR 2.08, 95% CI: 0.93-4.64, I[2]&#x2009;=&#x2009;65%), pre-eclampsia (aRR 1.79, 95% CI: 0.48-6.66, I[2]&#x2009;=&#x2009;71%), or major congenital anomalies (aRR 1.30, 95% CI: 0.55-3.06, I[2]&#x2009;=&#x2009;0%).<br><br>CONCLUSIONS AND RELEVANCE: COVID-19 requiring hospitalization is associated with adverse pregnancy outcomes, emphasizing the need to prevent severe illness during pregnancy. This study also highlights the importance of international collaboration for gathering pregnancy data and shows that building global research networks is essential for responding to future health crises.}, }
@article {pmid41392436, year = {2025}, author = {Celano, R and Urso, F and Bartoli, A and Meschia, A and Masseroli, MM and Cirigliano, F and Colaneri, M and Foschi, A and Gori, A and Cogliati, C and Calloni, M and Taino, A and Scoppettuolo, G and Pittiruti, M and Gidaro, A}, title = {COVID-19 and vascular access: Evidence and lessons for improving the standard of care, a scoping review.}, journal = {The journal of vascular access}, volume = {}, number = {}, pages = {11297298251398421}, doi = {10.1177/11297298251398421}, pmid = {41392436}, issn = {1724-6032}, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic has significantly impacted intravenous therapy practices, particularly in critically ill patients. Vascular access strategies were adapted to evolving clinical needs, infection control priorities, and resource limitations, with a focus on safety, efficacy, and technological advancements. This scoping review aimed to explore how the COVID-19 pandemic affected vascular access practices and catheter-related complications, with the objective of mapping innovations, identifying emerging trends, and summarizing preventive and therapeutic strategies. The review followed PRISMA-ScR guidelines and was registered in PROSPERO (CRD420251027530). A systematic search was conducted in PubMed[®], EMBASE[®], EBSCO-CINAHL[®], and CENTRAL for English-language studies published between January 2020 and May 2025 addressing catheter-related complications in COVID-19 patients, including catheter-related bloodstream infections (CRBSI), central line-associated bloodstream infections (CLABSI), catheter-related thrombosis (CRT), and accidental catheter removal. Among 521 screened articles, 58 met the inclusion criteria. Most studies reported higher rates of CRBSI, CLABSI, CRT, and accidental removal in COVID-19 patients, especially in critical care settings. Arterial catheters were also associated with elevated risks of thrombosis and infection during the pandemic. Mid-thigh femoral access sites emerged as practical alternatives to reduce central line use and healthcare personnel exposure. Technological advances, including power-injectable catheters, ultrasound-guided insertion, intracavitary ECG for tip confirmation, and securement tools such as cyanoacrylate glue and subcutaneous anchor systems, improved safety and reduced mechanical and infectious complications. Chlorhexidine-based antisepsis, antimicrobial-impregnated devices, and disinfectant caps effectively decreased CRBSI and CLABSI rates. In older, comorbid patients-now representing the majority of COVID-19 hospitalizations-nutritional and anticoagulant therapy must be carefully balanced to minimize bleeding and thrombotic risks. In conclusion, the pandemic catalyzed significant innovation and adaptation in vascular access practices. Integrating portable technologies, infection prevention strategies, and alternative access routes has enhanced patient care and established new standards for managing intravenous therapy in high-risk, resource-constrained settings.}, }
@article {pmid41391467, year = {2025}, author = {Rutter, H and Wabnitz, K and Nambiar, D and Garde, A and Benton, TG and Heymann, DL and Yates, R and Friel, S and Hollands, GJ and Cai, W and Chater, N and Bloom, DE and Guinto, RR and El Omrani, O and Wilsdon, J and Amuasi, JH and Butler, C and Tlou, S and Marteau, TM}, title = {The Lancet Commission on improving population health post-COVID-19.}, journal = {Lancet (London, England)}, volume = {}, number = {}, pages = {}, doi = {10.1016/S0140-6736(25)02061-6}, pmid = {41391467}, issn = {1474-547X}, }
@article {pmid41390653, year = {2025}, author = {Waqqas, HM and Pan, J and Xia, N and Chen, W}, title = {mRNA based vaccines and therapeutics for parasitic infections: a comprehensive review.}, journal = {Journal of nanobiotechnology}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12951-025-03787-z}, pmid = {41390653}, issn = {1477-3155}, support = {SKLRD-OP-202409//Open Project of the State Key Laboratory of Respiratory Disease/ ; }, abstract = {The success of mRNA vaccines during the COVID-19 pandemic has revealed a revolutionary platform for addressing neglected parasite zoonosis, which represent a continual and significant threat to world health, especially in resource-constrained settings. The current review consolidates recent progress in the development of mRNA-based treatments, vaccines, and diagnostic ways for these pathogens. We elucidate how customized delivery platforms, particularly lipid nanoparticles, augment the stability and immunogenicity of parasite-derived mRNA cargo by safeguarding it from degradation and promoting uptake by antigen-presenting cells. Our findings suggest that mRNA technology provides a particularly adaptable strategy to targeting complicated parasite life cycles and efficiently modulating host immune responses. However, important challenges, such as cold-chain logistics, scalability, clinical trial design for diverse populations, and managing public opinion, must be solved beforehand. Future initiatives must priorities the creation of thermostable formulations and effective community participation strategies. Finally, this review emphasizes that mRNA-based interventions represent a promising, albeit challenging, frontier in the fight against parasitic diseases, urging a collaborative cross-disciplinary effort to translate this potential into tangible health breakthroughs for the world's most vulnerable populations.}, }
@article {pmid41297153, year = {2025}, author = {Kattner, AA}, title = {Sticks and stones - mending bones.}, journal = {Biomedical journal}, volume = {48}, number = {6}, pages = {100931}, pmid = {41297153}, issn = {2320-2890}, mesh = {Humans ; *COVID-19/prevention &amp; control ; *Bone Regeneration ; COVID-19 Vaccines ; SARS-CoV-2 ; }, abstract = {A novel biomaterial demonstrates enhanced bone regeneration in critical defects, offering potential improvements in orthopedic repair. In immunology, a second booster dose of mRNA COVID-19 vaccine is shown to elicit robust responses in older adults in Taiwan. Hepatology research explores new therapeutic strategies for managing hepatitis B in kidney transplant recipients. Biomarker discovery advances with a new assay enabling the use of miRNAs for non-invasive diagnosis and staging of metabolic dysfunction-associated steatotic liver disease (MASLD). Finally, an optimized elastase assay improves FISH-based detection of ALK gene rearrangements, enhancing diagnostic accuracy in non-small cell lung cancer (NSCLC).}, }
@article {pmid40608563, year = {2026}, author = {Bernstein, WK and Pearl, RG and Huang, J and Mayrsohn, BG and Mery, MW and Banoub, M and Pease, S and Ayad, S and Saffary, R and Olszewski, RF and Aronson, S and Vetter, TR}, title = {Enhancing Anesthetic Preoptimization: Promising Opportunities for Innovation in Economically Diverse Regions.}, journal = {Anesthesia and analgesia}, volume = {142}, number = {1}, pages = {76-84}, pmid = {40608563}, issn = {1526-7598}, mesh = {Humans ; *COVID-19/economics/epidemiology ; *Perioperative Care/economics/methods ; *Anesthesia/economics/methods ; *Preoperative Care/economics/methods/trends ; Anesthesiologists/economics ; }, abstract = {The escalating costs of perioperative care are unsustainable, necessitating the identification of high-impact investment opportunities to enhance both quality and cost-effectiveness of perioperative processes. In both rural and urban areas with less access to health care resources, a sustainable health care system must focus on delivering value-based care and prioritizing population health, promoting efficiency, preventing complications, and optimizing outcomes. Given the shortage of primary care physicians, and the lessons learned from the COVID-19 pandemic, which emphasized the importance of a systems-based approach, as well as the evolving roles in the perioperative surgical home and ERAS pathways, anesthesiologists are in a prime position to contribute to these essential value-based objectives. They can achieve this by playing a more active role in the preoperative evaluation and optimization of patients.This paper presents a comprehensive review of pertinent perioperative medical conditions (obstructive sleep apnea, hypertension, anemia, food insecurity and nutrition, diabetes, cognitive and brain health) that can be optimized before surgery. It highlights the latest research and innovations in preoperative management that can significantly alter intraoperative anesthetic management of these conditions leading to reduced morbidity and mortality among surgical patients. Furthermore, this paper highlights existing gaps in preoperative management, particularly in the optimization of comorbid medical conditions.}, }
@article {pmid41387929, year = {2025}, author = {Kanno, H and Liu, Z and Sato, R and Endo, H and Niizuma, K and Goda, K}, title = {Single-pixel imaging flow cytometry for biomedical research.}, journal = {Inflammation and regeneration}, volume = {45}, number = {1}, pages = {36}, pmid = {41387929}, issn = {1880-9693}, abstract = {High-throughput single-cell analysis and screening have become essential tools in life science research. Imaging flow cytometry, in particular, enables large-scale image-based profiling of heterogeneous cell populations, allowing statistical analysis of cellular morphology, subcellular features, and functional responses. However, its analytical capability is often limited by the use of conventional two-dimensional (2D) image sensors. In this review, we highlight recent advances in single-pixel imaging flow cytometry, which replaces 2D image sensors with single-pixel photodetectors. This approach offers advantages in sensitivity, flexibility, and speed in imaging system design and has been implemented in various optical configurations to achieve high-throughput single-cell imaging. We first introduce its key techniques, then outline representative biomedical applications, including cancer and COVID-19 research, and finally discuss current limitations and prospects for future developments. Single-pixel imaging flow cytometry is expected to serve as a versatile platform supporting both basic and translational studies in diverse biomedical applications.}, }
@article {pmid41366793, year = {2025}, author = {Chen, H and Zhang, J and Huang, J and Wu, Z and Tang, L and Tian, Y and Gao, S and Huang, S and Cao, J and Chen, J and Li, Y}, title = {Convergence of mRNA technology and chimeric antigen receptor therapy: targeted technology optimizing targeted therapy.}, journal = {Journal of translational medicine}, volume = {23}, number = {1}, pages = {1393}, pmid = {41366793}, issn = {1479-5876}, abstract = {Engineering cells to express chimeric antigen receptors (CARs) represents a novel approach in cancer immunotherapy, demonstrating remarkable efficacy in the treatment of hematologic malignancies while also encountering numerous challenges. Against the backdrop of the widespread application of COVID-19 mRNA vaccines, the integration of mRNA technology to produce CAR cells and enhance CAR therapies marks the cutting edge of cancer treatment innovation, offering potential solutions to the challenges faced by traditional CAR therapies. This convergence offers distinct advantages. It enables the generation of CAR cells both in vitro and in vivo without transgene integration, thereby achieving transient expression that reduces the risk of various side effects. Meanwhile, this approach entails lower production costs. This method may therefore serve as a novel and promising alternative to existing therapies in the future. In this article, we review the latest advancements and clinical applications of mRNA-based CAR therapies, which utilize mRNA technology to generate CAR-T cells. Additionally, we explore the diverse therapies enabled by mRNA technology, such as gene editing and vaccines, and their combination with CAR therapies. By analyzing their challenges and prospects, we aim to provide new insights into comprehensively improving the therapeutic efficacy of CAR therapies and expanding their clinical application.}, }
@article {pmid40292916, year = {2025}, author = {Barton, MJ and Okada, M and Todorovic, M}, title = {Podcasts in health education-Insights from a scoping review and survey.}, journal = {Anatomical sciences education}, volume = {18}, number = {12}, pages = {1388-1405}, doi = {10.1002/ase.70037}, pmid = {40292916}, issn = {1935-9780}, mesh = {Humans ; *Webcasts as Topic ; *Health Education/methods ; Surveys and Questionnaires ; *COVID-19/epidemiology ; Adult ; Male ; Female ; }, abstract = {Podcasts have rapidly emerged as a powerful tool for health communication, especially since the COVID-19 pandemic. While evidence shows that podcasts can enhance student knowledge, confidence, and flexibility in learning, their educational impact is primarily studied within formal academic contexts. Despite their popularity and potential, little is known about how bioscience-focused health podcasts engage broader audiences beyond structured health education programs. Limited research examines who listens, why they choose podcasts, and how this format influences their learning or behavior. To address this, we used a mixed-methods approach comprising a scoping review and an exploratory online survey. The scoping review, following PRISMA guidelines, identified 14 eligible studies published between 2008 and 2024. The survey, distributed via social media and Dr. Matt &amp; Dr. Mike's Medical Education Podcast, captured responses from 226 participants-predominantly aged 25-34 and mostly from the USA-with two-thirds enrolled in health programs. Participants cited access to expert insights, enjoyment, and the ability to multitask as key reasons for podcast use. Content relevance and presenter expertise were rated the most important factors when selecting a health podcast. The preferred episode length was 30-60 min. On average, participants rated the impact of podcasts on their health knowledge at 4.22 out of 5, with 58% reporting changes in health-related behaviors. These findings suggest that podcasts offer a flexible, engaging way to communicate bioscience-focused health content and support learning across diverse audiences. Educators should consider listener motivations and preferences when integrating podcasts into educational practice.}, }
@article {pmid41386922, year = {2025}, author = {Bhalla, A and Tummalapalli, SL and Silberzweig, J}, title = {Quality Metrics in Dialysis: It Takes a Village.}, journal = {Advances in kidney disease and health}, volume = {32}, number = {5}, pages = {451-459}, doi = {10.1053/j.akdh.2024.12.001}, pmid = {41386922}, issn = {2949-8139}, mesh = {Humans ; *COVID-19/epidemiology ; *Renal Dialysis/standards ; *Kidney Failure, Chronic/therapy ; United States ; *Patient Care Team/organization &amp; administration ; SARS-CoV-2 ; *Quality of Health Care ; Hemodialysis, Home/standards ; }, abstract = {Dialysis is a specialized therapy rendered by a team of interdisciplinary professionals. Federal regulations mandate that dialysis facility staff, at minimum, include a registered nurse, physician, social worker, and dietitian. To ensure that patients on dialysis receive high-quality care, the Centers for Medicare and Medicaid Services introduced the first federally mandated pay for performance program in January 2012: the ESRD Quality Incentive Program. Quality metrics in the ESRD Quality Incentive Program have continuously evolved, necessitating greater involvement from the dialysis interdisciplinary team. In this article, we discuss the interdisciplinary nature of dialysis facility staffing and highlight the critical role of all care team members in attaining high performance on dialysis quality metrics. In the context of the coronavirus disease 2019 pandemic, we highlight recent staffing challenges and propose strategies to alleviate workforce shortages. Finally, we review 2 major trends: (1) an increased emphasis on home dialysis and (2) calls to address social determinants of health, which will require the interdisciplinary team to assume an even larger role in achieving high-quality care.}, }
@article {pmid41046954, year = {2025}, author = {Welc, N and Anioła, A and Ważniewicz, S and Michalak, M and Jałowska, M and Dańczak-Pazdrowska, A and Grzybowski, A and Żaba, R and Kavanagh, K}, title = {Syphilis incidence during the COVID-19 pandemic: systematic review and meta-analysis.}, journal = {Clinics in dermatology}, volume = {43}, number = {6}, pages = {836-849}, doi = {10.1016/j.clindermatol.2025.09.031}, pmid = {41046954}, issn = {1879-1131}, mesh = {Humans ; *Syphilis/epidemiology/diagnosis/transmission ; *COVID-19/epidemiology ; Incidence ; Pandemics ; SARS-CoV-2 ; Health Services Accessibility ; }, abstract = {The COVID-19 pandemic created a public health crisis that affected mental and physical health. Research examined its effect on sexually transmitted infections, particularly syphilis. Asymptomatic stages and inadequate screening likely delayed detection and increased transmission after restrictions eased. Limited health care access and lockdowns reduced social interactions. Studying syphilis reveals how changes in health care access influenced transmission, showcasing the pandemic as a natural experiment for sexually transmitted infection epidemiology. We used the PubMed database, selecting studies from 2019 to August 2024. The meta-analysis evaluated incidence rate ratios from 2019 to 2020 to assess the pandemic's global impact on syphilis rates. Published papers were categorized by region for subgroup analysis. Of the 233 studies, 21 were selected for further analysis. A common-effects model was used to calculate the incidence rate ratio with a 95% CI. We assessed publication bias using funnel plot asymmetry and Egger test, examining heterogeneity with the I[2] statistic. We found a 14% decrease in syphilis incidence in various regions (incidence rate ratio: 1.14; 95% CI: 1.06-1.24, P = .006). Analysis by country and city was inconclusive. This indicates that the impact of the epidemic on syphilis transmission and diagnosis may be multifactorial. Syphilis incidence fell during the pandemic, illustrating that reduced health care access and social restrictions affected transmission. National analyses were inconclusive, suggesting the pandemic's effects on syphilis may vary by location. These findings emphasize the need for further research on the pandemic's long-term impact on syphilis trends and the importance of improving sexually transmitted infection surveillance and health care access during recovery.}, }
@article {pmid41386679, year = {2025}, author = {Hamel, LP}, title = {Nicotiana benthamiana's Responses to Agroinfiltration, a Treasure Grove of New Avenues to Improve Protein Yields in Plant Molecular Farming.}, journal = {Plant biotechnology journal}, volume = {}, number = {}, pages = {}, doi = {10.1111/pbi.70460}, pmid = {41386679}, issn = {1467-7652}, abstract = {Transient expression of recombinant proteins in leaves of Nicotiana benthamiana is routinely employed for both basic research and manufacturing of biopharmaceutical products in plants. Relying on disarmed strains of the bacterial plant pathogen Agrobacterium tumefaciens as a transgene vector, this safe, cost-effective and easily scalable 'plant molecular farming' approach offers a reliable alternative to classical protein expression platforms. Commonly referred to as agroinfiltration, scaled-up versions of this manufacturing process have now become helpful in the fight against global health issues, such as those rapidly evolving virus strains causing influenza or coronavirus disease 2019. In the past decades, considerable efforts have been deployed to improve the efficacy of Agrobacterium-mediated expression, including through the development of new binary vectors, the design of strong promoters, and the deployment of approaches to increase levels and stability of transgene mRNAs. By comparison, much less attention has been given to understanding the effects that agroinfiltration unavoidably has on host plants, including the infiltration process itself, the perception of Agrobacterium and the subsequent accumulation of recombinant products throughout the expression phase. Using the upregulation profiles of plant receptor genes during the heterologous expression of virus-like particles in N. benthamiana leaves, I here describe how some of these host responses interact with each other to form an intricate signalling interplay at the molecular level. I also review host plant's responses to agroinfiltration and highlight strategies that have emerged to improve the efficacy of plant cell biofactories based on the better understanding of this transient expression system.}, }
@article {pmid41385537, year = {2025}, author = {Takkar, A and Mahesh, KV and Shree, R and Tigari, B and Chatterjee, D and Ahuja, CK and Lal, V}, title = {Neuro-ophthalmology of Infectious Diseases.}, journal = {Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society}, volume = {45}, number = {3}, pages = {362-377}, pmid = {41385537}, issn = {1536-5166}, mesh = {Humans ; *Ophthalmology/methods ; *Eye Infections/diagnosis ; *Neurology ; }, abstract = {BACKGROUND: According to the World Health Organization, infections, particularly sepsis, are linked to over 20% mortality worldwide and are leading cause of morbidity. A variety of infections have neuro-ophthalmic manifestations. The profile of infectious agents, clinical manifestations, severity, and prognosis of these diseases are highly heterogeneous, and it is therefore difficult to make generalized statements about management.<br><br>EVIDENCE ACQUISITION: Available literature with regard to individual infectious agents and their neuroophthalmic manifestations or complications was searched using electronic databases such as PubMed, MEDLINE, Scopus, ProQuest, and Embase. The current study is a review of the literature along with the authors' personal experience in this field.<br><br>RESULTS: In this review, we describe the key neuro-ophthalmic manifestations of common bacterial, fungal, viral (except HIV, opportunistic infections, and COVID-19 virus), parasitic, and protozoal infections using illustrative examples.<br><br>CONCLUSIONS: Infections may involve the afferent and efferent visual pathways, as well as higher order visual processing functions. They can directly invade the eye and the brain or may cause damage due to inflammation, necrosis, vascular compromise, and postinfective demyelination. With the shifting geographic boundaries and widespread international migration, the spectrum of infectious neuro-ophthalmic diseases is expanding. Clinical details, dedicated imaging, biochemical, serological, and at times histopathological confirmation aids in making prompt diagnosis.}, }
@article {pmid41385334, year = {2025}, author = {Yang, Y and Sun, Y and Kang, X and Wang, Y}, title = {mRNA vaccine platforms and novel delivery systems: From mechanistic principles to clinical translation.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2597629}, doi = {10.1080/21645515.2025.2597629}, pmid = {41385334}, issn = {2164-554X}, mesh = {Humans ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; *Drug Delivery Systems/methods ; *Vaccines, Synthetic/immunology/administration &amp; dosage ; *COVID-19/prevention &amp; control/immunology ; Nanoparticles ; Vaccine Development ; *RNA, Messenger/immunology/administration &amp; dosage/genetics ; *mRNA Vaccines/immunology/administration &amp; dosage ; SARS-CoV-2/immunology ; Vaccines, Virus-Like Particle/administration &amp; dosage/immunology ; }, abstract = {Messenger RNA (mRNA) vaccines have revolutionized the field of vaccinology, offering rapid design flexibility, scalable manufacturing, and strong immunogenicity. The unprecedented success of COVID-19 mRNA vaccines has accelerated research into novel delivery platforms and expanded therapeutic applications beyond infectious diseases to cancer immunotherapy and immune-mediated disorders. This review provides a comprehensive overview of the mechanistic principles underlying mRNA vaccine design, including mRNA engineering strategies, delivery innovations such as lipid nanoparticles (LNPs), polymeric nanoparticles (PNPs), and virus-like particles (VLPs), as well as emerging needle-free administration technologies. We further highlight recent advances in therapeutic areas spanning infectious diseases (e.g. HIV, tuberculosis, respiratory syncytial virus), oncology, and non-traditional indications such as autoimmune disorders. Despite remarkable progress, critical challenges persist in vaccine stability, delivery efficiency, large-scale manufacturing, and global accessibility. Finally, we discuss future research directions integrating artificial intelligence, nanotechnology, and systems immunology to accelerate next-generation mRNA vaccine development and clinical translation.}, }
@article {pmid41384659, year = {2025}, author = {Bessalah, S and Sinha, D and Yuan, X and Paul, S and Longet, S}, title = {[Long COVID: therapeutic challenges and opportunities in the face of persistent sequelae].}, journal = {Medecine sciences : M/S}, volume = {41}, number = {11}, pages = {869-876}, doi = {10.1051/medsci/2025185}, pmid = {41384659}, issn = {1958-5381}, mesh = {Humans ; *COVID-19/complications/therapy/epidemiology ; *SARS-CoV-2/physiology ; Post-Acute COVID-19 Syndrome ; Pandemics ; COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use ; Chronic Disease ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has not only led to a global health and economic crisis but also renewed attention to a clinical phenomenon of persistent symptoms after viral infection. This phenomenon is defined as long COVID or post-COVID-19 syndrome. Approximately one in eight patients experience persistent symptoms of varying intensity after the acute phase of the infection. This phenomenon, combined with the virus's high transmissibility and rapid mutation rate, poses a major public health challenge. This review examines various therapeutic approaches currently under consideration for treating long COVID, and explores future prospects in this field.}, }
@article {pmid41384439, year = {2025}, author = {Van Houtte, P and Lamarche, F and Every-Palmer, S}, title = {Effects of face coverings on people and interactions in mental health settings: scoping review.}, journal = {BJPsych open}, volume = {12}, number = {1}, pages = {e11}, doi = {10.1192/bjo.2025.10917}, pmid = {41384439}, issn = {2056-4724}, abstract = {BACKGROUND: Early in the SARS-CoV-2 pandemic, most jurisdictions implemented mandatory face covering policies across healthcare settings. This intervention, which lasted multiple years, was unprecedented in psychiatry. Masks may affect the delivery of mental healthcare, given its reliance on nuanced communication and establishing a therapeutic alliance.<br><br>AIMS: This scoping review aimed to provide an overview of the current literature concerning the impact of face masks in mental health settings beyond infection control and identify research gaps to guide future research and policy.<br><br>METHOD: Systematic searches were completed in the MEDLINE, Embase, PsycINFO, Scopus and CINAHL databases on 14 August 2024. Articles were eligible if they described peer-reviewed empirical studies involving people with mental disorders or mental health clinicians that reported on impacts of face coverings.<br><br>RESULTS: Twenty-eight studies were selected for inclusion, involving 5385 participants. There was considerable heterogeneity among studies. Negative effects of face masks were reported in 26 studies in at least one domain. Themes from the survey-based literature included face masks negatively affecting communication, the therapeutic relationship and overall assessment quality. Experimental studies using emotion recognition tasks showed that people with mental disorders were disadvantaged by masks when interpreting emotions from facial expressions. The most commonly studied population was people with autism spectrum disorder. Children and people with severe or acute mental illness were underrepresented. Only two studies expressly recruited psychiatrists.<br><br>CONCLUSIONS: Policy makers should be aware of adverse impacts of mask-wearing in mental health settings and consider these in evolving risk-benefit analyses. Further research is needed to establish the extent of impacts on population subgroups.}, }
@article {pmid41383825, year = {2025}, author = {Trulik, KG and Kumar, VA and Wu, W and Varma, M and Patel, MM and Manglani, K and Mathew, TA}, title = {Exploring Stress, Fatigue, Burnout, and Resilience Among Healthcare Personnel in Southern and South-Eastern Asia: A Scoping Review.}, journal = {Public health reviews}, volume = {46}, number = {}, pages = {1608603}, pmid = {41383825}, issn = {0301-0422}, abstract = {OBJECTIVES: This study aims to compare methods used to measure burnout, fatigue, stress, and resilience, as well as resilience-building interventions among healthcare personnel (HCP) in Southern and South-eastern Asia. Even before COVID-19, HCP faced high levels of burnout and stress, exacerbated by the pandemic. Identifying effective resilience-building strategies is essential to supporting a healthier workforce.<br><br>METHODS: Studies published from January 2016 to December 2021 focusing on burnout, stress, fatigue, and resilience were included. COVIDENCE software was used for screening.<br><br>RESULTS: A total of 55 studies were included in the review. Of these 55 studies, 51 measured burnout, stress, fatigue, or resilience, using 77 different instruments. The MBI-HSS, PSS-10, BRS, Brief-COPE, and CD-RISC were the most common tools to assess burnout, stress, and individual resilience. Four studies evaluated resilience interventions, using mindfulness training, meditation, progressive muscle relaxation, and yoga.<br><br>CONCLUSION: There are many studies assessing burnout, stress, and resilience among HCP in Southern and South-eastern Asia, yet gaps remain in identifying effective resilience-building interventions. Further research is needed to assess the impact of individual resilience on health systems resilience.}, }
@article {pmid41383811, year = {2025}, author = {Manivannan, SN and Diaz Arenas, C and Grubaugh, ND and Ogbunugafor, CB}, title = {The importance of epistasis in the evolution of viral pathogens.}, journal = {Virus evolution}, volume = {11}, number = {1}, pages = {veaf091}, pmid = {41383811}, issn = {2057-1577}, abstract = {Understanding the genetic and genomic underpinnings of infectious disease outbreaks has emerged as a frontier of epidemiology. Here, we argue that epistasis-where the phenotypic effects of mutations or gene variants are dictated by the presence of other mutations or genes-should become a focus of genomic epidemiology. To demonstrate this, we present the results of a systematic review of the literature on epistasis in viruses, focusing on three major human viral systems: (i) influenza, (ii) SARS-CoV-2, and (iii) human immunodeficiency virus, as well as two other bodies of the literature mainly focusing on nonhuman viruses: (iv) tobacco etch virus and (v) experimental evolution of viruses. Our systematic review of these five bodies of the literature highlights that epistasis is prevalent in host-virus systems of various kinds, manifesting within and between different loci, with effects of different magnitudes and directions, and shaping various phenotypic traits of epidemiological interest. At the same time, our systematic review demonstrates that our ability to draw general conclusions about the direction and magnitude of epistasis in viral evolution is constrained by several factors: the idiosyncrasies of virus-host systems, biases in the underlying data collection exercises, and the limitations of existing methods. Moving forward, we encourage collaborations between genomic epidemiologists and evolutionary biologists to identify and measure epistasis in studying the evolution of viral pathogens.}, }
@article {pmid41383618, year = {2025}, author = {Xu, T and Zhang, J and Hou, X and Xie, X and Qi, J and Wang, C and Yan, Y and Kuang, L and Zhu, B}, title = {MIS-C pathogenesis: immune dysregulation &amp; viral triggers.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1624963}, pmid = {41383618}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; *Systemic Inflammatory Response Syndrome/immunology/therapy/etiology/virology ; Child ; Immunity, Innate ; Adaptive Immunity ; Cytokine Release Syndrome/immunology ; }, abstract = {Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition emerging during the COVID-19 pandemic, strongly associated with prior SARS-CoV-2 infection. Characterized by systemic inflammation affecting multiple organs, MIS-C presents a complex clinical picture including fever, gastrointestinal distress, cardiac dysfunction, and neurological manifestations. Although its exact pathogenesis remains incompletely understood, immune dysregulation is recognized as a central mechanism. This review examines current understanding of MIS-C pathogenesis, focusing on immune dysfunction and viral triggers, particularly SARS-CoV-2. We analyze both innate and adaptive immune responses, cytokine storm dynamics, molecular mimicry, and virus-induced inflammatory cascades. Additionally, we discuss potential immunomodulatory therapeutic strategies and identify future research directions to improve MIS-C management and treatment outcomes.}, }
@article {pmid41383331, year = {2025}, author = {Okon, MB and Ugwu, OP and Ugwu, CN and Ogenyi, FC and Swase, DT and Anyanwu, CN and Eze, VHU and Ugwu, JN and Akinola, SA and Mujinya, R and Anyanwu, EG}, title = {From pandemics to preparedness: harnessing AI, CRISPR, and synthetic biology to counter biosecurity threats.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1711344}, pmid = {41383331}, issn = {2296-2565}, mesh = {Humans ; *Artificial Intelligence ; *Pandemics/prevention &amp; control ; *Synthetic Biology ; *Biosecurity ; *Bioterrorism/prevention &amp; control ; COVID-19/prevention &amp; control ; *Civil Defense/methods ; Global Health ; }, abstract = {Biosecurity threats, which include natural outbreaks, laboratory accidents, and intentional bioterrorism, are a major issue for global health security. The impact of poor preparedness on the health, social, and economic effects of the 1918 influenza pandemic, the 2001 anthrax attacks, and the COVID-19 crisis is devastating. Standard methods, such as quarantine and serology, as well as traditional inoculations, offered basic defences but were often reactive, slow, and unfair. The recent scientific and technological progress has altered the concept of biosecurity preparedness by providing new instruments of early detection, quick reaction, and fair health solutions. Artificial intelligence-based epidemic prediction, next-generation sequencing, CRISPR-based diagnostics, and digital epidemiology are emerging technologies that enable near-real-time surveillance. New therapeutic agents and vaccines, such as mRNA and DNA platforms, monoclonal antibodies, and nanobody therapies, have enhanced response capabilities. Containment measures based on robotics, biosensors, nanotechnology-based PPE, and portable biocontainment units have simultaneously improved frontline safety. Sensitive health information and enhanced coordination are today secured with the help of digital and cyber-biosecurity tools. Nonetheless, the innovations have ethical, legal, and equity issues, which point to the need to govern responsibly and make them accessible to all. This review brings forth the incorporation of emerging technologies with international cooperation, fair systems, and responsive policies as the keys to developing resilient and future-orientated systems that could help alleviate natural, accidental, and intentional biosecurity threats.}, }
@article {pmid41380396, year = {2025}, author = {Ballout, S and Darwish, SA and Kelly, PJ and Keller, T and Shegog, R and Aboul-Enein, BH}, title = {The use of storytelling in COVID-19 vaccine promotion: A scoping review of interventions and campaigns.}, journal = {Vaccine}, volume = {72}, number = {}, pages = {128098}, doi = {10.1016/j.vaccine.2025.128098}, pmid = {41380396}, issn = {1873-2518}, abstract = {BACKGROUND: The development of the COVID-19 vaccine, a groundbreaking scientific advancement, also fueled vaccine hesitancy mainly due to vaccine misinformation and the limited public understanding of the new technology and its rapid pace of development and deployment. A variety of public health communication strategies have been used that include engaging the community in identifying and developing messages, using culturally appropriate communication methods, applying behavioral health principles, and storytelling. The purpose of this scoping review was to assess the most relevant evidence from the research literature on storytelling interventions to mitigate COVID vaccine hesitancy during the pandemic.<br><br>METHODS: A scoping review was conducted using the PICOS framework and PRISMA-ScR guidelines, examining studies across 16 databases published between 2020 and October 2025.<br><br>RESULTS: Twelve studies met inclusion criteria. Studies involved diverse populations and four implementation themes (cultural relevance, emotional engagement, participant involvement and reach) were identified. The experimental and quasi-experimental studies consistently found that narratives elicited greater emotional engagement, heightened perceived credibility, and stronger identification with the messenger.<br><br>CONCLUSION: Storytelling is recognized as a critical component of public health campaigns in its ability to leverage the power of community influencers, such as religious leaders, educators, and local advocates who echo community values. Long-term cohort studies, community-based social marketing campaigns, and qualitative studies are needed to assess specific impacts on vaccination behaviors. Storytelling, when tailored to audience, culture, and context, can contribute to promotion of vaccination, particularly in improving trust, empathy, and misinformation.}, }
@article {pmid41380366, year = {2025}, author = {Sorotos, M and Firmani, G and Mareş, T and Ceccaroni, A and Santanelli di Pompeo, F}, title = {Epidemiology of Breast Implant-Associated Anaplastic Large Cell Lymphoma - A systematic review of literature.}, journal = {Journal of plastic, reconstructive &amp; aesthetic surgery : JPRAS}, volume = {113}, number = {}, pages = {399-410}, doi = {10.1016/j.bjps.2025.11.038}, pmid = {41380366}, issn = {1878-0539}, abstract = {INTRODUCTION: Breast Implant Associated - Anaplastic Large Cell Lymphoma (BIA-ALCL) cases are steadily increasing worldwide. When considering only the patients with textured implant as the active population, prevalence appears higher than previously reported, and uncertainty regarding incidence rate (IR) trends. We aimed to provide comprehensive estimates by identifying epidemiologic studies reporting prevalence, risk, and IR.<br><br>METHODS: A systematic review was conducted up to November 2024 across PubMed, Google Scholar, and Web of Science. Epidemiological data were extracted from the "Patient Registry and Outcomes for Breast Implants and Anaplastic Large Cell Lymphoma Etiology and Epidemiology" (PROFILE) registry (US-specific), Food and Drug Administration (FDA)-Medical Device Reporting (MDR) (US/global), and BIA-ALCL Global Network (worldwide), providing granular data for 2019-2024, enabling yearly IR analysis. All findings were normalized using textured implants patients as the denominator. Interrupted time-series analysis was used to determine the impact of the COVID-19 pandemic on BIA-ALCL reporting.<br><br>RESULTS: Among the 1949 studies, 23 were analyzed.<br><br>PREVALENCE: 1.0-397.9/100,000 persons; risk: 1:250-1:99,992; and IR 0.021-124/100.000 persons/year. Nationally (US), PROFILE and FDA-MDR data showed IR peaking in 2020 (16.4 and 25.7/100,000) and then declining. Globally, FDA-MDR estimates peaked in 2021 (0.95/100,000) and plummeted in 2022 (0.14/100,000). Global Network data peaked in 2018 (0.68/100,000), dropped in 2020 (0.18/100,000), but rose again in 2024 (0.73/100,000). Significant IR declines (p&#xa0;=&#xa0;0.02), were identified during the COVID-19 pandemic (2020-2022). Global data suggest transient underreporting and diagnostic delays.<br><br>CONCLUSION: BIA-ALCL IR decreased in 2022, then rose globally in 2023-2024, but not in the US, where it continued declining. IR trends were increasing but were influenced by COVID-19, with differences in absolute values likely reflecting smooth vs. textured implant market share variations. Contextualizing epidemiology by surface type and geography remains fundamental.}, }
@article {pmid41379427, year = {2025}, author = {Salamh, P and Dilibe-Daramola, F and Flannery, A and Pollard, C and Rocha, R and Lapidow, A and Wooten, L}, title = {Incidence and characteristics among individuals developing frozen shoulder following COVID-19 vaccine administration: A systematic review.}, journal = {Physiotherapy theory and practice}, volume = {}, number = {}, pages = {1-8}, doi = {10.1080/09593985.2025.2601894}, pmid = {41379427}, issn = {1532-5040}, abstract = {PURPOSE: Perform a systematic review to determine incidence and characteristics of vaccine administration of those developing frozen shoulder (FS) following COVID-19 vaccine administration.<br><br>METHODOLOGY: Systematic review of the literature (PROSPERO number CRD42024611140). Inclusion criteria; diagnosis of frozen shoulder, published or available in the English language and onset of frozen shoulder linked to COVID-19 vaccination. Studies were excluded if FS was linked to onset outside of vaccination and if data were not separated. Relevant studies were assessed for inclusion and selected studies were identified from PubMed, EMBASE, EBSCOhost, Cochrane Library, Web of Science and CINAHL databases. The search strategy was developed by a biomedical librarian run on August 4, 2025. Data were extracted from retained studies and underwent quality assessment using The Joanna Briggs Institute Critical Appraisal Checklist.<br><br>RESULTS: The search resulted in 1,506 studies and 9 retained for appraisal. A total of 140 individuals were identified among the retained studies with past medical history being reported in 6 of these studies identifying diabetes and hypothyroidism among the most common. Vaccine manufacturer and symptom manifestation data were reported in all retained studies. Incidence could not be determined based on available data.<br><br>CONCLUSION: In addition to known risk factors associated with vaccinations, those with comorbidities associated with the etiology of FS may also be predisposed to developing FS following COVID-19 vaccination administration. Clinicians evaluating those with suspected FS should be aware of the link between vaccinations and the development of FS. Additionally, clinicians administering COVID-19 vaccinations and boosters need to be aware of potential risk factors that may predispose individuals to developing FS following as well as possible signs and symptoms to be aware of post-vaccination.}, }
@article {pmid41379362, year = {2025}, author = {Nazarian, E and Sinnige, JS and Bos, LDJ and Smit, MR}, title = {Advances in bedside imaging: lung ultrasound.}, journal = {Intensive care medicine experimental}, volume = {13}, number = {1}, pages = {126}, pmid = {41379362}, issn = {2197-425X}, abstract = {Lung ultrasound has become an indispensable tool in the management of acute respiratory failure, offering real-time, radiation-free bedside imaging. Its portability, repeatability, and high sensitivity for detecting pulmonary abnormalities have made it particularly valuable in critical care settings, especially during the Coronavirus disease 2019 pandemic. This narrative review explores the evolving role of lung ultrasound, examining both its established clinical applications and recent advances in artificial intelligence and imaging analysis. These developments emphasize the growing importance of lung ultrasound not only as a diagnostic tool but also as a platform for innovation, with artificial intelligence-driven approaches to further enhance its clinical utility.}, }
@article {pmid41223433, year = {2025}, author = {Worthington, D}, title = {Integration of Virtual Care in the Audiology Service and Beyond.}, journal = {American journal of audiology}, volume = {34}, number = {4}, pages = {767-780}, doi = {10.1044/2025_AJA-25-00149}, pmid = {41223433}, issn = {1558-9137}, mesh = {Humans ; *Telemedicine/organization &amp; administration ; COVID-19 ; *Audiology/organization &amp; administration/methods ; United States ; United States Department of Veterans Affairs ; Pandemics ; SARS-CoV-2 ; Health Services Accessibility ; *Coronavirus Infections/epidemiology ; *Pneumonia, Viral/epidemiology ; Betacoronavirus ; }, abstract = {PURPOSE: This clinical focus article examines the history and evolution of telehealth, emphasizing its technological advancements, integration into health care systems, and the transformative impact of the COVID-19 pandemic on telehealth utilization in the United States, within the private sector and the Veterans Health Administration (VHA). Particular attention is given to the integration of audiology within telehealth, highlighting how the growth and use of teleaudiology services within the VHA have expanded access to this specialized care for Veterans. It aims to clarify how telehealth, including teleaudiology, has been established as a critical modality for enhancing health care access and delivery to Veterans.<br><br>CONCLUSIONS: The historical context reveals that, while telehealth has roots tracing back to the American Civil War or earlier, the COVID-19 pandemic catalyzed an unprecedented surge in adoption and integration of telehealth services in both the private sector and the VHA. The data indicate a significant increase in telehealth encounters and patient satisfaction before, during, and after the COVID-19 pandemic, reinforcing its role as a complementary modality alongside traditional in-person care. Challenges such as regulatory barriers and digital access disparities continue to exist, yet ongoing efforts to embed telehealth training in health care education and to foster technological innovation signal a promising future for telehealth. As the health care landscape evolves, telehealth is poised to remain an integral component of patient-centered care.}, }
@article {pmid41128286, year = {2025}, author = {Ajulo, HK and Alele, FO and Emeto, TI and Adegboye, OA}, title = {Spatial and spatiotemporal machine learning models for COVID-19 dynamics: a review of methodology and reporting practices.}, journal = {Epidemiologic reviews}, volume = {47}, number = {1}, pages = {}, doi = {10.1093/epirev/mxaf017}, pmid = {41128286}, issn = {1478-6729}, mesh = {*COVID-19/epidemiology ; Humans ; *Machine Learning ; *Spatio-Temporal Analysis ; SARS-CoV-2 ; Pandemics ; }, abstract = {COVID-19 has transitioned from a pandemic to an endemic state, but the emergence of novel variants continues to pose significant public health challenges. In this study, the application of spatial and spatiotemporal machine learning (ML) models in understanding the dynamics of COVID-19 was systematically reviewed, as were contextual local-level comprehensive socio-environmental drivers. A systematic search was conducted across the Scopus, Web of Science, PubMed, Emcare (via Ovid), and the World Health Organization COVID-19 databases, and gray literature, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data extraction was conducted according to the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies checklist, and study quality was assessed using a validated scoring system. A total of 42 studies met the inclusion criteria. The review Findings indicate that global-scale spatial and spatiotemporal ML models dominate the field. Long-standing standalone factors in the demographic, environmental, and socioeconomic domains are frequently used as local-level drivers. However, the integration of composite indicators, aggregating multiple standalone factors into a single score, is notably lacking. Such composite indicators have the potential to reduce model complexity, improve interpretability, and enhance performance by capturing multidimensional aspects of vulnerability or risk in a more simplified form. This review highlights critical gaps in the current use of spatial and spatiotemporal ML models to understand the spatial epidemiology of COVID-19. Addressing these gaps could significantly enhance the understanding of COVID-19 dynamics and inform the development of effective public health strategies to mitigate future threats.}, }
@article {pmid41102611, year = {2025}, author = {Karakonstantis, S and Lytras, T and Keske, S and Tsiodras, S and Papst, L and Ioannou, P and Velikov, P and Berg, LP and De Angelis, G and Prendki, V and Adlhoch, C and Penttinen, P and Rello, J and Gavazzi, G and Malhotra-Kumar, S and Skevaki, C and Slafkosky, M and Rath, B}, title = {The Care Continuum of Patients With Influenza in the Post-COVID-19 Era: A Position Paper.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S333-S346}, doi = {10.1093/infdis/jiaf333}, pmid = {41102611}, issn = {1537-6613}, mesh = {Humans ; *Influenza, Human/therapy/diagnosis ; *COVID-19/epidemiology ; *Continuity of Patient Care ; SARS-CoV-2 ; Health Services Accessibility ; }, abstract = {This position paper addresses the evolving care continuum for patients with respiratory viral infections in the context of the post-coronavirus disease 2019 pandemic phase. We emphasize the need to place the patient at the center of attention from the first signs of influenza-like illness to recovery. Current practices have revealed several deficiencies, such as timely access to healthcare, fragmentation of care, and inadequate follow-up instructions. This article proposes means to address these deficiencies and discusses diagnostic and management considerations for patients with suspected influenza infection.}, }
@article {pmid40982324, year = {2025}, author = {Cruise, C}, title = {Overview of Telehealth in the Department of Veterans Affairs.}, journal = {American journal of audiology}, volume = {34}, number = {4}, pages = {781-784}, doi = {10.1044/2025_AJA-24-00274}, pmid = {40982324}, issn = {1558-9137}, mesh = {Humans ; *Telemedicine/organization &amp; administration/trends ; United States ; *United States Department of Veterans Affairs ; COVID-19/epidemiology ; SARS-CoV-2 ; Health Services Accessibility ; Pandemics ; Veterans ; }, abstract = {BACKGROUND: Telehealth facilitates access to care via technology and broadband infrastructure, remotely connecting patients and their clinical care teams. This is particularly important for those in rural and medically underserved areas, where there may be a lack of specialty medical care, and terrain, weather, or transportation options may make travel to a health care facility difficult.<br><br>PURPOSE: The purpose of this clinical focus article is to provide an overview of the history, current state, and future direction of telehealth within the Department of Veterans Affairs.<br><br>CONCLUSIONS: A variety of tools and technology with which telehealth can be delivered exist. This enables health care organizations to leverage their clinical networks to match supply and demand across their enterprise and offer additional choices for how patients receive their care. The COVID-19 pandemic was an opportune time for expansion of telehealth. Postpandemic, in many health care systems, it has become a core part of clinical operations. To realize the full potential of telehealth and to ensure equity across populations, addressing gaps in broadband access and digital skills will be critical.}, }
@article {pmid40010790, year = {2025}, author = {Chen, JG and Chen, CY and Zhu, K and Ren, XY and Li, HB}, title = {[Interpretation of the Position Paper on Olfactory Dysfunction 2023 (PPOD-23)].}, journal = {Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery}, volume = {60}, number = {2}, pages = {212-216}, doi = {10.3760/cma.j.cn115330-20240428-00246}, pmid = {40010790}, issn = {1673-0860}, support = {2024SF-YBXM-345//Key Research and Development Program of Shaanxi Province/ ; xzy012020046//Basic Research Fund for the Central Universities/ ; 2021JQ-418//Natural Science Foundation of Shaanxi Province Youth Project/ ; }, mesh = {Humans ; COVID-19 ; *Olfaction Disorders/diagnosis/therapy ; Pandemics ; SARS-CoV-2 ; *Coronavirus Infections/complications ; *Pneumonia, Viral ; Betacoronavirus ; Practice Guidelines as Topic ; }, }
@article {pmid39905337, year = {2025}, author = {Pennestrì, F and Cabitza, F and Picerno, N and Banfi, G}, title = {Sharing reliable information worldwide: healthcare strategies based on artificial intelligence need external validation. Position paper.}, journal = {BMC medical informatics and decision making}, volume = {25}, number = {1}, pages = {56}, pmid = {39905337}, issn = {1472-6947}, support = {Ricerca Corrente//Ministero della Salute/ ; }, mesh = {Humans ; *Artificial Intelligence ; *COVID-19 ; *Information Dissemination/methods ; *Machine Learning ; Reproducibility of Results ; SARS-CoV-2 ; }, abstract = {Training machine learning models using data from severe COVID-19 patients admitted to a central hospital, where entire wards are specifically dedicated to COVID-19, may yield predictions that differ significantly from those generated using data collected from patients admitted to a high-volume specialized hospital for orthopedic surgery, where COVID-19 is only a secondary diagnosis. This disparity arises despite the two hospitals being geographically close (within20 kilometers). While machine learning can facilitate rapid public health responses, rigorous external validation and continuous monitoring are essential to ensure reliability and safety.}, }
@article {pmid39610162, year = {2024}, author = {Jacobsen, FF and Glasdam, S and Haukelien, H and van den Muijsenbergh, METC and Ågotnes, G}, title = {Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper.}, journal = {Primary health care research &amp; development}, volume = {25}, number = {}, pages = {e66}, pmid = {39610162}, issn = {1477-1128}, mesh = {Aged ; Aged, 80 and over ; Female ; Humans ; Male ; *COVID-19/epidemiology/prevention &amp; control ; *Frail Elderly ; *Healthy Aging ; *Long-Term Care/organization &amp; administration ; Nursing Homes ; Pandemics ; SARS-CoV-2 ; }, abstract = {AIM: This position paper focuses on healthy ageing for the frailest and institutionalized older adults in the context of the recent pandemic. The paper aims to identify and discuss hindering and promoting factors for healthy ageing in this context, taking both health safety and a meaningful social life into account, in a pandemic situation and beyond.<br><br>BACKGROUND: The recent COVID-19 pandemic has highlighted the vulnerability of frail older adults residing in long-term care institutions. This is a segment of the older population that does not seem to align well with the recent policy trend of healthy and active ageing. The need for healthy ageing in this population has been voiced by professionals and interest organizations alike, alluding to inadequate support systems during the pandemic, conditioned by both previous and newly emerging contextual factors. Supporting healthy ageing in older adults in nursing homes and other residential care settings calls for attending to meaningful social life as well as to disease control.<br><br>METHODS: Findings and early conclusions leading up to the position paper were presented with peer discussions involving healthcare professionals and researchers at two joint EFPC PRIMORE workshops 2021 and 2022, as well as other international research seminars on long-term care. The following aspects of long-term care and COVID-19 were systematically discussed in those events, with reference to relevant research literature: 1. Long-term care policies, 2. pre-COVID state of long-term care facilities and vulnerability to the pandemic, 3. factors influencing the extent of spread of infection in long-term care facilities, and 4. the challenge of balancing between strict measures for infection control and maintaining a meaningful social life for residents and their significant others.<br><br>FINDINGS: A policy shift towards ageing at home and supporting the healthiest of older adults seems to have had unwarranted effects both for frail older adults, their significant others, and professional care staff attending to their needs. Resulting insufficient investment in primary health care staff and in the built environment for frail older adults in nursing homes were detrimental both for the older adults living in nursing homes, their significant others, and staff. More investment in staff and in physical surroundings might improve the quality of care and the social life of older adults in nursing homes in a non-pandemic situation and be a resource for primary health care staff ensuring both protection from health hazards and a meaningful social life for frail older adults in a pandemic or epidemic situation. As for investing in the physical surroundings, smaller nursing homes are advantageous, with singular resident rooms and for developing out-and indoor spaces for socializing and for meeting with families and other visitors. Regarding investment in staff, there is a documented need for educated staff in full-time positions. Use of part-time or temporary staff should be limited.}, }
@article {pmid39441539, year = {2025}, author = {Vohra, KP and Johnson, KG and Dalal, A and Ibrahim, S and Krishnan, V and Abbasi-Feinberg, F and Abreu, AR and Bandyopadhyay, A and Gurubhagavatula, I and Kuhlmann, D and Martin, JL and Olson, EJ and Patil, SP and Shelgikar, AV and Trotti, LM and Wickwire, EM and Rowley, JA and Kapur, VK}, title = {Recommendations for permanent sleep telehealth: an American Academy of Sleep Medicine position statement.}, journal = {Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine}, volume = {21}, number = {2}, pages = {401-404}, pmid = {39441539}, issn = {1550-9397}, mesh = {Humans ; *Telemedicine/standards ; United States ; *Sleep Medicine Specialty ; *COVID-19/epidemiology ; *Sleep Wake Disorders/therapy ; Societies, Medical ; Academies and Institutes ; }, abstract = {UNLABELLED: Telehealth use greatly expanded under the Centers for Medicare and Medicaid Services waivers at the start of the COVID-19 pandemic; however, the uncertainty and limitations of continued coverage risks loss of this momentum. Permanent coverage with adequate reimbursement is essential for the long-term acceptance and expansion of telehealth services. Telehealth supports both the current and future need for sleep health management by expanding patient access, increasing clinician efficiency, improving patient safety, and addressing health care equity. Sleep medicine is an ideal field for telehealth due to limited provider access, safety concerns with sleepy patients, availability of remote patient monitoring for treatment management, and the minimal need for repeated physical examinations. Telehealth is noninferior for delivery of cognitive behavioral therapy for insomnia and can enhance obstructive sleep apnea treatment adherence. It is the position of the American Academy of Sleep Medicine that telehealth is an essential tool for the provision of high-quality, patient-centered care for patients with sleep disorders. We encourage all stakeholders including legislators, policymakers, clinicians, and patients to work together to address payment models, interstate care, technology access, prescribing practices, and ongoing research to ensure that sleep telehealth services are permanently available and accessible for all patients seeking sleep medicine care.<br><br>CITATION: Vohra KP, Johnson KG, Dalal A, et&#xa0;al. Recommendations for permanent sleep telehealth: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2025;21(2):401-404.}, }
@article {pmid39321629, year = {2024}, author = {Assiri, AM and Alshahrani, AM and Sakkijha, H and AlGeer, A and Zeitouni, M and AlGohary, M and Dhaini, L and Verma, R and Singh, H}, title = {Transforming respiratory tract infection diagnosis in the kingdom of saudi arabia through point-of-care testing: A white paper for policy makers.}, journal = {Diagnostic microbiology and infectious disease}, volume = {110}, number = {4}, pages = {116530}, doi = {10.1016/j.diagmicrobio.2024.116530}, pmid = {39321629}, issn = {1879-0070}, mesh = {Humans ; COVID-19/diagnosis/epidemiology ; Health Policy ; *Point-of-Care Testing/organization &amp; administration ; *Respiratory Tract Infections/diagnosis/drug therapy/epidemiology ; Saudi Arabia/epidemiology ; }, abstract = {With the evident increased prevalence of respiratory tract infections (RTIs) such as Respiratory Syncytial Virus (RSV), influenza, Group A Streptococcus (GAS), and COVID-19, the conventional diagnostic methods are considered sub-optimal in providing timely management to patients in the Kingdom of Saudi Arabia (KSA). Gaps in current diagnostics are magnified by the Kingdom's unique demographic composition, comprising 11.9 million foreign workers, and the annual influx of over 10 million pilgrims. Current gaps in timely diagnosis leads to delays in treatment, misuse of antibiotics, and protracted hospital stays, subsequently compromising patient care, and escalating healthcare costs. KSA healthcare stakeholders suggest that the integration of rapid molecular Point-of-Care Testing (POCT) into the Kingdom's healthcare infrastructure is an absolute necessity. This publication serves as an urgent call for action aimed at healthcare policymakers in Saudi Arabia, to review the existing diagnostic challenges and include rapid POCTs in the Saudi healthcare strategy for respiratory infections.}, }
@article {pmid39074368, year = {2024}, author = {Snyder Sulmasy, L and Burnett, JR and Carney, JK and DeCamp, M and , }, title = {Ethics and Academic Discourse, Scientific Integrity, Uncertainty, and Disinformation in Medicine: An American College of Physicians Position Paper.}, journal = {Annals of internal medicine}, volume = {177}, number = {9}, pages = {1244-1250}, doi = {10.7326/M24-0648}, pmid = {39074368}, issn = {1539-3704}, mesh = {Humans ; *COVID-19 ; Uncertainty ; *SARS-CoV-2 ; *Ethics, Medical ; *Pandemics ; United States ; Communication ; Pneumonia, Viral ; Betacoronavirus ; }, abstract = {Respect for the scientific process and a diversity of views; open discourse and debate based on principles of ethics, best available evidence, and scientific inquiry and integrity; and an understanding of evidence gaps and uncertainty and how to communicate about them are important values in the advancement of science and the practice of medicine. Physicians often must make decisions about their recommendations to patients in the face of scarce or conflicting data. Are these characteristics of medicine and science widely understood and effectively communicated among members of the profession and to patients and the public? Issues of scientific integrity are longstanding, but COVID-19 brought them to the forefront, in an environment that was sometimes characterized by communication missteps as guidance came and went-or changed-quickly. Today, is open debate flourishing? Have some debates shed more heat than light? Are people losing confidence in science and medicine? In health care institutions? The American College of Physicians explores these issues and offers guidance in this position paper.}, }
@article {pmid39028203, year = {2024}, author = {Hsu, VP and Pergam, SA and Shenoy, ES and Banach, DB and Jones Batshon, L and Branch-Elliman, W and Dumyati, G and Haessler, S and Jump, RLP and Malani, AN and Mathew, TA and Murthy, RK and Weber, DJ}, title = {SHEA position statement on pandemic preparedness for policymakers: emerging infectious threats.}, journal = {Infection control and hospital epidemiology}, volume = {45}, number = {7}, pages = {818-820}, doi = {10.1017/ice.2024.64}, pmid = {39028203}, issn = {1559-6834}, mesh = {Humans ; *Pandemics/prevention &amp; control ; Communicable Diseases, Emerging/prevention &amp; control/epidemiology ; COVID-19/prevention &amp; control/epidemiology ; Disaster Planning/organization &amp; administration ; Health Policy ; Pandemic Preparedness ; }, }
@article {pmid39002887, year = {2024}, author = {Freeman, RJ and States, LJ and Lewandowski, SA and Singer, DE and Patankar, SN and Niebuhr, DW}, title = {ACPM Position Statement: Air Pollution and Environmental Justice.}, journal = {American journal of preventive medicine}, volume = {67}, number = {5}, pages = {792-800}, doi = {10.1016/j.amepre.2024.07.003}, pmid = {39002887}, issn = {1873-2607}, mesh = {Humans ; *Air Pollution/adverse effects ; United States ; *COVID-19/prevention &amp; control/epidemiology ; *Environmental Justice ; Environmental Exposure/adverse effects/prevention &amp; control ; Preventive Medicine ; SARS-CoV-2 ; }, abstract = {The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices. Even during the coronavirus disease 2019 (COVID-19) lockdown, when the United States experienced significant decreases in polluting activities, these differences persisted. The American College of Preventive Medicine's Science and Translation Committee conducted a nonsystematic literature review to explore initiatives addressing air pollution as a key component of environmental justice, the state of the science regarding health impacts, and evidence supporting mitigations to reduce those impacts. We recommend advocacy for cleaner energy sources and increasing green space; and increasing research, surveillance, and education and training on linkages between air pollutants and health. We recommend preventive medicine physicians raise awareness about increased risks of cardiovascular disease, cancer, asthma, and reduced lung function with air pollution exposure. Preventive medicine physicians may also educate patients and other practitioners about exposures, and how "conventional" disease prevention strategies may have unintended consequences; and influence healthcare leaders to improve efficiency and reduce emissions. We also recommend physicians utilize social determinants of health Z-Codes to capture environmental factors. Private payers should incorporate pollution exposure data into social determinants of health risk adjustments for Medicare Advantage programs. Medicaid agencies should develop provider recommendations for pediatric populations, and states should finance in-home interventions for asthma.}, }
@article {pmid38835230, year = {2024}, author = {Branch-Elliman, W and Banach, DB and Batshon, LJ and Dumyati, G and Haessler, S and Hsu, VP and Jump, RLP and Malani, AN and Mathew, TA and Murthy, RK and Pergam, SA and Shenoy, ES and Weber, DJ}, title = {SHEA position statement on pandemic preparedness for policymakers: pandemic data collection, maintenance, and release.}, journal = {Infection control and hospital epidemiology}, volume = {45}, number = {7}, pages = {821-825}, doi = {10.1017/ice.2024.65}, pmid = {38835230}, issn = {1559-6834}, mesh = {Humans ; *Pandemics/prevention &amp; control ; *Data Collection/methods/standards ; United States ; COVID-19/prevention &amp; control/epidemiology ; Societies, Medical ; Information Dissemination/methods ; Pandemic Preparedness ; }, abstract = {The Society for Healthcare Epidemiology in America (SHEA) strongly supports modernization of data collection processes and the creation of publicly available data repositories that include a wide variety of data elements and mechanisms for securely storing both cleaned and uncleaned data sets that can be curated as clinical and research needs arise. These elements can be used for clinical research and quality monitoring and to evaluate the impacts of different policies on different outcomes. Achieving these goals will require dedicated, sustained and long-term funding to support data science teams and the creation of central data repositories that include data sets that can be "linked" via a variety of different mechanisms and also data sets that include institutional and state and local policies and procedures. A team-based approach to data science is strongly encouraged and supported to achieve the goal of a sustainable, adaptable national shared data resource.}, }
@article {pmid38835229, year = {2024}, author = {Weber, DJ and Malani, AN and Shenoy, ES and Banach, DB and Batshon, LJ and Branch-Elliman, W and Dumyati, G and Haessler, S and Hsu, VP and Jump, RLP and Mathew, TA and Murthy, RK and Pergam, SA}, title = {Society for Healthcare Epidemiology of America position statement on pandemic preparedness for policymakers: mitigating supply shortages.}, journal = {Infection control and hospital epidemiology}, volume = {45}, number = {7}, pages = {813-817}, doi = {10.1017/ice.2024.67}, pmid = {38835229}, issn = {1559-6834}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; United States ; *Personal Protective Equipment/supply &amp; distribution ; Pandemics/prevention &amp; control ; Infection Control/methods/organization &amp; administration ; SARS-CoV-2 ; Strategic Stockpile ; Pandemic Preparedness ; }, abstract = {The COVID-19 has had major direct (e.g., deaths) and indirect (e.g., social inequities) effects in the United States. While the public health response to the epidemic featured some important successes (e.g., universal masking ,and rapid development and approval of vaccines and therapeutics), there were systemic failures (e.g., inadequate public health infrastructure) that overshadowed these successes. Key deficiency in the U.S. response were shortages of personal protective equipment (PPE) and supply chain deficiencies. Recommendations are provided for mitigating supply shortages and supply chain failures in healthcare settings in future pandemics. Some key recommendations for preventing shortages of essential components of infection control and prevention include increasing the stockpile of PPE in the U.S. National Strategic Stockpile, increased transparency of the Stockpile, invoking the Defense Production Act at an early stage, and rapid review and authorization by FDA/EPA/OSHA of non-U.S. approved products. Recommendations are also provided for mitigating shortages of diagnostic testing, medications and medical equipment.}, }
@article {pmid38835227, year = {2024}, author = {Banach, DB and Mathew, TA and Batshon, LJ and Branch-Elliman, W and Dumyati, G and Haessler, S and Hsu, VP and Jump, RLP and Malani, AN and Murthy, RK and Pergam, SA and Shenoy, ES and Weber, DJ}, title = {SHEA position statement on pandemic preparedness for policymakers: building a strong and resilient healthcare workforce.}, journal = {Infection control and hospital epidemiology}, volume = {45}, number = {7}, pages = {804-807}, pmid = {38835227}, issn = {1559-6834}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; United States/epidemiology ; *Health Workforce ; *Health Personnel ; Pandemics/prevention &amp; control ; SARS-CoV-2 ; Infection Control/methods/organization &amp; administration ; Pandemic Preparedness ; }, abstract = {Throughout the COVID-19 pandemic, many areas in the United States experienced healthcare personnel (HCP) shortages tied to a variety of factors. Infection prevention programs, in particular, faced increasing workload demands with little opportunity to delegate tasks to others without specific infectious diseases or infection control expertise. Shortages of clinicians providing inpatient care to critically ill patients during the early phase of the pandemic were multifactorial, largely attributed to increasing demands on hospitals to provide care to patients hospitalized with COVID-19 and furloughs.[1] HCP shortages and challenges during later surges, including the Omicron variant-associated surges, were largely attributed to HCP infections and associated work restrictions during isolation periods and the need to care for family members, particularly children, with COVID-19. Additionally, the detrimental physical and mental health impact of COVID-19 on HCP has led to attrition, which further exacerbates shortages.[2] Demands increased in post-acute and long-term care (PALTC) settings, which already faced critical staffing challenges difficulty with recruitment, and high rates of turnover. Although individual healthcare organizations and state and federal governments have taken actions to mitigate recurring shortages, additional work and innovation are needed to develop longer-term solutions to improve healthcare workforce resiliency. The critical role of those with specialized training in infection prevention, including healthcare epidemiologists, was well-demonstrated in pandemic preparedness and response. The COVID-19 pandemic underscored the need to support growth in these fields.[3] This commentary outlines the need to develop the US healthcare workforce in preparation for future pandemics.}, }
@article {pmid38835222, year = {2024}, author = {Hsu, VP and Haessler, S and Banach, DB and Batshon, LJ and Branch-Elliman, W and Dumyati, G and Jump, RLP and Malani, AN and Mathew, TA and Murthy, RK and Pergam, SA and Shenoy, ES and Weber, DJ}, title = {SHEA position statement on pandemic preparedness for policymakers: introduction and overview.}, journal = {Infection control and hospital epidemiology}, volume = {45}, number = {7}, pages = {801-803}, pmid = {38835222}, issn = {1559-6834}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Pandemics/prevention &amp; control ; SARS-CoV-2 ; United States/epidemiology ; Health Policy ; Pandemic Preparedness ; }, abstract = {Throughout history, pandemics and their aftereffects have spurred society to make substantial improvements in healthcare. After the Black Death in 14[th] century Europe, changes were made to elevate standards of care and nutrition that resulted in improved life expectancy.[1] The 1918 influenza pandemic spurred a movement that emphasized public health surveillance and detection of future outbreaks and eventually led to the creation of the World Health Organization Global Influenza Surveillance Network.[2] In the present, the COVID-19 pandemic exposed many of the pre-existing problems within the US healthcare system, which included (1) a lack of capacity to manage a large influx of contagious patients while simultaneously maintaining routine and emergency care to non-COVID patients; (2) a "just in time" supply network that led to shortages and competition among hospitals, nursing homes, and other care sites for essential supplies; and (3) longstanding inequities in the distribution of healthcare and the healthcare workforce. The decades-long shift from domestic manufacturing to a reliance on global supply chains has compounded ongoing gaps in preparedness for supplies such as personal protective equipment and ventilators. Inequities in racial and socioeconomic outcomes highlighted during the pandemic have accelerated the call to focus on diversity, equity, and inclusion (DEI) within our communities. The pandemic accelerated cooperation between government entities and the healthcare system, resulting in swift implementation of mitigation measures, new therapies and vaccinations at unprecedented speeds, despite our fragmented healthcare delivery system and political divisions. Still, widespread misinformation or disinformation and political divisions contributed to eroded trust in the public health system and prevented an even uptake of mitigation measures, vaccines and therapeutics, impeding our ability to contain the spread of the virus in this country.[3] Ultimately, the lessons of COVID-19 illustrate the need to better prepare for the next pandemic. Rising microbial resistance, emerging and re-emerging pathogens, increased globalization, an aging population, and climate change are all factors that increase the likelihood of another pandemic.[4].}, }
@article {pmid38804606, year = {2024}, author = {Suen, LW and Incze, M and Simon, C and Englander, H and Bratberg, J and Groves Scott, G and Winograd, R}, title = {Methadone's Resurgence in Bridging the Treatment Gap in the Overdose Crisis: Position Statement of AMERSA, Inc (Association for Multidisciplinary Education, Research, Substance Use, and Addiction).}, journal = {Substance use &amp; addiction journal}, volume = {45}, number = {3}, pages = {337-345}, doi = {10.1177/29767342241255480}, pmid = {38804606}, issn = {2976-7350}, mesh = {Humans ; *Methadone/therapeutic use/poisoning ; *Opiate Substitution Treatment/methods ; United States ; *Opioid-Related Disorders/drug therapy ; *COVID-19 ; *Drug Overdose/drug therapy ; Analgesics, Opioid/poisoning/adverse effects ; Health Services Accessibility ; }, abstract = {BACKGROUND: The United States is grappling with an unprecedented overdose crisis, exacerbated by the proliferation of potent synthetic opioids like illicitly manufactured fentanyl. Despite the efficacy of methadone treatment in managing opioid use disorder, regulatory barriers hinder its widespread utilization. This article examines the complex landscape of methadone regulation across federal, state, and local levels, highlighting disparities and opportunities for reform.<br><br>ISSUE: The COVID-19 public health emergency prompted temporary flexibility in methadone regulations, including expanded take-home doses and telehealth counseling, leading to improved treatment experiences and retention. Permanent revisions to federal guidelines have since been introduced by the Substance Abuse and Mental Health Services Administration, reflecting a progressive shift toward patient-centered care and streamlined access. State regulations, managed by Single State Agencies and State Opioid Treatment Authorities, vary widely, often imposing additional restrictions that impede access to methadone treatment. Local OTP clinics further exacerbate barriers through stringent policies, despite federal and state guidelines advocating for flexibility.<br><br>RECOMMENDATIONS: Coordinated efforts among policymakers, healthcare providers, and communities are needed to promote the development of accountability measures, incentives, and community involvement to ensure equitable access and quality of care. To truly meet the demand needed to end the existing overdose crisis and enhance accessibility and comprehensive healthcare services, methadone treatment expansion beyond traditional OTP settings into primary care offices and community pharmacies should take place.}, }
@article {pmid38619233, year = {2024}, author = {Tomasiewicz, K and Woron, J and Kobayashi, A and Krasinski, Z and Rydzewska, G and Szymanski, FM}, title = {Post-COVID-19 syndrome in everyday clinical practice: interdisciplinary expert position statement endorsed by the Polish Society of Civilization Diseases.}, journal = {Polish archives of internal medicine}, volume = {134}, number = {5}, pages = {}, doi = {10.20452/pamw.16728}, pmid = {38619233}, issn = {1897-9483}, mesh = {Humans ; *COVID-19/complications/therapy ; Poland ; *Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {Post-COVID-19 syndrome, also known as long COVID-19 syndrome, is a complex set of symptoms that persist for weeks or months after recovery from an acute phase of COVID-19. These symptoms can affect various body systems, including the respiratory, nervous, cardiovascular, and digestive systems. The most common complaints are fatigue, shortness of breath, joint pain, taste and smell disorders, as well as problems with memory and concentration. Pathogenesis of post-COVID-19 syndrome is complicated and not fully understood, but it is likely related to an overactive immune system, disturbances in the intestinal microbiome, and cell and tissue damage caused by the virus. Incorporating a multidisciplinary approach to treating and rehabilitating patients and further research into this syndrome's underlying mechanisms and therapy are crucial for understanding and effectively treating this complex and multifaceted condition.}, }
@article {pmid38270369, year = {2024}, author = {Zuin, M and Di Fusco, SA and Zilio, F and Bilato, C and Corda, M and De Luca, L and Di Marco, M and Geraci, G and Iacovoni, A and Milli, M and Navazio, A and Pascale, V and Riccio, C and Scicchitano, P and Urbinati, S and Caldarola, P and Tizzani, E and Gabrielli, D and Colivicchi, F and Grimaldi, M and Oliva, F}, title = {[ANMCO Position paper - 2023 ANMCO States General: Towards a modern Cardiological Community Care].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {25}, number = {2}, pages = {121-125}, doi = {10.1714/4187.41762}, pmid = {38270369}, issn = {1972-6481}, mesh = {Humans ; *Cardiovascular Diseases/therapy ; Pandemics ; *Cardiovascular System ; *Cardiology ; *Cardiologists ; }, abstract = {Over the last two decades, cardiovascular diseases have become the leading cause of chronic disease morbidity and mortality in Italy. Therefore, the chronic cardiovascular care landscape has evolved rapidly in an era of unprecedented demand. Furthermore, the COVID-19 pandemic has highlighted significant deficiencies in existing health and social care systems, especially in the management of chronic cardiovascular disease. In this scenario, the National Reform for Recovery and Resilience (PNRR) may represent a unique opportunity for the development of a new integrated care system between hospital and community. The Italian Association of Hospital Cardiologists (ANMCO) recognizes the need for a statement on the integrated cardiological community care to guide health professionals caring for people with chronic cardiovascular conditions. The aim of the present statement is to outline the evidence for a modern integrated cardiological community care identifying challenges and offering advice for a future transdisciplinary and multi-organizational approach to ensure best practice in the management of chronic cardiovascular disease.}, }
@article {pmid38146232, year = {2024}, author = {Campbell, A and Teh, B and Mulligan, S and Ross, DM and Weinkove, R and Gilroy, N and Gangatharan, S and Prince, HM and Szer, J and Trotman, J and Lane, S and Dickinson, M and Quach, H and Enjeti, AK and Ku, M and Gregory, G and Hapgood, G and Ho, PJ and Cochrane, T and Cheah, C and Greenwood, M and Latimer, M and Berkahn, L and Wight, J and Armytage, T and Diamond, P and Tam, CS and Hamad, N}, title = {Australia and New Zealand consensus position statement: use of COVID-19 therapeutics in patients with haematological malignancies.}, journal = {Internal medicine journal}, volume = {54}, number = {2}, pages = {328-336}, doi = {10.1111/imj.16303}, pmid = {38146232}, issn = {1445-5994}, mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; Consensus ; New Zealand/epidemiology ; *Hematologic Neoplasms/complications/therapy ; }, abstract = {Despite widespread vaccination rates, we are living with high transmission rates of SARS-CoV-2. Although overall hospitalisation rates are falling, the risk of serious infection remains high for patients who are immunocompromised because of haematological malignancies. In light of the ongoing pandemic and the development of multiple agents for treatment, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID-19 management in patients with haematological disorders. It is our recommendation that both patients with haematological malignancies and treating specialists be educated regarding the preventive and treatment options available and that patients continue to receive adequate vaccinations, keeping in mind the suboptimal vaccine responses that occur in haematology patients, in particular, those with B-cell malignancies and on B-cell-targeting or depleting therapy. Patients with haematological malignancies should receive treatment for COVID-19 in accordance with the severity of their symptoms, but even mild infections should prompt early treatment with antiviral agents. The issue of de-isolation following COVID-19 infection and optimal time to treatment for haematological malignancies is discussed but remains an area with evolving data. This position statement is to be used in conjunction with advice from infectious disease, respiratory and intensive care specialists, and current guidelines from the National COVID-19 Clinical Evidence Taskforce and the New Zealand Ministry of Health and Cancer Agency Te Aho o Te Kahu COVID-19 Guidelines.}, }
@article {pmid38084472, year = {2024}, author = {Mayorga, C and Çelik, GE and Pascal, M and Hoffmann, HJ and Eberlein, B and Torres, MJ and Brockow, K and Garvey, LH and Barbaud, A and Madrigal-Burgaleta, R and Caubet, JC and Ebo, DG}, title = {Flow-based basophil activation test in immediate drug hypersensitivity. An EAACI task force position paper.}, journal = {Allergy}, volume = {79}, number = {3}, pages = {580-600}, doi = {10.1111/all.15957}, pmid = {38084472}, issn = {1398-9995}, support = {//European Academy of Allergy and Clinical Immunology/ ; }, mesh = {Humans ; Child ; Basophil Degranulation Test/methods ; Basophils ; COVID-19 Vaccines ; *Hypersensitivity, Immediate ; *Drug Hypersensitivity/diagnosis ; *Hypersensitivity ; }, abstract = {Diagnosing immediate drug hypersensitivity reactions (IDHRs) can pose a significant challenge and there is an urgent need for safe and reliable tests. Evidence has emerged that the basophil activation test (BAT), an in vitro assay that mirrors the in vivo response, can be a complementary test for many drugs. In this position paper, members of Task Force (TF) "Basophil activation test in the evaluation of Drug Hypersensitivity Reactions" from the European Academy of Allergy and Clinical Immunology (EAACI) present the data from a survey about the use and utility of BAT in IDHRs in Europe. The survey results indicate that there is a great interest for using BAT especially for diagnosing IDHRs. However, there are still main needs, mainly in the standardization of the protocols. Subsequently consensus-based recommendations were formulated for: (i) Technical aspects of BAT in IDHRs including type of sample, management of drugs, flow cytometry protocols, interpretation of the results; and (ii) Drug-specific aspects that should be taken into account when performing BAT in relation to betalactams, neuromuscular blocking agents, fluoroquinolones, chlorhexidine, opioids, radio contrast media, chemotherapeutics, biological agents, nonsteroidal anti-inflammatory drugs, COVID vaccine, and excipients. Moreover, aspects in the evaluation of pediatric population have also been considered. All this indicates that BAT offers the clinician and laboratory a complementary tool for a safe diagnostic for IDHRs, although its place in the diagnostic algorithm depends on the drug class and patient population (phenotype, geography, and age). The standardization of BAT is important for generalizing this method beyond the individual laboratory.}, }
@article {pmid38041429, year = {2024}, author = {Smolinska, S and Popescu, FD and Izquierdo, E and Antolín-Amérigo, D and Price, OJ and Alvarez-Perea, A and Eguíluz Gracia, I and Papadopoulos, NG and Pfaar, O and Fassio, F and Hoffmann-Sommergruber, K and Dramburg, S and Agache, I and Jutel, M and Brough, HA and Fonseca, JA and Angier, E and Boccabella, C and Bonini, M and Dunn Galvin, A and Gibson, PG and Gawlik, R and Hannachi, F and Kalayci, &#xd6; and Klimek, L and Knibb, R and Matricardi, P and Chivato, T}, title = {Telemedicine with special focus on allergic diseases and asthma-Status 2022: An EAACI position paper.}, journal = {Allergy}, volume = {79}, number = {4}, pages = {777-792}, doi = {10.1111/all.15964}, pmid = {38041429}, issn = {1398-9995}, support = {//European Academy of Allergy and Clinical Immunology/ ; }, mesh = {Humans ; Pandemics ; *Telemedicine/methods ; Confidentiality ; *Hypersensitivity/diagnosis/epidemiology/therapy ; *Asthma/diagnosis/epidemiology/therapy ; }, abstract = {Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID-19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face-to-face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described.}, }
@article {pmid37877648, year = {2024}, author = {Chernyshov, PV and Finlay, AY and Tomas-Aragones, L and Tognetti, L and Moscarella, E and Pasquali, P and Manolache, L and Pustisek, N and Svensson, A and Marron, SE and Bewley, A and Salavastru, C and Suru, A and Koumaki, D and Linder, D and Abeni, D and Augustin, M and Blome, C and Salek, SS and Evers, AWM and Poot, F and Sampogna, F and Szepietowski, J&#x421;}, title = {Quality of life measurement in teledermatology. Position statement of the European Academy of Dermatology and Venereology Task Forces on Quality of Life and Patient Oriented Outcomes and Teledermatology.}, journal = {Journal of the European Academy of Dermatology and Venereology : JEADV}, volume = {38}, number = {2}, pages = {254-264}, doi = {10.1111/jdv.19570}, pmid = {37877648}, issn = {1468-3083}, mesh = {Child ; Humans ; Quality of Life ; *Venereology ; *Dermatology/methods ; Pandemics ; *Skin Diseases/diagnosis/therapy ; }, abstract = {Many events, including the COVID-19 pandemic, have accelerated the implementation of teledermatology pathways within dermatology departments and across healthcare organizations. Quality of Life (QoL) assessment in dermatology is also a rapidly developing field with a gradual shift from theory to practice. The purpose of this paper organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on QoL and patient-oriented outcomes and the EADV TF on teledermatology is to present current knowledge about QoL assessment during the use of teledermatology approaches, including data on health-related (HR) QoL instruments used in teledermatology, comparison of influence of different treatment methods on HRQoL after face-to-face and teledermatology consultations and to make practical recommendations concerning the assessment of QoL in teledermatology. The EADV TFs made the following position statements: HRQoL assessment may be an important part in most of teledermatology activities; HRQoL assessment may be easily and effectively performed during teledermatology consultations. It is especially important to monitor HRQoL of patients with chronic skin diseases during lockdowns or in areas where it is difficult to reach a hospital for face-to-face consultation; regular assessment of HRQoL of patients with skin diseases during teledermatology consultations may help to monitor therapy efficacy and visualize individual patient's needs; we recommend the use of the DLQI in teledermatology, including the use of the DLQI app which is available in seven languages; it is important to develop apps for dermatology-specific HRQoL instruments for use in children (for example the CDLQI and InToDermQoL) and for disease-specific instruments.}, }
@article {pmid37831591, year = {2024}, author = {Rhee, C and Strich, JR and Chiotos, K and Classen, DC and Cosgrove, SE and Greeno, R and Heil, EL and Kadri, SS and Kalil, AC and Gilbert, DN and Masur, H and Septimus, EJ and Sweeney, DA and Terry, A and Winslow, DL and Yealy, DM and Klompas, M}, title = {Improving Sepsis Outcomes in the Era of Pay-for-Performance and Electronic Quality Measures: A Joint IDSA/ACEP/PIDS/SHEA/SHM/SIDP Position Paper.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {78}, number = {3}, pages = {505-513}, pmid = {37831591}, issn = {1537-6591}, mesh = {Aged ; Adult ; Humans ; United States ; Reimbursement, Incentive ; Medicare ; *Sepsis/diagnosis/drug therapy ; Systemic Inflammatory Response Syndrome ; Anti-Bacterial Agents/therapeutic use ; *Shock, Septic/diagnosis/therapy ; }, abstract = {The Centers for Medicare &amp; Medicaid Services (CMS) introduced the Severe Sepsis/Septic Shock Management Bundle (SEP-1) as a pay-for-reporting measure in 2015 and is now planning to make it a pay-for-performance measure by incorporating it into the Hospital Value-Based Purchasing Program. This joint IDSA/ACEP/PIDS/SHEA/SHM/SIPD position paper highlights concerns with this change. Multiple studies indicate that SEP-1 implementation was associated with increased broad-spectrum antibiotic use, lactate measurements, and aggressive fluid resuscitation for patients with suspected sepsis but not with decreased mortality rates. Increased focus on SEP-1 risks further diverting attention and resources from more effective measures and comprehensive sepsis care. We recommend retiring SEP-1 rather than using it in a payment model and shifting instead to new sepsis metrics that focus on patient outcomes. CMS is developing a community-onset sepsis 30-day mortality electronic clinical quality measure (eCQM) that is an important step in this direction. The eCQM preliminarily identifies sepsis using systemic inflammatory response syndrome (SIRS) criteria, antibiotic administrations or diagnosis codes for infection or sepsis, and clinical indicators of acute organ dysfunction. We support the eCQM but recommend removing SIRS criteria and diagnosis codes to streamline implementation, decrease variability between hospitals, maintain vigilance for patients with sepsis but without SIRS, and avoid promoting antibiotic use in uninfected patients with SIRS. We further advocate for CMS to harmonize the eCQM with the Centers for Disease Control and Prevention's (CDC) Adult Sepsis Event surveillance metric to promote unity in federal measures, decrease reporting burden for hospitals, and facilitate shared prevention initiatives. These steps will result in a more robust measure that will encourage hospitals to pay more attention to the full breadth of sepsis care, stimulate new innovations in diagnosis and treatment, and ultimately bring us closer to our shared goal of improving outcomes for patients.}, }
@article {pmid37487216, year = {2023}, author = {Serchen, J and Cline, K and Mathew, S and Hilden, D and , }, title = {Preparing for Future Pandemics and Public Health Emergencies: An American College of Physicians Policy Position Paper.}, journal = {Annals of internal medicine}, volume = {176}, number = {9}, pages = {1240-1244}, doi = {10.7326/M23-0768}, pmid = {37487216}, issn = {1539-3704}, mesh = {Humans ; *COVID-19/epidemiology ; Emergencies ; Pandemics ; Public Health ; Policy ; *Physicians ; }, abstract = {The onset of the COVID-19 pandemic revealed significant gaps in the United States' pandemic and public health emergency response system. At the federal level, government responses were undercut by a lack of centralized coordination, inadequately defined responsibilities, and an under-resourced national stockpile. Contradictory and unclear guidance throughout the early months of the pandemic, along with inconsistent funding to public health agencies, also created notable variance in state and local responses. The lack of a coordinated response added pressure to an already overwhelmed health care system, which was forced to resort to rationing care and personal protective equipment, creating moral distress and trauma for health care workers and their patients. Despite these severe shortcomings, the COVID-19 pandemic also highlighted successful policies and approaches, such as Operation Warp Speed, which led to the fastest development and distribution of a vaccine in history. In this position paper, the American College of Physicians (ACP) offers several policy recommendations for enhancing federal, state, and local preparedness for future pandemic and public health emergencies. This policy paper builds on various statements produced by ACP throughout the COVID-19 pandemic, including on the ethical distribution of vaccinations and resources, conditions to resume economic and social activity, and efforts to protect the health and well-being of medical professionals, among others.}, }
@article {pmid37454287, year = {2023}, author = {Whitcroft, KL and Altundag, A and Balungwe, P and Boscolo-Rizzo, P and Douglas, R and Enecilla, MLB and Fjaeldstad, AW and Fornazieri, MA and Frasnelli, J and Gane, S and Gudziol, H and Gupta, N and Haehner, A and Hernandez, AK and Holbrook, EH and Hopkins, C and Hsieh, JW and Huart, C and Husain, S and Kamel, R and Kim, JK and Kobayashi, M and Konstantinidis, I and Landis, BN and Lechner, M and Macchi, A and Mazal, PP and Miri, I and Miwa, T and Mori, E and Mullol, J and Mueller, CA and Ottaviano, G and Patel, ZM and Philpott, C and Pinto, JM and Ramakrishnan, VR and Roth, Y and Schlosser, RJ and Stjärne, P and Van Gerven, L and Vodicka, J and Welge-Luessen, A and Wormald, PJ and Hummel, T}, title = {Position paper on olfactory dysfunction: 2023.}, journal = {Rhinology}, volume = {61}, number = {33}, pages = {1-108}, doi = {10.4193/Rhin22.483}, pmid = {37454287}, issn = {0300-0729}, mesh = {Humans ; Smell ; Quality of Life ; Pandemics ; *Olfaction Disorders/diagnosis/therapy/epidemiology ; *COVID-19 ; }, abstract = {BACKGROUND: Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process.<br><br>CONCLUSIONS: We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.}, }
@article {pmid37312802, year = {2023}, author = {Brody, S and Loree, S and Sampson, M and Mensinkai, S and Coffman, J and Mueller, MH and Askin, N and Hamill, C and Wilson, E and McAteer, MB and Staines, H and , }, title = {Searching for evidence in public health emergencies: a white paper of best practices.}, journal = {Journal of the Medical Library Association : JMLA}, volume = {111}, number = {1-2}, pages = {566-578}, pmid = {37312802}, issn = {1558-9439}, mesh = {Humans ; *Public Health ; *COVID-19 ; Emergencies ; Reproducibility of Results ; Disease Outbreaks ; }, abstract = {OBJECTIVES: Information professionals have supported medical providers, administrators and decision-makers, and guideline creators in the COVID-19 response. Searching COVID-19 literature presented new challenges, including the volume and heterogeneity of literature and the proliferation of new information sources, and exposed existing issues in metadata and publishing. An expert panel developed best practices, including recommendations, elaborations, and examples, for searching during public health emergencies.<br><br>METHODS: Project directors and advisors developed core elements from experience and literature. Experts, identified by affiliation with evidence synthesis groups, COVID-19 search experience, and nomination, responded to an online survey to reach consensus on core elements. Expert participants provided written responses to guiding questions. A synthesis of responses provided the foundation for focus group discussions. A writing group then drafted the best practices into a statement. Experts reviewed the statement prior to dissemination.<br><br>RESULTS: Twelve information professionals contributed to best practice recommendations on six elements: core resources, search strategies, publication types, transparency and reproducibility, collaboration, and conducting research. Underlying principles across recommendations include timeliness, openness, balance, preparedness, and responsiveness.<br><br>CONCLUSIONS: The authors and experts anticipate the recommendations for searching for evidence during public health emergencies will help information specialists, librarians, evidence synthesis groups, researchers, and decision-makers respond to future public health emergencies, including but not limited to disease outbreaks. The recommendations complement existing guidance by addressing concerns specific to emergency response. The statement is intended as a living document. Future revisions should solicit input from a broader community and reflect conclusions of meta-research on COVID-19 and health emergencies.}, }
@article {pmid37186567, year = {2023}, author = {Brunetti, ND and Curcio, A and Nodari, S and Parati, G and Carugo, S and Molinari, M and Acquistapace, F and Gensini, G and Molinari, G and , }, title = {The Italian Society of Cardiology and Working Group on Telecardiology and Informatics 2023 updated position paper on telemedicine and artificial intelligence in cardiovascular disease.}, journal = {Journal of cardiovascular medicine (Hagerstown, Md.)}, volume = {24}, number = {Suppl 2}, pages = {e168-e177}, doi = {10.2459/JCM.0000000000001447}, pmid = {37186567}, issn = {1558-2035}, mesh = {Humans ; *Cardiovascular Diseases/diagnosis/therapy ; Artificial Intelligence ; *COVID-19 ; SARS-CoV-2 ; *Cardiology ; *Telemedicine ; Informatics ; }, abstract = {In 2015, the Italian Society of Cardiology and its Working Group on Telemedicine and Informatics issued a position paper on Telecardiology, resuming the most eminent evidence supporting the use of information and communication technology in principal areas of cardiovascular care, ranked by level of evidence. More than 5 years later and after the global shock inflicted by the SARS-CoV-2 pandemic, an update on the topic is warranted. Recent evidence and studies on principal areas of cardiovascular disease will be therefore reported and discussed, with particular focus on telemedicine for cardiovascular care in the COVID-19 context. Novel perspectives and opportunities disclosed by artificial intelligence and its applications in cardiovascular disease will also be discussed. Finally, modalities by which machine learning have realized remote patient monitoring and long-term care in recent years, mainly filtering critical clinical data requiring selective hospital admission, will be provided.}, }
@article {pmid37095331, year = {2023}, author = {Chen, A and Ayub, MH and Mishuris, RG and Rodriguez, JA and Gwynn, K and Lo, MC and Noronha, C and Henry, TL and Jones, D and Lee, WW and Varma, M and Cuevas, E and Onumah, C and Gupta, R and Goodson, J and Lu, AD and Syed, Q and Suen, LW and Heiman, E and Salhi, BA and Khoong, EC and Schmidt, S}, title = {Telehealth Policy, Practice, and Education: a Position Statement of the Society of General Internal Medicine.}, journal = {Journal of general internal medicine}, volume = {38}, number = {11}, pages = {2613-2620}, pmid = {37095331}, issn = {1525-1497}, support = {K23 HL157750/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; United States ; Pandemics ; *COVID-19 ; *Telemedicine ; Internal Medicine ; Policy ; }, abstract = {Telehealth services, specifically telemedicine audio-video and audio-only patient encounters, expanded dramatically during the COVID-19 pandemic through temporary waivers and flexibilities tied to the public health emergency. Early studies demonstrate significant potential to advance the quintuple aim (patient experience, health outcomes, cost, clinician well-being, and equity). Supported well, telemedicine can particularly improve patient satisfaction, health outcomes, and equity. Implemented poorly, telemedicine can facilitate unsafe care, worsen disparities, and waste resources. Without further action from lawmakers and agencies, payment will end for many telemedicine services currently used by millions of Americans at the end of 2024. Policymakers, health systems, clinicians, and educators must decide how to support, implement, and sustain telemedicine, and long-term studies and clinical practice guidelines are emerging to provide direction. In this position statement, we use clinical vignettes to review relevant literature and highlight where key actions are needed. These include areas where telemedicine must be expanded (e.g., to support chronic disease management) and where guidelines are needed (e.g., to prevent inequitable offering of telemedicine services and prevent unsafe or low-value care). We provide policy, clinical practice, and education recommendations for telemedicine on behalf of the Society of General Internal Medicine. Policy recommendations include ending geographic and site restrictions, expanding the definition of telemedicine to include audio-only services, establishing appropriate telemedicine service codes, and expanding broadband access to all Americans. Clinical practice recommendations include ensuring appropriate telemedicine use (for limited acute care situations or in conjunction with in-person services to extend longitudinal care relationships), that the choice of modality be done through patient-clinician shared decision-making, and that health systems design telemedicine services through community partnerships to ensure equitable implementation. Education recommendations include developing telemedicine-specific educational strategies for trainees that align with accreditation body competencies and providing educators with protected time and faculty development resources.}, }
@article {pmid37068276, year = {2023}, author = {Qaseem, A and MacLean, CH and Tierney, S and Cross, JT and MacDonald, ST and Goldzweig, CL and Fitterman, N and ,  and Andrews, R and Basch, P and Mathew, SM and McLean, RM and Mount, CA and Powell, RE and Saini, SD}, title = {Performance Measures for Physicians Providing Clinical Care Using Telemedicine: A Position Paper From the American College of Physicians.}, journal = {Annals of internal medicine}, volume = {176}, number = {5}, pages = {694-698}, doi = {10.7326/M23-0140}, pmid = {37068276}, issn = {1539-3704}, mesh = {Humans ; *COVID-19 ; Pandemics ; *Telemedicine/methods ; Delivery of Health Care ; *Physicians ; }, abstract = {There has been an exponential growth in the use of telemedicine services to provide clinical care, accelerated by the COVID-19 pandemic. Clinical care delivered via telemedicine has become a major and accepted method of health care delivery for many patients. There is an urgent need to understand quality of care in the telemedicine environment. This American College of Physicians position paper presents 6 recommendations to ensure the appropriate use of performance measures to evaluate quality of clinical care provided in the telemedicine environment.}, }
@article {pmid36976575, year = {2023}, author = {Franciosi, JP and Berg, EA and Rosen, JM and Lee, JA and Sandberg, KC and Srinath, A and Setty, M and Li, BUK}, title = {North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Statement for Telehealth.}, journal = {Journal of pediatric gastroenterology and nutrition}, volume = {76}, number = {5}, pages = {684-694}, doi = {10.1097/MPG.0000000000003754}, pmid = {36976575}, issn = {1536-4801}, mesh = {Child ; Humans ; *Gastroenterology/education ; *COVID-19 ; Societies ; *Telemedicine ; North America ; Societies, Medical ; }, abstract = {Telehealth (TH) broadly encompasses remote activities of clinical care (telemedicine), provider and patient education, and general health services. The use of synchronous video for TH first occurred in 1964 and then catapulted to the forefront in 2020 during the coronavirus disease 2019 public health emergency. Due to the sudden need for increased TH utilization by nearly all health care providers at that time, TH became essential to clinical practice. However, its sustainable future is unclear in part given that best practices for TH in pediatric gastroenterology (GI), hepatology, and nutrition remain undefined and non-standardized. Key areas for review include historical perspective, general and subspeciality usage, health care disparities, quality of care and the provider-patient interaction, logistics and operations, licensure and liability, reimbursement and insurance coverage, research and quality improvement (QI) priorities, and future use of TH in pediatric GI with a call for advocacy. This position paper from the Telehealth Special Interest Group of North American Society of Gastroenterology, Hepatology and Nutrition provides recommendations for pediatric GI-focused TH best practices, reviews areas for research and QI growth, and presents advocacy opportunities.}, }
@article {pmid36967217, year = {2023}, author = {Ravi, V and Kapil, A and Biswas, S and Saxena, S}, title = {Indian association of medical microbiologists (IAMM) position paper on guidelines for COVID and SARSCoV2 infections.}, journal = {Indian journal of medical microbiology}, volume = {42}, number = {}, pages = {53-54}, pmid = {36967217}, issn = {1998-3646}, mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; RNA, Viral ; }, }
@article {pmid36940066, year = {2023}, author = {Dugdale, LS and Esbensen, KL and Sulmasy, LS and , }, title = {Ethical Guidance on Family Caregiving, Support, and Visitation in Hospitals and Residential Health Care Facilities, Including During Public Health Emergencies: an American College of Physicians Position Paper.}, journal = {Journal of general internal medicine}, volume = {38}, number = {8}, pages = {1986-1993}, pmid = {36940066}, issn = {1525-1497}, mesh = {Humans ; *COVID-19/epidemiology ; Public Health ; Pandemics/prevention &amp; control ; Emergencies ; Hospitals ; Delivery of Health Care ; Family/psychology ; }, abstract = {Public health emergencies create challenges for the accommodation of visitors to hospitals and other care facilities. To mitigate the spread of COVID-19 early in the pandemic, health care institutions implemented severe visitor restrictions, many remaining in place more than 2 years, producing serious unintended harms. Visitor restrictions have been associated with social isolation and loneliness, worse physical and mental health outcomes, impaired or delayed decision-making, and dying alone. Patients with disabilities, communication challenges, and cognitive or psychiatric impairments are particularly vulnerable without caregiver presence. This paper critically examines the justifications for, and harms imposed by, visitor restrictions during the COVID-19 pandemic and offers ethical guidance on family caregiving, support, and visitation during public health emergencies. Visitation policies must be guided by ethical principles; incorporate the best available scientific evidence; recognize the invaluable roles of caregivers and loved ones; and involve relevant stakeholders, including physicians, who have an ethical duty to advocate for patients and families during public health crises. Visitor policies should be promptly revised as new evidence emerges regarding benefits and risks in order to prevent avoidable harms.}, }
@article {pmid36918016, year = {2023}, author = {Behr, J and Berger, M and Blum, TG and Bonella, F and Dinkel, J and Gläser, S and Hagmeyer, L and Kneidinger, N and Koschel, D and Prasse, A and Slevogt, H and Stacher-Priehse, E and Woehrle, H and Kreuter, M}, title = {[SARS-CoV-2-Infection and Interstitial Lung Disease: Position paper of the German Respiratory Society].}, journal = {Pneumologie (Stuttgart, Germany)}, volume = {77}, number = {3}, pages = {143-157}, doi = {10.1055/a-2007-9845}, pmid = {36918016}, issn = {1438-8790}, mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; *Lung Diseases, Interstitial/diagnosis/therapy ; Lung ; *Pneumonia, Viral/diagnosis/epidemiology/therapy ; }, abstract = {The SARS-CoV-2 pandemic had a tremendous impact on diagnosis and treatment of interstitial lung diseases (ILD). Especially in the early phase of the pandemic, when the delta variant was prevailling, a huge number of viral pneumonias were observed, which worsened pre-existing, triggered de novo occurence or discovery of previously subclincal interstitial lung diseases. The effect of SARS-CoV-2 infection - without or with accompanying viral pneumonia - on the further development of pre-existing ILD as well of new pulmonary inflitrates and consolidiations is difficult to predict and poses a daily challenge to interdisciplinary ILD boards. This position paper of the German Respiratory Society (DGP e.V.) provides answers to the most pressing questions based on current knowledge.}, }
@article {pmid36913975, year = {2023}, author = {Akbulut, AC and Arisz, RA and Baaten, CCFMJ and Baidildinova, G and Barakzie, A and Bauersachs, R and Ten Berg, J and van den Broek, WWA and de Boer, HC and Bonifay, A and Bröker, V and Buka, RJ and Ten Cate, H and Ten Cate-Hoek, AJ and Cointe, S and De Luca, C and De Simone, I and Diaz, RV and Dignat-George, F and Freson, K and Gazzaniga, G and van Gorp, ECM and Habibi, A and Henskens, YMC and Iding, AFJ and Khan, A and Koenderink, GH and Konkoth, A and Lacroix, R and Lahiri, T and Lam, W and Lamerton, RE and Lorusso, R and Luo, Q and Maas, C and McCarty, OJT and van der Meijden, PEJ and Meijers, JCM and Mohapatra, AK and Nevo, N and Robles, AP and Poncelet, P and Reinhardt, C and Ruf, W and Saraswat, R and Schönichen, C and Schutgens, R and Simioni, P and Spada, S and Spronk, HMH and Tazhibayeva, K and Thachil, J and Diaz, RV and Vallier, L and Veninga, A and Verhamme, P and Visser, C and Watson, SP and Wenzel, P and Willems, RAL and Willers, A and Zhang, P and Zifkos, K and van Zonneveld, AJ}, title = {Blood Coagulation and Beyond: Position Paper from the Fourth Maastricht Consensus Conference on Thrombosis.}, journal = {Thrombosis and haemostasis}, volume = {123}, number = {8}, pages = {808-839}, pmid = {36913975}, issn = {2567-689X}, support = {No 813409//European Union's Horizon 2020 research and innovation program under theMarie Sk&#x142;odowska-Curie grant agreements No 813409 (TICARDIO), No 722609 (INTRICARE) and 766118 (TAPAS)./ ; }, mesh = {Humans ; Anticoagulants/therapeutic use ; *COVID-19 ; Blood Coagulation ; *Thrombosis ; Hemostasis ; *Blood Coagulation Disorders/drug therapy ; Hemorrhage/drug therapy ; }, abstract = {The Fourth Maastricht Consensus Conference on Thrombosis included the following themes. Theme 1: The "coagulome" as a critical driver of cardiovascular disease. Blood coagulation proteins also play divergent roles in biology and pathophysiology, related to specific organs, including brain, heart, bone marrow, and kidney. Four investigators shared their views on these organ-specific topics. Theme 2: Novel mechanisms of thrombosis. Mechanisms linking factor XII to fibrin, including their structural and physical properties, contribute to thrombosis, which is also affected by variation in microbiome status. Virus infection-associated coagulopathies perturb the hemostatic balance resulting in thrombosis and/or bleeding. Theme 3: How to limit bleeding risks: insights from translational studies. This theme included state-of-the-art methodology for exploring the contribution of genetic determinants of a bleeding diathesis; determination of polymorphisms in genes that control the rate of metabolism by the liver of P2Y12 inhibitors, to improve safety of antithrombotic therapy. Novel reversal agents for direct oral anticoagulants are discussed. Theme 4: Hemostasis in extracorporeal systems: the value and limitations of ex vivo models. Perfusion flow chamber and nanotechnology developments are developed for studying bleeding and thrombosis tendencies. Vascularized organoids are utilized for disease modeling and drug development studies. Strategies for tackling extracorporeal membrane oxygenation-associated coagulopathy are discussed. Theme 5: Clinical dilemmas in thrombosis and antithrombotic management. Plenary presentations addressed controversial areas, i.e., thrombophilia testing, thrombosis risk assessment in hemophilia, novel antiplatelet strategies, and clinically tested factor XI(a) inhibitors, both possibly with reduced bleeding risk. Finally, COVID-19-associated coagulopathy is revisited.}, }
@article {pmid36906502, year = {2022}, author = {de Sequera, P and Quiroga, B and Goicoechea, M and , }, title = {Update of the prevention and isolation measure recommendations against SARS-COV-2 in dialysis units of Spain: A position paper of the Spanish Society of Nephrology Council.}, journal = {Nefrologia}, volume = {42}, number = {6}, pages = {714-721}, pmid = {36906502}, issn = {2013-2514}, mesh = {Humans ; SARS-CoV-2 ; *COVID-19/prevention &amp; control ; *Nephrology ; Spain/epidemiology ; COVID-19 Vaccines ; Renal Dialysis ; }, abstract = {SARS-CoV-2 pandemic has changed across the last two years. The development and approval of SARS-CoV-2 vaccines and the emergence of new variants has opened up a new scenario. On this regard, Spanish Society of Nephrology (S.E.N.) Council considers that an update of the previous recommendations should be performed. In the present statement, and taking into account the current epidemiological situation, are included updated recommendations of protection and isolation for patients on dialysis programs.}, }
@article {pmid36705045, year = {2023}, author = {Feleszko, W and Okarska-Napierała, M and Buddingh, EP and Bloomfield, M and Sediva, A and Bautista-Rodriguez, C and Brough, HA and Eigenmann, PA and Eiwegger, T and Eljaszewicz, A and Eyerich, S and Gomez-Casado, C and Fraisse, A and Janda, J and Jiménez-Saiz, R and Kallinich, T and Krohn, IK and Mortz, CG and Riggioni, C and Sastre, J and Sokolowska, M and Strzelczyk, Z and Untersmayr, E and Tramper-Stranders, G and , }, title = {Pathogenesis, immunology, and immune-targeted management of the multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome (PIMS): EAACI Position Paper.}, journal = {Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology}, volume = {34}, number = {1}, pages = {e13900}, doi = {10.1111/pai.13900}, pmid = {36705045}, issn = {1399-3038}, mesh = {SARS-CoV-2 ; Child ; Systemic Inflammatory Response Syndrome/diagnosis/therapy ; Humans ; COVID-19 Vaccines ; *COVID-19/complications ; }, abstract = {Multisystem inflammatory syndrome in children (MIS-C) is a rare, but severe complication of coronavirus disease 2019 (COVID-19). It develops approximately 4 weeks after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and involves hyperinflammation with multisystem injury, commonly progressing to shock. The exact pathomechanism of MIS-C is not known, but immunological dysregulation leading to cytokine storm plays a central role. In response to the emergence of MIS-C, the European Academy of Allergy and Clinical Immunology (EAACI) established a task force (TF) within the Immunology Section in May 2021. With the use of an online Delphi process, TF formulated clinical statements regarding immunological background of MIS-C, diagnosis, treatment, follow-up, and the role of COVID-19 vaccinations. MIS-C case definition is broad, and diagnosis is made based on clinical presentation. The immunological mechanism leading to MIS-C is unclear and depends on activating multiple pathways leading to hyperinflammation. Current management of MIS-C relies on supportive care in combination with immunosuppressive and/or immunomodulatory agents. The most frequently used agents are systemic steroids and intravenous immunoglobulin. Despite good overall short-term outcome, MIS-C patients should be followed-up at regular intervals after discharge, focusing on cardiac disease, organ damage, and inflammatory activity. COVID-19 vaccination is a safe and effective measure to prevent MIS-C. In anticipation of further research, we propose a convenient and clinically practical algorithm for managing MIS-C developed by the Immunology Section of the EAACI.}, }
@article {pmid36519288, year = {2023}, author = {DiScala, S and Uritsky, TJ and Brown, ME and Abel, SM and Humbert, NT and Naidu, D}, title = {Society of Pain and Palliative Care Pharmacists White Paper on the Role of Opioid Stewardship Pharmacists.}, journal = {Journal of pain &amp; palliative care pharmacotherapy}, volume = {37}, number = {1}, pages = {3-15}, doi = {10.1080/15360288.2022.2149670}, pmid = {36519288}, issn = {1536-0539}, mesh = {Humans ; *Analgesics, Opioid/adverse effects ; *COVID-19 ; Pain/drug therapy ; Pain Management ; Palliative Care ; Pandemics ; Pharmacists ; United States ; }, abstract = {Opioid stewardship is one essential function of pain and palliative care pharmacists and a critical need in the United States. In recent years, this country has been plagued by two public health emergencies: an opioid crisis and the COVID-19 pandemic, which has exacerbated the opioid epidemic through its economic and psychosocial toll. To develop an opioid stewardship program, a systematic approach is needed. This will be detailed in part here by the Opioid Stewardship Taskforce of the Society of Pain and Palliative Care Pharmacists (SPPCP), focusing on the role of the pharmacist. Many pain and palliative care pharmacists have made significant contributions to the development and daily operation of such programs while also completing other competing clinical tasks, including direct patient care. To ensure dedicated time and attention to critical opioid stewardship efforts, SPPCP recommends and endorses opioid stewardship models employing a full time, opioid stewardship pharmacist in both the inpatient and outpatient setting. Early research suggests that opioid stewardship pharmacists are pivotal to improving opioid metrics and pain care outcomes. However, further research and development in this area of practice is needed and encouraged.}, }
@article {pmid36448775, year = {2022}, author = {Vukoja, M and Kopitovic, I and Lazic, Z and Milenkovic, B and Stankovic, I and Tomic-Spiric, V and Zvezdin, B and Hromis, S and Cekerevac, I and Ilic, A and Vukcevic, M and Dimic-Janjic, S and Stjepanovic, M}, title = {Diagnosis and treatment of adult asthma patients in Serbia: a 2022 experts group position statement.}, journal = {Expert review of respiratory medicine}, volume = {16}, number = {11-12}, pages = {1133-1144}, doi = {10.1080/17476348.2022.2153674}, pmid = {36448775}, issn = {1747-6356}, mesh = {Humans ; Adult ; Serbia ; *Asthma/therapy ; }, abstract = {INTRODUCTION: Asthma is the most common non-communicable chronic lung condition across all ages. Epidemiological data indicate that many asthma patients in Serbia remain undiagnosed and untreated. The implementation of recent global advances in asthma management is limited due to the lack of a systematic approach, drug availability and regulatory affairs. In addition, the global coronavirus disease pandemic has posed a significant challenge, particularly in resource-limited settings.<br><br>AREAS COVERED: In this paper, we propose an algorithm for treating adult asthma patients in Serbia. We performed PubMed database search on published asthma clinical trials and guidelines from 1 January 2015 to 10 March 2020. The consensus process incorporated a modified Delphi method that included two rounds of e-mail questionnaires and three rounds of national asthma expert meetings. We focus on 1) objective diagnosis of asthma, 2) the implementation of up-to-date therapeutic options, and 3) the identification and referral of severe asthma patients to newly established severe asthma centers.<br><br>EXPERT OPINION: Regional specificities and variations in healthcare systems require the adaptation of evidence-based knowledge. Practical, clinically oriented algorithms designed to overcome local barriers in healthcare delivery may facilitate timely and adequate asthma diagnosis and the local implementation of current advances in asthma management.}, }
@article {pmid36427057, year = {2023}, author = {Strengers, P and O'Brien, SF and Politis, C and Mayr, W and Seifried, E and Spencer, BR}, title = {White paper on pandemic preparedness in the blood supply.}, journal = {Vox sanguinis}, volume = {118}, number = {1}, pages = {8-15}, doi = {10.1111/vox.13378}, pmid = {36427057}, issn = {1423-0410}, mesh = {Humans ; United States ; *COVID-19/epidemiology/prevention &amp; control ; SARS-CoV-2 ; Pandemics/prevention &amp; control ; Austria ; Germany ; }, abstract = {BACKGROUND AND OBJECTIVES: In March 2020, the WHO declared the SARS-CoV-2 corona virus a pandemic which caused a great disruption to global society and had a pronounced effect on the worldwide supply of blood.<br><br>MATERIALS AND METHODS: In 2022 an on-line meeting was organised with experts from Austria, Canada, Germany, Greece, Netherlands and United States to explore the opportunities for increasing preparedness within blood systems for a potential future pandemic with similar, or more devastating, consequences. The main themes included the value of preparedness, current risks to the blood supply, supply chain vulnerabilities, and the role of innovation in increasing resiliency and safety.<br><br>RESULTS: Seven key recommendations were formulated and including required actions at different levels.<br><br>CONCLUSION: Although SARS-CoV-2 might be seen as a unique event, global health risks are expected to increase and will affect blood transfusion medicine if no preparedness plans are developed.}, }
@article {pmid36371767, year = {2023}, author = {Perram, J and Purtill, D and Bajel, A and Butler, J and O'Brien, T and Teh, B and Gilroy, N and Ho, PJ and Doocey, R and Hills, T and Perera, T and Douglas, G and Ramachandran, S and Chee, L and Trotman, J and Weinkove, R and Keogh, S and Fraser, C and Cochrane, T and Watson, AM and Diamond, P and Latimer, M and Irving, I and Blyth, E and Cheah, C and Cole, T and Milliken, S and Yang, H and Greenwood, M and Bardy, P and Kennedy, G and Larsen, S and Conyers, R and Hamad, N}, title = {Australia and New Zealand Transplant and Cellular Therapies (ANZTCT) position statement: COVID-19 management in patients with haemopoietic stem cell transplant and chimeric antigen receptor T cell.}, journal = {Internal medicine journal}, volume = {53}, number = {1}, pages = {119-125}, pmid = {36371767}, issn = {1445-5994}, mesh = {Humans ; *Receptors, Chimeric Antigen/therapeutic use ; *COVID-19 ; New Zealand/epidemiology ; T-Lymphocytes ; *Hematopoietic Stem Cell Transplantation ; }, abstract = {Patients with post-haemopoietic stem cell transplant or chimeric antigen receptor T -cell (CAR-T) therapy face a significant risk of morbidity and mortality from coronavirus disease 2019 because of their immunosuppressed state. As case numbers in Australia and New Zealand continue to rise, guidance on management in this high-risk population is needed. Whilst we have learned much from international colleagues who faced high infection rates early in the pandemic, guidance relevant to local health system structures, medication availability and emerging therapies is essential to equip physicians to manage our patients optimally.}, }
@article {pmid36272444, year = {2023}, author = {Sacks-Zimmerman, A and Bergquist, TF and Farr, EM and Cornwell, MA and Kanellopoulos, D}, title = {Rehabilitation of Neuropsychiatric Symptoms in Patients With Long COVID: Position Statement.}, journal = {Archives of physical medicine and rehabilitation}, volume = {104}, number = {2}, pages = {350-354}, pmid = {36272444}, issn = {1532-821X}, mesh = {Adult ; Humans ; Post-Acute COVID-19 Syndrome ; *COVID-19 ; Quality of Life ; *Mental Disorders ; Chronic Disease ; }, abstract = {Long COVID, a term used to describe ongoing symptoms after COVID-19 infection, parallels the course of other postviral syndromes. Neuropsychiatric symptoms of long COVID can be persistent and interfere with quality of life and functioning. Within the biopsychosocial framework of chronic illness, rehabilitation professionals can address the neuropsychiatric sequelae of long COVID. However, current practice models are not designed to address concurrent psychiatric and cognitive symptoms in adults living with long COVID. Thus, we present a biopsychosocial framework for long COVID and provide treatment strategies based on evidence from current literature of postviral chronic illness. These recommendations will guide rehabilitation professionals in identifying common neuropsychiatric symptoms in long COVID that can be targeted for intervention and addressing these symptoms via integrative interventions taking into account the biopsychosocial presentation of long COVID symptoms.}, }
@article {pmid36178109, year = {2024}, author = {Castelletti, S and Gervasi, S and Ballardini, E and Casasco, M and Cavarretta, E and Colivicchi, F and Contursi, M and Cuccaro, F and D'Ascenzi, F and Gazale, G and Mos, L and Nistri, S and Palmieri, V and Patrizi, G and Scorcu, M and Spampinato, A and Tiberi, M and Zito, GB and Zorzi, A and Zeppilli, P and Sciarra, L and , }, title = {The athlete after COVID-19 infection: what the scientific evidence? What to do? A position statement.}, journal = {Panminerva medica}, volume = {66}, number = {1}, pages = {63-74}, doi = {10.23736/S0031-0808.22.04723-1}, pmid = {36178109}, issn = {1827-1898}, mesh = {Humans ; *COVID-19 ; Athletes ; Exercise ; Pandemics ; *Pericarditis ; }, abstract = {The Coronavirus-19 disease (COVID-19) related pandemic have deeply impacted human health, economy, psychology and sociality. Possible serious cardiac involvement in the infection has been described, raising doubts about complete healing after the disease in many clinical settings. Moreover, there is the suspicion that the vaccines, especially those based on mRNA technology, can induce myopericarditis. Myocarditis or pericarditis related scars can represent the substrate for life-threatening arrhythmias, triggered by physical activity. A crucial point is how to evaluate an athlete after a COVID-19 infection ensuring a safe return to play without increasing the number of unnecessary disqualifications from sports competitions. The lack of conclusive scientific data significantly increases the difficulty to propose recommendations and guidelines on this topic. At the same time, the psychological and physical negative consequences of unnecessary sports restriction must be taken into account. The present document aims to provide an updated brief review of the current knowledge about the COVID-19 cardiac involvement and how to recognize it and to offer a roadmap for the management of the athletes after a COVID-19 infections, including subsequent impact on exercise recommendations. Our document exclusively refers to cardiovascular implications of the disease, but pulmonary consequences are also considered.}, }
@article {pmid36117294, year = {2022}, author = {Filipiak, KJ and Babkowski, MC and Cameli, M and Carugo, S and Ferri, C and Irisov, DB and Narkiewicz, K and Nizamov, U and Pérez de Isla, L and Tomaszuk-Kazberuk, A and Ungar, A and Gąsecka, A}, title = {TIMES TO ACT. Italian-Spanish-Polish-Uzbek Expert Forum Position Paper 2022. Dyslipidemia and arterial hypertension: The two most important and modifiable risk factors in clinical practice.}, journal = {Cardiology journal}, volume = {29}, number = {5}, pages = {730-738}, pmid = {36117294}, issn = {1898-018X}, mesh = {Antihypertensive Agents/therapeutic use ; *COVID-19 ; *Cardiovascular Diseases/diagnosis/epidemiology/prevention &amp; control ; *Dyslipidemias/diagnosis/drug therapy/epidemiology ; Humans ; *Hypertension/diagnosis/drug therapy/epidemiology ; Lipids ; Lipoproteins ; Poland ; Proprotein Convertase 9 ; Risk Factors ; }, abstract = {Hypertension and lipid disorders are two of the main cardiovascular risk factors. Both risk factors - if detected early enough - can be controlled and treated with modern, effective drugs, devoid of significant side effects, available in four countries as different as Italy, Spain, Poland, and Uzbekistan. The aim herein, was to develop this TIMES TO ACT consensus to raise the awareness of the available options of the modern and intensified dyslipidemia and arterial hypertension treatments. The subsequent paragraphs involves consensus and discussion of the deleterious effects of COVID-19 in the cardiovascular field, the high prevalence of hypertension and lipid disorders in our countries and the most important reasons for poor control of these two factors. Subsequently proposed, are currently the most efficient and safe therapeutic options in treating dyslipidemia and arterial hypertension, focusing on the benefits of single-pill combination (SPCs) in both conditions. An accelerated algorithm is proposed to start the treatment with a PCSK9 inhibitor, if the target low-density-lipoprotein values have not been reached. As most patients with hypertension and lipid disorders present with multiple comorbidities, discussed are the possibilities of using new SPCs, combining modern drugs from different therapeutic groups, which mode of action does not confirm the "class effect". We believe our consensus strongly advocates the need to search for patients with cardiovascular risk factors and intensify their lipid-lowering and antihypertensive treatment based on SPCs will improve the control of these two basic cardiovascular risk factors in Italy, Spain, Poland and Uzbekistan.}, }
@article {pmid36043581, year = {2022}, author = {Cheah, FC and Thong, MK and Zulkifli, I and Zilfalil, A and Amir Hamzah, AL and Chan, PWK and Khoo, EJ and Noran, NH}, title = {COVID-19 vaccination for children in Malaysia - A position statement by the College of Paediatrics, Academy of Medicine of Malaysia.}, journal = {The Malaysian journal of pathology}, volume = {44}, number = {2}, pages = {177-185}, pmid = {36043581}, issn = {0126-8635}, mesh = {Adolescent ; *COVID-19/prevention &amp; control ; COVID-19 Vaccines ; Child ; Child, Preschool ; Humans ; Malaysia ; *Pediatrics ; SARS-CoV-2 ; Vaccination ; *Vaccines ; }, abstract = {The availability of COVID-19 vaccines and mass vaccination programmes in adults have significantly reduced the case attack rates and disease burden. COVID-19 vaccination successfully decreases the population at risk of infection, allowing for the safer re-opening of economies and reducing the pandemic's crippling impact on healthcare systems. However, the rapidly mutating severe acute respiratory syndrome-coronavirus-2 poses challenges in diminishing vaccine-induced immunity and vaccinating a significant proportion of adults to achieve herd immunity. These challenges necessitated adolescent vaccination. With the recent emergence of the highly transmissible Omicron variant and the increasing COVID-19 hospitalisation rates of children below 12 years old, many countries opted to also vaccinate younger children. Phase II/III clinical trials and real-world experience demonstrate that COVID-19 vaccinations are effective and safe for younger children and adolescents. Before Malaysia introduced its national COVID-19 vaccination programme for children 5-11 years old (which ran between March and June 2022), an expert advisory statement was issued by the College of Paediatrics, Academy of Medicine of Malaysia, to highlight the benefits and importance of vaccinating children. The advisory statement included clarifications about vaccine-related side effects such as post-vaccination myocarditis and allergic reactions to encourage informed decision making by healthcare providers and parents. This paper, which was prepared based on the critical appraisal of the current evidence, evaluation of the international experiences and the positive impact of COVID-19 vaccination in children, collectively sums up the rationale to support and ensure the success of the nationwide vaccination programme for children. Hence, the College recommends COVID-19 vaccination for children in Malaysia.}, }
@article {pmid35970790, year = {2022}, author = {Feng, LZ and Jiang, HY and Yi, J and Qian, LL and Xu, JD and Zheng, LB and Ma, ZB and Peng, SJ and Jiang, ST and Xu, EF and Chen, LH and Wang, LD and Gao, WZ and Yang, W}, title = {[Introduction and implications of WHO position paper: vaccines against influenza, May 2022].}, journal = {Zhonghua yi xue za zhi}, volume = {102}, number = {30}, pages = {2315-2318}, doi = {10.3760/cma.j.cn112137-20220518-01090}, pmid = {35970790}, issn = {0376-2491}, support = {2021-RC330-002//Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences/ ; INV-023808/GATES/Bill &amp; Melinda Gates Foundation/United States ; }, mesh = {*COVID-19 ; Humans ; *Influenza Vaccines ; *Influenza, Human/epidemiology/prevention &amp; control ; SARS-CoV-2 ; World Health Organization ; }, abstract = {On May 13, 2022, World Health Organization(WHO) Position Paper on Influenza Vaccine (2022 edition) was published. This position paper updates information on influenza epidemiology, high risk population, the impact of immunization on disease, influenza vaccines and effectiveness and safety, and propose WHO's position and recommendation that all countries should consider implementing seasonal influenza vaccine immunization programmes to prepare for an influenza pandemic. In addition, it proposes that the influenza surveillance platform can be integrated with the surveillance of other respiratory viruses, such as SARS-CoV-2 and Respiratory Syncytial Virus. This position paper has some implications for the prevention and control of influenza and other respiratory infectious diseases in China: (1) Optimize influenza vaccine policies to facilitate the implementation of immunization services; (2) Influenza prevention and control should from the perspective of Population Medicine focus on the individual and community to integrate with "Promotion, Prevention, Diagnosis, Control, Treatment, Rehabilitation"; (3) Incorporate prevention and control of other respiratory infectious diseases such as influenza, COVID-19, respiratory syncytial virus and adenovirus, and intelligently monitor by integrating multi-channel data to achieve the goal of co-prevention and control of multiple diseases.}, }
@article {pmid35921761, year = {2022}, author = {Beretta, GD and Casolino, R and Corsi, DC and Perrone, F and Di Maio, M and Cinieri, S and Gobber, G and Bellani, M and Petrini, F and Zocchi, MT and Traclò, F and Zagonel, V and ,  and ,  and ,  and ,  and ,  and , }, title = {Position paper of the Italian Association of Medical Oncology on the impact of COVID-19 on Italian oncology and the path forward: the 2021 Matera statement.}, journal = {ESMO open}, volume = {7}, number = {4}, pages = {100538}, pmid = {35921761}, issn = {2059-7029}, mesh = {*COVID-19 ; Ecosystem ; Humans ; *Medical Oncology ; Neoplasms ; Pandemics ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has severely affected cancer care and research by disrupting the prevention and treatment paths as well as the preclinical, clinical, and translational research ecosystem. In Italy, this has been particularly significant given the severity of the pandemic's impact and the intrinsic vulnerabilities of the national health system. However, whilst detrimental, disruption can also be constructive and may stimulate innovation and progress. The Italian Association of Medical Oncology (AIOM) has recognized the impact of COVID-19 on cancer care continuum and research and proposes the '2021 Matera statement' which aims at providing pragmatic guidance for policymakers and health care institutions to mitigate the impact of the global health crisis on Italian oncology and design the recovery plan for the post-pandemic scenario. The interventions are addressed both to the pillars (prevention, diagnosis, treatment, follow-up, health care professionals) and foundations of cancer care (communication and care relationship, system organization, resources, research, networking). The priorities to be implemented can be summarized in the MATERA acronym: Multidisciplinarity; Access to cancer care; Telemedicine and Territoriality; Equity, ethics, education; Research and resources; Alliance between stakeholders and patients.}, }
@article {pmid35868584, year = {2022}, author = {Marjot, T and Eberhardt, CS and Boettler, T and Belli, LS and Berenguer, M and Buti, M and Jalan, R and Mondelli, MU and Moreau, R and Shouval, D and Berg, T and Cornberg, M}, title = {Impact of COVID-19 on the liver and on the care of patients with chronic liver disease, hepatobiliary cancer, and liver transplantation: An updated EASL position paper.}, journal = {Journal of hepatology}, volume = {77}, number = {4}, pages = {1161-1197}, pmid = {35868584}, issn = {1600-0641}, support = {102176/B/13/Z/WT_/Wellcome Trust/United Kingdom ; }, mesh = {*COVID-19 ; Humans ; *Liver Diseases/epidemiology/surgery ; *Liver Transplantation ; *Neoplasms ; Pandemics ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic has presented a serious challenge to the hepatology community, particularly healthcare professionals and patients. While the rapid development of safe and effective vaccines and treatments has improved the clinical landscape, the emergence of the omicron variant has presented new challenges. Thus, it is timely that the European Association for the Study of the Liver provides a summary of the latest data on the impact of COVID-19 on the liver and issues guidance on the care of patients with chronic liver disease, hepatobiliary cancer, and previous liver transplantation, as the world continues to deal with the consequences of the COVID-19 pandemic.}, }
@article {pmid35816710, year = {2022}, author = {Crowley, R and Atiq, O and Hilden, D and , }, title = {Long-Term Services and Supports for Older Adults: A Position Paper From the American College of Physicians.}, journal = {Annals of internal medicine}, volume = {175}, number = {8}, pages = {1172-1174}, doi = {10.7326/M22-0864}, pmid = {35816710}, issn = {1539-3704}, mesh = {Aged ; *Assisted Living Facilities ; *COVID-19/epidemiology ; Humans ; Long-Term Care ; Pandemics ; *Physicians ; United States ; }, abstract = {The number of Americans aged 65 years or older is expected to increase in the coming decades. Because the risk for disability increases with age, more persons will need long-term services and supports (LTSS) to help with bathing, eating, dressing, and other everyday tasks. Long-term services and supports are delivered in nursing homes, assisted living facilities, the person's home, and other settings. However, the LTSS sector faces several challenges, including keeping patients and staff safe during the COVID-19 pandemic, workforce shortages, quality problems, and fragmented coverage options. In this position paper, the American College of Physicians offers policy recommendations on LTSS coverage, financing, workforce, safety and quality, and emergency preparedness and calls on policymakers and other stakeholders to reform and improve the LTSS sector so that care is high quality, accessible, equitable, and affordable.}, }
@article {pmid35759767, year = {2022}, author = {Serchen, J and Atiq, O and Hilden, D and , }, title = {Strengthening Food and Nutrition Security to Promote Public Health in the United States: A Position Paper From the American College of Physicians.}, journal = {Annals of internal medicine}, volume = {175}, number = {8}, pages = {1170-1171}, doi = {10.7326/M22-0390}, pmid = {35759767}, issn = {1539-3704}, mesh = {*COVID-19/epidemiology ; Child ; Humans ; Pandemics/prevention &amp; control ; *Physicians ; Poverty ; Public Health ; United States ; }, abstract = {Food insecurity functions as a social driver of health, directly negatively impacting health status and outcomes, which can further negatively impact employment and income and increase medical expenditures-all of which exacerbates food insecurity. Progress in meaningfully reducing the food-insecurity rate has stalled in recent years. Although rates have decreased since their peak during the Great Recession, these gains have been reversed by the economic implications of the COVID-19 pandemic. As the federal government is the largest provider of food assistance, there is much potential in better leveraging nutrition assistance programs like the Supplemental Nutrition Assistance Program (SNAP) and the Child Nutrition Programs to increase access to healthful foods and improve public health. However, these programs face many funding challenges and internal shortcomings that create uncertainties and prevent maximal effect. Physicians and other medical professionals also have a role in improving nutritional health by screening for food insecurity and serving as connectors between patients, community organizations, and government services. Governments and payers must support these efforts by providing sufficient resources to practices to fulfill this role. In this position paper, the American College of Physicians (ACP) offers several policy recommendations to strengthen the federal food-insecurity response and empower physicians and other medical professionals to better address those social drivers of health occurring beyond the office doors.}, }
@article {pmid35715014, year = {2022}, author = {Kohan, L and Pellis, Z and Provenzano, DA and Pearson, ACS and Narouze, S and Benzon, HT}, title = {American Society of Regional Anesthesia and Pain Medicine contrast shortage position statement.}, journal = {Regional anesthesia and pain medicine}, volume = {47}, number = {9}, pages = {511-518}, doi = {10.1136/rapm-2022-103830}, pmid = {35715014}, issn = {1532-8651}, mesh = {*Anesthesia, Conduction ; Humans ; Pain ; Pain Management ; *Physicians ; Societies, Medical ; United States ; }, abstract = {The medical field has been experiencing numerous drug shortages in recent years. The most recent shortage to impact the field of interventional pain medicine is that of iodinated contrast medium. Pain physicians must adapt to these changes while maintaining quality of care. This position statement offers guidance on adapting to the shortage.}, }
@article {pmid35692364, year = {2022}, author = {Kaap-Fröhlich, S and Ulrich, G and Wershofen, B and Ahles, J and Behrend, R and Handgraaf, M and Herinek, D and Mitzkat, A and Oberhauser, H and Scherer, T and Schlicker, A and Straub, C and Waury Eichler, R and Wesselborg, B and Witti, M and Huber, M and Bode, SFN}, title = {Position paper of the GMA Committee Interprofessional Education in the Health Professions - current status and outlook.}, journal = {GMS journal for medical education}, volume = {39}, number = {2}, pages = {Doc17}, pmid = {35692364}, issn = {2366-5017}, mesh = {*COVID-19/epidemiology ; Curriculum ; Health Occupations ; Humans ; *Interprofessional Education ; Pandemics ; }, abstract = {In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare.}, }
@article {pmid35579481, year = {2022}, author = {Khan, NA and Stergiou, GS and Omboni, S and Kario, K and Renna, N and Chapman, N and McManus, RJ and Williams, B and Parati, G and Konradi, A and Islam, SM and Itoh, H and Mooi, CS and Green, BB and Cho, MC and Tomaszewski, M}, title = {Virtual management of hypertension: lessons from the COVID-19 pandemic-International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension.}, journal = {Journal of hypertension}, volume = {40}, number = {8}, pages = {1435-1448}, doi = {10.1097/HJH.0000000000003205}, pmid = {35579481}, issn = {1473-5598}, mesh = {Adult ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; *COVID-19 ; Humans ; *Hypertension/diagnosis/drug therapy/epidemiology ; Pandemics ; }, abstract = {The coronavirus disease 2019 pandemic caused an unprecedented shift from in person care to delivering healthcare remotely. To limit infectious spread, patients and providers rapidly adopted distant evaluation with online or telephone-based diagnosis and management of hypertension. It is likely that virtual care of chronic diseases including hypertension will continue in some form into the future. The purpose of the International Society of Hypertension's (ISH) position paper is to provide practical guidance on the virtual management of hypertension to improve its diagnosis and blood pressure control based on the currently available evidence and international experts' opinion for nonpregnant adults. Virtual care represents the provision of healthcare services at a distance with communication conducted between healthcare providers, healthcare users and their circle of care. This statement provides consensus guidance on: selecting blood pressure monitoring devices, accurate home blood pressure assessments, delivering patient education virtually, health behavior modification, medication adjustment and long-term virtual monitoring. We further provide recommendations on modalities for the virtual assessment and management of hypertension across the spectrum of resource availability and patient ability.}, }
@article {pmid35533736, year = {2022}, author = {Burns, SP and Fleming, TK and Webb, SS and Kam, ASH and Fielder, JDP and Kim, GJ and Hu, X and Hill, MT and Kringle, EA}, title = {Stroke Recovery During the COVID-19 Pandemic: A Position Paper on Recommendations for Rehabilitation.}, journal = {Archives of physical medicine and rehabilitation}, volume = {103}, number = {9}, pages = {1874-1882}, pmid = {35533736}, issn = {1532-821X}, support = {K23 HL159240/HL/NHLBI NIH HHS/United States ; }, mesh = {*COVID-19/epidemiology ; Communicable Disease Control ; Humans ; Pandemics ; *Stroke/epidemiology ; *Stroke Rehabilitation ; }, abstract = {Health care delivery shifted and adapted with the COVID-19 pandemic caused by the novel severe acute respiratory syndrome coronavirus 2. Stroke care was negatively affected across the care continuum and may lead to poor community living outcomes in those who survived a stroke during the ongoing pandemic. For instance, delays in seeking care, changes in length of stays, and shifts in discharge patterns were observed during the pandemic. Those seeking care were younger and had more severe neurologic effects from stroke. Increased strain was placed on caregivers and public health efforts, and community-wide lockdowns, albeit necessary to reduce the spread of COVID-19, had detrimental effects on treatment and recommendations to support community living outcomes. The American Congress of Rehabilitation Medicine Stroke Interdisciplinary Special Interest Group Health and Wellness Task Force convened to (1) discuss international experiences in stroke care and rehabilitation and (2) review recently published literature on stroke care and outcomes during the pandemic. Based on the findings in the literature, the task force proposes recommendations and interdisciplinary approaches at the (1) institutional and societal level; (2) health care delivery level; and (3) individual and interpersonal level spanning across the care continuum and into the community.}, }
@article {pmid35508059, year = {2022}, author = {Moreira, HG and Oliveira Júnior, MT and Valdigem, BP and Martins, CN and Polanczyk, CA}, title = {Position Statement on Cardiovascular Safety of Vaccines Against COVID-19 - 2022.}, journal = {Arquivos brasileiros de cardiologia}, volume = {118}, number = {4}, pages = {789-796}, pmid = {35508059}, issn = {1678-4170}, mesh = {*COVID-19/prevention &amp; control ; COVID-19 Vaccines/adverse effects ; *Cardiovascular System ; Humans ; SARS-CoV-2 ; *Vaccines ; }, }
@article {pmid35460319, year = {2022}, author = {Rakusa, M and Öztürk, S and Moro, E and Helbok, R and Bassetti, CL and Beghi, E and Bereczki, D and Bodini, B and Di Liberto, G and Jenkins, TM and Macerollo, A and Maia, LF and Martinelli-Boneschi, F and Pisani, A and Priori, A and Sauerbier, A and Soffietti, R and Taba, P and von Oertzen, TJ and Zedde, M and Crean, M and Burlica, A and Cavallieri, F and Sellner, J and , }, title = {COVID-19 vaccination hesitancy among people with chronic neurological disorders: A position paper.}, journal = {European journal of neurology}, volume = {29}, number = {8}, pages = {2163-2172}, pmid = {35460319}, issn = {1468-1331}, mesh = {*COVID-19/complications/prevention &amp; control ; *COVID-19 Vaccines/administration &amp; dosage ; Humans ; *Nervous System Diseases ; Pandemics ; SARS-CoV-2 ; Vaccination/psychology ; *Vaccination Hesitancy ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND AND PURPOSE: Health risks associated with SARS-CoV-2 infection are undisputed. Moreover, the capability of vaccination to prevent symptomatic, severe, and fatal COVID-19 is recognized. There is also early evidence that vaccination can reduce the chance for long COVID-19. Nonetheless, the willingness to get vaccinated and receive booster shots remains subpar among people with neurologic disorders. Vaccine scepticism not only jeopardizes collective efforts to end the COVID-19 pandemic but puts individual lives at risk, as some chronic neurologic diseases are associated with a higher risk for an unfavorable COVID-19 course.<br><br>METHODS: In this position paper, the NeuroCOVID-19 Task Force of the European Academy of Neurology (EAN) summarizes the current knowledge on the prognosis of COVID-19 among patients with neurologic disease, elucidates potential barriers to vaccination coverage, and formulates strategies to overcome vaccination hesitancy. A survey among the Task Force members on the phenomenon of vaccination hesitancy among people with neurologic disease supports the lines of argumentation.<br><br>RESULTS: The study revealed that people with multiple sclerosis and other nervous system autoimmune disorders are most skeptical of SARS-CoV-2 vaccination. The prevailing concerns included the chance of worsening the pre-existing neurological condition, vaccination-related adverse events, and drug interaction.<br><br>CONCLUSIONS: The EAN NeuroCOVID-19 Task Force reinforces the key role of neurologists as advocates of COVID-19 vaccination. Neurologists need to argue in the interest of their patients about the overwhelming individual and global benefits of COVID-19 vaccination. Moreover, they need to keep on eye on this vulnerable patient group, its concerns, and the emergence of potential safety signals.}, }
@article {pmid35434988, year = {2022}, author = {Parthasaradhi, A and Ganguly, S and Kar, BR and Thomas, J and Neema, S and Tahiliani, S and Sathishkumar, D and Parasramani, SG and Chalam, KV and Komeravalli, H}, title = {Coronavirus disease 2019 vaccination in patients with psoriasis: A position statement from India by SIG psoriasis (IADVL Academy).}, journal = {Indian journal of dermatology, venereology and leprology}, volume = {88}, number = {3}, pages = {286-290}, doi = {10.25259/IJDVL_773_2021}, pmid = {35434988}, issn = {0973-3922}, mesh = {*COVID-19/epidemiology/prevention &amp; control ; COVID-19 Vaccines ; Humans ; India/epidemiology ; *Psoriasis/diagnosis/drug therapy/epidemiology ; SARS-CoV-2 ; Vaccination ; *Vaccines ; }, abstract = {Coronavirus disease 2019 (COVID-19) pandemic has affected every sphere of life including management of psoriasis. The availability of COVID-19 vaccines has given rise to hope and at the same time some apprehensions as well. With the general population becoming eligible for vaccination, there is some confusion, on the eligibility of patients with different medical conditions and patients on immunosuppressive or immunomodulating medications for COVID-19 vaccination. Dermatologists treating psoriasis patients frequently face questions from them, whether they can undergo coronavirus disease 2019 vaccination. A PUBMED search was performed using the following strategy: 'COVID-19' AND 'Vaccine' AND 'Psoriasis'. We also performed a PUBMED search using the following strategy: 'SARS-CoV-2' AND 'Vaccine' AND 'Psoriasis'. All articles irrespective of language and publication date were included to arrive at this position statement. This position statement deals with the safety, eligibility and modifications of treatment, if needed among psoriasis patients with regards to the coronavirus disease 2019 vaccines currently available in India.}, }
@article {pmid35343485, year = {2021}, author = {Violini, R and De Rosa, S and Leonardi, S and Doronzo, B and Cremonesi, A and Callea, G and Spandonaro, F and Tarantini, G and Esposito, G and Cernetti, C and Indolfi, C and Berti, S and Marchese, A and Saia, F and Monti, F}, title = {[GISE (Italian Society of Interventional Cardiology) Position paper: Short-term hospitalization for percutaneous coronary intervention; a helpful tool to manage post-COVID-19 backlogs].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {22}, number = {12 Suppl 2}, pages = {4-15}, doi = {10.1714/3723.37134}, pmid = {35343485}, issn = {1972-6481}, mesh = {*COVID-19 ; *Cardiology ; Hospitalization ; Humans ; Length of Stay ; Pandemics/prevention &amp; control ; *Percutaneous Coronary Intervention/adverse effects ; }, abstract = {Minimization of hospital lengths of stay has always been a key goal for healthcare systems. More so during the current COVID-19 pandemic. In fact, we have faced a reduction in no-COVID-19 admissions with the generation of huge backlogs. Low-risk patients undergoing elective percutaneous coronary intervention (PCI) can be candidate for short-term hospitalization, with consequent reduction of waiting lists. Several single-center and multicenter observational studies, multiple randomized trials and some meta-analyses have addressed this topic.In this position paper, we present a proposal for short hospitalization for elective PCI procedures in selected patients who present complications only exceptionally and exclusively immediately after the procedure, if the inclusion and exclusion criteria are met. Each Center can choose between admission in day surgery or one day surgery, extending hospital length of stay only for patients who present complications or who are candidate for urgent surgery. Short-term hospitalization considerably reduces costs even if, with the current model, it generally results in a parallel reduction in reimbursement. Hence, we present an actual model, already tested successfully in an Italian hospital, that warrants sustainability. This approach can then be tailored to single Centers.}, }
@article {pmid35240931, year = {2022}, author = {Kwasnicka, D and Keller, J and Perski, O and Potthoff, S and Ten Hoor, GA and Ainsworth, B and Crutzen, R and Dohle, S and van Dongen, A and Heino, M and Henrich, JF and Knox, L and König, LM and Maltinsky, W and McCallum, C and Nalukwago, J and Neter, E and Nurmi, J and Spitschan, M and Van Beurden, SB and Van der Laan, LN and Wunsch, K and Levink, JJJ and Sanderman, R}, title = {White Paper: Open Digital Health - accelerating transparent and scalable health promotion and treatment.}, journal = {Health psychology review}, volume = {16}, number = {4}, pages = {475-491}, doi = {10.1080/17437199.2022.2046482}, pmid = {35240931}, issn = {1743-7202}, mesh = {Humans ; *Pandemics/prevention &amp; control ; *COVID-19 ; Health Promotion ; Global Health ; }, abstract = {In this White Paper, we outline recommendations from the perspective of health psychology and behavioural science, addressing three research gaps: (1) What methods in the health psychology research toolkit can be best used for developing and evaluating digital health tools? (2) What are the most feasible strategies to reuse digital health tools across populations and settings? (3) What are the main advantages and challenges of sharing (openly publishing) data, code, intervention content and design features of digital health tools? We provide actionable suggestions for researchers joining the continuously growing Open Digital Health movement, poised to revolutionise health psychology research and practice in the coming years. This White Paper is positioned in the current context of the COVID-19 pandemic, exploring how digital health tools have rapidly gained popularity in 2020-2022, when world-wide health promotion and treatment efforts rapidly shifted from face-to-face to remote delivery. This statement is written by the Directors of the not-for-profit Open Digital Health initiative (n = 6), Experts attending the European Health Psychology Society Synergy Expert Meeting (n = 17), and the initiative consultant, following a two-day meeting (19-20th August 2021).}, }
@article {pmid35112371, year = {2022}, author = {Barbaud, A and Garvey, LH and Arcolaci, A and Brockow, K and Mori, F and Mayorga, C and Bonadonna, P and Atanaskovic-Markovic, M and Moral, L and Zanoni, G and Pagani, M and Soria, A and Jošt, M and Caubet, JC and Carmo, A and Mona, AA and Alvarez-Perea, A and Bavbek, S and Benedetta, B and Bilo, MB and Blanca-López, N and Bogas, HG and Buonomo, A and Calogiuri, G and Carli, G and Cernadas, J and Cortellini, G and Celik, G and Demir, S and Doña, I and Dursun, AB and Eberlein, B and Faria, E and Fernandes, B and Garcez, T and Garcia-Nunez, I and Gawlik, R and Gelincik, A and Gomes, E and Gooi, JHC and Grosber, M and Gülen, T and Hacard, F and Hoarau, C and Janson, C and Johnston, SL and Joerg, L and Kepil Özdemir, S and Klimek, L and Košnik, M and Kowalski, ML and Kuyucu, S and Kvedariene, V and Laguna, JJ and Lombardo, C and Marinho, S and Merk, H and Meucci, E and Morisset, M and Munoz-Cano, R and Murzilli, F and Nakonechna, A and Popescu, FD and Porebski, G and Radice, A and Regateiro, FS and Röckmann, H and Romano, A and Sargur, R and Sastre, J and Scherer Hofmeier, K and Sedláčková, L and Sobotkova, M and Terreehorst, I and Treudler, R and Walusiak-Skorupa, J and Wedi, B and Wöhrl, S and Zidarn, M and Zuberbier, T and Agache, I and Torres, MJ}, title = {Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper.}, journal = {Allergy}, volume = {77}, number = {8}, pages = {2292-2312}, doi = {10.1111/all.15241}, pmid = {35112371}, issn = {1398-9995}, mesh = {*Anaphylaxis/diagnosis ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/adverse effects ; *Drug Hypersensitivity/diagnosis/etiology/therapy ; Humans ; *Vaccines ; Vaccines, Synthetic ; mRNA Vaccines ; }, abstract = {BACKGROUND: Anaphylaxis, which is rare, has been reported after COVID-19 vaccination, but its management is not standardized.<br><br>METHOD: Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre-vaccination screening and management of allergic reactions to COVID-19 vaccines, and literature was analysed.<br><br>RESULTS: No death due to anaphylaxis to COVID-19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1-anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2-anaphylaxis to oral/topical PEG containing products; 3-recurrent anaphylaxis of unknown cause; 4-suspected or confirmed allergy to any mRNA vaccine; and 5-confirmed allergy to PEG or derivatives. We recommend a prick-to-prick skin test with the left-over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable.<br><br>CONCLUSIONS: These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID-19 vaccines and enable more people with history of allergy to be vaccinated.}, }
@article {pmid35103926, year = {2022}, author = {Cosentini, R and Groff, P and Brambilla, AM and Camajori Todeschini, R and Gangitano, G and Ingrassia, S and Marino, R and Nori, F and Pagnozzi, F and Panero, F and Ferrari, R and , }, title = {SIMEU position paper on non-invasive respiratory support in COVID-19 pneumonia.}, journal = {Internal and emergency medicine}, volume = {17}, number = {4}, pages = {1175-1189}, pmid = {35103926}, issn = {1970-9366}, mesh = {*COVID-19/complications/therapy ; *Emergency Medicine ; Humans ; *Noninvasive Ventilation/methods ; Respiration, Artificial ; *Respiratory Insufficiency ; SARS-CoV-2 ; }, abstract = {The rapid worldwide spread of the Coronavirus disease (COVID-19) crisis has put health systems under pressure to a level never experienced before, putting intensive care units in a position to fail to meet an exponentially growing demand. The main clinical feature of the disease is a progressive arterial hypoxemia which rapidly leads to ARDS which makes the use of intensive care and mechanical ventilation almost inevitable. The difficulty of health systems to guarantee a corresponding supply of resources in intensive care, together with the uncertain results reported in the literature with respect to patients who undergo early conventional ventilation, make the search for alternative methods of oxygenation and ventilation and potentially preventive of the need for tracheal intubation, such as non-invasive respiratory support techniques particularly valuable. In this context, the Emergency Department, located between the area outside the hospital and hospital ward and ICU, assumes the role of a crucial junction, due to the possibility of applying these techniques at a sufficiently early stage and being able to rapidly evaluate their effectiveness. This position paper describes the indications for the use of non-invasive respiratory support techniques in respiratory failure secondary to COVID-19-related pneumonia, formulated by the Non-invasive Ventilation Faculty of the Italian Society of Emergency Medicine (SIMEU) on the base of what is available in the literature and on the authors' direct experience. Rationale, literature, tips &amp; tricks, resources, risks and expected results, and patient interaction will be discussed for each one of the escalating non-invasive respiratory techniques: standard oxygen, HFNCO, CPAP, NIPPV, and awake self-repositioning. The final chapter describes our suggested approach to the failing patient.}, }
@article {pmid34973937, year = {2022}, author = {Manzano-Aquiahuatl, C and Tobar-Fredes, R and Zavala-Solares, MR and Salle-Levy, D and Imamura, R and Morales-Fernández, R and Ojeda-Peña, L and Parra-Reyes, D and Santoro, P and Ton, V and Trujillo-Benavides, OE and Vargas-García, MA and Furkim, AM}, title = {Position statement of the Latin American Dysphagia Society for the management of oropharyngeal and esophageal dysphagia during the COVID-19 pandemic.}, journal = {Revista de gastroenterologia de Mexico (English)}, volume = {87}, number = {1}, pages = {63-79}, pmid = {34973937}, issn = {2255-534X}, mesh = {*COVID-19 ; *Deglutition Disorders/epidemiology/therapy ; Humans ; Latin America/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: The SARS-CoV-2 virus that causes the COVID-19 disease is transmitted through the inhalation of droplets or aerosols and inoculation via the oronasal or ocular routes, transforming the management of swallowing disorders into a challenge for healthcare teams, given their proximity to the aerodigestive tract and the high probability of aerosol generation during patient evaluation and treatment.<br><br>AIM: To provide essential guidance for Latin American multidisciplinary teams, regarding the evaluation and treatment of oropharyngeal and esophageal dysphagia, at the different levels of healthcare. The position statement was formulated for the purpose of maintaining medical service continuity, in the context of a pandemic, and minimizing the propagation and infection risks of the virus.<br><br>METHODS: Thirteen experts in swallowing disorders were summoned by the Latin American Dysphagia Society to formulate a series of clinical suggestions, based on available evidence and clinical experience, for the management of dysphagia, taking the characteristics of Latin American healthcare systems into account.<br><br>RESULTS: The position statement of the Latin American Dysphagia Society provides a series of clinical suggestions directed at the multidisciplinary teams that manage patients with oropharyngeal and esophageal dysphagia. It presents guidelines for evaluation and treatment in different contexts, from hospitalization to home care.<br><br>CONCLUSIONS: The present statement should be analyzed by each team or healthcare professional, to reduce the risk for COVID-19 infection and achieve the best therapeutic results, while at the same time, being mindful of the reality of each Latin American country.}, }
@article {pmid34933373, year = {2022}, author = {Gralnek, IM and Hassan, C and Ebigbo, A and Fuchs, A and Beilenhoff, U and Antonelli, G and Bisschops, R and Arvanitakis, M and Bhandari, P and Bretthauer, M and Kaminski, MF and Lorenzo-Zuniga, V and Rodriguez de Santiago, E and Siersema, PD and Tham, TC and Triantafyllou, K and Tringali, A and Voiosu, A and Webster, G and de Pater, M and Fehrke, B and Gazic, M and Gjergek, T and Maasen, S and Waagenes, W and Dinis-Ribeiro, M and Messmann, H}, title = {ESGE and ESGENA Position Statement on gastrointestinal endoscopy and COVID-19: Updated guidance for the era of vaccines and viral variants.}, journal = {Endoscopy}, volume = {54}, number = {2}, pages = {211-216}, doi = {10.1055/a-1700-4897}, pmid = {34933373}, issn = {1438-8812}, mesh = {*COVID-19 ; Endoscopy, Gastrointestinal ; *Gastroenterology ; Humans ; SARS-CoV-2 ; *Vaccines ; }, }
@article {pmid34915764, year = {2021}, author = {Wang, X and Gkrouzman, E and Andrade, DCO and Andreoli, L and Barbhaiya, M and Belmont, HM and Branch, DW and de Jesús, GR and Efthymiou, M and Ríos-Garcés, R and Gerosa, M and El Hasbani, G and Knight, J and Meroni, PL and Pazzola, G and Petri, M and Rand, J and Salmon, J and Tektonidou, M and Tincani, A and Uthman, IW and Zuily, S and Zuo, Y and Lockshin, M and Cohen, H and Erkan, D and , }, title = {COVID-19 and antiphospholipid antibodies: A position statement and management guidance from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION).}, journal = {Lupus}, volume = {30}, number = {14}, pages = {2276-2285}, pmid = {34915764}, issn = {1477-0962}, support = {R01 AR069572/AR/NIAMS NIH HHS/United States ; }, mesh = {*Antibodies, Antiphospholipid ; *Antiphospholipid Syndrome ; *COVID-19/pathology ; Humans ; *Thrombosis/virology ; }, abstract = {Coronavirus disease 2019 (COVID-19) is associated with a high rate of thrombosis. Prolonged activated partial thromboplastin times (aPTT) and antiphospholipid antibodies (aPL) are reported in COVID-19 patients. The majority of publications have not reported whether patients develop clinically relevant persistent aPL, and the clinical significance of new aPL-positivity in COVID-19 is currently unknown. However, the reports of aPL-positivity in COVID-19 raised the question whether common mechanisms exist in the pathogenesis of COVID-19 and antiphospholipid syndrome (APS). In both conditions, thrombotic microangiopathy resulting in microvascular injury and thrombosis is hypothesized to occur through multiple pathways, including endothelial damage, complement activation, and release of neutrophil extracellular traps (NETosis). APS-ACTION, an international APS research network, created a COVID-19 working group that reviewed common mechanisms, positive aPL tests in COVID-19 patients, and implications of COVID-19 infection for patients with known aPL positivity or APS, with the goals of proposing guidance for clinical management and monitoring of aPL-positive COVID-19 patients. This guidance also serves as a call and focus for clinical and basic scientific research.}, }
@article {pmid34855691, year = {2022}, author = {Keder, RD and Mittal, S and Stringer, K and Wallis, KE and Wallace, JE and Soares, NS}, title = {Society for Developmental &amp; Behavioral Pediatrics Position Statement on Telehealth.}, journal = {Journal of developmental and behavioral pediatrics : JDBP}, volume = {43}, number = {1}, pages = {55-59}, doi = {10.1097/DBP.0000000000001046}, pmid = {34855691}, issn = {1536-7312}, mesh = {*COVID-19 ; Humans ; Pandemics ; *Pediatrics ; SARS-CoV-2 ; *Telemedicine ; }, abstract = {Telehealth has long held promise as a way to increase access to subspecialty care for children and families, including in developmental and behavioral pediatrics (DBP). The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid uptake of telehealth to continue care delivery that was facilitated by "temporary" policy changes related to the pandemic. As a result, the field of DBP has recognized telehealth as a potential model of care for performing home-based diagnostic assessments, providing medication management follow-up, and delivering therapeutic interventions for children with neurodevelopmental disorders. Telehealth has been helpful in mitigating barriers families often face when attending in-person visits (lack of transportation and child care, missed work hours, etc) but has also highlighted additional determinants of health that need to be addressed to provide equitable access to care (broadband connectivity, device access, digital literacy, access to interpretation and sign language services, etc). Anticipating the lifting of pandemic-related emergency declaration and expiration of temporary policies around telehealth, the ability to continue to deliver DBP care by telehealth is uncertain. The purpose of this policy statement is to advocate for legislation and policies that support ongoing, equitable, home-based telehealth care for patients seen by DBP providers while ensuring equitable access to DBP in general. In addition, there is a need to recognize the benefits and challenges of telehealth versus in-person care and to identify clinical scenarios that favor 1 model of care versus the other.}, }
@article {pmid34845404, year = {2021}, author = {Curcio, A and Spaccarotella, C and Brunetti, ND and Molinari, G and Carugo, S and Basso, C and Ciccone, MM and Filardi, PP and Mancone, M and Mercuro, G and Muscoli, S and Nodari, S and Pedrinelli, R and Barillà, F and Sinagra, G and Indolfi, C}, title = {[Italian Society of Cardiology (SIC) Position paper: Technical, instrumental and standards of interpretation for electrocardiography, ambulatory electrocardiographic and blood pressure monitoring in telemedicine].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {22}, number = {12}, pages = {1017-1023}, doi = {10.1714/3698.36881}, pmid = {34845404}, issn = {1972-6481}, mesh = {Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; *COVID-19 ; *Cardiology ; Electrocardiography, Ambulatory ; Humans ; Pandemics ; SARS-CoV-2 ; *Telemedicine ; }, abstract = {The current COVID-19 pandemic has renewed interest in providing healthcare services based on the implementation of innovative technologies. Such strategy capillarizes the therapeutic opportunities for larger urban areas, mostly when people are living under extraordinarily difficult circumstances. Improving care delivery in cardiovascular diseases appears particularly feasible when telemedicine is pursued, especially with regard to baseline standard 12-lead electrocardiography, ambulatory electrocardiographic monitoring, and 24-hour ambulatory blood pressure monitoring. Nowadays, these first-line cardiovascular examinations are also available in health centers and pharmacies, and in recent months, there has been an increasing demand of such local services in the absence of specific rules and regulations regarding technical requirements and standards of interpretation that ensure a high quality clinical consultation.The purpose of this position paper is to provide critical requirements for the type/model of devices to be used, training dedicated to healthcare personnel, ensuring security of sensitive data, highlighting type of platforms to be used, as well as for maintaining high reporting quality and standards.}, }
@article {pmid34841822, year = {2021}, author = {Latif, A and Faull, C and Waring, J and Wilson, E and Anderson, C and Avery, A and Pollock, K}, title = {Managing medicines at the end of life: a position paper for health policy and practice.}, journal = {Journal of health organization and management}, volume = {35}, number = {9}, pages = {368-377}, pmid = {34841822}, issn = {1758-7247}, mesh = {*COVID-19 ; Death ; Health Policy ; Humans ; *Pandemics ; SARS-CoV-2 ; }, abstract = {PURPOSE: The impact of population ageing is significant, multifaceted and characterised by frailty and multi-morbidity. The COVID-19 pandemic has accelerated care pathways and policies promoting self-management and home-based care. One under-researched area is how patients and family caregivers manage the complexity of end-of-life therapeutic medicine regimens. In this position paper the authors bring attention to the significant strain that patients and family caregivers experience when navigating and negotiating this aspect of palliative and end-of-life care.<br><br>DESIGN/METHODOLOGY/APPROACH: Focussing on self-care and organisation of medicines in the United Kingdom (UK) context, the paper examines, builds on and extends the debate by considering the underlying policy assumptions and unintended consequences for individual patients and family care givers as they assume greater palliative and end-of-life roles and responsibilities.<br><br>FINDINGS: Policy makers and healthcare professionals often lack awareness of the significant burden and emotional work associated with managing and administering often potent high-risk medicines (i.e. opioids) in the domiciliary setting. The recent "revolution" in professional roles associated with the COVID-19 pandemic, including remote consultations and expanding community-based care, means there are opportunities for commissioners to consider offering greater support. The prospect of enhancing the community pharmacist's medicine optimisation role to further support the wider multi-disciplinary team is considered.<br><br>ORIGINALITY/VALUE: The paper takes a person-focused perspective and adopts a holistic view of medicine management. The authors argue for urgent review, reform and investment to enable and support terminally ill patients and family caregivers to more effectively manage medicines in the domiciliary setting. There are clear implications for pharmacists and these are discussed in the context of public awareness, inter-professional collaboration, organisational drivers, funding and regulation and remote care delivery.}, }
@article {pmid34810293, year = {2022}, author = {Bharadva, K and Bellad, RM and Tiwari, S and Somasekar, R and Phadke, M and Bodhankar, U and Bang, A and Kinikar, AA and Mallikarjuna, HB and Shah, J and Khurana, O and Gunasingh, D and Basavaraja, GV and Kumar, R and Gupta, P}, title = {Breastfeeding in Coronavirus Disease 2019 (COVID-19): Position Statement of Indian Academy of Pediatrics and Infant and Young Child Feeding Chapter.}, journal = {Indian pediatrics}, volume = {59}, number = {1}, pages = {58-62}, pmid = {34810293}, issn = {0974-7559}, mesh = {Breast Feeding ; *COVID-19 ; Child ; Female ; Humans ; Infant ; Pandemics ; *Pediatrics ; SARS-CoV-2 ; }, abstract = {JUSTIFICATION: Recent research has provided evidence for lack of transmission of SARS-CoV-2 through human milk and breastfeeding. Updating the practice guidelines will help in providing appropriate advice and support regarding breastfeeding during the coronavirus 2019 (COVID-19) pandemic.<br><br>OBJECTIVES: To provide evidence-based guidelines to help the healthcare professionals to advise optimal breastfeeding practices during the COVID-19 pandemic.<br><br>PROCESS: Formulation of key questions was done under the chairmanship of President of the IAP. It was followed by review of literature and the recommendations of other international and national professional bodies. Through Infant and Young child (IYCF) focused WhatsApp group opinion of all members was taken. The final document was prepared after the consensus and approval by all members of the committee.<br><br>RECOMMENDATIONS: The IYCF Chapter of IAP strongly recommends unabated promotion, protection and support to breastfeeding during the COVID-19 pandemic with due precautions.}, }
@article {pmid34711104, year = {2022}, author = {Pandian, JD and Panagos, PD and Sebastian, IA and Sampaio Silva, G and Furie, KL and Liu, L and Owolabi, MO and Caso, V and Alrukn, SA}, title = {Maintaining stroke care during the COVID-19 pandemic in lower- and middle-income countries: World Stroke Organization Position Statement endorsed by American Stroke Association and American Heart Association.}, journal = {International journal of stroke : official journal of the International Stroke Society}, volume = {17}, number = {1}, pages = {9-17}, pmid = {34711104}, issn = {1747-4949}, support = {D43 TW012030/TW/FIC NIH HHS/United States ; R01 NS107900/NS/NINDS NIH HHS/United States ; R01 NS115944/NS/NINDS NIH HHS/United States ; U54 HG007479/HG/NHGRI NIH HHS/United States ; }, mesh = {American Heart Association ; *COVID-19 ; Developing Countries ; Humans ; Pandemics ; SARS-CoV-2 ; *Stroke/epidemiology/therapy ; United States/epidemiology ; }, abstract = {For more than a year, the SARS-CoV-2 pandemic has had a devastating effect on global health. High-, low-, and middle-income countries are struggling to cope with the spread of newer mutant strains of the virus. Delivery of acute stroke care remains a priority despite the pandemic. In order to maintain the time-dependent processes required to optimize delivery of intravenous thrombolysis and endovascular therapy, most countries have reorganized infrastructure to optimize human resources and critical services. Low-and-middle income countries (LMIC) have strained medical resources at baseline and often face challenges in the delivery of stroke systems of care (SSOC). This position statement aims to produce pragmatic recommendations on methods to preserve the existing SSOC during COVID-19 in LMIC and propose best stroke practices that may be low cost but high impact and commonly shared across the world.}, }
@article {pmid34694269, year = {2022}, author = {Nicastro, E and Ebel, NH and Kehar, M and Czubkowski, P and Ng, VL and Michaels, MG and Lobritto, SJ and Martinez, M and Indolfi, G}, title = {The Impact of Severe Acute Respiratory Syndrome Coronavirus Type 2 on Children With Liver Diseases: A Joint European Society for Pediatric Gastroenterology, Hepatology and Nutrition and Society of Pediatric Liver Transplantation Position Paper.}, journal = {Journal of pediatric gastroenterology and nutrition}, volume = {74}, number = {1}, pages = {159-170}, pmid = {34694269}, issn = {1536-4801}, mesh = {*COVID-19/complications ; Child ; *Gastroenterology ; Humans ; *Liver Diseases ; *Liver Transplantation ; RNA, Viral ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome ; }, abstract = {Children are seldom affected by severe forms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV2) infection; however, the impact of comorbidities in the clinical presentation and outcome of SARS-CoV2 in children is poorly characterized including that of chronic liver disease (CLD) and those taking immunosuppressive medications for autoimmune liver disease or following liver transplantation (LT). Although not the main target organ, a spectrum of liver involvement has been described in children infected with SARS-CoV2 and those presenting with Multisystem Inflammatory Syndrome in Children (MIS-C). The Hepatology Committee of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the Society of Pediatric Liver Transplantation (SPLIT) present an evidence-based position paper on liver involvement in children with SARS-CoV2 infection and its impact on those with CLD as well as LT recipients. All children may exhibit acute liver injury from SARS-CoV2 infection, and those with CLD and may experience hepatic decompensation. Preventative and therapeutic measures are discussed.}, }
@article {pmid34692391, year = {2021}, author = {,  and Ferat, LR and Forrest, R and Sehmi, K and Santos, RD and Stewart, D and Boulton, AJM and Jiménez, BY and Riley, P and Burger, D and Jones, ESW and Tomaszewski, M and Milanese, MR and Laffin, P and Jha, V and Borisch, B and Moore, M and Pinto, FJ and Piñeiro, D and Eiselé, JL and Lackland, DT and Whelton, PK and Zhang, XH and Stavdal, A and Li, D and Hobbs, R and Pandian, JD and Brainin, M and Feigin, V}, title = {Preventing the Next Pandemic: The Case for Investing in Circulatory Health - A Global Coalition for Circulatory Health Position Paper.}, journal = {Global heart}, volume = {16}, number = {1}, pages = {66}, pmid = {34692391}, issn = {2211-8179}, mesh = {Aged ; Humans ; *COVID-19 ; Global Health ; *Noncommunicable Diseases/epidemiology/prevention &amp; control ; Pandemics/prevention &amp; control ; SARS-CoV-2 ; }, abstract = {The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs). In addition to older age, people living with CVD, stroke, obesity, diabetes, kidney disease, and hypertension are at a particularly greater risk for severe forms of COVID-19 and its consequences. Meta-analysis indicates that hypertension, diabetes, chronic kidney disease, and thrombotic complications have been observed as both the most prevalent and most dangerous co-morbidities in COVID-19 patients. And despite the nearly incalculable physical, mental, emotional, and economic toll of this pandemic, forthcoming public health figures continue to place cardiovascular disease as the number one cause of death across the globe in the year 2020. The world simply cannot wait for the next pandemic to invest in NCDs. Social determinants of health cannot be addressed only through the healthcare system, but a more holistic multisectoral approach with at its basis the Sustainable Development Goals (SDGs) is needed to truly address social and economic inequalities and build more resilient systems. Yet there is reason for hope: the 2019 UN Political Declaration on UHC provides a strong framework for building more resilient health systems, with explicit calls for investment in NCDs and references to fiscal policies that put such investment firmly within reach. By further cementing the importance of addressing circulatory health in a future Framework Convention on Emergency Preparedness, WHO Member States can take concrete steps towards a pandemic-free future. As the chief representatives of the global circulatory health community and patients, the Global Coalition for Circulatory Health calls for increased support for the healthcare workforce, global vaccine equity, embracing new models of care and digital health solutions, as well as fiscal policies on unhealthy commodities to support these investments.}, }
@article {pmid34620212, year = {2021}, author = {Venturini, E and Montagnani, C and Garazzino, S and Donà, D and Pierantoni, L and Lo Vecchio, A and Krzysztofiak, A and Nicolini, G and Bianchini, S and Galli, L and Villani, A and Gattinara, GC and , }, title = {Treatment of children with COVID-19: update of the Italian Society of Pediatric Infectious Diseases position paper.}, journal = {Italian journal of pediatrics}, volume = {47}, number = {1}, pages = {199}, pmid = {34620212}, issn = {1824-7288}, mesh = {COVID-19/epidemiology/*therapy ; Child ; *Disease Management ; Female ; Humans ; *Infectious Disease Medicine ; Italy ; Male ; *Periodicals as Topic ; Practice Guidelines as Topic ; *SARS-CoV-2 ; *Societies, Medical ; }, }
@article {pmid34612556, year = {2021}, author = {Rosano, G and Jankowska, EA and Ray, R and Metra, M and Abdelhamid, M and Adamopoulos, S and Anker, SD and Bayes-Genis, A and Belenkov, Y and Gal, TB and Böhm, M and Chioncel, O and Cohen-Solal, A and Farmakis, D and Filippatos, G and González, A and Gustafsson, F and Hill, L and Jaarsma, T and Jouhra, F and Lainscak, M and Lambrinou, E and Lopatin, Y and Lund, LH and Milicic, D and Moura, B and Mullens, W and Piepoli, MF and Ponikowski, P and Rakisheva, A and Ristic, A and Savarese, G and Seferovic, P and Senni, M and Thum, T and Tocchetti, CG and Van Linthout, S and Volterrani, M and Coats, AJS}, title = {COVID-19 vaccination in patients with heart failure: a position paper of the Heart Failure Association of the European Society of Cardiology.}, journal = {European journal of heart failure}, volume = {23}, number = {11}, pages = {1806-1818}, pmid = {34612556}, issn = {1879-0844}, mesh = {Aged ; *COVID-19 ; COVID-19 Vaccines ; *Cardiology ; Frail Elderly ; *Heart Failure ; Humans ; *Iron Deficiencies ; SARS-CoV-2 ; Vaccination ; }, abstract = {Patients with heart failure (HF) who contract SARS-CoV-2 infection are at a higher risk of cardiovascular and non-cardiovascular morbidity and mortality. Regardless of therapeutic attempts in COVID-19, vaccination remains the most promising global approach at present for controlling this disease. There are several concerns and misconceptions regarding the clinical indications, optimal mode of delivery, safety and efficacy of COVID-19 vaccines for patients with HF. This document provides guidance to all healthcare professionals regarding the implementation of a COVID-19 vaccination scheme in patients with HF. COVID-19 vaccination is indicated in all patients with HF, including those who are immunocompromised (e.g. after heart transplantation receiving immunosuppressive therapy) and with frailty syndrome. It is preferable to vaccinate against COVID-19 patients with HF in an optimal clinical state, which would include clinical stability, adequate hydration and nutrition, optimized treatment of HF and other comorbidities (including iron deficiency), but corrective measures should not be allowed to delay vaccination. Patients with HF who have been vaccinated against COVID-19 need to continue precautionary measures, including the use of facemasks, hand hygiene and social distancing. Knowledge on strategies preventing SARS-CoV-2 infection (including the COVID-19 vaccination) should be included in the comprehensive educational programmes delivered to patients with HF.}, }
@article {pmid34570120, year = {2021}, author = {Di Tano, G and Di Lenarda, A and Iacoviello, M and Oliva, F and Urbinati, S and Aspromonte, N and Cipriani, M and Caldarola, P and Murrone, A and Gulizia, MM and Colivicchi, F and Gabrielli, D}, title = {[ANMCO Position paper: Use of sacubitril/valsartan in hospitalized patients with acute heart failure].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {22}, number = {10}, pages = {854-860}, doi = {10.1714/3666.36517}, pmid = {34570120}, issn = {1972-6481}, mesh = {Aminobutyrates ; Angiotensin Receptor Antagonists ; Biphenyl Compounds ; *COVID-19 ; Drug Combinations ; *Heart Failure/drug therapy ; Humans ; Pandemics ; Prospective Studies ; SARS-CoV-2 ; Stroke Volume ; Tetrazoles ; Treatment Outcome ; Valsartan ; }, abstract = {Sacubitril/valsartan (S/V) has been shown to reduce the risk of cardiovascular death or heart failure hospitalization and improve symptoms in chronic heart failure with reduced ejection fraction compared to enalapril. After 7 years since the publication of the results of PARADIGM-HF, further insight has been gained with potential new indications. Two prospective randomized multicenter studies (PIONEER-HF and TRANSITION) in patients hospitalized for acute heart failure (AHF) have shown an improved clinical outcome and biomarker profile as compared to enalapril, and good tolerability, safety and feasibility of initiating in-hospital administration of S/V. Furthermore, some studies have highlighted the favorable effects of S/V in attenuating adverse myocardial remodeling, supporting an early benefit after treatment. Observational data from non-randomized studies in AHF report that in-hospital and pre-discharge prescription of evidence-based drugs associated with better survival still remains suboptimal. Additionally, the COVID-19 pandemic has also negatively impacted on outpatient activities. Therefore, hospitalization, a real crossroads in the history of heart failure, must become a management and therapeutic opportunity for our patients. The objective of this ANMCO position paper is to encourage and facilitate early S/V administration in stabilized patients during hospitalization after an AHF episode, with the aim of improving care efficiency and clinical outcome.}, }
@article {pmid34570114, year = {2021}, author = {Bisceglia, I and Gabrielli, D and Canale, ML and Gallucci, G and Parrini, I and Turazza, FM and Russo, G and Maurea, N and Quagliariello, V and Lestuzzi, C and Oliva, S and Di Fusco, SA and Lucà, F and Tarantini, L and Trambaiolo, P and Gulizia, MM and Colivicchi, F}, title = {[ANMCO Position paper: Cardio-oncology in the COVID-19 era].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {22}, number = {10}, pages = {800-825}, doi = {10.1714/3666.36511}, pmid = {34570114}, issn = {1972-6481}, mesh = {*COVID-19 ; Humans ; *Myocardial Infarction ; *Neoplasms/therapy ; Pandemics ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic and its impact on patients with cancer and cardiovascular disease have confirmed the particular vulnerability of this population. Indeed, not only a higher risk of contracting the infection has been reported, but also an increased occurrence of a more severe course and unfavorable outcome. Beyond the direct consequences of COVID-19, the pandemic has an enormous impact on global health systems. Screening programs and non-urgent tests have been postponed; clinical trials have suffered a setback. Similarly, in the area of cardiology care, a significant decline in ST-elevation myocardial infarction accesses and an increase in cases of late presenting heart attacks with increased mortality and complication rates have been reported. Health care systems must therefore get ready to tackle the "rebound effect" that will likely show a relative increase in the short and medium term incidence of diseases such as heart failure, myocardial infarction, arrhythmias and cardio- and cerebrovascular complications. Scientific societies are taking action to provide general guidance and recommendations aimed at mitigating the unfavorable outcomes of this pandemic emergency. Cardio-oncology, as an emerging discipline, is more flexible in modulating care pathways and represents a beacon of innovation in the development of multi-specialty patient management. In the era of the COVID-19 pandemic, cardio-oncology has rapidly modified its clinical care pathways and implemented flexible monitoring protocols that include targeted use of cardiac imaging, increased use of biomarkers, and telemedicine systems. The goal of these strategic adjustments is to minimize the risk of infection for providers and patients while maintaining standards of care for the treatment of oncologic and cardiovascular diseases. The aim of this position paper is to evaluate the impact of the COVID-19 pandemic on the management of cardio-oncologic patients with the-state-of-the-art knowledge about SARS-CoV-2 and COVID-19 in order to optimize medical strategies during and after the pandemic.}, }
@article {pmid34561208, year = {2021}, author = {Sánchez-Álvarez, E and Quiroga, B and de Sequera, P and , }, title = {Position statement of the Spanish Society of Nephrology on the SARS-CoV-2 vaccines.}, journal = {Nefrologia}, volume = {41}, number = {4}, pages = {412-416}, pmid = {34561208}, issn = {2013-2514}, mesh = {*COVID-19/prevention &amp; control ; COVID-19 Vaccines ; Humans ; *Nephrology ; RNA, Messenger ; SARS-CoV-2 ; *Vaccines ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide over the last year causing more than one million deaths. Several treatments have tried to modify the natural history of the coronavirus disease 2019 (COVID-19) but only corticosteroids have demonstrated to be effective in moderate or severe affectation. In that situation, the development of vaccines for preventing the SARS-CoV-2 infection has focused the attention of the scientific community. At present, available messenger RNA-based technology vaccines have received the approval of local and international sanitary authorities. In this position statement, the Spanish Society of Nephrology wants to state that patients with chronic kidney disease and healthcare workers are at high-risk for contagion and complications of COVID-19 so they must have priority in the vaccine administration.}, }
@article {pmid34532923, year = {2022}, author = {Testino, G and Vignoli, T and Patussi, V and Allosio, P and Amendola, MF and Aricò, S and Baselice, A and Balbinot, P and Campanile, V and Fanucchi, T and Macciò, L and Meneguzzi, C and Mioni, D and Parisi, M and Renzetti, D and Rossin, R and Gandin, C and Bottaro, LC and Caio, G and Lungaro, L and Zoli, G and Scafato, E and Caputo, F}, title = {Alcohol use disorder in the COVID-19 era: Position paper of the Italian Society on Alcohol (SIA).}, journal = {Addiction biology}, volume = {27}, number = {1}, pages = {e13090}, pmid = {34532923}, issn = {1369-1600}, mesh = {Alcoholics Anonymous ; Alcoholism/epidemiology/*therapy ; Ambulatory Care/organization &amp; administration ; COVID-19/epidemiology/*prevention &amp; control ; COVID-19 Vaccines/therapeutic use ; *Communicable Disease Control ; Delivery of Health Care/organization &amp; administration ; Disease Susceptibility ; Drug Interactions ; Humans ; Immunosuppression Therapy/adverse effects ; Italy/epidemiology ; Liver Cirrhosis, Alcoholic/epidemiology/therapy ; Liver Transplantation ; Recurrence ; SARS-CoV-2 ; Societies, Medical ; Telemedicine ; COVID-19 Drug Treatment ; }, abstract = {Coronavirus disease 2019 (COVID-19) first emerged in China in November 2019. Most governments have responded to the COVID-19 pandemic by imposing a lockdown. Some evidence suggests that a period of isolation might have led to a spike in alcohol misuse, and in the case of patients with alcohol use disorder (AUD), social isolation can favour lapse and relapse. The aim of our position paper is to provide specialists in the alcohol addiction field, in psychopharmacology, gastroenterology and in internal medicine, with appropriate tools to better manage patients with AUD and COVID-19,considering some important topics: (a) the susceptibility of AUD patients to infection; (b) the pharmacological interaction between medications used to treat AUD and to treat COVID-19; (c) the reorganization of the Centre for Alcohol Addiction Treatment for the management of AUD patients in the COVID-19 era (group activities, telemedicine, outpatients treatment, alcohol-related liver disease and liver transplantation, collecting samples); (d) AUD and SARS-CoV-2 vaccination. Telemedicine/telehealth will undoubtedly be useful/practical tools even though it remains at an elementary level; the contribution of the family and of caregivers in the management of AUD patients will play a significant role; the multidisciplinary intervention involving experts in the treatment of AUD with specialists in the treatment of COVID-19 disease will need implementation. Thus, the COVID-19 pandemic is rapidly leading addiction specialists towards a new governance scenario of AUD, which necessarily needs an in-depth reconsideration, focusing attention on a safe approach in combination with the efficacy of treatment.}, }
@article {pmid41379358, year = {2025}, author = {Gomes, P and de Menêses, AG and Silveira, RCCP and Guerra, ENS and Dos Reis, PED and Ferreira, EB}, title = {Radiation recall dermatitis in cancer patients previously undergoing radiotherapy: a scoping review.}, journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer}, volume = {34}, number = {1}, pages = {26}, pmid = {41379358}, issn = {1433-7339}, mesh = {Humans ; *Radiodermatitis/etiology/epidemiology ; *Neoplasms/radiotherapy/drug therapy ; Antineoplastic Agents/adverse effects/administration &amp; dosage ; Female ; Radiotherapy/adverse effects ; }, abstract = {PURPOSE: To map the evidence related to radiation recall dermatitis (RRD) in cancer patients previously treated with radiotherapy.<br><br>METHODS: A scoping review was conducted following the methodology outlined by the JBI Collaboration. The search was performed in PubMed, CINAHL, LILACS, Scopus, Web of Science Core Collection, Cochrane, and grey literature using Google Scholar and ProQuest on January 28, 2025. Studies published in any language and without restrictions on publication year were included.<br><br>RESULTS: This review incorporated 210 studies on RRD in cancer patients, with a predominance of case reports and case series (84.7%). Approximately 48% of cases were reported in breast cancer patients. Among these studies, 92 primary articles documented 201 instances of RRD. A significant association was identified with antineoplastic agents (73.6%), predominantly due to chemotherapy, with docetaxel identified as the most frequently reported agent (13.5%). The radiotherapy doses administered ranged from 8 to 65 Grays, and the time intervals between radiotherapy and the onset of the RRD-triggering agent varied widely, from hours to 40&#xa0;years. This condition can cause symptoms such as erythema, dry and moist desquamation, edema, itching, pain, ulceration, necrosis, and bleeding.<br><br>CONCLUSION: RRD is a significant adverse event, particularly among women with breast cancer, most commonly associated with chemotherapy involving docetaxel and doxorubicin. COVID-19 infection and vaccination have also been reported as potential new triggers of RRD. Further research is needed to clarify the underlying mechanisms and to optimize therapeutic strategies for at-risk patients.}, }
@article {pmid41379341, year = {2025}, author = {Mahdizadeh, S and Hamid, KH and Roudsari, MB and Jamil, NY and Alfarttoosi, KH and Taher, SG and Alwan, M and Jawad, M and Mushtaq, H and Soleimani, M and Tabatabaei, SN}, title = {Impact of emerging and re-emerging viral infections on periodontitis progression.}, journal = {Archives of microbiology}, volume = {208}, number = {1}, pages = {59}, pmid = {41379341}, issn = {1432-072X}, mesh = {Humans ; *Periodontitis/virology/microbiology/pathology/immunology ; *COVID-19/complications/virology ; *Virus Diseases/virology/complications ; Disease Progression ; SARS-CoV-2 ; }, abstract = {Periodontitis is a chronic inflammatory disease that progressively destroys the tooth-supporting structures, including the gums, periodontal ligament, and alveolar bone. This destruction is primarily driven not by the bacteria themselves, but by the host's dysregulated immune response to a dysbiotic subgingival biofilm. Bacterial colonization in periodontal disease (PD) triggers both innate and adaptive immune responses. Furthermore, numerous viruses-including human cytomegalovirus (HCMV), Epstein-Barr virus (EBV), and herpes simplex virus (HSV)-have been linked to periodontal disorders and contribute to the etiopathogenesis of periodontitis alongside bacteria. Since its emergence in 2020, COVID-19 has posed a significant global health threat. SARS-CoV-2 infection within the periodontium may induce local inflammation, potentially exacerbating PDs. Given that viral replication and persistence in tissues are thought to increase with the severity of inflammation, the presence of these viruses may be linked to the development and progression of periodontitis. The current study is unique in its synthesis of data on a wide spectrum of viruses associated with periodontitis. This includes common viruses (EBV, HCMV, HSV, human papillomavirus (HPV), and human immunodeficiency virus (HIV)), emerging viruses (Chikungunya, Dengue), and novel viruses such as SARS-CoV-2. By providing a comprehensive overview of viral co-infections in periodontitis, this review advocates for the development of new antiviral diagnostic and therapeutic strategies that adopt a broad, virus-centric approach. We conducted a literature search across PubMed, Google Scholar, and Web of Science using keywords and Medical Subject Headings (MeSH) terms such as "viral infection," "periodontitis," and specific virus names.}, }
@article {pmid41379191, year = {2025}, author = {La Scaléa, ACR and Uehara, SCDSA}, title = {Pain in Long COVID: A scoping review of clinical characteristics and patterns of manifestation.}, journal = {Revista latino-americana de enfermagem}, volume = {33}, number = {}, pages = {e4777}, doi = {10.1590/1518-8345.7836.4777}, pmid = {41379191}, issn = {1518-8345}, mesh = {Humans ; *COVID-19/complications ; Female ; *Pain/etiology/diagnosis/epidemiology ; Male ; Pain Measurement ; SARS-CoV-2 ; }, abstract = {to map the available scientific evidence on the clinical characteristics and patterns of pain manifestation (location, frequency, duration, intensity, and quality) in individuals with Long COVID. a scoping review of publications from March 2020 to June 2024, indexed across four databases. Study selection was conducted by two independent, blinded reviewers. Data were extracted using a standardized instrument and analyzed descriptively. nineteen studies were included, indicating that pain affects individuals across all age groups, with higher prevalence among women, primarily involving the head, neck, shoulder, lower back, and hip. Pain frequency ranged from daily to monthly episodes, with duration exceeding one year in some cases. Intensity varied from mild to severe, and pain characteristics were diverse, with descriptors including burning, pressure, colicky, and throbbing pain. the clinical characteristics and patterns of pain manifestation in Long COVID are diverse. However, there is a paucity of studies providing detailed analyses of pain features and the influence of individual variables. These findings should guide future research and clinical practice toward a more comprehensive and contextualized assessment of pain in Long COVID.}, }
@article {pmid41378159, year = {2025}, author = {Mahamadou, D and Abdoul-Aziz, AB and Moustapha, LM and Alkassoum, I and Fils, SA and Hamsatou, B and Bachir, G and Abdourahmane, Y and Farouk, M and Lagare, A and Eric, A and Issifou, D and Hassane, N and Habibatou, I and Eholié, SP}, title = {Resurgence of epidemics in Zinder: effect of the decrease in vaccination coverage and the impacts of climate change.}, journal = {IJID regions}, volume = {17}, number = {}, pages = {100781}, pmid = {41378159}, issn = {2772-7076}, abstract = {OBJECTIVES: Several epidemic outbreaks have affected the Zinder region. These include diseases targeted by the expanded immunization program and other emerging diseases. This study aimed to analyze these epidemics.<br><br>METHODS: This is documentary research of the epidemics of meningitis, measles, cholera, COVID-19, and diphtheria, which occurred in the Zinder region from 2015 to 2023, as well as their determinants. The data collection is made from the linear list of notifiable diseases of the Regional Directorate of Health and Public Hygiene of Zinder, associated with literature review on the determinants of the appearance of these epidemics.<br><br>RESULTS: The number of meningitis cases has gradually increased in Zinder from 2019 to 2024. A total of 5019 cases were registered during these epidemics, with a mortality rate of 6.31%. Five measles epidemics have been recorded since 2015. A total of 13,887 cases were notified during these epidemics, with a mortality rate of 0.30%. Three cholera epidemics occurred: in 2021, in 2022, and in 2024. During these epidemics, 884 cases were recorded, with 24 deaths or a lethality of 2.71%. The COVID-19 epidemic occurred in 2020, with 364 cases, including 17 deaths, i.e. a mortality rate of 4.67%. Since 2022, the region has been facing a diphtheria epidemic. A total of 3310 cases has been reported, with 173 deaths. The causes of these epidemics are multifaceted; they involve the decline in vaccination coverage, migration, insecurity, the COVID-19 pandemic, and climate change.<br><br>CONCLUSIONS: The impact of epidemics on the health of the population and the socio-economic development of regions implies a greater mastery of the root causes mentioned in this study.}, }
@article {pmid41378119, year = {2025}, author = {Shepherd, J and Leake, MC}, title = {Invention, innovation, and commercialisation in British biophysics.}, journal = {Biophysical reviews}, volume = {17}, number = {4}, pages = {1143-1156}, pmid = {41378119}, issn = {1867-2450}, abstract = {British biophysics has a tradition of scientific invention and innovation, resulting in new technologies transforming biological insight, such as rapid DNA sequencing, super-resolution and label-free microscopy, high-throughput and single-molecule bio-sensing, and bio-inspired synthetic materials. Some advances were established through democratised platforms and many have biomedical success, a key example involving the SARS-CoV-2 spike protein during the COVID-19 pandemic. Here, three UK labs made crucial contributions revealing how the spike protein targets human cells and how therapies of vaccines and neutralising nanobodies work, enabled largely through biophysical innovations of cryo-electron microscopy. Here, we discuss leading-edge innovations which resulted from discovery-led British "Physics of Life" research (capturing blends of physical-life sciences research in the UK including biophysics and biological physics) and have matured into wide-reaching sustainable commercial ventures enabling translational impact. We describe the biophysical science which led to these academic spinouts, presenting the scientific questions that were addressed through innovating new techniques and approaches. We consider these examples through the lens of opportunities and challenges for academic biophysics research in partnership with British industry. We highlight how commercial breakthroughs have emerged organically from fundamental research rather than from technology-first approaches but also discuss lessons to learn from past failures. Finally, we propose recommendations concerning future resourcing and structuring of UK biophysics research and the training and support of its researchers to ensure that UK plc punches above its weight in biophysics innovation and a need to educate the policymakers and public that an absence of basic science impoverishes innovation.}, }
@article {pmid41378112, year = {2025}, author = {Mijangos, LRR and Harding, SE and Darton, NJ}, title = {Developing high-concentration monoclonal antibody formulations for subcutaneous administration to improve patient treatment.}, journal = {Biophysical reviews}, volume = {17}, number = {4}, pages = {1013-1031}, pmid = {41378112}, issn = {1867-2450}, abstract = {The transition of immunotherapy administration from intravenous infusion to subcutaneous (SC) administration of monoclonal antibody formulations for oncology patients has garnered significant interest. SC administration offers multiple benefits, including potential for at-home administration, enhanced patient compliance, reduced hospital congestion, lowered health care costs, and improved sustainability by reducing drug wastage and minimizing environmental impact. However, for many biologics, the shift to SC administration requires the development of high-concentration monoclonal antibody products (HCmAP) due to the need for large dose volumes. Here we explore the impact of the COVID-19 pandemic on immunotherapy administration and the imperative of adopting SC administration. We discuss challenges encountered throughout the manufacturing, shipping, storage, and delivery of HCmAP. A central hurdle identified involves the biophysical instability and the large increase in viscosity of these biologics due to increased antibody concentration. Further complications can arise from "non-ideality" effects through molecular crowding or co-exclusion effects (macromolecules blocking the free movement in solution of other macromolecules) and elevated macromolecular interactions. For reducing the viscosity for a given concentration of antibody, the main excipients reported are salts and amino acids, with Arg-HCl demonstrating particularly improved formulation viscosity in an HCmAP. However, excipients with viscosity-lowering effects can also impact protein stability. The journey to discover suitable excipient strategies remains ongoing, combined with emerging approaches such as molecular engineering and computational techniques, with the ultimate aim of facilitating the successful integration of SC administration for economic savings, environmental sustainability, and social equity.}, }
@article {pmid41377933, year = {2025}, author = {Yang, B and Liu, J and Li, Y and Liu, X}, title = {mRNA Cancer Vaccines: From Pandemic Paradigm to Personalized Oncology Therapeutics.}, journal = {Cancer innovation}, volume = {4}, number = {6}, pages = {e70041}, pmid = {41377933}, issn = {2770-9183}, abstract = {The groundbreaking success of messenger RNA (mRNA) vaccines during the COVID-19 pandemic has significantly accelerated their application in oncology. This review comprehensively synthesizes the recent advancements in mRNA cancer vaccine development, emphasizing three critical domains: mechanistic innovations, clinical translation, and ongoing challenges. Technologically, advancements in nucleotide modification, lipid nanoparticle (LNP) delivery systems, and AI-driven neoantigen selection have significantly improved vaccine stability, immunogenicity, and personalization. Clinically, more than 150 trials have demonstrated the synergistic efficacy of mRNA vaccines (e.g., mRNA-4157/V940, BNT122) in combination with immune checkpoint inhibitors (ICIs), particularly in melanoma, with Phase III trials currently underway. Individualized neoantigen vaccines targeting patient-specific mutations have shown unprecedented response rates (> 50% in certain cohorts), while shared-antigen vaccines are progressing for high-incidence cancers. However, several critical challenges remain: (1) overcoming immunosuppressive tumor microenvironments (TME), (2) addressing systemic toxicities and LNP-related limitations, (3) scaling up cost-effective personalized manufacturing, and (4) optimizing targeted delivery. Future research directions encompass self-amplifying mRNA constructs, novel biomaterial vectors, neoadjuvant applications, and multi-omics integration for next-generation vaccine development. With rapid industrialization and evolving regulatory frameworks, mRNA vaccines are well-positioned to revolutionize precision cancer immunotherapy despite persistent translational barriers.}, }
@article {pmid41377469, year = {2025}, author = {Ali, A and Shariq, K and Ashok Kumar, K and Zakai, A and Mumtaz, K and Ali, Z and Akmal, M and Kailash, SJ}, title = {Analyzing global research trends in hepatology during Coronavirus Disease 2019: a bibliometric analysis.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {12}, pages = {8376-8384}, pmid = {41377469}, issn = {2049-0801}, abstract = {OBJECTIVE: Analyzing global hepatology trends during Coronavirus Disease 2019 (COVID-19) to accelerate effective treatments and protocols for researchers and healthcare systems.<br><br>METHODS: The related papers to COVID-19 and hepatology were extracted from 2019 to 2023. The articles were ranked according to the number of citations and a final list of top 101 most-cited articles were shortlisted. Analysis was carried out on the following: total citation count, publication year, journal name and its Impact factor, gender and their H-index, country of origin, funding information, and content of the articles. Citations per year and citations per author were calculated for all articles.<br><br>RESULTS: Between 2019 and 2023, the top 101 cited articles covered various topics. The highest number were published in 2021 (n =&#xa0;42), with the American Journal of Transplantation contributing the most (n =&#xa0;23). The University of Pennsylvania had the most influential presence (n =&#xa0;5). These articles came from 44 countries where the US ranked first with 35 articles. There were a total of 160 authors involved, with each paper having a median and mean of 6 and 7.3 authors, respectively. The articles were categorized into nine main topics, with therapeutic intervention being the most common (n =&#xa0;26) followed by pathophysiology (n =&#xa0;20). Males outnumbered females as first and senior authors. A majority (n =&#xa0;55) received funding, and most (n =&#xa0;81) did not declare conflicts of interest.<br><br>CONCLUSION: Top articles in our analysis focused on liver transplantation, pathophysiology, and healthcare management. It can aid researchers in assessing the effectiveness of different treatment modalities for hepatic impairment in COVID-19 patients.}, }
@article {pmid41377081, year = {2025}, author = {Lin, L and Talib, MBA}, title = {Exploring the relationship between domain-specific self-efficacy and motivation among university students: a systematic review (2019-2024).}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1702507}, pmid = {41377081}, issn = {1664-1078}, abstract = {The interplay between domain-specific self-efficacy and motivation in higher education has garnered significant attention, particularly in the context of challenges such as the COVID-19 pandemic that have profoundly altered the educational landscape. This study provides a systematic review of the literature on the relationship between domain-specific self-efficacy and motivation among university students, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. From an initial pool of 5,890 articles sourced from the Education Resources Information Centre (ERIC), Scopus, and Web of Science (WoS) databases, 31 studies published between 2019 and 2024 were analyzed. Our findings underscore a predominantly positive correlation between domain-specific self-efficacy and motivation. Higher levels of self-efficacy are consistently linked to increased motivation, suggesting that enhancing self-efficacy could be a crucial strategy for boosting student motivation and, thus, academic success. Notably, many studies focus on Asian regions, highlighting both the universality and cultural specificity of these findings. However, the presence of an outlier study that found no significant relationship between self-efficacy and motivation indicates the complexity of these constructs and the potential impact of situational factors, warranting further investigation. Additionally, this review reveals a growing academic interest in self-efficacy and motivation, particularly within social sciences and education. This trend underscores the importance of a multidisciplinary approach to understanding the intricate dynamics between self-efficacy and motivation. The documented rise in research attention reflects a growing recognition of the critical role that self-efficacy and motivation play in student learning outcomes. In conclusion, this systematic review not only highlights the significant positive impact of domain-specific self-efficacy on student motivation but also calls for more nuanced studies. Future research should explore under-represented contexts and examine the broader implications of these findings across diverse educational and cultural settings.}, }
@article {pmid41376972, year = {2025}, author = {Soto-Feijóo, R and Landín, E and Martínez-Martínez, H and Carreiras, M and Fanego, A and Ferreiro, L and Rodríguez-Núñez, N and Toubes, ME and Valdés, L}, title = {Analyzing pleural fluid attributes in SARS-CoV-2 infection: a systematic review.}, journal = {Journal of thoracic disease}, volume = {17}, number = {11}, pages = {10510-10518}, pmid = {41376972}, issn = {2072-1439}, abstract = {BACKGROUND: The characteristics of pleural fluid (PF) in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are poorly understood. During the pandemic, several cases of pleural effusion (PE) have been reported, but no clear conclusions have been reached regarding the features of this fluid. This systematic review aimed to analyze and summarize the available evidence on PF attributes in patients with SARS-CoV-2 infection.<br><br>METHODS: Systematic literature search using the PRISMA methodology of studies describing PF characteristics of SARS-CoV-2 patients and treatment of PE.<br><br>RESULTS: Eighteen articles (32 patients and 37 PF samples) were included. Median age was 61 years (range, 25-81 years), male/female ratio 5.4:1. PE was predominantly unilateral (71.4%), with no distinction between one side and the other; it usually extended over 2/3 of the hemithorax (50%) and its appearance was variable [serous (50%), hematic or serohematic (28.1%) and purulent (21.9%)]. PF was exudative in 88.9% of cases, but with PF protein and PF/serum protein ratio values less than 3 g/dL and 0.5 in 36.7% and 54.5%, respectively. The pH and glucose values were less than 7.20 and 60 mg/dL in 28.6% and 24% of cases, respectively. The percentage of neutrophils (&#x2265;50%) was higher than that of lymphocytes/monocytes [12/26 (46.2%) vs. 7/26 (26.9%), respectively]. Polymerase chain reaction (PCR) on PF was positive for SARS-CoV-2 in 6/23 cases (26.1%) and for other pathogens in 8 (5 bacteria and 3 fungi). Almost all patients underwent thoracentesis and the medical treatment received by the cases with positive PCR for SARS-CoV-2 on PF varied. Patient follow-up was provided in 25 cases and 10 cases died (40%).<br><br>CONCLUSIONS: PE from coronavirus disease 2019 (COVID-19) infection is more frequent among males aged 50-80 years, generally unilateral and large. Its appearance is variable, with features of lactate dehydrogenase (LDH)-discordant exudate, usually predominantly neutrophilic, with treatment like that of any other PE. PE from COVID-19 infection is a poor prognostic sign and associated with worse mortality.}, }
@article {pmid41376141, year = {2025}, author = {Sucu, R and Erku, D and Filiniuk, O and Kohler, R}, title = {Establishing an independent HTA agency in Ukraine: a conceptual framework for governance, operations, and long-term sustainability.}, journal = {International journal of technology assessment in health care}, volume = {41}, number = {1}, pages = {e85}, doi = {10.1017/S0266462325103255}, pmid = {41376141}, issn = {1471-6348}, support = {AID-121-C-17-00004//United States Agency for International Development/ ; }, mesh = {Ukraine ; *Technology Assessment, Biomedical/organization &amp; administration/legislation &amp; jurisprudence ; Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Health Policy ; }, abstract = {OBJECTIVES: Health technology assessment (HTA) has become an integral part of Ukraine's health system since its formal introduction into national legislation in 2017. By 2020, HTA was mandated for evaluating publicly funded medicines, laying the groundwork for more evidence-based healthcare decisions. Although the creation of an independent HTA agency was initially planned for 2022, implementation was delayed due to the COVID-19 pandemic and Russia's ongoing invasion. The relevant Cabinet Resolution calls for the establishment of an autonomous agency by January 2026. This commentary outlines a strategic, evidence-informed framework to guide the agency's formation.<br><br>METHODS: Drawing on the 2018 State Strategy for Access to Medicines, the 2022 Law on Medicinal Products, and international best practices, we proposed to the Government of Ukraine a two-tier structure encompassing core business functions (HTA and appraisal, guideline development, pricing, and listing) and support business functions (data and analytics, finance and strategy, IT, human resources, legal, and communications). Each department is tasked with clear mandates and supported by performance indicators to promote transparency, accountability, and operational efficiency.<br><br>RESULTS: A phased roadmap for 2025-2027 details the legal, institutional, and financial steps required for successful implementation. Key opportunities - including international partnerships and system-wide reform - are weighed alongside risks such as funding uncertainty, workforce limitations, and geopolitical instability.<br><br>CONCLUSION: By embedding HTA into national policy processes and ensuring institutional independence, Ukraine can enhance the value of healthcare investments and build long-term resilience into its health system.}, }
@article {pmid41375836, year = {2025}, author = {Stratulat-Chiriac, I and Țarcă, E and Chistol, RO and Halip, IA and Țarcă, V and Furnică, C}, title = {Association Between Congenital Gastrointestinal Malformation Outcome and Largely Asymptomatic SARS-CoV-2 Infection in Pediatric Patients-A Systematic Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {23}, pages = {}, doi = {10.3390/jcm14238533}, pmid = {41375836}, issn = {2077-0383}, abstract = {Objective. Limited evidence is available concerning the surgical outcomes of patients with congenital gastrointestinal malformations and perioperative SARS-CoV-2 infection. This study examines the scientific evidence on SARS-CoV-2 infection and congenital gastrointestinal malformations requiring surgery in children. Material and Methods. We performed a systematic review of studies reporting data on children with congenital gastrointestinal malformations and SARS-CoV-2 infection, published in international databases (PubMed and Embase) from pandemic inception up to August 2024. Studies not reporting data on the SARS-CoV-2 infection status on patients with congenital digestive malformation were excluded. We assessed the quality of the included studies according to the Joanna Institute (JBI) appraisal checklist, adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and registered the protocol with the PROSPERO database (CRD42024550744). Results. From the 902 titles retrieved, eight observational studies met the inclusion criteria comprising 29 patients from countries with different socioeconomic statuses. Most patients were neonates (75%) with a median age of 3 days at diagnosis and male to female ratio of 2:1. In total, 18 (62%) presented upper gastrointestinal tract anomalies, including esophageal atresia ± tracheoesophageal fistula (n = 10, 34.48%), duodenal atresia (n = 3, 10.3%), and congenital hypertrophic pyloric stenosis (n = 5, 17.2%). Lower digestive tract malformations (11, 38%) included anorectal malformations (n = 6, 20.6%), intestinal atresia (n = 3, 10.3%), Hirschsprung disease (n = 1, 3.44%), and Meckel's diverticulum (n = 1, 3.44%). Surgeries were primarily emergency or urgent procedures and only pyloromyotomy (5/5) was consistently operated minimally invasively. SARS-CoV-2 infection was identified mainly on routine screening (>95%). Of 29 patients, 85% were discharged home, and no postoperative surgical mortality and significant complications directly associated with COVID-19 were identified, although routine postoperative morbidity not linked to SARS-CoV-2 was observed. Conclusions. Pediatric patients with congenital gastrointestinal malformationsand perioperative SARS-CoV-2 infection typically have mild illness and favorable surgical outcomes. SARS-CoV-2 positivity alone should not delay essential surgery when infection control measures are ensured. Standardized, multicenter studies are needed to clarify perioperative risks to and inform management of this high-risk group.}, }
@article {pmid41375650, year = {2025}, author = {Watts, P and Deac, A and Netuveli, G}, title = {An Umbrella Review of Quality of Life Among the General Population During the COVID-19 Pandemic.}, journal = {Journal of clinical medicine}, volume = {14}, number = {23}, pages = {}, doi = {10.3390/jcm14238348}, pmid = {41375650}, issn = {2077-0383}, abstract = {Background/Objectives: The COVID-19 pandemic has had widespread effects on quality of life (QoL). This umbrella review aimed to synthesise review-level evidence on the impact of the COVID-19 pandemic on QoL across the general population, including children, adolescents, adults, and older people. Methods: A systematic search of databases (MEDLINE (PubMed); EBSCOHost; Scopus; Google Scholar) and review repositories was conducted to identify systematic reviews, meta-analyses, and scoping reviews published between 2019 and 2025. Eligible reviews (2019-2025, English, peer-reviewed) included narrative, systematic and meta-analytic syntheses of quantitative, qualitative or mixed-methods evidence examining the impact of the COVID-19 pandemic on quality of life in the general population, using validated QoL measures. The review followed Joanna Briggs Institute methodology for umbrella reviews, with data synthesised narratively by QoL domain and population group. Results: Nine reviews met the inclusion criteria, encompassing 272 primary studies. Most reported declines in QoL across psychological, physical, and social domains. Children and adolescents experienced reductions in emotional and social functioning. Working-age adults reported psychological strain linked to economic and health-related stressors, while older adults were vulnerable to isolation and reduced social QoL. Environmental and structural factors also influenced QoL. Sociodemographic disparities were observed, with lower QoL reported among women, younger individuals, and those with lower socioeconomic status. Conclusions: The COVID-19 pandemic was associated with substantial declines in QoL across population groups, shaped by psychological, social, and structural factors. Findings highlight the importance of addressing social inequalities and enhancing resilience in future public health crises.}, }
@article {pmid41375068, year = {2025}, author = {Isidoro, C}, title = {SARS-CoV2 and Anti-COVID-19 mRNA Vaccines: Is There a Plausible Mechanistic Link with Cancer?.}, journal = {Cancers}, volume = {17}, number = {23}, pages = {}, doi = {10.3390/cancers17233867}, pmid = {41375068}, issn = {2072-6694}, abstract = {To contrast the COVID-19 pandemic brought by the corona virus SARS-CoV-2, two mRNA-based anti-COVID-19 vaccines (by Pfizer-BioNTech and Moderna) were made available relatively quickly and deployed worldwide based on an emergency approval. Being considered vulnerable and at risk of infection, cancer patients have been prioritized for COVID-19 vaccination and vaccinated repeatedly because of the short time protection provided by these vaccines. Recently, a surge in the incidence and rapid progression of cancers has been observed in many countries, which could (at least partially) represent cancers undiagnosed or untreated during the pandemic. It has also been suggested that the SARS-CoV-2 itself or even the anti-COVID-19 mRNA vaccines could have contributed to the recurrence and worse clinical outcome in cancer patients, given the high incidence of COVID-19 in hospitalized patients and that these patients have been vaccinated with priority several times and in a short period. Although it appears extremely unlikely that SARS-CoV-2 and anti-COVID-19 mRNA vaccines elicit genotoxic events and cause neo-cancerogenesis in a short time, they could still cause non-genotoxic pro-carcinogenic effects by triggering an exaggerated inflammatory reaction, compromising immune homeostasis, stimulating cell proliferation, and negatively affecting cellular stress response and damage repair machinery. This could result in the promotion of regrowth of dormant micrometastases or relapses of stable minimal residual disease. Such a harmful outcome may likely result from a synergy between the virus and the vaccine, especially in multi-vaccinated and multi-infected individuals. Here, I bring the cell pathologist's point of view and discuss the multiple possible mechanisms by which the virus and the anti-COVID-19 mRNA vaccine might favor tumorigenesis. While a causal link cannot be established at this stage, knowledge of potential carcinogenic risks could help doctors and health policymakers take the best actions to protect vulnerable patients and convince the vaccine developer to design a vaccine free from such harm.}, }
@article {pmid41374027, year = {2025}, author = {Koliou, MP and Skalkos, D}, title = {Post-Pandemic Shifts in Sustainable Food Behavior: A Systematic Review of Emerging Consumer Trends.}, journal = {Nutrients}, volume = {17}, number = {23}, pages = {}, doi = {10.3390/nu17233737}, pmid = {41374027}, issn = {2072-6643}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Feeding Behavior/psychology ; *Consumer Behavior ; *Food Preferences/psychology ; SARS-CoV-2 ; Pandemics ; Hunger ; Female ; Emotions ; Male ; }, abstract = {The COVID-19 pandemic and its associated economic stressors have profoundly reshaped consumer eating behaviors, presenting an urgent and underexplored challenge for the academic community. This interdisciplinary review critically examines how these disruptions have influenced both food approach and food avoidance patterns, offering a structured analysis of eight key behavioral parameters: Hunger (H), Food Responsiveness (FR), Emotional Overeating (EOE), Enjoyment of Food (EF), Satiety Responsiveness (SR), Emotional Under Eating (EUE), Food Fussiness (FF), and Slowness in Eating (SE). Drawing on recent literature, we highlight significant shifts in these traits-such as heightened hedonic hunger, age-related changes in food preferences, and gender-specific emotional-satiety dynamics-underscoring the complex interplay between emotional states, physiological cues, and behavioral tendencies. Grounded in the systematic examination of peer-reviewed studies in the post-COVID period, this review offers a robust and comprehensive synthesis of current evidence. The novelty of this work lies in its integration of findings into targeted proposition statements for each parameter, visually supported by original flow charts. These culminate in the development of a "Consumers' Eating Behavior Index"-a conceptual tool designed to guide researchers, healthcare professionals, and policymakers in understanding and responding to post-pandemic dietary transformations. By emphasizing the emotional and psychological dimensions of eating, this index offers a timely framework for designing tailored public health interventions that promote sustainable nutritional habits. This study calls for renewed academic attention to the behavioral consequences of global crises, positioning eating behavior research as a critical frontier in post-COVID recovery and resilience.}, }
@article {pmid41373962, year = {2025}, author = {Rosanoff, A and von Ehrlich, B and Nelson, D}, title = {A Proposed Scale to Assess Magnesium Status Using Serum Calcium and Magnesium Ratios.}, journal = {Nutrients}, volume = {17}, number = {23}, pages = {}, doi = {10.3390/nu17233671}, pmid = {41373962}, issn = {2072-6643}, mesh = {Humans ; *Magnesium/blood ; *Calcium/blood ; COVID-19/blood/mortality ; Biomarkers/blood ; *Magnesium Deficiency/blood/diagnosis ; SARS-CoV-2 ; Adult ; Female ; Male ; Middle Aged ; }, abstract = {Background/Objectives: Reliable markers of human magnesium (Mg) status are needed. Methods: Current Mg studies report ratios between serum Mg and calcium (Ca) using four interchangeable expressions (i.e., molar or weight calculations of Mg/Ca or Ca/Mg). We propose a scale using ratios of serum Mg and Ca to assess Mg status, unified for all four expressions. We explore its application for case studies and published research. Results:Case Studies (4)-the proposed serum Mg/Ca scale showed better Mg diagnostic value than serum Mg alone. Published Studies-A. The proposed Mg/Ca scale's "depleted Mg" status predicted mortality among hospitalized COVID-19 patients in ROC/AUC analyses. B. The serum Ca/Mg proposed scale, when applied to "healthy" adults with "normal" serum Mg, exposed a "seriously depleted" to "adequate" range of Mg status. C. In a study of periodontal disease, patients designated "adequate" or "mild" Mg depletion by the proposed scale showed greater 5-year improvement than those with scale's "moderate to serious" Mg depletion status. D. Finally, the proposed scale demonstrated appropriate diagnostic value of serum Ca/Mg in acute coronary syndrome patients only when "corrected Ca" was NOT used in ratio calculation. Conclusions: The proposed scale needs both total serum Ca and Mg measures in identical units, i.e., mg/dL or mg% (for weight ratios); mmol/L or mEq/L (for molar ratios). Authors/reviewers/editors need to take care when reporting units/methodology of serum Mg and Ca ratios for clear reporting as to weight or molar ratio and use of total or corrected values. Future trials and statistical testing are needed to determine whether ratios between serum Mg and Ca yield more precise measures of physiological Mg status than serum Mg alone. Our findings indicate the proposed scale is worthy of further study as a marker of Mg deficit.}, }
@article {pmid41373540, year = {2025}, author = {Popa, AE and Popa, E and Dramba, T and Coman, EA and Poroch, M and Ungureanu, M and Bacusca, A and Slanina, AM and Bacoanu, G and Poroch, V}, title = {Dysregulated Resolution of Inflammation After Respiratory Viral Infections: Molecular Pathways Linking Neuroinflammation to Post-Viral Neuropathic Pain-A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, doi = {10.3390/ijms262311383}, pmid = {41373540}, issn = {1422-0067}, mesh = {Humans ; *Neuroinflammatory Diseases/immunology/etiology/metabolism/pathology ; *Neuralgia/immunology/etiology/virology ; *COVID-19/complications/immunology ; Animals ; *Inflammation ; SARS-CoV-2 ; Microglia/immunology/metabolism ; Mitochondria/metabolism ; Signal Transduction ; Macrophages/immunology/metabolism ; Immunity, Innate ; *Respiratory Tract Infections/complications/immunology ; }, abstract = {Post-viral neuroinflammatory syndromes, particularly those occurring after SARS-CoV-2 infection, have received increasing attention due to their complex and persistent neurological manifestations. The aim of this narrative review is to integrate current evidence on the molecular and cellular mechanisms underlying chronic neuroinflammation following viral infections, with a focus on dysregulated innate immune responses, macrophage-microglia interactions, oxidative-mitochondrial stress, and impaired inflammation resolution pathways. Our synthesis shows that prolonged activation of macrophages and glial cells promotes the continuous release of pro-inflammatory mediators, while defective phagocytosis and inadequate clearance of cellular debris maintain an inflammatory microenvironment. Mitochondrial dysfunction further amplifies immune activation by stimulating metabolic stress and reactive oxygen species production. In parallel, deficiencies in mediators specialized in inflammation resolution impede the transition from inflammation to resolution, allowing neuroimmune imbalance and nociceptive sensitization to persist long after virus clearance. Key conclusions indicate that these interconnected mechanisms collectively contribute to the long-term neurological symptoms observed in post-viral states, including cognitive impairment, neuropathic pain, and fatigue. Emerging therapeutic strategies targeting cytokine signaling, microglial reactivity, mitochondrial function, and resolution pathways are promising, but remain insufficiently validated in clinical practice. Overall, evidence suggests that post-viral neuroinflammation results from the convergence of sustained immune activation and failure of endogenous resolution mechanisms, highlighting the need for further mechanistic studies and targeted interventions.}, }
@article {pmid41373500, year = {2025}, author = {Leonardi, R and Lo Bianco, M and Spinello, S and Betta, P and Gagliano, C and Calabrese, V and Polizzi, A and Malaguarnera, G}, title = {Resveratrol as an Adjunct Antiviral Agent in Pediatric Viral Infections: A Review on Mechanistic Insights and Gut Microbiota Modulation.}, journal = {International journal of molecular sciences}, volume = {26}, number = {23}, pages = {}, doi = {10.3390/ijms262311341}, pmid = {41373500}, issn = {1422-0067}, mesh = {Humans ; *Resveratrol/therapeutic use/pharmacology ; *Gastrointestinal Microbiome/drug effects ; *Antiviral Agents/therapeutic use/pharmacology ; Child ; *Virus Diseases/drug therapy/microbiology ; SARS-CoV-2/drug effects ; Dysbiosis/drug therapy ; COVID-19 ; Rotavirus/drug effects ; }, abstract = {Pediatric viral infections impose a heavy burden on child health, often worsened by infection-induced gut dysbiosis. Resveratrol, a natural polyphenol with antiviral, anti-inflammatory, and microbiota-modulating properties, has been proposed to interrupt this pathogenic feedback. To our knowledge, this is the first narrative review focused on resveratrol's antiviral activity in pediatric viral infections, concurrently evaluating its impact on the gut microbiota and their interrelationship. We synthetized preclinical and the limited available pediatric clinical data regarding resveratrol's effect on SARS-CoV-2, respiratory syncytial virus, influenza, rotavirus, and norovirus, extracting information on the models, routes of administration, dosages, mechanisms, and outcomes. Resveratrol interferes with viral lifecycles via diverse mechanisms (modulation of host signaling cascades, capsid or structural protein interactions, and suppression of pro-viral chaperones) while concurrently reshaping the gut microbiota (reducing opportunistic taxa and enriching beneficial genera such as Bifidobacterium and Lactobacillus) leading to improved short-chain fatty acid profiles, barrier integrity, and dampened inflammation. Intranasal resveratrol in children shows clinical benefit, while oral use is underexplored and limited by poor bioavailability; adult data hint at supportive microbiome and anti-inflammatory effects if the delivery is optimized. These dual antiviral and microbiome-directed effects position resveratrol as a promising adjunct in pediatric viral disease management, though well-powered pediatric clinical trials are needed to define dosages, delivery strategies, and the contribution of microbiota-mediated synergy.}, }
@article {pmid41373396, year = {2025}, author = {Shiel, EV and Connor, Z and Downes, M and Bailey-Shaw, A and Hemingway, S and Walters, C and Kola-Palmer, S}, title = {What Evidence Exists on the Effectiveness of Psychotherapy for Trauma-Related Distress? A Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, doi = {10.3390/healthcare13233180}, pmid = {41373396}, issn = {2227-9032}, abstract = {Background/Objectives: Trauma-related distress poses significant mental health challenges, with psychotherapy serving as a primary intervention. The Walters Method is a promising new alternative that may help where traditional methods fall short (i.e., in complex or violent cases), but before it can be implemented widely, the existing evidence on the effectiveness of other psychotherapies for trauma-related distress must be mapped to see how and where it relates to other techniques. The aim of this scoping review was to provide an overview of existing evidence on the effectiveness of psychotherapy for trauma-related distress. Methods: A scoping review was conducted to better understand the effectiveness of psychotherapies for trauma-related distress (including PTSD, acute stress disorder, or other serious mental health issues). Results: Thirty-three articles were analysed. Included articles included adults with PTSD, incarcerated women, childbirth trauma survivors, female survivors of sexual abuse, hospitalised COVID-19 patients, adults with serious mental illness, veterans and active soldiers, firefighters, and refugees. Eye Movement Desensitisation and Reprocessing and Cognitive Behavioural Therapy were the most studied and effective treatments. Prolonged Exposure and Narrative Exposure Therapy were less common but noteworthy. Other therapies, including psychodynamic approaches, are seldom studied but have proven effective when explored, highlighting knowledge gaps and potential missed opportunities. Success with these alternative approaches-especially in complex trauma cases like intimate partner violence or child loss where EMDR and CBT may be less effective-suggests they have potential, but further research is needed for validation. Conclusions: This review offers novel contributions to the field by emphasising innovative therapeutic perspectives that extend beyond traditional, more studied, evidence-based approaches such as CBT and EMDR, thereby expanding treatment options for diverse clinical presentations. Alternative therapies show promise, particularly for complex trauma cases like intimate partner violence or child loss where established approaches may be less effective; however, further research is needed to validate their efficacy across diverse populations. Selection of psychotherapy should be based on clients' goals and comfort, and the cultural and contextual compatibility between the person and intervention. Future research should prioritise underexplored therapies to address current knowledge gaps and improve treatment accessibility for varied clinical needs.}, }
@article {pmid41373324, year = {2025}, author = {Haimi, M and Inchi, L}, title = {Bridging Distance, Delivering Care: Pediatric Tele-Nutrition in the Digital Health Era-A Narrative Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, doi = {10.3390/healthcare13233107}, pmid = {41373324}, issn = {2227-9032}, abstract = {BACKGROUND: The emergence of telehealth has transformed healthcare delivery across multiple disciplines, with tele-nutrition representing a rapidly evolving field that addresses nutritional assessment, counseling, and management through digital platforms.<br><br>OBJECTIVE: This narrative review examines the current landscape of pediatric tele-nutrition services, exploring technological platforms, clinical applications, evidence for effectiveness, implementation considerations, and future directions.<br><br>METHODS: A comprehensive literature search was conducted across PubMed, CINAHL, Embase, and Web of Science databases from January 2010 to October 2025. A total of 114 relevant sources were selected, encompassing randomized controlled trials, observational studies, systematic reviews, implementation studies, clinical guidelines, and policy documents.<br><br>RESULTS: This review synthesized 114 sources, predominantly from the United States (54%) and European nations (21%), with evidence expansion accelerating post-COVID-19 pandemic. Evidence suggests pediatric tele-nutrition demonstrates clinical outcomes comparable to traditional in-person care across diverse populations including obesity management, diabetes, gastrointestinal disorders, feeding difficulties, metabolic conditions, and preventive nutrition services. Multiple technology platforms are utilized, with synchronous video consultations most common (60-85% of encounters). Benefits include enhanced access to specialized care, increased frequency of contact, reduced family burden, and high satisfaction rates (>80% across most studies). Challenges include limitations in physical assessment, digital equity concerns affecting vulnerable populations, variable reimbursement policies, and the need for provider training. Hybrid models combining virtual and in-person care appear optimal for many conditions.<br><br>CONCLUSIONS: Pediatric tele-nutrition represents a viable and effective care delivery model with particular advantages for families facing geographic, logistic, or access barriers. Continued attention to digital equity, provider training, regulatory frameworks, sustainable reimbursement policies, and rigorous evidence generation will optimize implementation and outcomes. Future directions include artificial intelligence applications, precision nutrition approaches, and expanded global health applications.}, }
@article {pmid41373248, year = {2025}, author = {Alagood, J and Senn, WD and Prybutok, G}, title = {Hybrid Analysis of Videoconference Technology Use by Aging-in-Place Organizations to Promote Social Engagement for Older Adults: A Scoping Review with Latent Topic Modeling.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, doi = {10.3390/healthcare13233031}, pmid = {41373248}, issn = {2227-9032}, abstract = {Background/Objectives: Loneliness and social isolation are common among older adults and linked to adverse health outcomes. Videoconferencing can support social connections, but the role of aging-in-place organizations (AIPOs), such as senior centers and Area Agencies on Aging, in facilitating adoption is poorly understood. This review examined how AIPOs use relational videoconferencing to promote social engagement among older adults. Methods: We applied a hybrid methodology combining a scoping review with latent topic modeling to contextualize and analyze the evidence base. Exploratory searches revealed limited literature specifically addressing AIPO involvement; therefore, we first conducted latent topic modeling of the broader literature on social videoconferencing among older adults to establish a thematic foundation for the subsequent PRISMA-guided scoping review. Thematic analysis of this broader corpus, identified through 2021 database searches, applied Latent Dirichlet Allocation (LDA) to a collection of peer-reviewed articles. Subsequent refinement of this corpus by removing non-primary research and non-AIPO records produced the narrower PRISMA subset used for the scoping review. The scoping review followed JBI guidelines and was based on database searches (EBSCOhost: MEDLINE, AgeLine, SocINDEX, Health Source: Nursing/Academic Edition, and Family &amp; Society Studies Worldwide; ProQuest Social Science Premium Collection; and PubMed, including MEDLINE, PMC, and in-process content) for peer-reviewed studies published between 2011 and 2025. Inclusion criteria required primary research involving adults aged 65 years or older, use of videoconferencing technology for social engagement, and reference to AIPOs or analogous community-based aging services. The protocol was post-registered with the Open Science Framework. Results: The LDA analysis of 101 peer-reviewed articles identified six latent themes describing the broader research landscape: problem of isolation, character of socialization, physical health, technology as intervention, technology as social medium, and supportive environments. This thematic framework informed the scoping review, which screened 1908 records and retained 25 publications (representing 24 unique studies) explicitly referencing AIPO involvement in relational videoconferencing. Only one study predated COVID-19. Mapping these studies to the LDA-derived themes revealed the least consistent coverage to be in supportive environments and physical health, particularly among AIPOs other than senior or community centers. Conclusions: Relational videoconferencing has potential to sustain and expand older adults' social connections, but evidence mapped through the scoping review shows that documentation of how AIPOs support adoption is sparse. The hybrid approach advances understanding of videoconferencing in aging contexts and identifies priorities for documenting, comparing, and refining AIPO practices to inform future interventions and policy.}, }
@article {pmid41373238, year = {2025}, author = {Diener, BL and Berdella, M and DeCelie-Germana, J and Stables-Carney, T and Kier, C}, title = {Transforming Care Models in Cystic Fibrosis: A Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, doi = {10.3390/healthcare13233022}, pmid = {41373238}, issn = {2227-9032}, abstract = {Cystic fibrosis (CF) is a multisystemic, chronic disease that requires a large multidisciplinary team for effective treatment. Over the past 20 years, the landscape of cystic fibrosis care has evolved from an almost exclusively pediatric disease to both a pediatric and adult condition. The median age of cystic fibrosis patients is rising, and the number of adults with CF is also increasing. With new developments in cystic fibrosis care, patients' health and needs have changed, and therefore the care model of the cystic fibrosis team has also changed. The introduction of highly effective CFTR modulator therapy, the COVID-19 pandemic, and the partnership of people with CF (PwCF) and their families have catalyzed the transformation of the CF care model, which includes the growth and evolution of the CF care team given the changes in the demographics of CF patients and the incorporation of telehealth and remote patient monitoring, shared decision-making, and coproduction of care. This narrative review, focusing on the United States (US) experience, explores the transformation of CF care, highlighting demographic changes, medical breakthroughs, and systemic adaptations.}, }
@article {pmid41373226, year = {2025}, author = {Narymbayeva, N and Kamaliev, M and Juszkiewicz, KT and Kanafyanova, K and Aliyeva, S and Aitambayeva, N and Nazarova, L and Moiynbayeva, S and Saktapov, A and Svetlanova, S}, title = {Temporal and Contextual Variations in Job Satisfaction Between Physicians and Nurses: A Systematic Review and Meta-Analysis.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {23}, pages = {}, doi = {10.3390/healthcare13233008}, pmid = {41373226}, issn = {2227-9032}, abstract = {Objectives: This systematic review and meta-analysis evaluated differences in job satisfaction scores between nurses and physicians, examining variation by (a) care setting (hospital, emergency department, outpatient, mixed), and (b) time period (pre-COVID, during COVID, post-COVID). Methods: We systematically searched PubMed, Scopus, ScienceDirect, Web of Science, and CINAHL for studies published between January 2020 and July 2025. Eligible studies reported mean and standard deviation values for job satisfaction among physicians and nurses in healthcare settings across the specified timeframes. Studies were excluded if they assessed other types of satisfaction or combined data across COVID periods. Pooled standardized mean difference (SMD) was calculated using random-effects models in R. Results: Before COVID-19, the SMD was -2.40 (95% CI -8.05 to 3.26; I[2] = 98%). During the pandemic, the estimate was 1.39 (95% CI -0.57 to 3.35; I[2] = 91.5%), and post-pandemic, it remained small (SMD = 0.29; 95% CI -1.63 to 2.22; I[2] = 95.8%). Emergency care during COVID showed a significant advantage for physicians (SMD = 0.29; 95% CI 0.05 to 0.52; I[2] = 0%). Post-COVID, mixed settings slightly favored physicians (SMD = 0.06), while primary care favored nurses (SMD = -0.30); subgroup differences were significant. Conclusions: The findings reveal that job satisfaction is not solely determined by professional role but is significantly influenced by temporal and contextual factors. Job satisfaction is shaped more by temporal and contextual factors than by professional role. While no consistent differences were observed pre-pandemic, emergency care favored physicians during COVID, and post-pandemic trends showed modest advantages for nurses in primary care and physicians in mixed settings. Due to the methodological limitations of this meta-analysis, including high heterogeneity, reliance on cross-sectional data, and very low/low certainty of evidence, these results should be interpreted with caution.}, }
@article {pmid41369839, year = {2025}, author = {Obradovic, J and Jurisic, V}, title = {The - 216G/T polymorphism in the EGFR gene: A review focusing on Non-Small lung cancer.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {172}, pmid = {41369839}, issn = {1573-4978}, support = {Agreements No. 451-03-136/2025-03/200378//The Ministry of Science, Technological Development and Innovation, Republic of Serbia/ ; Agreements No. 451-03-137/2025-03/200111//The Ministry of Science, Technological Development and Innovation, Republic of Serbia,/ ; }, mesh = {Humans ; *Carcinoma, Non-Small-Cell Lung/genetics ; ErbB Receptors/genetics ; *Polymorphism, Single Nucleotide/genetics ; *Lung Neoplasms/genetics ; Genetic Predisposition to Disease ; Mutation ; Promoter Regions, Genetic ; }, abstract = {The epidermal growth factor receptor (EGFR) is a key regulator of cell proliferation and a well-established therapeutic target in non-small-cell lung cancer (NSCLC). Somatic mutations in the EGFR gene have been widely studied in the context of tyrosine kinase inhibitors (TKIs), but germline polymorphisms as potentially predictive biomarkers have emerged as a variants of interest over the years. Among these, the - 216G/T (rs712829) single nucleotide polymorphism (SNP), located in the EGFR promoter region, is gaining attention for its potential clinical relevance. This narrative review aims to provide a comprehensive chronological overview of the discovery, functional implications, clinical relevance, and broader oncological and non-oncological associations of the EGFR - 216G/T SNP. Relevant studies were identified from 2005 to 2025 through literature searches across publicly available databases and bibliographies of key publications. This SNP was associated to increased EGFR promotor activity, pleural metastasis, susceptibility to EGFR mutations, NSCLC risk, and different inter-individual and inter-ethnic allele frequencies. Conflicting findings regarding survival outcomes and toxicity underscore the need for further validation. Beyond NSCLC, this SNP has demonstrated relevance in colorectal cancer, glioma, breast cancer, cardiovascular disease, and even COVID-19 susceptibility. The - 216G/T polymorphism represents a promising germline biomarker for NSCLC susceptibility. However, population-specific studies and investigations integrating multi-omics data, along with machine learning models are essential to clarify its utility in precision oncology.}, }
@article {pmid40367274, year = {2025}, author = {Hau, J and Chan, SCC and Hussain, I and Kelly, J and Rashid, MA}, title = {Implementation of virtual pathology teaching in health professions education: A systematic review: BEME Systematic Review No. 95.}, journal = {Medical teacher}, volume = {47}, number = {12}, pages = {1918-1926}, doi = {10.1080/0142159X.2025.2497890}, pmid = {40367274}, issn = {1466-187X}, mesh = {Humans ; *Education, Distance/organization &amp; administration/methods ; COVID-19/epidemiology ; *Pathology/education ; *Health Occupations/education ; SARS-CoV-2 ; Education, Medical ; }, abstract = {PURPOSE: Rapid changes to learning technologies, accelerated by the COVID-19 pandemic, have led to the widespread adoption of virtual education. Pathology is an important medical science that is central to many curricula in health professions education (HPE). It has been impacted by the broader transition to virtual education. This systematic review and meta-ethnography evaluated the experiences of virtual pathology education within HPE.<br><br>METHODS: MEDLINE and EMBASE were systematically searched for peer-reviewed qualitative journal articles describing the experiences of virtual pathology in HPE. Of 1119 articles identified, 17 were synthesised using a meta-ethnographic approach.<br><br>RESULTS: The final synthesis represented a total of 2126 participants, including 1256 undergraduate medical students, 297 resident doctors, 473 senior clinicians, and 100 teaching faculty. We identified the following third-order constructs: 'Adaptability to learner's needs', 'negative human consequences', and 'uncertainty about trajectory'.<br><br>CONCLUSION: This review highlights both positive and negative impacts of transitioning pathology education to virtual delivery. The need to enhance current educational practice according to these findings is particularly pressing since the shift to virtual education in pathology looks set to accelerate in years to come.}, }
@article {pmid36922164, year = {2023}, author = {,  and ,  and ,  and , }, title = {[Expert consensus on diagnosis and treatment of COVID-19 infection related cough in children].}, journal = {Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]}, volume = {57}, number = {3}, pages = {309-317}, doi = {10.3760/cma.j.cn112150-20230120-00052}, pmid = {36922164}, issn = {0253-9624}, support = {BE2021656//Jiangsu Province Key Research and Development Program (Social Development Project)/ ; SZYJTD201806//Suzhou "Clinical Medicine Expert Team"/ ; 82070009, 82270018//National Nature Science Fundation of China/ ; }, mesh = {Child ; Humans ; *Cough/diagnosis/etiology/therapy ; *COVID-19/therapy ; SARS-CoV-2 ; Consensus ; COVID-19 Testing ; }, abstract = {An epidemic outbreak of the corona virus disease 2019(COVID-19) Omicron variant occurred in most regions of China. Children are susceptible to COVID-19 and the vast majority of them suffer from upper respiratory tract infection. Cough is one of the most common symptoms. COVID-19 infection related cough includes acute cough, persistent cough and chronic cough, and children with original chronic cough or chronic lung disease can also induce or aggravate symptom of cough after infection, which has a great impact on children's physical and mental health. The treatment for COVID-19 infection related cough vary with the etiology. Improper treatment would delay the patient's condition and increase adverse drug reaction. Currently, there is no guideline or consensus on the diagnosis and treatment of COVID-19 infection related cough in children in China, therefore this consensus is drafted. Referring to the latest international research and the diagnostic and therapeutic strategy for COVID-19 infection (Tenth Edition For Trial Implementation), and combining with clinical diagnosis and treatment experience,the consensus elaborates the pathogenesis and etiology of COVID-19 infection related cough, the use of cough relievers and expectorants, as well as the key points of diagnosis and treatment of different etiological factors. It is expected to provide specific and feasible guidance scheme for pediatricians, general practitioners and clinical pharmacists.}, }
@article {pmid36822865, year = {2023}, author = {,  and ,  and ,  and , }, title = {[Expert consensus on the infection prevention and control of SARS-CoV-2 Omicron variant in healthcare facilities].}, journal = {Zhonghua yi xue za zhi}, volume = {103}, number = {8}, pages = {545-558}, doi = {10.3760/cma.j.cn112137-20220929-02059}, pmid = {36822865}, issn = {0376-2491}, support = {2020-53//China National Health Development Research Center "Evidence Based Evaluation and Demonstration Base Construction Project for Medical Institutions' Sense and Control Measures"/ ; 20411950104//Emergency Science and Technology Project of Science and Technology Commission of Shanghai Municipality/ ; SHDC22021315//Shanghai Hospital Development Center Foundation/ ; 20411950104//Shanghai Committee of Science and Technology/ ; }, mesh = {Humans ; *COVID-19 ; Consensus ; SARS-CoV-2 ; Delivery of Health Care ; }, abstract = {SARS-CoV-2 has been mutating ever since COVID-19 became a global pandemic in 2020, resulting in changes in its viral characteristics. Dealing with infections due to the Omicron variant, it is important for healthcare facilities to dynamically carry out accurate and scientific prevention and control strategies. The current consensus aimed to target the most concerned aspects, including the detection, transmission, prevention and disinfection of the Omicron variant. Through reviewing the latest evidence-based literature, rounds of discussions, and multiple revisions, the panel of experts formed 22 evidence-based recommendations. This consensus provides scientific and practical guidance for the medical institutions, as well as providing reference for other professional organizations and personnel.}, }
@article {pmid36629948, year = {2023}, author = {Ishige, T and Shimizu, T and Watanabe, K and Arai, K and Kamei, K and Kudo, T and Kunisaki, R and Tokuhara, D and Naganuma, M and Mizuochi, T and Murashima, A and Inoki, Y and Iwata, N and Iwama, I and Koinuma, S and Shimizu, H and Jimbo, K and Takaki, Y and Takahashi, S and Cho, Y and Nambu, R and Nishida, D and Hagiwara, SI and Hikita, N and Fujikawa, H and Hosoi, K and Hosomi, S and Mikami, Y and Miyoshi, J and Yagi, R and Yokoyama, Y and Hisamatsu, T}, title = {Expert consensus on vaccination in patients with inflammatory bowel disease in Japan.}, journal = {Journal of gastroenterology}, volume = {58}, number = {2}, pages = {135-157}, pmid = {36629948}, issn = {1435-5922}, support = {20316729//Ministry of Health, Labour and Welfare/ ; }, mesh = {Adult ; Pregnancy ; Female ; Humans ; Child ; Consensus ; Japan ; *COVID-19 ; *Inflammatory Bowel Diseases/drug therapy ; Vaccination/adverse effects ; }, abstract = {Immunosuppressive therapies can affect the immune response to or safety of vaccination in patients with inflammatory bowel disease (IBD). The appropriateness of vaccination should be assessed prior to the initiation of IBD treatment because patients with IBD frequently undergo continuous treatment with immunosuppressive drugs. This consensus was developed to support the decision-making process regarding appropriate vaccination for pediatric and adult patients with IBD and physicians by providing critical information according to the published literature and expert consensus about vaccine-preventable diseases (VPDs) [excluding cervical cancer and coronavirus disease 2019 (COVID-19)] in Japan. This consensus includes 19 important clinical questions (CQs) on the following 4 topics: VPDs (6 CQs), live attenuated vaccines (2 CQs), inactivated vaccines (6 CQs), and vaccination for pregnancy, childbirth, and breastfeeding (5 CQs). These topics and CQs were selected under unified consensus by the members of a committee on intractable diseases with support by a Health and Labour Sciences Research Grant. Physicians should provide necessary information on VPDs to their patients with IBD and carefully manage these patients' IBD if various risk factors for the development or worsening of VPDs are present. This consensus will facilitate informed and shared decision-making in daily IBD clinical practice.}, }
@article {pmid36599436, year = {2023}, author = {,  and , }, title = {[Expert consensus on treatment of severe COVID-19 caused by Omicron variants].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {46}, number = {2}, pages = {101-110}, doi = {10.3760/cma.j.cn112147-20221230-00994}, pmid = {36599436}, issn = {1001-0939}, support = {2022-NHLHCRF-LX-01-01//National High Level Hospital Clinical Research Funding/ ; 2022-I2M-JB-016//CAMS Innovation Fund for Medical Sciences/ ; 2022YFC2504401//National Key Research and Development Program of China/ ; 2022&#x2011;NHLHCRF&#x2011;LX&#x2011;01&#x2011;01//National High Level Hospital Clinical Research Funding/ ; 2022&#x2011;I2M&#x2011;JB&#x2011;016//CAMS Innovation Fund for Medical Sciences/ ; }, mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; Consensus ; Critical Care ; China ; }, abstract = {Severe novel coronavirus infection (COVID-19) caused by Omicron variants has arisen in many places of China recently, and critical care is currently the biggest challenge for medical institutions in China. How to manage these patients in a procedural and standardized way to minimize the mortality is a problem that the medical staff with different professional backgrounds has to face. Therefore, the Chinese Thoracic Society and Chinese Association of Chest Physicians Critical Care Group jointly initiated and organized pulmonary and critical care experts to write this recommendation based on the current medical evidence and clinical practice, in order to standardize the clinical treatment of critically ill patients.}, }
@article {pmid36567574, year = {2022}, author = {World Federation Of Chinese Medical Societies Emergency Committee,  and World Federation Of Chinese Medical Societies Respiratory Diseases,  and World Federation Of Chinese Medical Societies Heat Disease Committee,  and Chinese Association Of Chinese Medicine Pulmonary Disease Chapter,  and The First Aid Group Of Integrated Traditional Chinese And Western Medicine Of The Emergency Branch Of The Chinese Medical Association,  and The First Aid Group Of Integrated Traditional Chinese And Western Medicine Of The Emergency Branch Of The Emergency Physician Branch Of The Chinese Medical Doctor Association,  and The Emergency Branch Of The Shanghai Chinese Medical Association,  and The Institute Of Emergency And Critical Care Of The Shanghai University Of Traditional Chinese Medicine,  and National Health Commission's Key Laboratory Of Critical Care Medicine, }, title = {[Expert consensus on traditional Chinese medicine health management in adults with SARS-CoV-2 variant infection at home].}, journal = {Zhonghua wei zhong bing ji jiu yi xue}, volume = {34}, number = {12}, pages = {1233-1237}, doi = {10.3760/cma.j.cn121430-20221210-01079}, pmid = {36567574}, issn = {2095-4352}, mesh = {Adult ; Humans ; SARS-CoV-2 ; *COVID-19 ; Consensus ; East Asian People ; *Drugs, Chinese Herbal/therapeutic use ; China ; Medicine, Chinese Traditional ; }, abstract = {In order to more actively respond to the new situation of prevention and control of coronavirus disease 2019 (COVID-19), and to guide home health management for adults who are asymptomatic carriers or exhibit mild symptoms, the World Federation of Chinese Medical Societies Emergency Committee, World Federation of Chinese Medical Societies Respiratory Diseases, World Federation of Chinese Medical Societies Heat Disease Committee, Chinese Association of Chinese Medicine Pulmonary Disease Chapter, the First Aid Group of Integrated Traditional Chinese and Western Medicine of the Emergency Branch of the Chinese Medical Doctor Association, the First Aid Group of Integrated Traditional Chinese and Western Medicine of the Emergency Branch of the Emergency Physician Branch of the Chinese Medical Association, the Emergency Branch of the Shanghai Chinese Medical Association, the Institute of Emergency and Critical Care of the Shanghai University of Traditional Chinese Medicine, National Health Commission's Key Laboratory of Critical Care Medicine and other academic institutions have organized the medical experts at treating COVID-19 front line in China to investigate and discuss the traditional Chinese medicine (TCM) health management at home for adults infected with SARS-CoV-2 variants, and concluded the "Expert consensus on traditional Chinese medicine health management at home for adults infected with SARS-CoV-2 variants", in combination with "Guideline on SARS-CoV-2 variant infection recover at home" issued by the Joint Prevention and Control Mechanism of the State Council. The expert consensus included home environment, asymptomatic infection, infection with mild symptoms, recovery period, and TCM non-drug therapy intervention, which will provide a guidance to TCM intervention at home to adults infected with SARS-CoV-2 variants.}, }
@article {pmid36319453, year = {2022}, author = {,  and , }, title = {[Chinse expert consensus on issues related to the protection, treatment and management of patients with solid tumors during COVID-19 (2022 edition)].}, journal = {Zhonghua zhong liu za zhi [Chinese journal of oncology]}, volume = {44}, number = {10}, pages = {1083-1090}, doi = {10.3760/cma.j.cn112152-20220505-00309}, pmid = {36319453}, issn = {0253-3766}, mesh = {Humans ; *COVID-19 ; Pandemics ; Consensus ; *Neoplasms ; China ; }, abstract = {The new coronavirus is still in the global pandemic stage. At present, the Delta strain and the Omicron strain are the main circulating strains. The mutant strain has stronger infectivity than the original virus. In the content of COVID-19 pandemic, social public resources and medical resources may be affected, which lead to the medical treatment being delayed or interrupted in some patients with malignant tumors. Based on relevant research and clinical practice at home and abroad, the Cancer Support Therapy Committee of China Anti-Cancer Association and the Cancer Clinical Chemotherapy Committee of China Anti-Cancer Association, in the light of China's national conditions and the availability of resources such as vaccines and antiviral drug, to formulate a consensus of Chinese experts on issues related to the prevention, treatment and management of patients with solid tumors. The main contents include the vaccination of cancer patients with COVID-19, the optimization of medical resources, and the timing of restarting anti-tumor therapy after COVID-19 infection. This article is aimed at providing reference for clinical practice.}, }
@article {pmid36152123, year = {2022}, author = {Chen, S and Zhao, W and Li, J and Wu, D and , }, title = {Chinese expert consensus on oral drugs for the treatment of mature B-cell lymphomas (2020 edition).}, journal = {Frontiers of medicine}, volume = {16}, number = {5}, pages = {815-826}, pmid = {36152123}, issn = {2095-0225}, mesh = {Humans ; Consensus ; *Lymphoma, B-Cell/drug therapy ; China ; }, abstract = {Oral drugs such as ibrutinib play an important role in the treatment of mature B-cell lymphoma (BCL) due to their reliable efficacy, manageable safety, high accessibility, and convenience for use. Still, no guidelines or consensus focusing on oral drug therapies for BCL is available. To provide a reference of oral agent-based treatment for mature BCL, a panel of experts from the Lymphocyte Disease Group, Chinese Society of Hematology, Chinese Medical Association conducted an extensive discussion and reached a consensus on oral drugs for Chinese BCL patients on the basis of the current application status of oral drugs in China, combined with the latest authoritative guidelines in the world and current research reports. This consensus reviewed the application of oral drugs in the treatment of BCL and the latest research and provided appropriate recommendations on the use of oral drugs for indolent or aggressive BCL patients. With the deepening of research and the development of standardized clinical applications, oral medications will bring better treatment to BCL patients, enabling more patients to benefit from them.}, }
@article {pmid36103964, year = {2022}, author = {Shang, Y and Wu, J and Liu, J and Long, Y and Xie, J and Zhang, D and Hu, B and Zong, Y and Liao, X and Shang, X and Ding, R and Kang, K and Liu, J and Pan, A and Xu, Y and Wang, C and Xu, Q and Zhang, X and Zhang, J and Liu, L and Zhang, J and Yang, Y and Yu, K and Guan, X and Chen, D and , }, title = {Expert consensus on the diagnosis and treatment of severe and critical coronavirus disease 2019.}, journal = {Chinese medical journal}, volume = {135}, number = {16}, pages = {1913-1916}, pmid = {36103964}, issn = {2542-5641}, mesh = {Humans ; *COVID-19 ; Consensus ; SARS-CoV-2 ; China ; }, }
@article {pmid35739055, year = {2022}, author = {Chen, X and Han, CP and Zhang, W and , }, title = {Shanghai expert consensus on clinical protocol for traditional Chinese medicine treatment of COVID-19 among the elderly population (second edition).}, journal = {Journal of integrative medicine}, volume = {20}, number = {5}, pages = {427-431}, pmid = {35739055}, issn = {2095-4964}, mesh = {Aged ; China ; Clinical Protocols ; Consensus ; Humans ; *Medicine, Chinese Traditional ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; }, abstract = {This document is the revised edition of the previously issued Shanghai Expert Consensus on Clinical Protocol for Traditional Chinese Medicine Treatment of COVID-19 among the Elderly Population. Based on the clinical experience and the Protocol for Diagnosis and Treatment of COVID-19 (Trial 9th Edition), this revised edition provides treatment approaches and recommendations to proactively cope with Omicron variant and increase the therapeutic efficacy for coronavirus disease 2019 among the elderly population in Shanghai, China.}, }
@article {pmid35381631, year = {2022}, author = {, }, title = {[Chinese expert consensus on the use of Omalizumab in allergic asthma (2021 version)].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {45}, number = {4}, pages = {341-354}, doi = {10.3760/cma.j.cn112147-20220115-00051}, pmid = {35381631}, issn = {1001-0939}, support = {82161138020, U1801286//National Natural Science Foundation of China/ ; 202102010011//Science and Technology Program of Guangzhou/ ; ZNSA-2020013, ZNSA-2020003//Zhongnanshan Medical Foundation of Guangdong Province/ ; }, mesh = {*Anti-Asthmatic Agents/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; *Asthma/drug therapy ; *COVID-19 ; Consensus ; Humans ; Omalizumab/therapeutic use ; Quality of Life ; }, abstract = {As the first targeted biotherapy for asthma, Omalizumab, was officially approved in China in August 2017, and was applied in clinical practice since March, 2018. Dozens of experts in Respirology and Allergy from China fully discussed the important clinical issues on the use of Omalizumab in allergic asthma by referring to the relevant publications over the world and the first version of consensus published in March 2018. Until now, over 30, 000 allergic asthma patients have received the treatment of Omalizumab. Therefore, with the latest evidence of clinical and basic research around the world, we updated the consensus with the following issues: (1) The mechanisms and available evidence on anti-IgE treatment; (2) Selection and exclusion criteria for patients using Omalizumab; (3) Cautions on the administration of Omalizumab and highlights of the use of Omalizumab with various vaccines, including novel Coronavirus vaccines, and key points to note during a Novel Coronavirus pandemic; (4) Long-term use and safety; (5) The use of Omalizumab in specific populations; (6) Clinical applications of omalizumab with other targeted therapies and allergen-specific immunotherapy. Omalizumab, combining to the Cε3 area of IgE, reduces the free IgE level, and downregulates the expression of FcεRⅠ, which inhibits the release of inflammatory mediators of mast cell sources, and leads to reduced asthma exacerbation, decreased rate of emergency visit and hospitalization, improved symptoms and quality of life, as well as less concomitant moderate to severe asthma, poorly controlled after at least 3 months treatment of ICS/LABA, and confirmed with allergic status through skin prick test or serum total IgE or specific IgE. Conditions that exclude the use of Omalizumab include patients who are suspected to be allergic to drug ingredients. Omalizumab is administered based on dosing tables by subcutaneous injection. Omalizumab should be administered by a health care professional (doctor or nurse) in a medical institution equipped with facilities for post-injection observation and rescue treatment for anaphylactic shock. After the injection, the patient should be closely monitored whether there is an anaphylactic reaction. The duration of Omalizumab treatment should be at least 16 weeks to judge its effectiveness, after 16 weeks, Omalizumab treatment will be continued or withdrawn based on the overall asthma control evaluation. Patients should be followed every 3 months to assess the disease control and dosing adjustment. The common adverse reactions were injection sites reactions. Based on the latest evidence around the word, we focused on updating the relevant treatment course, administration method and use of specific populations, in order to guide clinicians in the use of Omalizumab. The use of Omalizumab in China still requires long-term observation and further research. With the increase of clinical evidence, this consensus will be continuously improved and supplemented.}, }
@article {pmid35257524, year = {2022}, author = {Choi, JH and Moon, J and Kim, S and Bae, H and Lee, J and Choe, YJ}, title = {Expert Consensus on COVID-19 Vaccination in Korean Adolescents: A Modified Delphi Survey.}, journal = {Journal of Korean medical science}, volume = {37}, number = {9}, pages = {e69}, pmid = {35257524}, issn = {1598-6357}, support = {2021-10-023//Korea Disease Control and Prevention Agency/Korea ; }, mesh = {Adolescent ; Adult ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines ; Child ; Consensus ; Humans ; Republic of Korea ; Vaccination ; }, abstract = {The effectiveness of coronavirus disease 2019 (COVID-19) vaccines had been shown in many studies in adult population, however, the real-world evidence in the childhood population was scarce. We aimed to organize the collective expert's opinions on adolescent vaccination against COVID-19 in Korea, therefore to guide the vaccination policy in the setting of available evidence. The Delphi panels responded that adolescents were greatly impacted by the quarantine measures, and COVID-19 is an important health problem for adolescents. Panels responded that in general, the benefits of the COVID-19 vaccine overweigh the potential risks in Korean adolescents. Continuing monitoring of available data is needed to provide the best vaccination practices in adolescents guided by the updated evidence.}, }
@article {pmid35125460, year = {2022}, author = {Iyer, S and Bovonratwet, P and Samartzis, D and Schoenfeld, AJ and An, HS and Awwad, W and Blumenthal, SL and Cheung, JPY and Derman, PB and El-Sharkawi, M and Freedman, BA and Hartl, R and Kang, JD and Kim, HJ and Louie, PK and Ludwig, SC and Neva, MH and Pham, MH and Phillips, FM and Qureshi, SA and Radcliff, KE and Riew, KD and Sandhu, HS and Sciubba, DM and Sethi, RK and Valacco, M and Zaidi, HA and Zygourakis, CC and Makhni, MC}, title = {Appropriate Telemedicine Utilization in Spine Surgery: Results From a Delphi Study.}, journal = {Spine}, volume = {47}, number = {8}, pages = {583-590}, doi = {10.1097/BRS.0000000000004339}, pmid = {35125460}, issn = {1528-1159}, mesh = {*COVID-19/epidemiology ; Consensus ; Delphi Technique ; Humans ; Patient Satisfaction ; *Telemedicine ; }, abstract = {STUDY DESIGN: Delphi expert panel consensus.<br><br>OBJECTIVE: To obtain expert consensus on best practices for appropriate telemedicine utilization in spine surgery.<br><br>SUMMARY OF BACKGROUND DATA: Several studies have shown high patient satisfaction associated with telemedicine during the COVID-19 peak pandemic period as well as after easing of restrictions. As this technology will most likely continue to be employed, there is a need to define appropriate utilization.<br><br>METHODS: An expert panel consisting of 27 spine surgeons from various countries was assembled in February 2021. A two-round consensus-based Delphi method was used to generate consensus statements on various aspects of telemedicine (separated as video visits or audio visits) including themes, such as patient location and impact of patient diagnosis, on assessment of new patients. Topics with &#x2265;75% agreement were categorized as having achieved a consensus.<br><br>RESULTS: The expert panel reviewed a total of 59 statements. Of these, 32 achieved consensus. The panel had consensus that video visits could be utilized regardless of patient location and that video visits are appropriate for evaluating as well as indicating for surgery multiple common spine pathologies, such as lumbar stenosis, lumbar radiculopathy, and cervical radiculopathy. Finally, the panel had consensus that video visits could be appropriate for a variety of visit types including early, midterm, longer term postoperative follow-up, follow-up for imaging review, and follow-up after an intervention (i.e., physical therapy, injection).<br><br>CONCLUSION: Although telemedicine was initially introduced out of necessity, this technology most likely will remain due to evidence of high patient satisfaction and significant cost savings. This study was able to provide a framework for appropriate telemedicine utilization in spine surgery from a panel of experts. However, several questions remain for future research, such as whether or not an in-person consultation is necessary prior to surgery and which physical exam maneuvers are appropriate for telemedicine.Level of Evidence: 4.}, }
@article {pmid35057603, year = {2022}, author = {Chopra, HK and Nair, T and Ponde, CK and Kaul, S and Mehta, Y and Vora, A and Mukhopadhyay, P and Jayagopal, PB and Behera, M and Patil, R and Deshpande, M and Anantharaman, R}, title = {COVID-Inflicted Coagulopathy: Expert Consensus on Management with Novel Oral Anticoagulants in India.}, journal = {The Journal of the Association of Physicians of India}, volume = {69}, number = {12}, pages = {11-12}, pmid = {35057603}, issn = {0004-5772}, mesh = {Administration, Oral ; Anticoagulants/therapeutic use ; *COVID-19 ; Consensus ; *Heparin, Low-Molecular-Weight ; Humans ; India/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {Coronavirus disease 2019 (COVID-19) is a highly hypercoagulable viral infection complicated as COVID-inflicted coagulopathy (CIC), that is associated with increased risk of morbidity and mortality. International guidelines recommend low molecular weight heparin (LMWH) to treat CIC in both in-hospital and in-home settings. However, in India, using subcutaneous LMWH may not be a feasible option for a vast majority of patients under home management. Additionally, while some evidence advocates the use of novel oral anticoagulants (NOACs), in hospitalized settings, most guidelines find no role of NOACs in hospital settings. On the other hand, the resource crunch faced in recent COVID-19 pandemic in India forced physicians to treat many patients in home settings. These patients had been usually prescribed NOACs for ease of administration and adherence. Therefore, there is a need to form a consensus on the use of NOACs to manage CIC in India.}, }
@article {pmid34815248, year = {2024}, author = {Dewhurst, F and Hanratty, B and Frew, K and Paes, P and Walker, R and Barnes, C and Maddock, H and Elverson, J and Byrne-Davis, L}, title = {Palliative medicine trainees be should learn about frailty: meta-synthesis and Delphi study to establish curriculum content.}, journal = {BMJ supportive &amp; palliative care}, volume = {13}, number = {e3}, pages = {e1008-e1018}, doi = {10.1136/bmjspcare-2021-003013}, pmid = {34815248}, issn = {2045-4368}, mesh = {Aged ; Humans ; Curriculum ; Delphi Technique ; *Frailty/therapy ; Palliative Care ; *Palliative Medicine ; }, abstract = {OBJECTIVES: Frailty is common and highly associated with morbidity and mortality, a fact that has been highlighted by COVID-19. Understanding how to provide palliative care for frail individuals is an international priority, despite receiving limited mention in Palliative Medicine curricula or examinations worldwide. This study aimed to synthesise evidence and establish expert consensus on what should be included in a Palliative-Medicine Specialist Training Curriculum for frailty.<br><br>METHODS: Literature Meta-synthesis conducted by palliative medicine, frailty and education experts produced a draft curriculum with Bologna based Learning-Outcomes. A Delphi study asked experts to rate the importance of Learning-Outcomes for specialist-training completion and propose additional Learning-Outcomes. This process was repeated until 70% consensus was achieved for over 90% of Learning-Outcomes. Experts divided Learning-Outcomes into specific (for inclusion in a frailty subsection) or generic (applicable to other palliative conditions). The Delphi panel was Subject Matter Experts: Palliative-Medicine Consultants (n=14) and Trainees (n=10), representing hospital, community, hospice and care home services and including committee members of key national training organisations. A final reviewing panel of Geriatric Medicine Specialists including experts in research methodology, national training requirements and frailty were selected.<br><br>RESULTS: The meta-synthesis produced 114 Learning-Outcomes. The Delphi Study and Review by Geriatric Medicine experts resulted in 46 essential and 33 desirable Learning-Outcomes.<br><br>CONCLUSIONS: This frailty curriculum is applicable internationally and highlights the complex and unique palliative needs of frail patients. Future research is required to inform implementation, educational delivery and service provision.}, }
@article {pmid33946120, year = {2021}, author = {Elalamy, I and Gerotziafas, G and Alamowitch, S and Laroche, JP and Van Dreden, P and Ageno, W and Beyer-Westendorf, J and Cohen, AT and Jimenez, D and Brenner, B and Middeldorp, S and Cacoub, P and , }, title = {SARS-CoV-2 Vaccine and Thrombosis: An Expert Consensus on Vaccine-Induced Immune Thrombotic Thrombocytopenia.}, journal = {Thrombosis and haemostasis}, volume = {121}, number = {8}, pages = {982-991}, pmid = {33946120}, issn = {2567-689X}, mesh = {COVID-19/*prevention &amp; control ; COVID-19 Vaccines/*adverse effects/therapeutic use ; Clinical Decision-Making ; Hemorrhage/etiology ; Humans ; Purpura, Thrombocytopenic, Idiopathic/*etiology ; Risk Factors ; Thrombocytopenia/etiology ; Thrombosis/*etiology ; Vaccination/adverse effects/methods ; }, abstract = {Historically, the vaccination strategies developed in the second half of the 20th century have facilitated the eradication of infectious diseases. From the onset of COVID-19 pandemic to the end of April 2021, more than 150 million cases and 3 million deaths were documented worldwide with disruption of the economic and social activity, and with devastating material, physical, and psychological consequences. Reports of unusual and severe thrombotic events, including cerebral and splanchnic venous thrombosis and other autoimmune adverse reactions, such as immune thrombocytopenia or thrombotic microangiopathies in connection with some of the SARS-CoV-2 vaccines, have caused a great deal of concern within the population and the medical community. This report is intended to provide practical answers following an overview of our knowledge on these thrombotic events that are extremely rare but have serious consequences. Vaccine hesitancy threatens to reverse the progress made in controlling vaccine-preventable diseases. These adverse events must be put into perspective with an objective analysis of the facts and the issues of the vaccination strategy during this SARS-CoV-2 pandemic. Health care professionals remain the most pertinent advisors and influencers regarding vaccination decisions; they have to be supported to provide reliable and credible information on vaccines. We need to inform, reassure, and support our patients when the prescription is made. Facing these challenges and observations, a panel of experts express their insights and propose a tracking algorithm for vaccinated patients based on a 10-point guideline for decision-making on what to do and not to do.}, }
@article {pmid33857654, year = {2021}, author = {Ng, YS and Ong, PH and Mah, SM and Koh, CWC and Loh, YJ and Chew, E}, title = {Rehabilitation prioritization: Development of expert consensus on essential rehabilitation during pandemics.}, journal = {Annals of physical and rehabilitation medicine}, volume = {64}, number = {6}, pages = {101512}, pmid = {33857654}, issn = {1877-0665}, mesh = {Consensus ; Humans ; *Pandemics ; }, }
@article {pmid33630471, year = {2021}, author = {Asbun, HJ and Abu Hilal, M and Kunzler, F and Asbun, D and Bonjer, J and Conlon, K and Demartines, N and Feldman, LS and Morales-Conde, S and Pietrabissa, A and Pryor, AD and Schlachta, CM and Sylla, P and Targarona, EM and Agra, Y and Besselink, MG and Callery, M and Cleary, SP and De La Cruz, L and Eckert, P and Evans, C and Han, HS and Jones, DB and Gan, TJ and Koch, D and Lillemoe, KD and Lomanto, D and Marks, J and Matthews, B and Mellinger, J and Melvin, WS and Moreno-Paquentin, E and Navarrete, C and Pawlik, TM and Pessaux, P and Ricciardi, W and Schwaitzberg, S and Shah, P and Szokol, J and Talamini, M and Torres, R and Triboldi, A and Udomsawaengsup, S and Valsecchi, F and Vauthey, JN and Wallace, M and Wexner, SD and Zinner, M and Francis, N}, title = {International Delphi Expert Consensus on Safe Return to Surgical and Endoscopic Practice: From the Coronavirus Global Surgical Collaborative.}, journal = {Annals of surgery}, volume = {274}, number = {1}, pages = {50-56}, pmid = {33630471}, issn = {1528-1140}, mesh = {COVID-19/epidemiology/*prevention &amp; control/transmission ; Consensus ; Delphi Technique ; *Elective Surgical Procedures ; *Endoscopy ; Humans ; Infection Control/*organization &amp; administration ; Internationality ; Intersectoral Collaboration ; Triage ; }, abstract = {OBJECTIVE: The aim of this work is to formulate recommendations based on global expert consensus to guide the surgical community on the safe resumption of surgical and endoscopic activities.<br><br>BACKGROUND: The COVID-19 pandemic has caused marked disruptions in the delivery of surgical care worldwide. A thoughtful, structured approach to resuming surgical services is necessary as the impact of COVID-19 becomes better controlled. The Coronavirus Global Surgical Collaborative sought to formulate, through rigorous scientific methodology, consensus-based recommendations in collaboration with a multidisciplinary group of international experts and policymakers.<br><br>METHODS: Recommendations were developed following a Delphi process. Domain topics were formulated and subsequently subdivided into questions pertinent to different aspects of surgical care in the COVID-19 crisis. Forty-four experts from 15 countries across 4 continents drafted statements based on the specific questions. Anonymous Delphi voting on the statements was performed in 2 rounds, as well as in a telepresence meeting.<br><br>RESULTS: One hundred statements were formulated across 10 domains. The statements addressed terminology, impact on procedural services, patient/staff safety, managing a backlog of surgeries, methods to restart and sustain surgical services, education, and research. Eighty-three of the statements were approved during the first round of Delphi voting, and 11 during the second round. A final telepresence meeting and discussion yielded acceptance of 5 other statements.<br><br>CONCLUSIONS: The Delphi process resulted in 99 recommendations. These consensus statements provide expert guidance, based on scientific methodology, for the safe resumption of surgical activities during the COVID-19 pandemic.}, }
@article {pmid33484264, year = {2021}, author = {Ma, B and Fan, X and Kong, W and Xiao, S and Zhu, S and Yao, M and Liu, Y and Zhu, W and Wang, J and Zeng, Y and Zhao, Y and Su, B and Xu, S and Dong, Z and Gu, H and Li, W and Jiang, Y and Gu, D and Xia, Z}, title = {Expert Consensus on Clinical Practice of Burn Units in Shanghai During the COVID-19 Epidemic.}, journal = {Journal of burn care &amp; research : official publication of the American Burn Association}, volume = {42}, number = {4}, pages = {642-645}, doi = {10.1093/jbcr/irab010}, pmid = {33484264}, issn = {1559-0488}, support = {81930057//National Natural Science Foundation of China/ ; 2019-I2M-5-076//CAMS Innovation Fund for Medical Sciences/ ; }, mesh = {Burn Units/*organization &amp; administration ; Burns/epidemiology/*therapy ; COVID-19/*epidemiology/therapy ; China/epidemiology ; *Consensus ; Critical Care/*organization &amp; administration ; Humans ; Infection Control/organization &amp; administration ; }, abstract = {In response to coronavirus disease 2019 (COVID-19), the Shanghai Burn Clinical Quality Control Center organized experts to formulate and implement a set of rapid, simple, and effective prevention and control measures, and there have not been any cases of health care professionals or inpatients in burn units suspected or confirmed with COVID-19. This article elaborates on the specific measures in burn units in response to the epidemic, including the implementation of standardized procedures, remote consultations, strengthened follow-up, exchange of experience, and popular science, among others. We share experience from Shanghai to benefit related disciplines in other countries and regions.}, }
@article {pmid33394078, year = {2021}, author = {Lan, X and Long, Y and Shao, F and Song, Y}, title = {Expert consensus on the safety prevention and control of nuclear medicine diagnosis and treatment during the outbreak of COVID-19 (1st edition): (translated from Chinese version).}, journal = {European journal of nuclear medicine and molecular imaging}, volume = {48}, number = {4}, pages = {1134-1143}, pmid = {33394078}, issn = {1619-7089}, mesh = {COVID-19/*prevention &amp; control ; China/epidemiology ; Consensus ; Disease Outbreaks/*prevention &amp; control ; Humans ; Nuclear Medicine/*trends ; SARS-CoV-2 ; }, abstract = {In December 2019, an infectious disease caused by a new type of coronavirus infection was prevalent in Wuhan and across the country. On January 20, 2020, the National Health Commission of the People's Republic of China issued No.1 Announcement, which incorporated the novel coronavirus pneumonia into the Class B infectious disease according to the Law on Prevention and Control of Infectious Disease, but the disease should be adopted in the management of Class A infectious disease. In order to effectively control the source of infection, cut off the transmission route, protect the susceptible population, ensure the medical quality and medical safety, perform epidemic prevention and control, and comprehensively guarantee the life safety and physical health of medical staff, patients, and family members, it is very important to organize and carry out nuclear medicine diagnosis and treatment scientifically and safely. According to the national prevention and control policy, Chinese Society of Nuclear Medicine and editorial board of the Chinese Journal of Nuclear Medicine and Molecular Imaging organized professionals to formulate the expert consensus on the safety prevention process of nuclear medicine imaging and nuclide therapy during the period of new coronavirus infection.}, }
@article {pmid33323819, year = {2020}, author = {Sun, TW and Zhang, XJ and Yu, Z and Shang, Y}, title = {Chinese expert consensus on the diagnosis and treatment of severely and critically ill patients with coronavirus disease 2019.}, journal = {Chinese medical journal}, volume = {133}, number = {24}, pages = {2963-2965}, pmid = {33323819}, issn = {2542-5641}, mesh = {COVID-19/diagnosis/*therapy ; Consensus ; Critical Illness ; Humans ; *SARS-CoV-2 ; }, }
@article {pmid33272328, year = {2020}, author = {Chan, Y and Banglawala, SM and Chin, CJ and Côté, DWJ and Dalgorf, D and de Almeida, JR and Desrosiers, M and Gall, RM and Gevorgyan, A and Hassan Hassan, A and Janjua, A and Lee, JM and Leung, RM and Mechor, BD and Mertz, D and Monteiro, E and Nayan, S and Rotenberg, B and Scott, J and Smith, KA and Sommer, DD and Sowerby, L and Tewfik, MA and Thamboo, A and Vescan, A and Witterick, IJ}, title = {CSO (Canadian Society of Otolaryngology - Head &amp; Neck Surgery) position paper on rhinologic and skull base surgery during the COVID-19 pandemic.}, journal = {Journal of otolaryngology - head &amp; neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale}, volume = {49}, number = {1}, pages = {81}, pmid = {33272328}, issn = {1916-0216}, mesh = {*COVID-19/diagnosis/epidemiology/prevention &amp; control ; *COVID-19 Testing ; Disease Transmission, Infectious/prevention &amp; control ; Humans ; Nose/*surgery ; Otolaryngology/methods/*standards ; Otorhinolaryngologic Diseases/surgery ; Otorhinolaryngologic Surgical Procedures/*standards ; *Pandemics ; Personal Protective Equipment/*standards ; Postoperative Care/standards ; Preoperative Care/methods/*standards ; Skull Base/*surgery ; }, abstract = {Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. Amongst the most impacted are the elective medical and surgical services in order to conserve resources to care for COVID-19 patients. As the number of infected patients decrease across Canada, elective surgeries are being restarted in a staged manner. Since Otolaryngologists - Head &amp; Neck Surgeons manage surgical diseases of the upper aerodigestive tract where the highest viral load reside, it is imperative that these surgeries resume in a safe manner. The aim of this document is to compile the current best evidence available and provide expert consensus on the safe restart of rhinologic and skull base surgeries while discussing the pre-operative, intra-operative, and post-operative care and tips. Risk assessment, patient selection, case triage, and pre-operative COVID-19 testing will be analyzed and discussed. These guidelines will also consider the optimal use of personal protective equipment for specific cases, general and specific operative room precautions, and practical tips of intra-operative maneuvers to optimize patient and provider safety. Given that the literature surrounding COVID-19 is rapidly evolving, these recommendations will serve to start our specialty back into elective rhinologic surgeries over the next months and they may change as we learn more about this disease.}, }
@article {pmid33213540, year = {2021}, author = {Khan, S and Tsang, KK and Mertz, D and Dolovich, M and Tunks, M and Demers, C and Hassall, K and Maharaj, N and Margallo, K and Cividino, M and Chagla, Z and Duong, M}, title = {A regional Canadian expert consensus on recommendations for restoring exercise and pulmonary function testing in low and moderate-to-high community prevalence coronavirus disease 2019 (COVID-19) settings.}, journal = {Infection control and hospital epidemiology}, volume = {42}, number = {12}, pages = {1535-1537}, pmid = {33213540}, issn = {1559-6834}, mesh = {*COVID-19 ; Canada/epidemiology ; Consensus ; Humans ; Prevalence ; SARS-CoV-2 ; }, }
@article {pmid33089297, year = {2020}, author = {Zhu, L and Wang, JB and Yu, Q and Huang, ZW and Han, FK and Li, SJ and Sha, Y and Shi, HM and Tao, XF}, title = {[Shanghai municipal expert consensus on standardized prevention and control of COVID-19 during procedures of oral radiology].}, journal = {Shanghai kou qiang yi xue = Shanghai journal of stomatology}, volume = {29}, number = {4}, pages = {431-434}, pmid = {33089297}, issn = {1006-7248}, mesh = {Betacoronavirus ; COVID-19 ; China ; Consensus ; *Coronavirus Infections ; Humans ; *Pandemics ; *Pneumonia, Viral ; *Radiography, Dental ; SARS-CoV-2 ; }, abstract = {The announcement of National Health Commission on January 20, 2020 (No.1 of 2020) has included novel coronavirus pneumonia into the B class infectious diseases according to the law of the People's Republic of China on the prevention and control of infectious diseases, and has been managed as A class infectious diseases. People's governments at all levels and health administration departments have been paying high attention to it. With the alleviation of COVID-19 nationwide, dental clinics gradually resume to work. The main transmission routes of COVID-19 are respiratory droplets and contact transmission, hence oral radiological examination is kind of a high-risk operation. Standardized radiologic process is of great significance to reduce the risk of COVID-19 transmission. In accordance with the national and Shanghai epidemic prevention requirements, and in combination with the actual situation of various medical institutions, Oral and Maxillofacial Radiology Committee of Shanghai Stomatological Association formulated the expert consensus on standardized prevention and control of COVID-19 for clinical reference. This recommendation will be updated according to the situation of epidemic prevention and control in China and the new relevant diagnosis and treatment plans.}, }
@article {pmid32852385, year = {2020}, author = {Yang, XH and Hu, B and Shang, Y and Liu, J and Zhong, M and Shang, XL and Wu, ZX and Yu, Z and Sun, RH and Wang, HL and Zhao, MY and Meng, M and Xu, QH and Zheng, X and Chen, DC}, title = {Expert consensus on management of analgesia and sedation for patients with severe coronavirus disease 2019.}, journal = {Chinese medical journal}, volume = {133}, number = {18}, pages = {2186-2188}, doi = {10.1097/CM9.0000000000001034}, pmid = {32852385}, issn = {2542-5641}, mesh = {Analgesia/*methods ; *Betacoronavirus ; COVID-19 ; Conscious Sedation/*methods ; Consensus ; Coronavirus Infections/*complications ; Humans ; Pandemics ; Pneumonia, Viral/*complications ; SARS-CoV-2 ; }, }
@article {pmid32794674, year = {2020}, author = {Bone Circulation And Osteonecrosis Professional Committee Shockwave Medical Specialty Committee Of Chinese Research Hospital Association, }, title = {[Expert consensus on prevention and treatment strategies for osteonecrosis of femoral head during the prevention and control of novel coronavirus pneumonia (2020)].}, journal = {Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery}, volume = {34}, number = {8}, pages = {1031-1035}, pmid = {32794674}, issn = {1002-1892}, mesh = {Betacoronavirus ; COVID-19 ; Consensus ; Coronavirus Infections/*epidemiology ; Femur Head/pathology ; Femur Head Necrosis/*prevention &amp; control/*therapy ; Humans ; Osteonecrosis/*prevention &amp; control/*therapy ; Pandemics ; Pneumonia, Viral/*epidemiology ; SARS-CoV-2 ; }, abstract = {Novel coronavirus pneumonia is a new type of respiratory infectious disease that has rapidly spread in many countries or regions around the world. The World Health Organization (WHO) named it "coronavirus disease 2019 (COVID-19)". Glucocorticoids (GC) have certain application value in patients with COVID-19, but they need to be used with caution and strict indications and dosage. Application of large doses of GC can also cause osteonecrosis of femoral head (ONFH). On the basis of the latest literature and evidence-based medical evidence on the fight against COVID-19 epidemic and steroid ONFH diagnosis and treatment, the Bone Circulation and Osteonecrosis Professional Committee, Shockwave Medical Specialty Committee of Chinese Research Hospital Association organized Chinese bone necrosis related experts to jointly write this consensus, focusing on the prevention strategy and the protective management measures in the ONFH diagnosis and treatment process during the prevention and control of COVID-19, which can provide reference for hospitals at all levels to carry out early prevention and treatment of ONFH.}, }
@article {pmid32641446, year = {2020}, author = {Wang, F and Liu, J and Zhang, P and Jiang, W and Zhang, L and Zhang, M and Teng, J and Wang, J and Xie, X and Cao, J and Li, W and Wu, Y and Zhou, H and Su, Y and Pan, S and Liu, L}, title = {Expert consensus on prevention and control of COVID-19 in the neurological intensive care unit (first edition).}, journal = {Stroke and vascular neurology}, volume = {5}, number = {3}, pages = {242-249}, pmid = {32641446}, issn = {2059-8696}, mesh = {Betacoronavirus/*pathogenicity ; COVID-19 ; Consensus ; Coronavirus Infections/diagnosis/*prevention &amp; control/transmission/virology ; Critical Illness ; Cross Infection/diagnosis/*prevention &amp; control/transmission/virology ; Host-Pathogen Interactions ; Humans ; Infection Control/*standards ; Infectious Disease Transmission, Patient-to-Professional/*prevention &amp; control ; Intensive Care Units/*standards ; Nervous System Diseases/diagnosis/*therapy ; Neurology/*standards ; Occupational Health ; Pandemics/*prevention &amp; control ; Patient Safety ; Pneumonia, Viral/diagnosis/*prevention &amp; control/transmission/virology ; Risk Assessment ; Risk Factors ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {During the COVID-19 epidemic, the treatment of critically ill patients has been increasingly difficult and challenging. During the epidemic, some patients with neurological diseases also have COVID-19, which could be misdiagnosed and cause silent transmission and nosocomial infection. Such risk is high in a neurological intensive care unit (NCU). Therefore, prevention and control of epidemic in critically ill patients is of utmost importance. The principle of NCU care should include comprehensive screening and risk assessment, weighing risk against benefits and reducing the risk of COVID-19 transmission while treating patients as promptly as possible.}, }
@article {pmid32627963, year = {2020}, author = {Corona-Cruz, J and Alba, EG and Iñiguez-García, M and López-Saucedo, R and Olivares-Torres, C and Rodriguez-Cid, J and Salazar-Otaola, G and Martínez-Said, H and Flores, RM and Arrieta, O}, title = {Surgical care of thoracic malignancies during the COVID-19 pandemic in México: An expert consensus guideline from the Sociedad Mexicana de Oncología (SMeO) and the Sociedad Mexicana de Cirujanos Torácicos Generales (SMCTG).}, journal = {Thoracic cancer}, volume = {11}, number = {8}, pages = {2370-2375}, pmid = {32627963}, issn = {1759-7714}, mesh = {COVID-19/complications/*epidemiology/virology ; Guidelines as Topic ; Humans ; Lung Neoplasms/complications/*epidemiology/surgery/virology ; Medical Oncology/trends ; Mexico/epidemiology ; *Pandemics ; SARS-CoV-2/pathogenicity ; Thoracic Neoplasms/complications/*epidemiology/surgery/virology ; Triage ; }, abstract = {To date, the impact, timeline and duration of COVID-19 pandemic remains unknown and more than ever it is necessary to provide safe pathways for cancer patients. Multiple triage systems for nonemergent surgical procedures have been published, but potentially curative cancer procedures are essential surgery rather than elective surgery. In the present and future scenario of our country, thoracic oncology teams may have the difficult decision of weighing the utility of surgical intervention against the risk for inadvertent COVID-19 exposure for patients and medical staff. In consequence, traditional pathways of surgical care must be adjusted to reduce the risk of infection and the use of resources. It is recommended that all thoracic cancer patients should be offered treatment according to the accepted standard of care until shortage of services require a progressive reduction in surgical cases. Here, we present a consensus of recommendations discussed by a multidisciplinary panel of experts on thoracic oncology and based on the best available evidence, and hope it will provide a modifiable framework of guidance for local strategy planners in thoracic cancer care services in Mexico. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: This article provides recommendations to guarantee the continuity of surgical care for thoracic oncology cases during COVID-19 pandemic, whilst maintaining the safety of patients and medical staff. WHAT THIS STUDY ADDS: This guideline is the result of an expert consensus on thoracic surgical oncology with recommendations adapted to medical, economic and social realities of Mexico.}, }
@article {pmid32521580, year = {2020}, author = {,  and , }, title = {[Expert consensus on special blood purification technics in patients with corona virus disease 2019].}, journal = {Zhonghua nei ke za zhi}, volume = {59}, number = {11}, pages = {847-853}, doi = {10.3760/cma.j.cn112138-20200306-00202}, pmid = {32521580}, issn = {0578-1426}, mesh = {Betacoronavirus ; COVID-19 ; China ; Consensus ; Coronavirus Infections/*blood ; *Hemofiltration ; *Hemoperfusion ; Humans ; Pandemics ; *Plasma Exchange ; Pneumonia, Viral/*blood ; SARS-CoV-2 ; }, abstract = {The outbreak of corona virus disease 2019 (COVID-19) has spread to more than 70 countries worldwide and there was a higher mortality in those who developed serious illness.Cytokine storm syndrome is an important pathophysiological basis for COVID-19 patients developing into severe or critical conditions. It was indicated in the diagnosis and treatment scheme, by the National Health Commission of the People's Republic of China, that blood purifications such as plasma exchange, plasma adsorption, hemoperfusion, hemofiltration and plasmafiltration could be considered for use in the critical patients with cytokine storm syndrome. This expert consensus, proposed by the Chinese Society of Nephrology and the Nephrology Committee of Chinese Research Hospital Association, is to guide and standardize the clinical application of blood purifications in the treatment of severe or critical patients with COVID-19.}, }
@article {pmid32358326, year = {2020}, author = {Tang, PF and Hou, ZY and Wu, XB and Zhang, CQ and Wang, JW and Xing, X and Shao, ZW and Yu, AX and Wang, G and Chen, B and Zhang, P and Hu, YJ and Wang, BW and Guo, XD and Tang, X and Zhou, DS and Liu, F and Chen, AM and Zhang, K and Li, KN and Zhu, YB and , }, title = {Expert consensus on management principles of orthopedic emergency in the epidemic of coronavirus disease 2019.}, journal = {Chinese medical journal}, volume = {133}, number = {9}, pages = {1096-1098}, pmid = {32358326}, issn = {2542-5641}, mesh = {*Betacoronavirus ; COVID-19 ; Consensus ; *Coronavirus Infections/complications/epidemiology/prevention &amp; control ; Epidemics ; Humans ; Minimally Invasive Surgical Procedures ; *Musculoskeletal Diseases/complications/therapy ; *Pandemics/prevention &amp; control ; *Pneumonia, Viral/complications/epidemiology/prevention &amp; control ; SARS-CoV-2 ; }, }
@article {pmid32307014, year = {2020}, author = {Song, JC and Wang, G and Zhang, W and Zhang, Y and Li, WQ and Zhou, Z and , }, title = {Chinese expert consensus on diagnosis and treatment of coagulation dysfunction in COVID-19.}, journal = {Military Medical Research}, volume = {7}, number = {1}, pages = {19}, pmid = {32307014}, issn = {2054-9369}, mesh = {Aged ; Anticoagulants/therapeutic use ; *Betacoronavirus ; Blood Coagulation Disorders/*diagnosis/drug therapy/virology ; COVID-19 ; China ; Consensus ; Coronavirus Infections/*complications ; Humans ; Middle Aged ; Pandemics ; Pneumonia, Viral/*complications ; SARS-CoV-2 ; }, abstract = {Since December 2019, a novel type of coronavirus disease (COVID-19) in Wuhan led to an outbreak throughout China and the rest of the world. To date, there have been more than 1,260,000 COVID-19 patients, with a mortality rate of approximately 5.44%. Studies have shown that coagulation dysfunction is a major cause of death in patients with severe COVID-19. Therefore, the People's Liberation Army Professional Committee of Critical Care Medicine and Chinese Society on Thrombosis and Hemostasis grouped experts from the frontline of the Wuhan epidemic to come together and develop an expert consensus on diagnosis and treatment of coagulation dysfunction associated with a severe COVID-19 infection. This consensus includes an overview of COVID-19-related coagulation dysfunction, tests for coagulation, anticoagulation therapy, replacement therapy, supportive therapy and prevention. The consensus produced 18 recommendations which are being used to guide clinical work.}, }
@article {pmid32295323, year = {2020}, author = {,  and , }, title = {[Expert consensus on sleep study and non-invasive positive airway pressure therapy during the epidemic of coronavirus disease 2019].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {43}, number = {6}, pages = {490-495}, doi = {10.3760/cma.j.cn112147-20200309-00283}, pmid = {32295323}, issn = {1001-0939}, mesh = {Betacoronavirus ; COVID-19 ; China ; Consensus ; *Coronavirus ; Coronavirus Infections/epidemiology/*therapy ; Humans ; Noninvasive Ventilation/*methods ; Pandemics ; Pneumonia, Viral/epidemiology/*therapy ; Respiratory Insufficiency/*prevention &amp; control ; SARS-CoV-2 ; Sleep/*physiology ; }, abstract = {Coronavirus disease (COVID-19) is mainly transmitted through respiratory droplets, close unprotected contact, and intense aerosols-generating procedures. Sleep study and non-invasive positive airway pressure (NIPAP) therapy can increase the risk of exposure and transmission of new coronaviruses to medical staff and patients. China's national epidemic control has entered a critical stage of overall prevention and control together with the restoration of normal medical care delivery. Based on the characteristics of sleep-disordered breathing, this consensus elaborates on the recommendations from the following four aspects that include patient and medical staff education, optimization of diagnostic and treatment protocols, sterilization of medical devices and the environment, and control of hospital-acquired infection. It is emphasized that the indications for sleep study and NIPAP should be strictly defined according to the local epidemic situation. Portable home sleep study and auto-titration positive airway pressure is recommended. The applications of disposable nasal pressure transducer for sleep study and disposable or personal masks and ventilator tubing for NIPAP are strongly suggested. Moreover, it is necessary to standardize the procedure of NIPAP, to separate the functional divisions in sleep lab, to comply with the protection regulations for medical personnel, and to strengthen the cleaning and disinfection management.}, }
@article {pmid32294813, year = {2020}, author = {, }, title = {[Expert consensus on preventing nosocomial transmission during respiratory care for critically ill patients infected by 2019 novel coronavirus pneumonia].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {43}, number = {4}, pages = {288-296}, doi = {10.3760/cma.j.cn112147-20200304-00239}, pmid = {32294813}, issn = {1001-0939}, mesh = {Betacoronavirus ; Bronchoscopy ; COVID-19 ; Consensus ; Coronavirus Infections/*prevention &amp; control/*therapy/transmission ; Critical Illness ; Cross Infection/*prevention &amp; control/virology ; Filtration ; Humans ; Masks ; Pandemics/*prevention &amp; control ; Pneumonia, Viral/*prevention &amp; control/*therapy/transmission ; Respiratory Therapy/*standards ; SARS-CoV-2 ; Ventilators, Mechanical ; }, abstract = {Definite evidence has shown that the novel coronavirus (COVID-19) could be transmitted from person to person, so far more than 1 700 bedside clinicians have been infected. A lot of respiratory treatments for critically ill patients are deemed as high-risk factors for nosocomial transmission, such as intubation, manual ventilation by resuscitator, noninvasive ventilation, high-flow nasal cannula, bronchoscopy examination, suction and patient transportation, etc, due to its high possibility to cause or worsen the spread of the virus. As such, we developed this consensus recommendations on all those high-risk treatments, based on the current evidence as well as the resource limitation in some areas, with the aim to reduce the nosocomial transmission and optimize the treatment for the COVID-19 pneumonia patients. Those recommendations include: (1)Standard prevention and protection, and patient isolation; (2)Patient wearing mask during HFNC treatment; (3)Using dual limb ventilator with filters placed at the ventilator outlets, or using heat-moisture exchanger (HME) instead of heated humidification in single limb ventilator with HME placed between exhalation port and mask; avoid using mask with exhalation port on the mask; (4)Placing filter between resuscitator and mask or artificial airway; (5)For spontaneous breathing patients, placing mask for patients during bronchoscopy examination; for patients receiving noninvasive ventilation, using the special mask with bronchoscopy port to perform bronchoscopy; (6)Using sedation and paralytics during intubation, cuff pressure should be maintained between 25-30 cmH(2)O(1 cmH(2)O=0.098 kPa); (7)In-line suction catheter is recommended and it can be used for one week; (8)Dual-limb heated wire circuits are recommended and only changed with visible soiled; (9)For patients who need breathing support during transportation, placing an HME between ventilator and patient; (10)PSV is recommended for implementing spontaneous breathing trial (SBT), avoid using T-piece to do SBT. When tracheotomy patients are weaned from ventilator, HME should be used, avoid using T-piece or tracheostomy mask. (11)Avoid unnecessary bronchial hygiene therapy; (12) For patients who need aerosol therapy, dry powder inhaler metered dose inhaler with spacer is recommended for spontaneous breathing patients; while vibrating mesh nebulizer is recommended for ventilated patients and additional filter is recommended to be placed at the expiratory port of ventilation during nebulization.}, }
@article {pmid32268984, year = {2020}, author = {He, Y and Wei, J and Bian, J and Guo, K and Lu, J and Mei, W and Ma, J and Xia, Z and Xu, M and Yan, F and Yu, C and Wang, E and Wang, W and Zeng, N and Wang, S and Xu, J and Huang, Y and Huang, J}, title = {Chinese Society of Anesthesiology Expert Consensus on Anesthetic Management of Cardiac Surgical Patients With Suspected or Confirmed Coronavirus Disease 2019.}, journal = {Journal of cardiothoracic and vascular anesthesia}, volume = {34}, number = {6}, pages = {1397-1401}, pmid = {32268984}, issn = {1532-8422}, mesh = {Anesthesiology/methods ; Anesthetics/*therapeutic use ; COVID-19 ; Cardiovascular Diseases/surgery/virology ; Cardiovascular Surgical Procedures ; Cardiovascular System/virology ; China/epidemiology ; *Consensus ; Coronavirus Infections/*drug therapy/epidemiology ; Disease Outbreaks ; Humans ; Pandemics ; Pneumonia, Viral/*drug therapy/epidemiology ; Practice Guidelines as Topic ; Renin-Angiotensin System/physiology ; }, abstract = {The outbreak of a new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) in China in December 2019 has brought serious challenges to disease prevention and public health. Patients with severe coronavirus disease 2019 (COVID-19) who undergo cardiovascular surgery necessitate extremely high demands from anesthesia personnel, and face high risks of mortality and morbidity. Based on the current understanding of COVID-19 and the clinical characteristics of cardiovascular surgical patients, the authors provide anesthesia management guidelines for cardiovascular surgery along with the prevention and control of COVID-19.}, }
@article {pmid32234175, year = {2020}, author = {,  and , }, title = {[Expert consensus on principal of clinical management of patients with severe emergent cardiovascular diseases during the epidemic period of COVID-19].}, journal = {Zhonghua xin xue guan bing za zhi}, volume = {48}, number = {3}, pages = {189-194}, doi = {10.3760/cma.j.cn112148-20200210-00066}, pmid = {32234175}, issn = {0253-3758}, mesh = {*Betacoronavirus ; COVID-19 ; *Cardiovascular Diseases/complications ; Consensus ; Coronavirus Infections/*complications/epidemiology ; Epidemics ; Humans ; Pandemics ; Pneumonia, Viral/*complications/epidemiology ; SARS-CoV-2 ; }, }
@article {pmid32219814, year = {2020}, author = {Specialized Committee Of Neurogenetics Neurophysician Branch Of Chinese Medical Doctor Association,  and Jiang, H and Tang, B}, title = {[Expert consensus on the management strategy of patients with hereditary ataxia during prevention and control of novel coronavirus pneumonia epidemic].}, journal = {Zhonghua yi xue yi chuan xue za zhi = Zhonghua yixue yichuanxue zazhi = Chinese journal of medical genetics}, volume = {37}, number = {4}, pages = {359-366}, doi = {10.3760/cma.j.issn.1003-9406.2020.04.001}, pmid = {32219814}, issn = {1003-9406}, mesh = {Betacoronavirus ; COVID-19 ; China/epidemiology ; Consensus ; Coronavirus Infections/complications/*epidemiology ; Epidemics ; Health Status ; Humans ; Mental Health ; Nervous System Diseases/virology ; Pandemics ; Pneumonia, Viral/complications/*epidemiology ; SARS-CoV-2 ; *Spinocerebellar Degenerations/complications/diagnosis/prevention &amp; control/therapy ; }, abstract = {Since December 2019, a series of highly infectious cases of unexplained pneumonia have been discovered in Wuhan, Hubei Province, which have been confirmed as '2019 corona virus disease' caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 virus can invade many human systems including the lungs. Patients with central nervous system involvement may show a series of neurological symptoms, which is easy to be misdiagnosed and neglected, thereby increasing the risk of SARS-CoV-2 transmission. Hereditary ataxia is a large group of neurodegenerative diseases with great clinical and genetic heterogeneity and high mortality and disability. In view of the seriousness of the COVID-19 epidemic, a series of prevention and control measures adopted by the government have restricted the follow-up, diagnosis and treatment of patients by the hospitals, which has a great impact on their mental and physical health. In order to standardize the management of patients during the prevention and control of COVID-19 epidemic, the Specialized Committee of Neurogenetics of the Neurophysician Branch of Chinese Medical Doctor Association has formulated this consensus, with an aim to help patients to overcome the difficulties and pass the epidemic prevention period safely.}, }
@article {pmid32164085, year = {2020}, author = {, }, title = {[Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {43}, number = {3}, pages = {185-188}, doi = {10.3760/cma.j.issn.1001-0939.2020.03.009}, pmid = {32164085}, issn = {1001-0939}, support = {2020B111113001//Emergency program for major public health event of Ministry of Science and Technology, Department of Science and Technology of Guangdong Province/ ; 2020GZR110106003//Guangzhou Regenerative Medicine and Health Guangdong Laboratory: Evaluation of clinical efficacy of chloroquine on 2019 novel coronavirus pneumonia/ ; }, mesh = {Anti-Inflammatory Agents, Non-Steroidal/*administration &amp; dosage ; COVID-19 ; China ; Chloroquine/administration &amp; dosage/*analogs &amp; derivatives ; Consensus ; Coronavirus Infections/*complications ; Drug Administration Schedule ; Humans ; Length of Stay ; Pneumonia, Viral/*complications/drug therapy/etiology ; Practice Guidelines as Topic ; }, abstract = {At the end of December 2019, a novel coronavirus (COVID-19) caused an outbreak in Wuhan, and has quickly spread to all provinces in China and 26 other countries around the world, leading to a serious situation for epidemic prevention. So far, there is still no specific medicine. Previous studies have shown that chloroquine phosphate (chloroquine) had a wide range of antiviral effects, including anti-coronavirus. Here we found that treating the patients diagnosed as novel coronavirus pneumonia with chloroquine might improve the success rate of treatment, shorten hospital stay and improve patient outcome. In order to guide and regulate the use of chloroquine in patients with novel coronavirus pneumonia, the multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia developed this expert consensus after extensive discussion. It recommended chloroquine phosphate tablet, 500mg twice per day for 10 days for patients diagnosed as mild, moderate and severe cases of novel coronavirus pneumonia and without contraindications to chloroquine.}, }
@article {pmid32164084, year = {2020}, author = {Zhao, JP and Hu, Y and Du, RH and Chen, ZS and Jin, Y and Zhou, M and Zhang, J and Qu, JM and Cao, B}, title = {[Expert consensus on the use of corticosteroid in patients with 2019-nCoV pneumonia].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {43}, number = {3}, pages = {183-184}, doi = {10.3760/cma.j.issn.1001-0939.2020.03.008}, pmid = {32164084}, issn = {1001-0939}, mesh = {Adrenal Cortex Hormones/*therapeutic use ; *Betacoronavirus ; COVID-19 ; Consensus ; Coronavirus Infections/*drug therapy ; Humans ; Pneumonia, Viral/*drug therapy ; SARS-CoV-2 ; COVID-19 Drug Treatment ; }, }
@article {pmid32129580, year = {2020}, author = {,  and , }, title = {[Expert consensus on pulmonary function testing during the epidemic of coronavirus disease 2019].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {43}, number = {4}, pages = {302-307}, doi = {10.3760/cma.j.cn112147-20200225-00175}, pmid = {32129580}, issn = {1001-0939}, support = {2018YFC1311900, 2016YFC1304603//National Key Research and Develop Program of China/ ; 2015BAI12B10//National Science and Technology Support Plan/ ; }, mesh = {Betacoronavirus ; COVID-19 ; Consensus ; Coronavirus Infections/*prevention &amp; control ; Disinfection ; Humans ; Infection Control/*methods ; Pandemics/*prevention &amp; control ; Pneumonia, Viral/*prevention &amp; control ; Respiratory Function Tests/*standards ; SARS-CoV-2 ; }, abstract = {Coronavirus disease 2019 (COVID-19) is transmitted mainly by respiratory droplets and close contact, probably by aerosol. Pulmonary function testing procedures have been associated with an increasing risk of COVID-19 transmission among patients/subjects and medical staffs. Effective prevention and control strategies must be compulsorily implemented to prevent nosocomial infection. This recommendation is intended to be followed by healthcare workers (HCWs) of pulmonary function testing laboratory when COVID-19 is in epidemic. Based on the features of pulmonary function testing, precaution principles and considerations are developed in three aspects of management for HCWs, operating procedure, environment and equipment. Indications of pulmonary function testing should be followed strictly. It is strongly recommended to suspend the test for the confirmed or suspected cases of COVID-19 during the contagious stage, and to postpone the test for other patients if it is not imperative. Medical personnel should mandatorily adhere to the standard stratification of precaution measures. Patients/Subjects should be isolated in a separate area for testing. Disposable in-line filters must be used during pulmonary function testing. Cleaning and disinfection procedures for environment and equipment in pulmonary function testing laboratory should be paid more attention.}, }
@article {pmid32028773, year = {2020}, author = {, }, title = {Fighting the novel coronavirus: the publication of the Chinese expert consensus on the perinatal and neonatal management for the prevention and control of the 2019 novel coronavirus infection (First edition).}, journal = {Annals of palliative medicine}, volume = {9}, number = {2}, pages = {524-525}, doi = {10.21037/apm.2020.02.02}, pmid = {32028773}, issn = {2224-5839}, mesh = {Betacoronavirus ; COVID-19 ; China ; *Consensus ; Coronavirus Infections/*prevention &amp; control/therapy ; Female ; Humans ; Infant Care/standards ; Infant Welfare/*prevention &amp; control ; Infant, Newborn ; Mass Screening/standards ; Pandemics/*prevention &amp; control ; Perinatal Care/*standards ; Pneumonia, Viral/*prevention &amp; control/therapy ; Practice Guidelines as Topic ; Pregnancy ; SARS-CoV-2 ; }, }
@article {pmid41369685, year = {2025}, author = {Mohammadi, R and Morovati, H and Safari, F}, title = {The human mycobiome: a critical yet understudied component of health and disease.}, journal = {Microbiology (Reading, England)}, volume = {171}, number = {12}, pages = {}, doi = {10.1099/mic.0.001631}, pmid = {41369685}, issn = {1465-2080}, mesh = {Humans ; *Mycobiome ; *Fungi/genetics/classification/isolation &amp; purification/physiology ; COVID-19/microbiology/complications ; Dysbiosis/microbiology ; SARS-CoV-2 ; Metagenomics ; Neoplasms/microbiology ; }, abstract = {The human body hosts a complex and dynamic microbial community that is crucial for maintaining health. While bacteria dominate this system, fungal communities, collectively called the mycobiome, are increasingly recognized as vital contributors. However, fungi remain understudied due to challenges in culturing many species, limiting our understanding of their roles, interactions and effects on human biology. Advances in next-generation sequencing have transformed mycobiome research, revealing fungal diversity and its impact on health and disease. This review examines the mycobiome's composition and function across major body sites, including the gut, mouth, lungs, reproductive tract and skin. It also explores connections between fungal imbalances (dysbiosis) and diseases such as neurological disorders, cancer and post-COVID-19 complications. Despite progress, challenges persist, including the need for better culture-independent diagnostic tools and standardized research methods. Combining culturomics and metagenomics could help overcome these limitations and identify new treatment targets. By summarizing current knowledge and highlighting research gaps, this review aims to guide future studies on the mycobiome's role in human health.}, }
@article {pmid41369389, year = {2025}, author = {Niedzielska, A and Bossowska-Nowicka, M and Biernacka, Z and Gregorczyk-Zboroch, K and Toka, FN and Szulc-Dąbrowska, L}, title = {Shaping the Immune Response: Cathepsins in Virus-Dendritic Cell Interactions.}, journal = {Cells}, volume = {14}, number = {23}, pages = {}, doi = {10.3390/cells14231900}, pmid = {41369389}, issn = {2073-4409}, support = {UMO-2020/39/O/NZ6/03252//National Science Centre/ ; //Science Development Fund of the Warsaw University of Life Sciences-SGGW/ ; }, mesh = {Humans ; *Dendritic Cells/immunology/virology/metabolism ; *Cathepsins/metabolism/immunology ; Animals ; *Virus Diseases/immunology ; SARS-CoV-2/immunology ; }, abstract = {Dendritic cells (DCs) are among the first immune cells to detect viral invasion and play a central role in initiating and shaping antiviral immune responses. Many innate and adaptive immune functions of DCs are regulated by cathepsins, proteolytic enzymes primarily found in acidic endolysosomal compartments. Different DC subsets exhibit distinct cathepsin expression patterns, influencing their functional capacities and interactions with viruses. In DCs, cathepsins contribute to virus sensing through innate receptors, regulate cytokine production and DC migration, and are essential for viral antigen degradation and loading onto MHC molecules for T-cell activation. Many viruses, however, have evolved mechanisms to alter cathepsin expression and activity, thereby subverting DC function and promoting their own persistence. Indeed, cathepsins can facilitate viral entry into DCs, promote viral replication, and support immune evasion strategies. In this review, we summarize recent advances in understanding the role of cathepsins in DC-virus interactions, emphasizing both how DCs exploit cathepsins to generate protective immune responses and how viruses manipulate cathepsin activity to their advantage. We particularly focus on clinically relevant viral pathogens, including HIV, influenza virus, hepatitis C virus, human cytomegalovirus, Ebola virus, and SARS-CoV-2, to illustrate the multifaceted influence of cathepsins on DC biology during viral infection.}, }
@article {pmid41368891, year = {2025}, author = {Pinero, S and Li, X and Zhang, J and Winter, M and Lee, SH and Nguyen, T and Liu, L and Li, J and Le, TD}, title = {Omics-based computational approaches for biomarker identification, prediction, and treatment of Long COVID.}, journal = {Critical reviews in clinical laboratory sciences}, volume = {}, number = {}, pages = {1-27}, doi = {10.1080/10408363.2025.2583083}, pmid = {41368891}, issn = {1549-781X}, abstract = {Long COVID, or post-acute sequelae of COVID-19 (PASC), is a major global health problem, with cumulative estimates suggesting that around 400 million people worldwide have been affected. It is characterized by persistent or new symptoms such as fatigue, cognitive impairment, and breathlessness lasting beyond four weeks after acute infection. Diverse clinical manifestations, chronic course, and incompletely understood pathophysiology-including hypotheses involving viral persistence, immune dysregulation, autoimmunity, endothelial dysfunction, and metabolic reprogramming-impede the development of diagnostic criteria, biomarkers, and targeted therapies. We conducted a critical review of 101 Long COVID omics studies, focusing on the computational methods used and their methodological quality. Using standardized criteria, we evaluated study design, statistical rigor, reproducibility, and clinical relevance across genomics, epigenomics, transcriptomics, proteomics, metabolomics, and multiomics integration, and mapped these findings onto regulatory and translational frameworks. Despite substantial methodological heterogeneity, convergent biological signals emerged. Genomic studies implicate risk loci in immune and cardiopulmonary pathways. Epigenomic analyses identify differentially methylated regions in immune and circadian genes. Transcriptomic studies reveal persistent dysregulation of innate immune and coagulation pathways, as well as reproducible molecular endotypes. Proteomic studies consistently show abnormalities in the complement cascade and coagulation, with a small panel of complement proteins showing highly reproducible changes across independent cohorts. Metabolomic studies demonstrate sustained mitochondrial dysfunction and altered cellular bioenergetics for up to two years after infection. Multiomics integration supports at least two major endotypes, characterized by predominant inflammatory versus metabolic dysregulation, and provides a basis for patient stratification and computational treatment discovery. Machine learning models frequently achieve high classification performance, but are rarely externally validated. Critical limitations restrict clinical translation. Most studies are underpowered relative to analytical complexity, use heterogeneous case definitions and controls, and report platform-specific signatures with limited overlap. External validation, preregistered analysis plans, and regulatory-aligned assay development are uncommon. To date, no regulatory-approved diagnostic assay or evidence-based therapeutic intervention has directly emerged from these computational findings. Future progress requires harmonized phenotyping protocols, adequately powered longitudinal cohorts with external validation, integration of spatial omics and explainable artificial intelligence, and early engagement with regulatory and health-technology assessment pathways. This review provides a critical assessment and a translational roadmap, outlining how methodologically robust computational omics can be advanced toward clinically actionable tools for Long COVID.}, }
@article {pmid41317559, year = {2025}, author = {Angeloni, NA and Adhikari, NK and Lamontagne, F}, title = {A Practical Review of Adaptive Platform Trials.}, journal = {Transfusion medicine reviews}, volume = {39}, number = {4}, pages = {150935}, doi = {10.1016/j.tmrv.2025.150935}, pmid = {41317559}, issn = {1532-9496}, mesh = {Humans ; *COVID-19/therapy/epidemiology ; *SARS-CoV-2 ; Bayes Theorem ; *Randomized Controlled Trials as Topic/methods ; *Adaptive Clinical Trials as Topic/methods ; Research Design ; Pandemics ; }, abstract = {Traditional randomized controlled trials (RCTs) can provide rigorous evidence but are often slow and resource-intensive, requiring separate trials for each intervention. Adaptive platform trials (APTs) have been promoted as a solution, offering a framework that tests multiple therapies under a single protocol, with arms added or dropped as evidence accumulates. However, their advantages come with trade-offs that warrant scrutiny. In this review, we critically appraise 3 landmark APTs. The I-SPY2 trial accelerated Phase II oncology research by utilizing Bayesian adaptive randomization and surrogate endpoints; however, much of its efficiency stemmed from relying on intermediate outcomes, which may not reliably predict survival. RECOVERY demonstrated the power of scale on a pragmatic UK-wide platform, but its success reflected health system infrastructure, political leadership, and the unique circumstances of the COVID-19 pandemic as much as its design. REMAP-CAP, a perpetual platform trial for pneumonia, rapidly switched to pandemic mode in 2020 and tested COVID-19 therapies using Bayesian models and response-adaptive randomization (RAR); however, the RAR amplified random noise in some domains, exposing patients to interventions later shown to be ineffective. A recent systematic review confirmed wide heterogeneity in APTs and suboptimal reporting. APTs are not inherently better than classical RCTs. Gains in speed may depend on less rigorous endpoints, complex adaptive methods, or streamlined oversight, each of which introduces new risks of error. As APTs spread to new fields such as transfusion medicine, clinicians and researchers must learn to recognize both the potential benefits and the pitfalls of this design.}, }
@article {pmid40866234, year = {2025}, author = {Chen, G and Yuan, J and Wei, Y and Wu, Y and Zhang, Q and Li, X and Fu, L and Gao, Y and Zheng, Y and Sun, H and Weng, W and Chen, J and Chong, Y and Wu, T and Wu, G and Gong, Z and Deng, X and Mao, L and Huang, C and Qu, Z and Qin, B and Jiang, Y and Lin, F and Lin, B and Liu, X and Xu, K and Peng, J and Wu, Z and Liu, C and Li, W and Qiao, K and Yang, L and Ye, C and Huang, J and Xu, Y and Zhang, J and Sun, Y and Lai, X and Liu, B and Qian, W and Li, X and Yu, H and Yang, X and Hu, Z and Lu, H and , }, title = {Chinese expert consensus on the combined use of antiviral drugs for novel coronavirus infection.}, journal = {Bioscience trends}, volume = {19}, number = {5}, pages = {484-494}, doi = {10.5582/bst.2025.01244}, pmid = {40866234}, issn = {1881-7823}, mesh = {Humans ; *Antiviral Agents/therapeutic use/administration &amp; dosage ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; China ; Drug Therapy, Combination ; Ritonavir/therapeutic use ; Consensus ; COVID-19 ; East Asian People ; }, abstract = {The persistent mutation of the novel coronavirus (SARS-CoV-2) not only remains a threat to human health but also continues to challenge existing antiviral therapeutic strategies. In current clinical practice, the resistance of novel coronavirus to antivirals, the rebound of viral load after treatment with drugs such as nirmatrelvir/ritonavir (NTV/r), and the urgent need for rapid clearance of the virus in the management of critically and emergently ill patients suggest that the existing single-drug regimens may have limitations and that the intensity of suppression may be insufficient in some cases. In clinical practice, we have observed that a combination of antivirals with different mechanisms of action can result in better efficacy and not significantly increase adverse drug reactions (ADRs). For some immunosuppressed, post-transplantation, or other special patients in particular, such as those in whom COVID-19 nucleic acids tended not to be negative after conventional treatment, when virus clearance is still the main goal, the combination of small-molecule antivirals can help to clear the virus as early as possible and attempt to improve the success rate of salvage. Based on evidence-based medicine and in light of the current situation of China, we assembled experts from disciplines such as infectious diseases, respiratory medicine, critical care medicine, and clinical pharmacy into a group to carry out a systematic literature search and identify key issues and to put forward relevant recommendations to reach an Expert Consensus on Combined Use of Oral Small-molecule Antivirals to Treat COVID-19, which is intended to serve as a reference for clinical practice.}, }
@article {pmid40850755, year = {2025}, author = {Chen, G and Lu, H}, title = {Expert consensus on combination antiviral therapy for high-risk COVID-19 patients: A timely call to action.}, journal = {Bioscience trends}, volume = {19}, number = {5}, pages = {479-483}, doi = {10.5582/bst.2025.01254}, pmid = {40850755}, issn = {1881-7823}, mesh = {Humans ; *Antiviral Agents/therapeutic use/administration &amp; dosage ; *COVID-19 Drug Treatment ; Consensus ; COVID-19 ; SARS-CoV-2 ; Drug Therapy, Combination ; China/epidemiology ; }, abstract = {On May 5, 2023, the WHO declared that the COVID-19 pandemic no longer constitutes a public health emergency of international concern (PHEIC), but SARS-CoV-2 continues to spread and evolve on a global scale. The WHO reported that COVID-19 still poses a threat to humanity, and especially in some areas with large numbers of infected people. For some high-risk COVID-19 patients, such as those with underlying conditions, elderly patients, patients who need long-term immunosuppressive therapy after organ transplantation, patients with immunosuppressive diseases, patients who tend not to test negative for SARS-CoV-2 despite standard antiviral therapy, and cancer patients, special attention is still required after infection with SARS-CoV-2. How to clear SARS-CoV-2 in a timely manner is the key to treating such patients. Based on the demands of clinical practice and medical evidence, the National Center for Infectious Diseases of China assembled experts from relevant disciplines to reach the Chinese expert consensus on the combined use of antivirals to treat COVID-19, providing timely suggestions to resolve the medication issues that have been plaguing clinical practice. The consensus suggests that for special patients, combined medication can promptly eliminate the virus without increasing the risk to patient safety.}, }
@article {pmid40205292, year = {2025}, author = {Unni, EJ and Schougaard, LMV and Aiyegbusi, OL and Mate, KKV and Austin, EJ and Greffin, K and Roberts, N and Grove, BE and Muehlan, H and , }, title = {Expert consensus on implementing patient-reported outcomes in telehealth: findings from an international Delphi study.}, journal = {Journal of patient-reported outcomes}, volume = {9}, number = {1}, pages = {40}, pmid = {40205292}, issn = {2509-8020}, mesh = {Humans ; *Telemedicine ; Delphi Technique ; *Patient Reported Outcome Measures ; Consensus ; *COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: Using Patient Reported Outcomes (PROs) in clinical care can reduce healthcare service utilization by improving the quality of care. Telehealth, defined by WHO, as the use of "telecommunications and virtual technology to deliver healthcare outside of traditional healthcare facilities", can facilitate a dynamic dialogue between patients and healthcare providers for timely interventions. With the increased use of telehealth facilitated by the infrastructure development during the COVID-19 pandemic, there is an opportunity to utilize telehealth for PRO implementation and a need for guidelines for using PROs via telehealth. This study aimed to generate expert consensus on the utilization of PROs in telehealth.<br><br>METHODS: Delphi methodology was used to achieve consensus among international experts with a predetermined consensus threshold of 70%. Experts were mainly identified through the ISOQOL Clinical Practice SIG. Surveys asked a combination of structured and open-ended questions about the conceptualization of PROs in telehealth, its applicability, target population, implementation challenges and successful strategies, evaluation approaches, and the essential stakeholders. Data from each round were iteratively analyzed using descriptive statistics (quantitative data) and content analysis (qualitative data).<br><br>RESULTS: Out of 24 invitations sent, 17 completed the first round, and 11 completed all three rounds. Respondents were equally distributed between clinicians and researchers and 70% had used PROs via telehealth before the pandemic. Consensus was achieved and some of the relevant aspects are monitoring patients for applicability; individuals with chronic diseases as the target population; resources, staff buy-in, and clinical workflow as the implementation challenges and strategies; utilization metrics for evaluation; and clinicians and patients as essential stakeholders. Though consensus was not reached for the conceptualization of PROs using telehealth, the modified FDA definition of telehealth with the addition of its purpose, and the mode of administration was the most acceptable version. See attached table.<br><br>CONCLUSION: The expert consensus achieved provides important insights from an international perspective on how PROs are currently used via telehealth and the needed implementation support to advance their expansion in research and practice. Lack of consensus on the definition of PROs in telehealth signals the continued rapid evolution of their use and the need for additional research.}, }
@article {pmid40108925, year = {2025}, author = {Sinha, V and Roy, S and Shinde, S and Mondal, D and Dixit, V and Dwivedi, D and Pandey, SK and Gupta, RK and Vishwakarma, NK and Shukla, D}, title = {Navigating Cardiovascular Challenges of Obesity: Exploring Preventive Approaches.}, journal = {Endocrine, metabolic &amp; immune disorders drug targets}, volume = {25}, number = {12}, pages = {918-940}, pmid = {40108925}, issn = {2212-3873}, mesh = {Humans ; *Obesity/epidemiology/therapy/complications ; *Cardiovascular Diseases/prevention &amp; control/epidemiology/etiology ; *COVID-19/epidemiology/prevention &amp; control ; SARS-CoV-2 ; Risk Factors ; Life Style ; }, abstract = {The global prevalence of obesity has surged to epidemic proportions, posing a significant threat to public health in the twenty-first century. Beyond its established association with metabolic diseases, obesity profoundly impacts cardiovascular health, serving as a major risk factor for various cardiovascular illnesses (CVDs), including coronary artery disease, heart failure, hypertension, and stroke. Mechanistically, obesity triggers a cascade of pathophysiological processes, including chronic inflammation and insulin resistance, exacerbating atherosclerosis and endothelial dysfunction. Moreover, obesity correlates with metabolic abnormalities that further elevate the risk of cardiovascular events. As global community has faced the COVID-19 pandemic, and thus, the aftereffects of the pandemic might pose a spectrum of post-viral complications, including cardiovascular sequelae such as myocarditis and arrhythmias. Considering the intersectionality of obesity, COVID-19, and cardiovascular health are imperative, particularly as obese individuals face heightened risks of severe post-COVID-19 effects and subsequent cardiovascular complications. Lifestyle management emerges as a cornerstone in preventing and managing obesity-related cardiovascular risks, encompassing dietary modifications, physical activity, behavioural therapies, and patient education. Embracing innovative approaches, including modulation of gut microbiota and novel drug developments, holds promise in addressing the intricate nexus between obesity and cardiovascular diseases. This review underscores the paramount importance of lifestyle interventions over pharmacological measures, advocating for a comprehensive approach involving healthcare practitioners, researchers, and policymakers to mitigate the long-term cardiovascular consequences of obesity and COVID-19.}, }
@article {pmid40059678, year = {2025}, author = {,  and ,  and , }, title = {[Chinese expert consensus on prevention and treatment of immunotherapeutic and molecular targeted agents-related infections in patients with hematological malignancies (2025)].}, journal = {Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi}, volume = {46}, number = {1}, pages = {18-30}, pmid = {40059678}, issn = {0253-2727}, mesh = {Humans ; Consensus ; COVID-19/prevention &amp; control ; Evidence-Based Medicine ; *Hematologic Neoplasms/therapy/drug therapy/complications ; *Immunotherapy ; *Molecular Targeted Therapy/adverse effects ; SARS-CoV-2 ; China ; East Asian People ; }, abstract = {As novel therapeutic agents continue to emerge, immunotherapy and molecular-targeted drugs demonstrate expanding application prospects in hematological malignancy treatment. This expert consensus revision incorporates the latest evidence-based medicine from domestic and international sources, updating recommendations for infection diagnosis, prevention, and treatment. The document integrates recommendations for recently launched or imminent antibodies and small molecule targeted compounds, including COVID-19 considerations. This format of recommendations is modified according to the levels of evidence of The Oxford Centre for Evidence-Based Medicine (CEBM).}, }
@article {pmid39865009, year = {2025}, author = {, }, title = {[Expert consensus on flow cytometry-based assays for SARS-CoV-2-specific T cells and related operating procedure].}, journal = {Zhonghua yi xue za zhi}, volume = {105}, number = {4}, pages = {261-270}, doi = {10.3760/cma.j.cn112137-20240923-02164}, pmid = {39865009}, issn = {0376-2491}, support = {EKPG21-30-3//Emergency Key Program of Guangzhou Laboratory/ ; }, mesh = {Humans ; *Flow Cytometry/methods ; *SARS-CoV-2/immunology ; Consensus ; COVID-19/immunology ; *T-Lymphocytes/immunology ; }, abstract = {T-cell immune response is an important component of antiviral immunity, it is of great significance to determine their absolute counts, relative frequencies and functionalities for evaluating protective immunity in individuals and population. However, there is a lack of guidelines or a consensus on assays for antigen-specific T cells. It is necessary to evaluate the SARS-CoV-2-specific T cells in population during and after COVID-19 epidemic. To standardize the detection method for SARS-CoV-2-specific T cells, the Chinese Society for Immunology organized experts and reached a consensus on the detection method, biomarker combination scheme, technical points of SOP, quality control, data analysis and interpretation of results, personnel training, etc. The consensus is of guiding significance to establish standard detection methods and operating procedures for SARS-CoV-2-specific T cells, which is beneficial for the consistency and comparability of results from different laboratories, and also provides reference for antigen-specific T cell standard detection methods for other pathogens (such as influenza) infection.}, }
@article {pmid39757093, year = {2025}, author = {, }, title = {[Chinese expert consensus on the diagnosis and treatment of pneumonia in the elderly (2024 Edition)].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {48}, number = {1}, pages = {18-34}, doi = {10.3760/cma.j.cn112147-20240611-00328}, pmid = {39757093}, issn = {1001-0939}, support = {2023YFC0872500//National Key Research and Development Program Sponsored by the Ministry of Science and Technology of the People's Republic of China/ ; 2022YFC2303200//National Key Research and Development Program Sponsored by the Ministry of Science and Technology of the People's Republic of China/ ; }, mesh = {Humans ; *Pneumonia/diagnosis/therapy ; Aged ; China/epidemiology ; *Consensus ; Quality of Life ; East Asian People ; }, abstract = {China is experiencing a demographic shift as its population ages. The elderly population becomes increasingly susceptible to pneumonia. Pneumonia in the elderly is characterized by its insidious onset, rapid progression, multiple comorbidities, poor prognosis, and high morbidity and mortality. Physicians need to pay attention to developing more comprehensive diagnostic evaluations and treatment strategies, and ensuring personalized care to the greatest extent. In order to improve the prevention and management of pneumonia in elderly, this consensus incorporates the latest guidelines and consensus from both domestic and international sources. The latest progress in this research field is also included. The document addresses 17 clinical issues in a question-and-answer format and provides 13 recommendations on the etiology, pathogenesis, clinical diagnosis, treatment, and prevention of pneumonia in older adults. It provides reference for the prevention and treatment of pneumonia in elderly, improving their quality of life, reducing hospitalization and mortality, and promoting healthy aging. The specific recommendations are as follows.Recommendation 1:The main risk factors for pneumonia in the elderly include age (Recommended Level ⅠA), age-related systemic factors (such as poor physical condition, underlying diseases, and concomitant medications), and specific factors (specifically dysphagia and aspiration). The risk increases progressively with age (Recommended Level Ⅱ-1A).Recommendation 2:Pneumonia in elderly individuals often presents with an insidious onset and atypical respiratory symptoms, especially in super-elderly patients. Initially, symptoms may include fatigue, loss of appetite, and disturbance of consciousness. Moreover, elderly patients often have underlying conditions such as pulmonary, cardiovascular, and neurological disorders, which can lead to rapid deterioration, multiple complications and sequelae. Pneumonia-related laboratory parameters in the elderly lack typical characteristic changes (Recommended Level ⅢA). The high proportion of comorbidities significantly increases the risk of pneumonia, especially pneumonia caused by drug-resistant bacteria, and the likelihood of a worse prognosis in elderly patients (Recommended Level Ⅱ-2A). Neurological or psychiatric disorders and therapeutic drugs such as antipsychotic drugs increase the risk of pneumonia including aspiration pneumonia, necrotizing pneumonia, lung abscess, hypostatic pneumonia and atelectasis in elderly patients (Recommended Level Ⅱ-2B).Recommendation 3:For elderly patients with suspected pneumonia, chest CT should be performed as early as possible in cases of long-term bed-ridden patients, aspiration pneumonia, or viral pneumonia (Recommended Level ⅢA). If conventional tests fails to identify the pathogen and empirical treatment proves to be ineffective, or if special pathogen infection such as viruses, severe or complex infection, or immunosuppression is suspected, it is advised to use invasive procedures to obtain bronchoalveolar lavage fluid (BALF), pleural effusion, or lung biopsy, and to conduct molecular biology testing (PCR, mNGS, tNGS, etc.) concurrently with conventional pathogen tests (Recommended Level ⅢA).Recommendation 4:The pharmacokinetics (PK) changes of antimicrobial drugs in elderly patients and necessity of dosage reduction should be evaluated according to the unique physiological characteristics of the elderly, such as declining body function, the presence of multiple diseases, and potential medication interactions. It is recommended to combine the PK/PD characteristics of antimicrobial drugs and therapeutic drug monitoring (TDM) methods to guide the individualized and precise prescription for elderly patients with pneumonia. This approach aims to ensure efficacy, minimizing the risk of bacterial resistance, and reduce the incidence of adverse reactions (Recommended Level Ⅱ-2B).Recommendation 5:Timing of treatment: Empiric antimicrobial therapy should be initiated as soon as the diagnosis is made. Except for outpatient clinic visitors with mild symptoms, properly collected respiratory secretions and blood samples should be sent without delay for pathogenic microorganisms testing. During the influenza season, timely empiric antiviral therapy should be initiated without positive result (Recommended Level Ⅱ-1A).Recommendation 6:Coverage of possible pathogens: Due to the increased detection rate of various pathogens such as gram-negative bacteria, anaerobic bacteria, fungi, etc., the initial treatment should cover the possible pathogens. Individualized treatment should be started according to the estimation of drug resistance risk, the of PK/PD principle, and potential drug side effects (Recommended Level Ⅱ-1A).Recommendation 7:Appropriate treatments for promoting sputum drainage and airway clearance in elderly pneumonia patients should be chosen after a comprehensive evaluation of the patient's condition. It is crucial to assess the patient's coughing efficacy to avoid asphyxia (Recommended Level ⅢA).Recommendation 8:We recommend cautious use of glucocorticoids in elderly pneumonia patients. When it is indeed necessary to use glucocorticoids in severe pneumonia cases accompanied by septic shock and hemodynamic instability, it's crucial to tailor drug regimens carefully, monitor closely for adverse reactions, and avoid excessive or prolonged glucocorticoid use (Recommended Level ⅢB).Recommendation 9:Assessing the swallowing abilities of elderly patients is important, and individuals with dysphagia should undergo swallowing rehabilitation. These measures can help reduce the risk of aspiration pneumonia, such as adopting a semi-recumbent posture, thickened fluids and soft foods, proper dental care, tube feeding, and discontinuing medications that increase the risk of aspiration pneumonia in older patients (Recommended Level ⅡA).Recommendation 10:We recommend that elderly individuals get an annual influenza virus vaccine (Recommended Level ⅠA), 23-valent pneumococcal polysaccharide vaccine (PPV 23) or the 13-valent pneumococcal conjugate vaccine (PCV 13) to prevent CAP (Recommended Level ⅠB), and COVID-19 vaccine should also be recommended in accordance with national guidelines (Recommended Level ⅠA).Recommendation 11:Older individuals should quit smoking, limit alcohol intake, participate in moderate-intensity physical activity (Recommended Level Ⅱ-1A), have regular dental examinations, maintain good nutritional status and personal hygiene, and avoid close contact with children with acute viral respiratory infections (Recommended Level Ⅱ-2A).Recommendation 12:The super-elderly are more likely to experience geriatric syndromes, particularly sarcopenia and frailty, which are closely associated with the occurrence of aspiration pneumonia. Preventing and improving sarcopenia and weakness through nutrition supplement, exercise, cognitive training, etc., can effectively reduce the incidence of pneumonia (Recommended Level ⅢA).Recommendation 13:We recommend that older adults with chronic underlying medical conditions, who are at increased risk of developing pneumonia, should receive personalized management and comprehensive preventive measures to strengthen the management of underlying diseases. Perioperative care for older patients should be optimized to reduce the risk of postoperative pneumonia (Recommended Level ⅢA).}, }
@article {pmid38832476, year = {2024}, author = {Kang, CR and Ahn, B and Choe, YJ and Lim, SY and Kim, HW and Kang, HM and Park, JY and Lee, H and Lee, S and Jeong, S and Kwon, S and Choi, EH}, title = {Expert Consensus on the Structure, Role, and Procedures of the Korea Expert Committee on Immunization Practices.}, journal = {Journal of Korean medical science}, volume = {39}, number = {21}, pages = {e166}, pmid = {38832476}, issn = {1598-6357}, support = {2023-10-019/KDCA/Korea Disease Control and Prevention Agency/Korea ; }, mesh = {Humans ; Republic of Korea ; *COVID-19/prevention &amp; control ; Surveys and Questionnaires ; *Consensus ; Immunization ; Advisory Committees ; SARS-CoV-2 ; Health Policy ; COVID-19 Vaccines ; }, abstract = {BACKGROUND: The Korea Expert Committee on Immunization Practices (KECIP) is a key advisory body the government to develop guidelines and provide technical advisory activities on immunization policies in Korea. A recent policy study, inspired by global best practices, aims to enhance KECIP's functionality for providing timely and transparent recommendations in the face of evolving vaccine science and emerging infectious diseases like COVID-19.<br><br>METHODS: This study reviewed the current status of KECIP and collected expert opinions through surveys and consultations. Among the 40 panel members who were surveyed, 19 responded to a questionnaire specifically designed to assess the potential areas of improvement within KECIP.<br><br>RESULTS: The majority of respondents favored maintaining the current member count and emphasized the need for a subcommittee. Opinions varied on issues such as the length of KECIP's term, the representation of vaccine manufacturers' perspectives, and the chairperson's role. However, there was a consensus on the importance of expertise, transparency, and fair proceedings within the committee.<br><br>CONCLUSION: This study underscores the pivotal role of KECIP in shaping national immunization policies, emphasizing the necessity for informed guidance amidst evolving vaccine science and emerging infectious diseases. Furthermore, it stressed the importance of enhancing KECIP's capacity to effectively address evolving public health challenges and maintain successful immunization programs in South Korea.}, }
@article {pmid38782749, year = {2024}, author = {,  and ,  and , }, title = {[Expert consensus on the clinical application of oral small-molecule antiviral drugs against COVID-19].}, journal = {Zhonghua yi xue za zhi}, volume = {104}, number = {20}, pages = {1812-1824}, doi = {10.3760/cma.j.cn112137-20240124-00177}, pmid = {38782749}, issn = {0376-2491}, support = {EKPG21-06//Emergency Key Program of Guangzhou Laboratory/ ; 0022/2021/A1//the Macao Science and Technology Development Fund/ ; 2021TQ060189//the Young Top Talent of Science and Technology Innovation Department of Guangdong Province/ ; ZYYCXTU-D-202201//National Administration of Traditional Chinese Medicine's Interdisciplinary Innovation Team Project/ ; }, mesh = {*Antiviral Agents/therapeutic use ; Humans ; *COVID-19 ; *SARS-CoV-2 ; *Pandemics ; Pneumonia, Viral/drug therapy ; COVID-19 Drug Treatment ; Coronavirus Infections/drug therapy ; Consensus ; Betacoronavirus ; Administration, Oral ; China ; Pregnancy ; }, abstract = {Although COVID-19 no longer constitutes a "public health emergency of international concern", which still has being spreading around the world at a low level. Small molecule drugs are the main antiviral treatment for novel coronavirus recommended in China. Although a variety of small-molecule antiviral drugs against COVID-19 have been listed in China, there is no specific drug recommendation for special populations. Society of Bacterial Infection and Resistance of Chinese Medical Association, together with the National Clinical Research Center for Respiratory Disease, and the National Center for Respiratory Medicine, organized domestic experts in various fields such as respiratory, virology, infection, critical care, emergency medicine and pharmacy to release Expert Consensus on the Clinical Application of Oral Small-Molecule Antiviral Drugs against COVID-19. The main content of this consensus includes the introduction of seven small-molecule antiviral drugs against COVID-19, focusing on the drug recommendations for 14 special groups such as the elderly, patients with complicated chronic diseases, tumor patients, pregnant women, and children, and providing suggestions for clinicians to standardize drug use.}, }
@article {pmid38228543, year = {2024}, author = {,  and ,  and , }, title = {[Expert consensus on vaccinations in adult patients with autoimmune rheumatic diseases in China (2023 Edition)].}, journal = {Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine]}, volume = {58}, number = {1}, pages = {1-10}, doi = {10.3760/cma.j.cn112150-20231018-00274}, pmid = {38228543}, issn = {0253-9624}, mesh = {Adult ; Humans ; COVID-19 Vaccines ; Consensus ; Quality of Life ; Vaccination ; *Influenza Vaccines ; *Rheumatic Diseases ; *Respiratory Distress Syndrome ; }, abstract = {Vaccination is one of the critical tools to prevent infections among individuals with autoimmune rheumatic diseases (ARDs), ultimately improving the quality of life and reducing mortality. The incorporation of vaccination strategies into clinical decision-making processes has been recognized as pivotal. However, the absence of clinical guidelines and consensus on vaccination for ARDs patients still persists in China. Drawing from existing clinical evidence, this expert consensus encompasses eight prevalent vaccines: Influenza vaccine, pneumococcal polysaccharide vaccine, COVID-19 vaccine, herpes zoster vaccine, human papillomavirus vaccine, hepatitis A vaccine, hepatitis B vaccine, and rabies virus vaccine. This initiative aims to furnish highly practical technical directives for vaccination personnel and rheumatologists, thereby fostering standardized vaccination practices to combat infectious diseases among adult ARDs patients in China.}, }
@article {pmid38156914, year = {2023}, author = {Wang, J and Shao, L and Liang, J and Wu, Q and Zhu, B and Deng, Q and Liu, Z and Liu, L and Wang, D and Yu, Z and Tan, X and Wang, F and Meng, J and Xu, X and Xia, Z and Li, Z and Wang, H and Wang, L and Wu, W and Xie, Q and Huang, X and Sun, Z and Zhang, Y and Zhou, H and Zhou, H and Yang, W and Ren, H and Liu, Z and Qiao, M and Tang, F and Qi, X and Wu, H and Deng, L and Gao, L and Zhang, H and Chen, P and Zhang, H and Zhang, X and Zhou, J and Chuanqing, TU and Guan, L and Yin, Q and Shu, R and Chen, F and He, M and Wang, Q and Guo, Z and ,  and , }, title = {Chinese expert consensus on the management of patients with hematologic malignancies infected with SARS-CoV-2.}, journal = {Journal of cancer research and therapeutics}, volume = {19}, number = {6}, pages = {1495-1500}, doi = {10.4103/jcrt.JCRT_782_23}, pmid = {38156914}, issn = {1998-4138}, mesh = {Humans ; SARS-CoV-2 ; *COVID-19 ; Consensus ; *Hematologic Neoplasms/complications/therapy ; China/epidemiology ; }, abstract = {In December 2022, the Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became dominant in China due to its high infectivity and lower mortality rate. The risk of critical illness and mortality among patients with hematologic malignancies who contracted SARS-CoV-2 was particularly high. The aim of this study was to draft a consensus to facilitate effective treatments for these patients based on the type and severity of the disease. Following the outbreak of the novel coronavirus in China, a steering committee consisting of experienced hematologists was formed by the Specialized Committee of Oncology and Microecology of the Chinese Anti-Cancer Association. The expert group drafted a consensus on the management and intervention measures for different types of hematologic malignancies based on the clinical characteristics of the Omicron variant of the SARS-CoV-2 infection, along with relevant guidelines and literature. The expert group drafted independent recommendations on several important aspects based on the epidemiology of the Omicron variant in China and the unique vulnerability of patients with hematologic malignancies. These included prophylactic vaccinations for those with hematologic malignancies, the use of plasma from blood donors who recovered from the novel coronavirus infection, the establishment of negative pressure wards, the use of steady-state mobilization of peripheral blood hematopoietic stem cells, the provision of psychological support for patients and medical staff, and a focus on maintaining a healthy intestinal microecology.}, }
@article {pmid38044048, year = {2023}, author = {, }, title = {[Expert consensus on the management of interstitial lung disease during the COVID-19 epidemic].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {46}, number = {12}, pages = {1204-1218}, doi = {10.3760/cma.j.cn112147-20230922-00187}, pmid = {38044048}, issn = {1001-0939}, support = {2022-PUMCH-B-108, 2022-PUMCH-A-130, 2022-PUMCH-C-069//National High Level Hospital Clinical Reseach Funding/ ; }, mesh = {Humans ; *COVID-19 ; *Coinfection ; COVID-19 Vaccines ; Consensus ; *Janus Kinase Inhibitors ; *Lung Diseases, Interstitial/therapy ; Immunosuppressive Agents ; Adrenal Cortex Hormones/therapeutic use ; Receptors, Interleukin-6 ; Biological Factors ; }, abstract = {Coronavirus disease 2019(COVID-19) is prevalent around the world, and pre-existing ILD is associated with increased severity and mortality of COVID-19. However, the current knowledge on the management strategy for COVID-19 patients with pre-existing interstitial lung disease (ILD) is very limited. There is still a need for consensus on treatments for these patients. In addition, ILD that occurs after the acute phase of COVID-19 (Post-acute Covid-19 ILD, PC-ILD) is also very common, and how to manage PC-ILD is also under debate. Therefore, a consensus was established by experts from the related disciplines in the field of ILD based on available scientific evidence and experience of the expert working group. This consensus elucidated 22 practical questions for practicing physicians, such as clinical characteristics, risk factors and treatment of COVID-19 patients with pre-existing ILD and PC-ILD patients. Finally, 15 recommendations were made regarding the diagnosis and management of COVID-19 patients with pre-existing ILD and PC-ILD patients. We hope to assist physicians in making appropriate decisions, thereby improving the management of COVID-19 with pre-existing ILD and PC-ILD.Recommendation 1: It is recommended to differentiate COVID-19 from ILD with acute/subacute onset based on duration, exposure history, symptoms and signs, chest high-resolution CT (HRCT) features, and laboratory tests.Recommendation 2: According to the guidelines on the diagnosis and treatment of new coronavirus pneumonia (version 10) issued by the National Health Commission of China on January 6[th], 2023, we recommended the following disease severity definition and management for the COVID-19 patients with pre-existing ILD.Recommendation 3: ILD is an independent risk factor for severe/critical COVID-19. We recommend antiviral treatment for COVID-19 patients with pre-existing ILD as early as possible after symptoms onset, ideally within 5 days.Recommendation 4: We recommend that the use of systemic corticosteroids in COVID-19 patients with pre-existing ILD who had no indications for corticosteroids therapy should follow the guidelines of COVID-19 for the general population. Those with pre-existing ILD who need to start or are already on systemic corticosteroids are recommended to start or continue corticosteroids if they develop COVID-19. The dose adjustment is based on the severity of COVID-19 with pre-existing ILD: For the patients with severe/critical COVID-19 with pre-existing ILD but no AE-ILD, the use of corticosteroids should follow the guidelines of COVID-19 in the general population; the patients with AE-ILD are recommended to follow the use of corticosteroids in AE-ILD.Recommendation 5: There is no evidence available for the use of interleukin-6 receptor blockers in COVID-19 patients with pre-existing ILD. Recommendations regarding interleukin-6 receptor blockers in COVID-19 patients with pre-existing ILD may follow the guideline of COVID-19 in the general population.Recommendation 6: There is no evidence to support the use of Janus kinase inhibitors in COVID-19 patients with pre-existing ILD. The use of Janus kinase inhibitors in COVID-19 patients with pre-existing ILD is recommended to follow the guideline of COVID-19 in the general population.Recommendation 7: For patients who have not started immunosuppressants/biological agents for pre-existing ILD at the time of COVID-19, delayed initiation of immunosuppressants/biological agents is recommended, if the risk of ILD progression in the short term is low. For patients who are already on immunosuppressants/biological agents, a multidisciplinary discussion with rheumatologists is recommended to weigh the benefits and risks of discontinuing immunosuppressants/biological agents. It is recommended to discontinue immunosuppressants/biological agents for pre-existing ILD in acute phase of COVID-19 unless short-term discontinuation affects control of underlying ILD or connective tissue disease.Recommendation 8: It is recommended that the COVID-19 patients with pre-existing ILD who are on anti-fibrotic medication should continue to take anti-fibrotic medication. For COVID-19 patients with newly diagnosed fibrotic ILD who need to start anti-fibrotic therapy, it is recommended to start anti-fibrotic treatment as early as possible.Recommendation 9: It is recommended to investigate and monitor co-infections and secondary infections in COVID-19 patients with pre-existing ILD, and to promptly prevent and treat co-infections and secondary infections such as bacteria, fungi, Pneumocystis jirovecii, and cytomegalovirus.Recommendation 10: Anticoagulation therapy for the COVID-19 patients with pre-existing ILD is recommended to be used in accordance with guideline of COVID-19 in general population.Recommendation 11: For COVID-19 patients with pre-existing ILD, we recommend follow-up at 4 weeks after recovery (non-hospitalized patients) or 4 weeks after discharge (hospitalized patients), and then the routine monitoring frequency for ILD once stable, i.e. every 3 to 6 months. Pulmonary function testing is a routine investigation. Chest HRCT is suggested when clinically indicated. Arterial blood gas analysis, echocardiography, CT pulmonary angiography, and blood examinations can be selected when necessary.Recommendation 12: Severe/critical COVID-19 survivors are the main target population for rehabilitation intervention. Rehabilitation therapy should be administered individualized.Recommendation 13: Healthcare providers should fully inform patients with pre-existing ILD about the benefits and risks of vaccination, and involve patients in a shared decision-making process to discuss whether or not to receive a COVID-19 vaccine.Recommendation 14: For PC-ILD patients with persistent or progressive respiratory symptoms, persistent interstitial lung abnormalities and lung function impairment following acute COVID-19 pneumonia, may be treated with glucocorticoids after exclusion of other causes such as infection.Recommendation 15: For PC-ILD patients who have recovered from severe/critical COVID-19, anti-fibrotic medications may be administered after discussing disease-and treatment-related factors with patients. The optimal timing and duration of anti-fibrotic treatment are still uncertain. We conditionally recommend against anti-fibrotic medications in patients who have recovered from mild or moderate COVID-19. This recommendation does not apply to patients with pre-existing fibrotic ILD.}, }
@article {pmid37805779, year = {2023}, author = {,  and ,  and , }, title = {[Expert consensus on the clinical treatment of burn patients complicated with Coronavirus infection (2023 version)].}, journal = {Zhonghua shao shang yu chuang mian xiu fu za zhi}, volume = {39}, number = {8}, pages = {701-712}, pmid = {37805779}, issn = {2097-1109}, support = {2021YFA1101100//National Key Research and Development Program of China/ ; cstc2019jcyj-cxttX0001//Innovation Group Science Foundation of Chongqing Natural Science Foundation/ ; }, mesh = {Humans ; Consensus ; *COVID-19 ; Delivery of Health Care ; China ; Burn Units ; }, abstract = {With China downgrading the management of Coronavirus infection (COVID-19) from Category A to Category B, a large number of COVID-19 patients have occurred in multiple waves across the country. Meanwhile, the long-term impact of Coronavirus on the body has gradually been noticed. However, the clinical treatment of burns complicated with COVID-19 is still a major challenge in Chinese burn centers. It is then essential to standardize the clinical treatment of such patients, improve the prognosis to the greatest extent, and provide valuable experiences for similar infectious diseases in future. Therefore, Chinese Burn Association, Burn Medicine Branch of China International Exchange and Promotion Association for Medical and Healthcare, and Editorial Committee of Chinese Journal of Burns and Wounds jointly initiated and organized multidisciplinary experts to develop this expert consensus based on the current medical evidence, clinical practice, and authoritative guidelines of other disciplines, in order to standardize the clinical treatment of burn patients complicated with COVID-19.}, }
@article {pmid37670643, year = {2023}, author = {,  and ,  and ,  and , }, title = {[Expert consensus on the diagnosis and management of Birt-Hogg-Dubé syndrome].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {46}, number = {9}, pages = {897-908}, doi = {10.3760/cma.j.cn112147-20230705-00362}, pmid = {37670643}, issn = {1001-0939}, support = {2022YFC2703901//National Key Reseach and Development Program of China/ ; 2021-I2M-1-003//CAMS Innovation Fund of Medical Sciences/ ; 2021szdzk05//Key Medical and Health Specialty Construction Project of Anhui Province/ ; 2021A1515011352, 2023A1515010308//Natural Science Foundation of Guangdong Province/ ; ZNSA-2020013//Independent Project Funding for Key Projects of Guangzhou Institute of Respiratory Health, Zhongnanshan Medical Foundation of Guangdong Province/ ; }, mesh = {Adult ; Female ; Pregnancy ; Humans ; *Birt-Hogg-Dube Syndrome ; COVID-19 Vaccines ; Consensus ; *Pneumothorax ; Prospective Studies ; *COVID-19 ; SARS-CoV-2 ; *Kidney Neoplasms ; COVID-19 Testing ; }, abstract = {Birt-Hogg-Dubé syndrome (BHD) is a rare autosomal dominant disorder characterized by diffuse pulmonary cysts often leading to recurrent spontaneous pneumothorax, cutaneous fibrofolliculomas or trichodiscomas, and a variety of renal cell cancers. It is caused by pathogenic variants in the FLCN gene located on chromosome 17p11.2. Although an increasing number of patients with BHD syndrome are being recognized in China, the missed diagnosis and delayed diagnosis are still common. In addition, appropriate management is difficult for most of them. Pulmonary cysts and pneumothorax are the main presenting features, but skin and renal lesions appear to be less common in Chinese subjects than those reported from European and American countries. Therefore, the consensus is established by experts from the related disciplines to improve the diagnosis and management of BHD syndrome. This consensus consists of 15 recommendations related to BHD syndrome, including clinical assessments, diagnosis, differential diagnosis, treatment, follow-up, and family management. In particular, it provides revised diagnostic criteria based on the Chinese situation. We hope to promote scientific and clinical progress in this rare disease and improve the prognosis of the patients.Summary of recommendations[Recommendation 1] The folliculin (FLCN) gene is currently the only affirmative causative gene for Birt-Hogg-Dubé (BHD) syndrome, and the pedigree analysis of genetic testing of family members' samples can assist in the rapid identification of causative gene variants. The genetic testing methods, including Sanger sequencing, Multiplex Ligation-dependent Probe Amplification (MLPA), and Next-Generation Sequencing (NGS), can be chosen based on individual patient's care needs. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 2] Patients with BHD syndrome should undergo chest CT scan to evaluate cystic lesions in the lungs, and routine evaluation of the kidneys for tumor foci, using ultrasound, enhanced CT, or MR as appropriate. (43 experts voted; 43 in favor, 0 against, 0 abstention).[Recommendation 3] Clinicians should establish a diagnosis based on the appropriate clinical presentation and in conjunction with genetic test results and/or a family history of BHD syndrome. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 4] Lung histopathological biopsy is not recommended as the first choice for patients with suspected BHD syndrome based on clinical and pulmonary imaging manifestations. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 5] BHD syndrome should be particularly distinguished from other diffuse cystic lung diseases, such as lymphangioleiomyomatosis (LAM), lymphocyte interstitial pneumonia (LIP), pulmonary Langerhans cell histiocytosis (PLCH), etc. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 6] BHD syndrome is clinically rare and often involves multiple disciplines, such as respiratory and critical care medicine, radiology, pathology, thoracic surgery, urology, genetics, and dermatology, and multidisciplinary discussions are recommended to improve the diagnosis of BHD syndrome. (43 voting experts; 43 in favor, 0 against, 0 abstentions).[Recommendation 7] Patients with BHD syndrome should avoid smoking, and are recommended to be vaccinated with influenza, pneumococcal, and SARS-Cov-2 vaccines to prevent infections. (43 voting experts; 43 in favor, 0 against, 0 abstentions).[Recommendation 8] Air travel is not recommended for patients with BHD syndrome who have experienced pneumothorax until it has been recovered. (43 voting experts; 42 in favor, 0 against, 1 abstention).[Recommendation 9] In patients with BHD syndrome complicated by pneumothorax, early pleurodesis is recommended to reduce the risk of recurrence. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 10] Observation or topical treatment may be chosen for patients with BHD syndrome complicated by fibrofolliculoma or trichodiscoma. (43 voting experts; 42 in favor, 0 against, 1 abstention).[Recommendation 11] For patients with BHD syndrome complicated by renal tumors, annual abdominal MR examination is recommended when tumors are <1 cm in diameter; when tumors are 1-3 cm in diameter, abdominal MR examination at every 6 months or ablation surgery is recommended; when renal tumors are >3 cm in diameter, local excision of renal tumors with preservation of renal function is recommended. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 12] Patients with BHD syndrome are associated with significantly increased risks of kidney cancer, and routine screenings of kidney cancer during their lifetime are recommended. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 13] Couples with BHD syndrome are advised to undergo prenatal genetic counseling when preparing for pregnancy, to work with a prenatal diagnostician to assess genetic risk, and to discuss the feasibility of prenatal diagnosis during pregnancy. (43 experts voted; 43 in favor, 0 against, 0 abstention).[Recommendation 14] Family members of patients with BHD syndrome should receive health education, and FLCN gene testing is recommended for asymptomatic adults to rule out BHD syndrome in a timely manner. (43 voting experts; 43 in favor, 0 against, 0 abstention).[Recommendation 15] Improvements in the clinical diagnosis and treatment of BHD syndrome and overall management are needed. Due to the scarcity of effective therapeutic drugs, multicenter, prospective clinical trials are recommended. (43 experts voted; 43 in favor, 0 against, 0 abstention).}, }
@article {pmid37466079, year = {2023}, author = {Tyo, MB and McCurry, MK}, title = {e-Delphi Study: Expert Consensus on the Needs and Resources Available to Family Caregivers of Individuals with Substance Use Disorder.}, journal = {Substance use &amp; misuse}, volume = {58}, number = {12}, pages = {1560-1573}, doi = {10.1080/10826084.2023.2236203}, pmid = {37466079}, issn = {1532-2491}, mesh = {Humans ; Caregivers ; Consensus ; Delphi Technique ; Pandemics ; *COVID-19 ; *Substance-Related Disorders/therapy ; }, abstract = {Family caregivers of individuals with substance use disorder (SUD) experience a significant burden and have few evidence-based resources available. To obtain a consensus of expert views on the needs, and resources available, to family caregivers of individuals with SUD given the COVID-19 pandemic and other sociopolitical factors. Quantitative design using the Classic e-Delphi method of multiple iterations of questioning to reach a consensus among expert panelists. Purposive sampling was used to recruit a multidisciplinary, nationwide panel of SUD experts from professional contacts, professional organization list servers, websites relevant to support groups for family caregivers, flyers, and word of mouth. In round 1 panelists (n = 96) responded to open-ended questions about the support provided to family caregivers, and the additional needs of family caregivers. In subsequent rounds, the panel rated collated responses in terms of agreement (n = 54) and importance (n = 48). Thematic content analysis identified ten needs in the resources available to family caregivers. Consensus was obtained across thematic categories and the remaining items were ranked according to importance. Participatory-based SUD research that includes the expertise of healthcare providers, support leaders, and family caregivers is necessary to develop evidence-based interventions to increase caregiver resilience and facilitate coping. Several clear conclusions that address social and structural determinants of health emerged, including the need for increased access to healthcare and community services, more self-care strategies for families, and focused public advocacy to reduce SUD-related stigma.}, }
@article {pmid37438079, year = {2023}, author = {,  and ,  and , }, title = {[Expert Consensus on the prevention and treatment of indolent B-cell non-Hodgkin lymphoma with novel coronavirus infection].}, journal = {Zhonghua yi xue za zhi}, volume = {103}, number = {26}, pages = {1980-1985}, pmid = {37438079}, issn = {0376-2491}, mesh = {Humans ; *COVID-19 ; COVID-19 Vaccines ; Consensus ; SARS-CoV-2 ; *Lymphoma, B-Cell/therapy ; *Lymphoma, Non-Hodgkin/therapy ; }, abstract = {Indolent B-cell non-Hodgkin lymphoma (B-iNHL) is a group of mature B-cell lymphomas that develop slowly. It is characterized by low immune function and could be risky when complicated with novel coronavirus infection (COVID-19). In order to guide the prevention and treatment of B-iNHL combined with COVID-19, China Anti-Cancer Association Hematological malignancies Committee, the Chinese Society of Hematology Medical Association and Chinese Chronic lymphoproliferative Diseases Working Group formed consensus on COVID-19 vaccination, prognosis, treatment and follow-up of B-iNHL patients for clinician reference.}, }
@article {pmid37035881, year = {2023}, author = {,  and , }, title = {Expert Consensus on Prevention and Treatment of COVID-19 Infection in Patients with Lung Cancer.}, journal = {Zhongguo fei ai za zhi = Chinese journal of lung cancer}, volume = {26}, number = {3}, pages = {165-176}, pmid = {37035881}, issn = {1999-6187}, mesh = {Humans ; *COVID-19 ; SARS-CoV-2 ; *Lung Neoplasms/complications/drug therapy ; Consensus ; Vaccination ; China/epidemiology ; }, abstract = {Corona virus disease 2019 (COVID-19) infection has become a major public health issue affecting human health. The main goal of epidemic prevention and control at the current stage in China is to "protect people's health and prevent severe cases". Patients with lung cancer who receive antitumor therapy have low immunity, and the risk of severe illness and death once infected is much higher than healthy people, so they are vulnerable to COVID-19 infection. At present, less attention has been paid to the prevention and treatment of COVID-19 infection in patients with lung cancer in domestic guidelines and consensus. Based on the published data in China and abroad, we proposed recommendations and formed expert consensus on the vaccination of COVID-19, the use of neutralizing antibodies and small molecule antiviral drugs for patients with lung cancer, for physician's reference.}, }
@article {pmid35353681, year = {2022}, author = {Carrasco-Sánchez, FJ and Carretero-Anibarro, E and Gargallo, M&#xc1; and Gómez-Huelgas, R and Merino-Torres, JF and Orozco-Beltrán, D and Pines Corrales, PJ and Ruiz Quintero, MA}, title = {Executive Summary from Expert consensus on effectiveness and safety of iDPP-4 in the treatment of patients with diabetes and COVID-19.}, journal = {Endocrinologia, diabetes y nutricion}, volume = {69}, number = {3}, pages = {209-218}, pmid = {35353681}, issn = {2530-0180}, mesh = {Humans ; *COVID-19 ; *Diabetes Mellitus, Type 2/complications/drug therapy ; *Dipeptidyl-Peptidase IV Inhibitors/pharmacology/therapeutic use ; Pandemics ; }, abstract = {BACKGROUND: This consensus aims to clarify the role of Dipeptidyl Peptidase-4 inhibitors (iDPP-4) in managing patients with diabetes during the COVID-19 pandemic.<br><br>MATERIALS AND METHODS: A PubMed bibliographic search was carried out (December 2019-February 2021). Oxford methodology was used for the evaluation of evidence and possible recommendations were established by consensus.<br><br>RESULTS: Diabetes appears to be an independent factor in COVID-19 disease (evidence 2b). No increased risk of contagion with iDPP-4 is demonstrated (evidence 2b), and its use has been shown to be safe (evidence 2b). The use of this drug may present a specific benefit in reducing mortality, particularly in in-hospital use (evidence 2a), reducing admission to intensive care units (evidence 2b) and the need for mechanical ventilation (evidence 2b).<br><br>CONCLUSIONS: The use of iDPP-4 appears to be safe in patients with COVID-19, and quality studies are needed to clarify their possible advantages further.}, }
@article {pmid41368508, year = {2025}, author = {Kim, CG}, title = {Hospice and Palliative Care Response Policy During the Coronavirus Disease 2019 (COVID-19) Pandemic in South Korea.}, journal = {Journal of hospice and palliative care}, volume = {28}, number = {4}, pages = {138-151}, doi = {10.14475/jhpc.2025.28.4.138}, pmid = {41368508}, issn = {2765-3080}, abstract = {South Korea received international acclaim for its rapid response to the initial coronavirus disease 2019 (COVID-19) pandemic crisis through the "K-Quarantine" model, successfully managing it without closing its borders; however, terminally ill patients awaiting death in 19 public hospice facilities (83.4%/297 beds) had to vacate their beds to accommodate patients with COVID-19. This study examines and analyzed South Korea's hospice response policies during the pandemic. It draws on empirical data from domestic and international literature reviews and relevant websites. This study aimed to provide foundational data and policy recommendations for future pandemic preparedness. The findings revealed that, owing to the national response policy focused on infectious disease control and hospital bed allocation, 21 of the 88 inpatient hospice units in South Korea were closed, with their beds repurposed Therefore, hospice palliative care services became a "negotiable service" largely excluded from pandemic response policies. Strict visitation policies lowered hospice service utilization and disrupted service continuity. Emergency care support helped to mitigate care gaps; however, hospice care was limited in addressing patients' specialized needs, demonstrating structural fragmentation within the health and welfare systems. In conclusion, South Korea's hospice and palliative care response policy to the COVID-19 pandemic has failed to meet the essential goal of hospice palliative care: enhancing patient dignity and quality of life. To strengthen preparedness for future pandemics, designating specialized hospice institutions as essential health facilities, establishing infrastructure stabilization funds, developing a crisis-responsive payment systems, are essential.}, }
@article {pmid41368135, year = {2025}, author = {Folorunsho, EF and Malabu, UH and Anderson, E and Malau-Aduli, BS}, title = {A Systematic Review of Emotional, Cognitive, and Logistical Factors Influencing Simulated Patient Performance in Simulation-Based Education.}, journal = {Advances in medical education and practice}, volume = {16}, number = {}, pages = {2229-2247}, doi = {10.2147/AMEP.S548904}, pmid = {41368135}, issn = {1179-7258}, abstract = {PURPOSE: Simulated patients (SPs) are critical to simulation-based education (SBE) in developing learners' clinical, communication, and professional skills. However, limited research has examined the factors influencing SP performance and consequent learning outcomes.<br><br>PATIENTS AND METHODS: We conducted a systematic review (2013-2025) using six databases, focusing on human SPs in healthcare education. Nineteen studies met the inclusion criteria and were analyzed using inductive thematic analysis. Study quality was assessed using the QATSDD tool.<br><br>RESULTS: Inductive thematic analysis identified three key domains influencing SP performance: emotional (anxiety, fulfillment), cognitive (task complexity, improvisation), and logistical (training, scheduling). SP involvement enhanced educational outcomes (empathy, communication, clinical reasoning) but was sometimes limited by SP fatigue, stress, or cognitive overload. Among the reviewed studies, 7 were high and 12 were of medium quality (no low-quality studies).<br><br>CONCLUSION: Authentic SP portrayals enhance student learning, but factors such as emotional strain and cognitive load can limit effectiveness. We recommend structured SP training, robust feedback mechanisms, and attention to SP cognitive and cultural challenges. Future research should prioritize long-term SP outcomes, measurement of SP cognitive load, and exploration of ethical and cultural dimensions of SP engagement.}, }
@article {pmid41366790, year = {2025}, author = {Razi-Soofiyani, S and Saadat, YR and Vahed, SZ and Saghaleini, SH and Nakhjavani, MJ and Abediazar, S}, title = {Vasculitis syndromes: the pathogenic roles of COVID-19 and related vaccinations.}, journal = {Virology journal}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12985-025-03032-x}, pmid = {41366790}, issn = {1743-422X}, support = {77930//Tabriz University of Medical Sciences/ ; }, abstract = {Infection by SARS-CoV-2 has contributed to more than four million deaths worldwide. Based on clinical observations, it has been revealed that the virus can easily disturb the function of various organs in the body. Besides its main damage to the respiratory system, the extra-pulmonary manifestations are deemed to be common in affected patients even after COVID-19 vaccination. COVID-19 has been accompanied by various types of skin manifestations, including varicella-like exanthemas, dengue-like petechial rashes, or urticarial eruptions. However, not only have viral rashes been related to COVID-19, but also other types of skin symptoms that are reminiscent of a vascular disease, such as acro-ischaemic lesions. This literature review aims to provide information on various forms of COVID-19-induced vasculitis and vasculitis following vaccination. It has been hypothesized that various forms of vasculitis can be considered as pathological consequences following SARS-CoV-2 infection. Numerous suggested mechanisms are involved in vasculitis, including the deregulation of the immune system, increased activation of mastocyte, augmented production of proinflammatory cytokines, which in turn lead to indirect endothelial damage, complement system activation, recruitment of neutrophils, and deposition of immune complexes. Based on previous studies, the mRNA-based COVID-19 vaccine is much more implicated in relation to vasculitis. SARS-CoV-2 and COVID-19 vaccination lead to the onset and relapse of different types of vasculitis that should be clinically evaluated by exact monitoring.}, }
@article {pmid41366372, year = {2025}, author = {Alqahtani, MA and Toloo, GS}, title = {Disaster management knowledge, education and training among Saudi paramedics a scoping review.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-025-25218-2}, pmid = {41366372}, issn = {1471-2458}, abstract = {BACKGROUND AND AIM: Appropriate disaster knowledge, education and training are essential elements for adequate disaster preparedness. This is particularly evident for paramedics who are integral part of frontline disaster response teams. No reviews evaluated the published research on this subject within the Saudi context. The present review aimed to analyze the published studies on Saudi paramedics' knowledge, education and training in the context of disaster management.<br><br>METHODS: The present review was synthesized according 5-stage process: (1) Identification of the research question, (2) Identification of relevant studies, (3) Study selection, (4) Charting the data (5) Collating, summarizing and reporting the results.<br><br>RESULTS: Sixteen studies were included in final analysis. The vast majority of included studies (15, 93.8%) were published in last 6 years. The location of the included studies was Riyadh (8, 50.0%), Mecca (3, 19.0%), multiple provinces (3, 19.0%) and other provinces (2, 12.5%). Study design also varied with 9 studies (56.3%) following a descriptive design, 5 studies (31.3%) using mixed methods and 2 studies (12.5%) using a quasi-experimental design. The study sample included paramedics or paramedic students in 13 studies (81.3%) among other healthcare workers while only 3 studies (18.8%) studies were exclusively conducted on paramedic students. Thematic analysis of data extracted form included studies identified three themes: (1) Knowledge/awareness about COVID-19 pandemic preparedness; (2) Knowledge about other disasters and (3) Disaster education and training.<br><br>CONCLUSIONS: Research output from Saudi Arabia on paramedics' involvement in disaster knowledge, education and training has mostly emerged in the last six years and mainly focused on the two cities of Riyadh and Mecca. There a paucity of interventional and qualitative studies. Also, few studies exclusively included paramedics or paramedical students.}, }
@article {pmid41363008, year = {2025}, author = {Yazdani, B and Sirous, H and Farzam, F and Ansarizadeh, S and Karimi Taheri, M and Pourmohammad-Hosseini, G and Noei, M and Daneshipour, K and Shakeri, D and Houshangi, M and Calderone, V and Brogi, S}, title = {In Silico Exploration of Potential Inhibitors Targeting SARS-CoV-2 Non-Structural Protein 15 (Nsp15): A Comprehensive Overview of Current Research.}, journal = {Chemical biology &amp; drug design}, volume = {106}, number = {6}, pages = {e70218}, doi = {10.1111/cbdd.70218}, pmid = {41363008}, issn = {1747-0285}, support = {2402233//Isfahan University of Medical Sciences/ ; }, mesh = {*Viral Nonstructural Proteins/antagonists &amp; inhibitors/metabolism/chemistry ; *Antiviral Agents/chemistry/pharmacology ; Humans ; SARS-CoV-2/drug effects ; Computer Simulation ; COVID-19 ; *Betacoronavirus/drug effects ; COVID-19 Drug Treatment ; Molecular Docking Simulation ; *Endoribonucleases/antagonists &amp; inhibitors/metabolism/chemistry ; Protein Binding ; }, abstract = {The SARS-CoV-2 nonstructural protein 15 (Nsp15) is an endoribonuclease that plays a critical role in viral replication and immune evasion through its NendoU domain. The unique enzymatic mechanism of Nsp15 has attracted considerable attention as a potential therapeutic target, and the identification of its inhibitors could facilitate the development of novel antiviral agents against coronaviruses. Although biochemical and structural studies have provided important insights into Nsp15 function, no comprehensive review has yet focused on computational approaches applied to the discovery of Nsp15 inhibitors. Consequently, this study aims to address this gap by summarizing recent in silico research focused on the structure, function, and inhibition of Nsp15. Special attention is given to inhibitors derived from both natural and synthetic sources, as well as their binding interactions and predicted pharmacological potential. By integrating current computational findings, this review highlights novel prospects for the rational design of Nsp15-targeted therapeutics to combat SARS-CoV-2 and other related pathogenic coronaviruses.}, }
@article {pmid41361900, year = {2025}, author = {Vedlog Kveen, K and Lilier, K and Råberg Kjøllesdal, MK and Naranjo-Zolotov, M and Lapanun, P and Veiga, I and Dias, S and Overgaard, HJ and Bärnighausen, K}, title = {Public health messaging and community engagement during COVID-19: a rapid-review from the Greater Mekong Subregion.}, journal = {One health outlook}, volume = {7}, number = {1}, pages = {61}, pmid = {41361900}, issn = {2524-4655}, abstract = {BACKGROUND: The COVID-19 pandemic highlighted the importance of public health messaging and community engagement in reducing disease transmission. This rapid review analyzes these approaches in the Greater Mekong Subregion (GMS), a hotspot for emerging infectious diseases, to help inform future pandemic preparedness and response strategies.<br><br>METHODS: This rapid review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Checklist. We used Web of Science and PubMed databases. Articles were included if they addressed COVID-19-related public health messaging and/or community engagement initiatives, focused on countries within the GMS, were published in English between 2020 and 2024, and provided full-text access. Articles focusing on unrelated topics, such as vaccine development or adverse effects of the pandemic were excluded. Data extraction was performed using a calibrated data extraction sheet, with two researchers extracting and verifying the data.<br><br>RESULTS: After the screening process, 26 articles were included, and 24 were excluded. Three articles use qualitative methods, five articles use quantitative approaches, eleven articles are identified as descriptive and seven are literature reviews. In most countries the government employed a centralized strategy for streamlined and coherent communication using traditional media, social media and mobile applications. Vietnam demonstrated an innovative and inclusive approach to risk communication, leveraging creative approaches such as songs and slogans to disseminate messages. Thailand effectively utilized its pre-existing network of village health volunteers to inform community members, though marginalized groups remained hard to reach.<br><br>CONCLUSION: The GMS employed diverse public health messaging and community engagement strategies during COVID-19. Our findings emphasize the importance of adaptable and inclusive strategies to ensure equitable public health outcomes in future pandemics.}, }
@article {pmid41360485, year = {2025}, author = {Anyikwa, CL}, title = {Global health and the dialectics of solidarity through Ubuntu and European perspectives.}, journal = {BMJ global health}, volume = {10}, number = {12}, pages = {}, pmid = {41360485}, issn = {2059-7908}, mesh = {Humans ; *Global Health ; COVID-19/epidemiology ; Europe ; SARS-CoV-2 ; *Social Responsibility ; Pandemics ; International Cooperation ; }, abstract = {The concept of solidarity plays a central role in shaping both African and European cultural responses to social and political challenges, although its interpretations diverge significantly. In African societies, solidarity is rooted in the relational philosophy of ubuntu, where individual identity is understood as inseparable from the community, emphasising collective well-being and mutual care. This is reflected in practices, such as community-based caregiving for the sick and elderly, traditional healing networks and shared child-rearing. In parts of West Africa, for example among the Igbo, co-wives may sleep over at the home of a bereaved wife to provide emotional support and boost morale during mourning.In contrast, European models of solidarity are often institutionalised and rights-based, focusing on balancing individual autonomy with collective welfare within legal frameworks. This paper explores these two distinct approaches to solidarity and examines their implications in global health, especially in the context of the COVID-19 pandemic and other global health crises. Ubuntu's emphasis on communal responsibility offers a valuable framework for addressing health inequities, suggesting that global health is a shared responsibility that transcends national borders and individual interests. Conversely, European solidarity, shaped by enlightenment principles and liberal democratic traditions, often prioritises individual rights and institutional mechanisms to ensure health equity. This dialectical exploration highlights the evolving nature of solidarity in a globalised world, where African and European models of solidarity are increasingly hybridised to address global health disparities. Drawing on examples such as the Ritshidze community-led HIV care monitoring initiative in South Africa, alongside international efforts like COVAX, this paper evaluates how solidarity, in both its African and European forms, can influence global health policy and collective action, promoting more inclusive and equitable health systems worldwide.}, }
@article {pmid41360478, year = {2025}, author = {Zhou, W and Chen, C and Qi, J and Chen, M and Yuan, Z and Miao, J and Chen, J and Jiang, D and Yang, M and Du, Y and Cao, K and Wu, X and You, Y and Chen, D and Qu, R and Yang, S}, title = {Adherence to handwashing behaviour and its impact on the incidence and death of viral respiratory infectious diseases: a systematic review, meta-analysis and modelling study.}, journal = {BMJ global health}, volume = {10}, number = {12}, pages = {}, pmid = {41360478}, issn = {2059-7908}, mesh = {Humans ; *Hand Disinfection ; Incidence ; *COVID-19/prevention &amp; control/mortality ; *Respiratory Tract Infections/prevention &amp; control/mortality/epidemiology ; *Guideline Adherence/statistics &amp; numerical data ; *Virus Diseases/mortality/prevention &amp; control/epidemiology ; Pandemics ; SARS-CoV-2 ; Global Health ; }, abstract = {OBJECTIVES: Washing hands is considered an effective way for preventing viral respiratory infections. This study systematically investigated the global and regional adherence to hand-washing behaviour and its impact on the incidence and death of viral respiratory infectious diseases (VRIDs).<br><br>METHODS: In our systematic review and meta-analysis, we searched PubMed, Embase, Web of Science and Scopus for related studies. We included observational studies with raw data of adherence to handwashing (rates of acceptability of handwashing, daily habitual handwashing and key-moment handwashing) during VRID pandemics/epidemics. Pooled rates and effect of handwashing were calculated by random-effects model and generalised linear model.<br><br>RESULTS: We analysed 108 articles, generating 227 datasets. During VRID epidemics/pandemics, the global pooled rate of daily handwashing was 72.23% (95% CI 66.95% to 76.95%). The lowest rate was observed in Africa (pooled rate 59.46%, 95% CI 50.73% to 67.68%) and among public transportation workers (18.15%, 95% CI 6.54% to 41.26%). Global pooled rate of key moment handwashing was 65.11% (95% CI 59.74% to 70.28%), with the lowest rate being after handshaking (36.40%, 95% CI 18.49% to 56.52%) and among the elderly (22.86%, 95% CI 16.77% to 29.58%) and was higher during the COVID-19 pandemic than the 2009 H1N1 pandemic (72.02% vs 31.33%). The pooled rate of global acceptability of handwashing was 90.01% (95% CI 83.73% to 94.05%). Key-moment handwashing was associated with a reduction in COVID-19 incidence (&#x3b2;=-151.1, p=0.010), COVID-19 mortality (&#x3b2;=-0.066, p<0.001) and other COVID-19 related deaths (&#x3b2;=-0.112, p<0.001).<br><br>CONCLUSION: During the VRID epidemics/pandemics, the handwashing behaviour adherence was relatively low. Health education efforts targeting public transportation workers and the elderly should be intensified. Augmented key-moment handwashing adherence potentially led to a significant reduction of the incidence and death of VRIDs.<br><br>PROSPERO REGISTRATION NUMBER: CRD42024499090.}, }
@article {pmid41360360, year = {2025}, author = {Pillay, TS and Rampul, A and Subramoney, EL and van Deventer, BS and van Niekerk, C and Gwiliza, S}, title = {The double-edged role of point-of-care testing in modern medicine.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {}, number = {}, pages = {120770}, doi = {10.1016/j.cca.2025.120770}, pmid = {41360360}, issn = {1873-3492}, abstract = {Point-of-care testing (POCT) has emerged as a transformative force in clinical diagnostics, enabling rapid, near-patient testing that can expedite decision-making, improve patient outcomes, and expand access to care. This review critically examines the double-edged nature of POCT, balancing its clear clinical and operational advantages against persistent challenges of accuracy, quality assurance, governance, and cost-effectiveness. The scope of POCT technologies ranges from simple lateral-flow assays to advanced molecular platforms, increasingly integrated with digital health ecosystems. Their clinical utility is evident in emergency medicine, chronic disease management, and resource-limited settings, where timely results reduce delays, hospital stays, and downstream complications, while supporting personalized and preventive care. The COVID-19 pandemic further highlighted the flexibility and scalability of POCT during public health emergencies. However, these benefits are countered by risks of variable analytical performance, inadequate training of non-laboratory operators, fragmented data integration, and economic trade-offs from high per-test costs and potential overuse. Governance frameworks-anchored in ISO 22870 (and now ISO 15189:2022), rigorous quality management, connectivity solutions, and multidisciplinary oversight-are essential to ensuring safe, effective, and sustainable implementation. Successful programs demonstrate that strong laboratory leadership, continuous training, and robust data integration mitigate risks while maximizing impact. Ultimately, POCT should be viewed not as a replacement but as a complement to central laboratory services, whose value is realized only through thoughtful deployment and governance. With advancing technology and improved oversight, POCT can be harnessed as a powerful adjunct in modern healthcare, turning its double-edged potential into a precise tool for patient-centered diagnostics.}, }
@article {pmid41359142, year = {2025}, author = {Dikamu, M and Syraji, Y and Pr, J and K, G and Raza, A and Ezez, D}, title = {Nanotechnology in COVID-19 prevention, diagnosis, and treatment: a comprehensive review.}, journal = {Discover nano}, volume = {20}, number = {1}, pages = {225}, pmid = {41359142}, issn = {2731-9229}, abstract = {The worst of the COVID-19 (coronavirus disease 2019) pandemic may be over, but its impact continues to be felt worldwide. During the outbreak, medical regulatory authorities introduced several principles for outbreak control, with the World Health Organization emphasizing three key strategies: prevention, early detection, and treatment. In this context, technological advancements have played a critical role, particularly nanotechnology, which has emerged as a promising platform for medical innovation. Its applications span multiple sectors, including healthcare, environmental protection, and diagnostics. These applications offer unmatched potential to enhance personal protective equipment, develop antiviral surface coatings, and engineer rapid point-of-care diagnostics. Nanotechnology contributed significantly to combating COVID-19, enhancing prevention through nanofiber-enhanced masks and nanoparticle-based disinfectants; facilitating diagnosis via gold nanoparticles (AuNPs) and magnetic nanoparticle biosensors, quantum dots, and artificial intelligence-integrated nanosensors; and supporting treatment efforts through lipid nanoparticle (LNP) vaccines, virus-like particles, and targeted drug delivery systems. We highlight key nanomaterials such as silver nanoparticles, copper nanoparticles, AuNPs, zinc oxide nanoparticles, and selenium nanoparticles, alongside advanced formulations like LNPs and polymeric nanocarriers, exploring their mechanisms of viral inactivation, sensitive detection, and controlled delivery of therapeutics. Furthermore, this review addresses critical regulatory and translational challenges and post-pandemic adaptations of nanotechnologies for emerging viral threats.}, }
@article {pmid41359099, year = {2025}, author = {Ramanan, RS and Kesavan, KV and Ravikumar, V}, title = {Pulmonary fibrosis in post-COVID-19: epithelial-mesenchymal transition as a key mechanism and target for therapy.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41359099}, issn = {1568-5608}, support = {VIR/COVID-19/6/2021/ECD-I//Indian Council of Medical Research/ ; }, abstract = {Pulmonary fibrosis is a serious threat to global health, especially in after math of covid-19 infection, eventually results in fibrotic remodeling and organ damage. This SARS-CoV 2 induced fibrosis initiates cascade of proinflammatory responses such as cytokine release. EMT (Epithelial-mesenchymal transition) is a central event in post COVID 19 pulmonary fibrosis which is characterized by the accumulation of stimulated fibroblast and myoblast, finally epithelial morphology changed to mesenchymal traits. This transformation is marked by the loss of intercellular adhesion and polarity. A study of SARS-CoV 2 pathogenesis and EMT can provide insights to pulmonary fibrosis. Hence identification of biomarkers of EMT activation helps early diagnosis and determination of therapeutic approaches against pathogenesis. This review focusing on the mechanism of post-covid 19 pulmonary fibrosis through EMT with a special importance to TGF-β/Smad, NF-κB pathways and oxidative stress. Previous studies marked the EMT induced fibronectin, collagen deposition that can potentially disrupt lung structure and its function. SARS CoV 2 infection can trigger Hyper activation of profibrotic pathways like TGF-β/Smad, NF-κB pathways that maintain EMT via downregulation of E-Cadherin and upregulation of vimentin, fibronectin and α-SMA. SARS-CoV spike-protein binds to AEC-2 cells initiates cytokine storm followed by amplified NF-κB pathway, and oxidative stress. Elevated activation of this pathway increases Snail, Slug, Twist expression that leads to EMT. Moreover, increased ROS production creates fibrotic environment in lung. This review examined the mechanism behind the pulmonary fibrosis by analyzing interplay between the SARS-CoV 2 infection and EMT, providing effective therapeutic strategies to prevent EMT.}, }
@article {pmid41358652, year = {2025}, author = {Gadsby, E and King, E and Bell, M and Wong, G and Kendall, S}, title = {Health visiting in the UK in light of the COVID-19 pandemic experience (RReHOPE): study synopsis.}, journal = {Health and social care delivery research}, volume = {13}, number = {42}, pages = {1-28}, doi = {10.3310/GJEG0402}, pmid = {41358652}, issn = {2755-0079}, mesh = {Humans ; *COVID-19/epidemiology ; United Kingdom/epidemiology ; SARS-CoV-2 ; Pandemics ; Delivery of Health Care/organization &amp; administration ; }, abstract = {BACKGROUND: The COVID-19 pandemic interrupted and, in some cases, transformed the way health visiting teams work, the way they interact with families and children and with the wider community and other service providers. Health visiting services are organised, delivered and experienced differently in different places, with little evidence to suggest what works best, for whom and in what contexts.<br><br>OBJECTIVE: To synthesise the evidence on changes during the pandemic to identify the potential for improving health visiting services and their delivery in the United Kingdom.<br><br>METHODS: This realist review engaged professional stakeholders (N&#x2005;=&#x2005;28) and those caring for babies during the pandemic (N&#x2005;=&#x2005;6) throughout the process. We searched five electronic databases for publications on health visiting during the COVID-19 pandemic from October 2022 to April 2023. This was followed by citation searching and review of organisational websites. Programme theory was iteratively refined through discussions with the team, professional stakeholders and people with lived experience and was translated into key findings and recommendations.<br><br>RESULTS: One hundred and eighteen documents informed this review; most focused on health visiting in England (56%) or the United Kingdom (34%), with relatively few from Wales (6%), Scotland (3%) and Northern Ireland (1%). Documents highlighted the widespread, uneven and lasting impact of the COVID-19 pandemic on babies and families. Findings revealed significant concerns expressed by both families and practitioners and corresponding actions taken by health visiting services. These concerns and responses emphasised the flexibility and resourcefulness of health visitors, the vital role of trusting relationships between health visitors and families and the importance of holistic assessments for early intervention. Changes in service delivery were varied and were not always evaluated or sustainable. While the data illuminated some of the hidden complexities of health visiting practice, limited evidence was found on decision-making at organisational and managerial levels during the pandemic response.<br><br>EVIDENCE LIMITATIONS: Included papers were predominantly from an advocacy or practitioner perspective, and few focused on health visiting in Scotland, Wales and Northern Ireland. Our focus on the universal health visiting pathways meant that documents pertaining to additional support received by the most vulnerable families might have been excluded. Experiences of Black, Asian and minority ethnic families and staff were illustrated in several papers.<br><br>CONCLUSIONS: The COVID-19 pandemic highlighted the essential role of health visitors in safeguarding child and family well-being in the United Kingdom. While digital adaptations provide necessary continuity, face-to-face interactions remain essential for effective health visiting. The crisis exposed pre-existing workforce pressures and inconsistencies in service provision, emphasising the need for adequate support and funding. Policy-makers must recognise the complexity of health visiting and ensure sustained investment in universal home visiting services. Future resilience requires a realistic understanding of health visitors' work, integration into broader child health policies and enhanced interagency collaboration to address inequalities and improve long-term public health outcomes.<br><br>FUTURE WORK: Our implications for policy-makers will be translated into reflexive questions to prompt critical thinking about health visiting services in local areas. The small number of documents from countries outside England highlights this as a key area for future research.<br><br>FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR134986.}, }
@article {pmid41357714, year = {2025}, author = {Kouchaki, H and Tabrizi, R and Kamyab, P and Pourrahimi, M and Ghanei, A and Goudarzi, S and Lankarani, KB}, title = {Mask Usage in Healthcare Settings: Is It the Right Time for Easing Restrictions? A Narrative Review.}, journal = {Iranian journal of public health}, volume = {54}, number = {10}, pages = {2190-2198}, pmid = {41357714}, issn = {2251-6093}, abstract = {Since the onset of the coronavirus disease 2019 (COVID-19) pandemic, personal protective equipment, particularly face masks, has been central to infection control and reducing associated mortality. Global mask mandates, combined with widespread vaccination, helped curb peak pandemic phases. In 2023, the WHO reclassified COVID-19 as an ongoing health priority rather than an emergency, prompting reassessment of mask policies in healthcare settings. Yet, hospitals remain high-risk, especially with the concurrent "triple epidemic" of COVID-19, influenza, and respiratory syncytial virus. This review summarizes current evidence on mask efficacy, adherence, and policy changes to determine whether, when, and under what conditions mask use can be safely eased in clinical settings.}, }
@article {pmid41357710, year = {2025}, author = {Thoriq, M and Rachmadina, WF and Swannjo, JB and Farhany, FF and Kuś, A and Rachmanto, A and Sulistiawati, }, title = {Trade-offs between Accessibility and Practicality in Global Telemedicine: A Systematic Review.}, journal = {Iranian journal of public health}, volume = {54}, number = {10}, pages = {2173-2189}, pmid = {41357710}, issn = {2251-6093}, abstract = {BACKGROUND: Telemedicine is increasingly vital in healthcare, offering remote consultations via message-based and video call-based platforms. These methods improve healthcare accessibility, particularly when in-person visits are limited. Telemedicine is increasingly vital in healthcare, offering remote consultations via message-based and video call-based platforms. These methods improve healthcare accessibility, particularly when in-person visits are limited.<br><br>METHODS: A systematic search was conducted in ScienceDirect, PubMed, and up to August 2024. Studies evaluating the accessibility and practicality of global telemedicine were evaluated. From initial 439 records, 19 studies were finally in this systematic review. Studies were reviewed thoroughly with quality appraisal using the Newcastle Ottawa Scale, in which those rated for high quality studies were included.<br><br>RESULTS: Most studies (74%) were from high-income countries, notably the United States (26%) and Denmark (11%). Observational studies dominated (95%), focusing on follow-up consultations (47%) and diagnostic services (32%), particularly in general care (32%), neurology (11%), and surgery (5%). Research peaked in 2022 (32%) during the COVID-19 pandemic. Common platforms included WhatsApp, AnyDesk, and QliqSOFT. Accessibility was the primary focus in 53% of studies, while 47% addressed feasibility. Challenges like technological barriers and privacy concerns were particularly noted in lower-income regions.<br><br>CONCLUSION: Telemedicine has enhanced healthcare accessibility and demonstrated feasibility. However, technological limitations and remote consultation challenges persist, particularly in lower-income regions. Continued research is needed to optimize telemedicine and equitable access.}, }
@article {pmid41357404, year = {2025}, author = {Avila-Rojo, JA and Martínez-Sánchez, FD and Rosales-Rentería, LA and Aguirre-Villarreal, D and Contreras, AG and Cruz-Martinez, R and Servin-Rojas, M and Ramírez-Del Val, A and Zamora-Valdés, D and Leal-Leyte, P and Aguirre-Valadez, J and Paez-Zayas, VM and Sánchez-Cedillo, AI and Lugo-Baruqui, A and Covarrubias-Esquer, JD and García-Juárez, FI and Ruiz, I and García-Juárez, I}, title = {Overcoming barriers and expanding opportunities in liver transplantation in Mexico.}, journal = {World journal of transplantation}, volume = {15}, number = {4}, pages = {110496}, pmid = {41357404}, issn = {2220-3230}, abstract = {Liver transplantation (LT) is the only curative treatment for end-stage liver disease. Although Mexico has made important strides in surgical capacity and institutional development, the country continues to report one of the lowest LT rates in Latin America. Multiple challenges remain, including inequitable access to care, limited organ donation, and structural inefficiencies in allocation systems. To review the current status of LT in Mexico, describe historical trends, highlight significant barriers to progress, and discuss potential opportunities for program expansion. We conducted a narrative review incorporating data from the National Transplant Center (Centro Nacional de Trasplantes in Spanish), relevant peer-reviewed literature, and global benchmarks. The analysis focused on trends in liver transplant volume, donor types, etiology shifts, institutional disparities, and the impact of the coronavirus disease 2019 (COVID-19) pandemic. LT activity in Mexico increased from 25 transplants in 1999 to 297 in 2023. However, over 68% of transplants are concentrated in Mexico City, and only eight centers perform more than ten LTs per year. Deceased donors account for most grafts, while living donor transplants remain rare and mostly limited to private institutions. The national waiting list functions primarily as a registry rather than a priority-based allocation system. The COVID-19 pandemic further disrupted transplant programs, particularly in the public sector. Innovative approaches such as donation after circulatory death, hepatitis C virus-positive donor utilization, and advanced perfusion technologies are currently unavailable or underutilized in Mexico. Mexico's LT system faces geographic, regulatory, and resource-related limitations. To improve outcomes and ensure equitable access, strategic reforms focused on donor expansion, centralized allocation, perfusion technologies, and standardization of care are urgently needed.}, }
@article {pmid41356999, year = {2025}, author = {Swealem, A and Wahb, M and Abosheisha, M and Basha, A and Al-Hasani, F and Moustafa Mahmoud Shaheen, A and Alqasem, M and Fahmy, M and Dief Allah, M and Nabil Rofaeel Ibrahim, F}, title = {Virtual Examination Techniques, Clinical Effectiveness, and Future Directions of Telemedicine in Orthopedic Practice: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97548}, pmid = {41356999}, issn = {2168-8184}, abstract = {Telemedicine adoption has made notable changes in orthopedic practice. It was greatly expanded with the COVID-19 pandemic, with the adoption across subspecialties offering comparable diagnostic accuracy, patient satisfaction, and safety to traditional visits. This narrative review summarizes the current applications of telemedicine and future directions in orthopedic telemedicine. Virtual examinations for the elbow, shoulder, hip, and knee have been successfully modified for remote assessment. The modifications of some tests now allow patients to perform self-tests under physician guidance using household tools. Randomized controlled trials (RCTs) demonstrate that telehealth consultations are not inferior to in-person evaluations in clinical decision-making. Limitations include the inability to replicate certain hands-on maneuvers, disparities in digital access among minority and low-income populations, and variable patient adherence. To optimize remote care, standardized telehealth protocols, improved image transmission, and targeted patient preparation are required. Artificial intelligence (AI) and large language models (LLMs) promise to enhance virtual care. Telemedicine is positioned to become a permanent, high-quality complement to in-person orthopedic practice, expanding global access to efficient and patient-centered musculoskeletal healthcare.}, }
@article {pmid41356611, year = {2025}, author = {Dolatshahi, Z and Raeissi, P and Nargesi, S and Saniee, N}, title = {Emotional Experiences of the Home-Dwelling Older Adults During the Isolation of the Coronavirus Disease 2019 Pandemic: A Qualitative Systematic Review.}, journal = {Health science reports}, volume = {8}, number = {12}, pages = {e71614}, pmid = {41356611}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: This systematic qualitative review aimed to provide an in-depth understanding of the emotional experiences and coping strategies of home-dwelling older adults, as expressed in their own words, during the quarantine period of the COVID-19 pandemic.<br><br>METHODS: Electronic searches were conducted in PsycINFO, CINAHL, Scopus, Web of Science, PubMed, and other related databases. Articles published between January 2020 and December 2021 were identified using predefined keywords. After screening studies based on inclusion and exclusion criteria, relevant data were extracted, and the results were synthesized. The quality of the included studies was assessed using the COREQ checklist. A total of 43 qualitative studies were included in the final review.<br><br>RESULTS: Based on COREQ evaluation, most studies demonstrated good methodological quality, with a mean score of 25.81 out of 32 (range: 17-29); no study fully satisfied all COREQ criteria. Thematic synthesis revealed two main categories: (i) Emotional Challenges, which encompassed psychological, physical, technological, and social dimensions; (ii) Coping Strategies, which were classified into cognitive (mindset-based), behavioral (function-based), and technology-assisted strategies. These findings highlight the emotional complexity and adaptability of older adults during isolation.<br><br>CONCLUSIONS: Contrary to initial assumptions of vulnerability, many older adults approached the pandemic with rational understanding and adaptive responses. By drawing on past life experiences, they actively organized coping mechanisms to navigate the crisis. These insights emphasize the need for health policymakers to invest in resilience-building initiatives, such as digital literacy training and community-based emotional and physical support programs. Such strategies can enhance the quality of life for older adults and promote efficient resource utilization within health systems.}, }
@article {pmid41355379, year = {2025}, author = {Danopoulos, E and Armstrong, N and McDermott, K and Chen, J and Tian, X and Noake, C and Westwood, M}, title = {Accuracy and clinical effectiveness of fetal growth monitoring strategies for the prediction of small for gestational age at birth: a systematic review and meta-analysis.}, journal = {Health technology assessment (Winchester, England)}, volume = {29}, number = {62}, pages = {1-216}, doi = {10.3310/AJLK7403}, pmid = {41355379}, issn = {2046-4924}, mesh = {Humans ; Female ; Pregnancy ; Infant, Newborn ; *Infant, Small for Gestational Age ; *Fetal Development ; *Fetal Growth Retardation/diagnosis ; Gestational Age ; *Fetal Monitoring/methods/standards ; }, abstract = {BACKGROUND: Smallness for gestational age has been associated with an increased risk of neonatal/fetal adverse outcomes. The Healthcare Safety Investigation Branch has issued a safety recommendation aimed at improving fetal growth monitoring strategies and reducing risk for babies.<br><br>OBJECTIVES: The objective was to summarise available evidence to inform the Healthcare Safety Investigation Branch recommendation. The review comprised four research questions on: effects of fetal growth monitoring on neonatal/parental outcomes; effects of implementing fetal growth monitoring guidelines on neonatal/parental outcomes; accuracy of fetal growth monitoring strategies for predicting smallness for gestational age neonates/fetal growth restriction and factors affecting the accuracy of fetal growth monitoring strategies.<br><br>METHODS: Nineteen databases were searched from 2000 to March 2023 and were updated September 2023. Pregnant people with and without risk factors were included. Each review question had further eligibility criteria. For accuracy results, summary estimates of the sensitivity and specificity with 95% confidence intervals for the prediction of smallness for gestational age at delivery were calculated. Random-effects models were used for the meta-analysis of clinical outcomes. Further outcomes, including the results of risk of bias assessments, were summarised narratively.<br><br>RESULTS: Fifty-eight studies (78 publications) were included in the review. Q1 - Antenatal identification of smallness for gestational age pregnancies was associated with increased rates of intervention (two retrospective cohort studies, n&#x2005;=&#x2005;100, 198 and 2928), but the available evidence did not support an effect on stillbirths or neonatal outcomes. Q2 - Meta-analysis (three observational studies and one randomised controlled trial, n&#x2005;=&#x2005;318,523) indicated that implementation of the Growth Assessment Protocol was associated with a reduction in the risk of stillbirth and risk ratio of 0.79 (95% confidence interval 0.74 to 0.84). Meta-analyses (one observational study and one randomised controlled trial, n&#x2005;=&#x2005;11,978) indicated that Growth Assessment Protocol implementation was associated with a reduction in the risk of 5-minute Apgar score <&#x2005;7, risk ratio of 0.78 (95% confidence interval 0.64 to 0.95); however, the effect estimate for neonatal intensive care unit admission was highly uncertain, 0.59 (95% confidence interval 0.02 to 20.03). Q3 (53 studies) and Q4 (15 studies) - regarding accuracy, the highest sensitivity for both general and high-risk populations was achieved using a combination of estimated fetal weight and abdominal circumference tests, where the threshold was defined as either parameter <&#x2005;10th percentile. No clear trends were observed for the type of reference charts, either for the use of general versus local reference charts (either the estimated fetal weight or birthweight) or for the use of non-sex-specific versus sex-specific birthweight reference charts (nine studies).<br><br>LIMITATIONS AND CONCLUSIONS: There is limited evidence linking fetal growth monitoring tests results to the changes in fetal/neonatal outcomes. There is some evidence supporting the reduction of adverse outcomes by Growth Assessment Protocol implementation. Testing during the third trimester is likely to result in more accurate prediction of smallness for gestational age at birth than earlier testing. Use of a locally derived reference chart for estimated fetal weight may result in optimised sensitivity for a given birthweight reference chart (definition of smallness for gestational age).<br><br>FUTURE WORK: Large diagnostic cohort studies and comparative studies are needed to further examine whether and how fetal growth monitoring testing and implementation of guidance can affect clinical outcomes.<br><br>STUDY REGISTRATION: This study is registered as PROSPERO CRD42023408030.<br><br>FUNDING: This award was funded by the National Institute for Health and Care Research (NIHR) Evidence Synthesis programme (NIHR award ref: NIHR135862) and is published in full in Health Technology Assessment; Vol. 29, No. 62. See the NIHR Funding and Awards website for further award information.}, }
@article {pmid41355334, year = {2025}, author = {Johnson, GU}, title = {From the ICU Bedside: Applying the Transnational Clinical Academic Doctorate Lens to a Clinically Embedded PhD Journey.}, journal = {Journal of advanced nursing}, volume = {}, number = {}, pages = {}, doi = {10.1111/jan.70421}, pmid = {41355334}, issn = {1365-2648}, support = {//Australian Government Research Training Program Scholarship/ ; }, abstract = {AIM: To critically reflect on a transnational, clinically embedded doctoral journey undertaken during and after the COVID-19 pandemic, and to draw conceptual and systemic lessons for doctoral education and clinical academic nursing pathways.<br><br>BACKGROUND: Reflective accounts of doctoral study exist, yet few examine practice-based PhDs conducted across different countries and health systems during a global crisis. This paper analyses one such pathway-enrolment at an Australian university with research embedded within the UK National Health Service-to explore resilience, identity formation, mentorship ecologies and organisational conditions that support or hinder clinical academic development.<br><br>METHOD: Using analytic autoethnography and reflective case study logic, experiential data (field notes, supervisory records, ethics correspondence, project artefacts and publication trajectories) were synthesised with relevant scholarship. A conceptual framework, the TCAD lens, was developed to structure analysis across contexts, constraints, mechanisms and outcomes.<br><br>DISCUSSION: Four phases are outlined: starting in crisis as a senior ICU nurse, transitioning to lead educator, serving as surgical matron while implementing changes, and moving into academia to complete the thesis by publication. Dual ethics and governance procedures, contractual arrangements and GDPR-compliant data stewardship imposed significant administrative burdens but fostered global literacy and networks. Mentorship functioned as an ecology-supportive, critical, pragmatic and strategic-evolving towards independence. COVID-19 served as a stress test, narrowing scope while improving the feasibility and sustainability of the family member's voice reorientation intervention. Personal adversity intersected with identity development, with compassionate supervision enabling timely completion (3.7&#x2009;years) and five peer-reviewed publications.<br><br>CONCLUSION: Transnational, clinically embedded doctoral pathways can enhance nursing research capacity but require deliberate institutional design: genuine protected time, cross-jurisdictional support and mentorship ecosystems. The TCAD lens provides a transferable framework for educators, supervisors and health systems.<br><br>IMPLICATIONS FOR NURSING: Recommendations cover programme development, cross-border oversight, NHS-university collaborations, funding arrangements in different currencies and resilience infrastructure for clinician-researchers.}, }
@article {pmid41354625, year = {2025}, author = {Cernuto, F and Maleki, A and Russo, G and Di Salvatore, V and Pappalardo, F}, title = {In-silico epitope-based vaccines design: progress, challenges and the road ahead.}, journal = {Expert opinion on drug discovery}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/17460441.2025.2599178}, pmid = {41354625}, issn = {1746-045X}, abstract = {INTRODUCTION: In silico technologies are increasingly shaping vaccine development, supporting the field beyond empirical discovery toward rational, data-driven design. Contemporary computational pipelines enable rapid antigen screening, high-precision epitope-MHC binding prediction, structural modeling, and immune response simulations. These approaches are accelerating vaccine discovery not only for infectious diseases but also in oncology, where neoantigen prediction underpins personalized cancer immunotherapy.<br><br>AREAS COVERED: This review explores recent advances in computational pipelines for epitope-based vaccine design, covering antigen discovery; B- and T-cell epitope mapping; safety and specificity assessment; vaccine construct assembly with adjuvants and linkers; structural modeling; and immune-response simulations that predict efficacy in specific disease contexts using advanced platforms. It showcases applications in infectious diseases, including SARS-CoV-2, tuberculosis, and influenza, and poxivirus infections, as well as in cancer immunotherapy. It is based on literature obtained through searches utilizing PubMed, Scopus, and Web of Science databases covering publications up to 2025, using combinations of keywords such as epitope-based vaccines, reverse vaccinology, immunoinformatics, and immune system simulation.<br><br>EXPERT OPINION: In silico approaches offer a transformative advantage to vaccine research by delivering speed, cost-efficiency, and enhanced precision. Yet the predictive power of current computational pipelines is still constrained by algorithmic limitations and by their incomplete integration of immune-regulatory processes. Progress in artificial intelligence, multi-omics integration, and formal recognition of digital evidence by regulatory agencies will be crucial for narrowing the gap between computational predictions and experimental validation. Ultimately, combining predictive immunoinformatics with advanced immune simulations and rigorous verification could help establish in silico methodologies as a cornerstone of next-generation vaccine development.}, }
@article {pmid41354607, year = {2025}, author = {Bian, S and Say, J and Brinson, D and Karoubi, G}, title = {Advances in lung biomimetic systems: exploring biophysical cues in lung regenerative medicine.}, journal = {Trends in biotechnology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.tibtech.2025.11.009}, pmid = {41354607}, issn = {1879-3096}, abstract = {The COVID-19 pandemic highlighted the urgent need for advanced lung regenerative medicine. While traditional research focused on biochemical pathways, biophysical cues are equally critical regulators of lung cell behavior. This review discusses the role of key mechanical cues including cyclic stretch, strain/pressure, geometry, and matrix stiffness on lung cells in health and disease. The focus is on the evaluation of biomimetic platforms (decellularized scaffolds, dynamic surfaces, biomaterial constructs, and lung-on-chip devices) that recapitulate these environments; and the paradigm shifts in the field which show the importance of physiologically relevant systems. Finally, we identify challenges and future directions for translating mechanobiology-informed approaches into clinical therapies, highlighting their transformative potential for lung tissue engineering.}, }
@article {pmid41354496, year = {2025}, author = {Sourani, A and Kalantari, F and El-Rabbany, M and Shahmoradi, M and Haridas, A and Vahdat, N and Mirza, S and Sourani, A and Foroughi, M and Baradaran Mahdavi, S}, title = {COVID-19 and jaw osteonecrosis: A systematic review on clinical presentations and treatment outcomes.}, journal = {Current problems in surgery}, volume = {73}, number = {}, pages = {101897}, doi = {10.1016/j.cpsurg.2025.101897}, pmid = {41354496}, issn = {1535-6337}, }
@article {pmid41353643, year = {2025}, author = {Abreu, C and Peres, S and Cunha, F and Miranda, J and Nunes-Silva, C and Silva-Pinto, A and Ribeiro-Dias, L and Oliveira, J}, title = {[Vaccination Recommendations for the Immunocompromised Adult Patient].}, journal = {Acta medica portuguesa}, volume = {38}, number = {12}, pages = {814-827}, doi = {10.20344/amp.22966}, pmid = {41353643}, issn = {1646-0758}, mesh = {Humans ; *Immunocompromised Host ; *Vaccination/standards ; Adult ; Practice Guidelines as Topic ; }, abstract = {The manuscript collates indications for vaccination in immunocompromised adults based on recommendations from leading international institutions. These individuals have increased vulnerability to vaccine-preventable infectious diseases, and their immune response to vaccination is often weaker than that of immunocompetent individuals. Therefore, whenever possible, it is important to assess vaccine response (serological or other). Emphasis is placed on adapting vaccination to the net state of immunosuppression, following a careful evaluation of risks, indications, contraindications, and the optimal timing for administration. Whenever feasible, vaccination should be carried out before the initiation of pharmacological immunosuppression, prior to splenectomy, or before receiving a solid organ transplant. Immunocompromised individuals are categorised into groups such as those with immune-mediated inflammatory diseases, individuals who have undergone splenectomy, recipients of solid organ or haematopoietic transplants, people living with HIV, and those with congenital immunodeficiencies (inborn errors). The article describes vaccination recommendations for different clinical scenarios and types of immunosuppression. Vaccines against respiratory viral diseases, including influenza, COVID-19, and respiratory syncytial virus, as well as hepatitis A and B, varicella-zoster, and vaccines protecting against encapsulated bacteria such as pneumococci, meningococci, and Haemophilus influenzae, are discussed. Some vaccination recommendations in the context of travel and post-exposure prophylaxis in high-risk situations are included. The article also addresses the importance of vaccinating household contacts and healthcare professionals for additional protection. Finally, it highlights that ongoing advancements in vaccines and vaccination guidelines require continuous updates.}, }
@article {pmid41353585, year = {2025}, author = {Song, YL and Gao, YD and Geng, XY and Liu, YB}, title = {Application of mRNA Vaccines in Children's Vaccination: Technical Advantages, Clinical Practice and Future Challenges.}, journal = {Acta paediatrica (Oslo, Norway : 1992)}, volume = {}, number = {}, pages = {}, doi = {10.1111/apa.70412}, pmid = {41353585}, issn = {1651-2227}, abstract = {AIM: To summarise the current paediatric applications of Message RNA (mRNA) vaccines and to identify the key efficacy, safety, and future challenges that must be solved before routine childhood use can be expanded beyond Corona Virus Disease 2019 (COVID-19).<br><br>METHODS: PubMed and ClinicalTrials.gov were searched (up to May 2025) for clinical studies of mRNA vaccines administered to children aged 0-17&#x2009;years. Search terms combined "mRNA vaccine" with "child", "infant", "adolescent", "paediatric", "safety", "immunogenicity", and "trial".<br><br>RESULTS: COVID-19 and RSV mRNA vaccines have effectively reduced the incidence rate among certain age groups of children, while serious adverse events or deaths were rarely observed. Most trials about mRNA vaccines are mainly conducted among adults. More studies are needed to explore the long-term safety and efficacy of mRNA vaccines in children.<br><br>CONCLUSION: mRNA vaccines offer rapid, precise, and child-tailored protection, but robust longitudinal data and public-science frameworks are urgently needed before their promise can be fully translated into routine paediatric prevention strategies.}, }
@article {pmid41353057, year = {2025}, author = {Flegr, J}, title = {Does peptidome mimicry shape host-parasite coevolution?.}, journal = {Trends in parasitology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pt.2025.11.002}, pmid = {41353057}, issn = {1471-5007}, abstract = {The peptidome mimicry hypothesis (PMH) builds on the principle that vertebrate immunity recognizes peptides absent from the host proteome. It extends this idea to predict host-parasite coevolution outcomes, systematic 'missing peptides', the narrow host specificity of many parasites, and the higher susceptibility of some interspecies hybrids to infection. PMH proposes that long-term coevolution reduces parasite peptide vocabularies and drives convergence toward host repertoires - a pattern that can help to infer a parasite's original host. For example, analyses of SARS-CoV-2 peptide vocabularies have been used to reconstruct the virus's likely host-switching history. Beyond theory, PMH provides an independent and effective way to nominate immunogenic peptide targets for vaccine design, complementary to existing prediction methods.}, }
@article {pmid41352221, year = {2025}, author = {Nowzari, F and Nowzari, F and Kian, M and Zahedi, M and Samimi, K and Karimzadeh, A and Tanideh, N and Mussin, NM and Tamadon, A}, title = {Evolution and trends in non-viral mRNA Cancer vaccines: A scoping review from 2015 to 2025.}, journal = {Vaccine}, volume = {71}, number = {}, pages = {128059}, doi = {10.1016/j.vaccine.2025.128059}, pmid = {41352221}, issn = {1873-2518}, abstract = {This scoping review synthesizes clinical trials from 2015 to 2025 investigating non-viral messenger RNA (mRNA)-based cancer vaccines, emphasizing trends in delivery platforms-ex vivo dendritic cell (DC) vaccines versus in vivo lipid-based systems-and their association with cancer types. A systematic search of PubMed and ClinicalTrials.gov identified 72 early-phase trials, revealing a significant shift from DC-based ex vivo approaches (dominant 2015-2020) to lipid nanoparticle (LNP)-based in vivo delivery post-2021 (p = 0.0025), propelled by advancements from COVID-19 vaccines. Statistical analyses, including linear regression and Fisher's exact test, demonstrate a strong association between ex vivo delivery and brain/CNS cancers (p = 0.00042) and no significant correlation between DC vaccine administration routes and cancer types (p = 0.25). The surge in combination immunotherapies, particularly with immune checkpoint inhibitors post-2019, underscores the field's move toward multimodal strategies. This article offers a data-driven roadmap of the field's evolution, highlighting gaps in delivery optimization, reporting transparency, and standardization for future research. Companion articles detail ex vivo DC vaccine strategies and in vivo mRNA vaccine advancements.}, }
@article {pmid41352167, year = {2025}, author = {Erduran, S and Cheung, KKC}, title = {How science education research journals address (and neglect) trust in science.}, journal = {Current opinion in psychology}, volume = {68}, number = {}, pages = {102218}, doi = {10.1016/j.copsyc.2025.102218}, pmid = {41352167}, issn = {2352-2518}, abstract = {Science education is pivotal in enhancing scientific literacy and potentially contributing to trust in science. The paper examines how trust in science has been addressed in science education by investigating the content of 5 leading research journals. Of the 116 articles published between January 2024 and June 2025 that mentioned "trust" and "mistrust", only 17 directly engaged with trust in science. Analysis revealed an emphasis on the epistemic aspects of science, with limited attention to affective or political dimensions, and a disproportionate focus on global issues such as COVID-19 and climate change rather than local issues. There was a marked lack of an explicit definition or conceptualisation of 'trust' in the papers. We argue that science education research would benefit from interdisciplinary perspectives on trust, including frameworks on the emotional, relational, and ideological characterisations of trust. Such multiplicity of perspectives is relevant to science education given educational contexts inherently embody not only epistemic but also social, political and affective dimensions. Suggestions are made for future directions in science education research for a critical yet balanced account so that trust in science can be appropriated.}, }
@article {pmid41351657, year = {2025}, author = {Oyama, S and Matsunaga, A and Teratake, Y and Takahashi, H and Yamashita, H and Ishizaka, Y and Kaneko, H}, title = {COVID-19-associated large-vessel vasculitis with elevated anti-angiotensin converting enzyme 2 antibody: three cases and a review of the literature.}, journal = {Clinical rheumatology}, volume = {}, number = {}, pages = {}, pmid = {41351657}, issn = {1434-9949}, support = {22A2010D//Japan Society for the Promotion of Science/ ; 21fk0108435h000//AMED/ ; }, abstract = {INTRODUCTION: Since the COVID-19 pandemic, a growing number of reports suggest an association between severe acute respiratory syndrome coronavirus 2 and autoimmune diseases, including large-vessel vasculitis (LVV). However, the mechanism remains unclear. This report describes three cases of COVID-19-associated LVV with elevated anti-angiotensin-converting enzyme 2 (ACE2) antibodies.<br><br>CASE PRESENTATIONS: The first case was a 59-year-old man who developed a persistent headache and fever 2&#xa0;weeks after SARS-CoV-2 infection. FDG-PET/CT revealed diffuse vascular inflammation extending from the carotid arteries to the abdominal aorta. The second case was a 71-year-old man who presented with prolonged fever after SARS-CoV-2 infection. Imaging demonstrated vascular wall enhancement and FDG uptake from the thoracic aorta to the iliac aorta. The third case was a 67-year-old man who had persistent fever 10&#xa0;days after COVID-19, with FDG-PET/CT showing uptake from the ascending aorta to the aortic arch. In all cases, workups for immune and infectious diseases were negative. Symptoms and inflammatory markers resolved spontaneously or with nonsteroidal anti-inflammatory drugs. Serum anti-ACE2 IgG was positive during the active phase in all three patients and became negative during remission.<br><br>DISCUSSION: We have encountered three cases of COVID-19-associated LVV with elevated anti-ACE2 antibodies that normalized after clinical remission. There have been multiple reports of LVV following SARS-CoV-2 infection, with onset typically within weeks of infection, and of elevated anti-ACE2 antibody levels in patients with COVID-19-related neurological complications. Further studies are warranted to determine if anti-ACE2 antibodies are associated with the pathogenesis of post-COVID-19 vasculitis.}, }
@article {pmid41351160, year = {2025}, author = {Keikha, L and Shahraki-Mohammadi, A and Nabiolahi, A}, title = {Strategies and prerequisites for combating health misinformation on social media: a systematic review.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-025-25858-4}, pmid = {41351160}, issn = {1471-2458}, abstract = {OBJECTIVE: The speed and complexity of transmitting health misinformation through social media can lead to the transfer of information that causes irreparable damage to the state of health, control, and prevention of diseases. This research aimed to identify the prerequisites and best strategies for combating health misinformation on social media.<br><br>METHOD: The current systematic review was carried out following the PRISMA guidelines. In September 2024, a search was conducted using "misinformation" and "social media" keywords and their equivalents in selected databases (Scopus, Web of Science, and PubMed). Inclusion criteria comprised the implementation of an intervention aimed at combating health misinformation on social media, while studies not in English and those that did not address health misinformation on social media were excluded. The data were analyzed using the conventional content analysis method. EndNote 21 and Excel 2021 software were used to collect and analyze the articles.<br><br>RESULT: Out of 6395 identified articles, 20 articles were included in the present study. Half of the studies addressing health misinformation were published in 2023 and 2024, with the United States leading the way. The combat of COVID-19 misinformation was the most frequent. From the content analysis of the included studies in a total of three strategies: communication strategies, technology-based strategies, and multimedia strategies to combat health misinformation on social media, it was identified. Four categories: needs assessment, educating community leaders, content design, and content quality assessment, were identified as the primary prerequisites to combat health misinformation on social media.<br><br>CONCLUSION: Combating health information in social media requires basic infrastructures and the use of hybrid approaches. In addition, due to the different roles of celebrities and influencers, reputable health organizations and healthcare institutions should benefit from their participation in combating health misinformation.}, }
@article {pmid41350176, year = {2025}, author = {Miller, CM and Moen, JK and Iwasaki, A}, title = {The lingering shadow of epidemics: post-acute sequelae across history.}, journal = {Trends in immunology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.it.2025.10.010}, pmid = {41350176}, issn = {1471-4981}, abstract = {The SARS-CoV-2 pandemic has drawn global attention to post-acute infection syndromes (PAIS), with millions affected by post-acute sequelae of COVID-19 (PASC, or Long COVID). While Long COVID is newly defined, PAIS have been described for over a century following epidemic infections. Multiple pathogens - including influenza, Epstein-Barr virus, and Borrelia burgdorferi, among others - can precipitate persistent, poorly understood symptoms. Chronic illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) have long been linked to infectious triggers. This recurring association highlights critical knowledge gaps and underscores the need for systematic investigation. Unlike prior pandemics, the current era offers advanced technologies and analytic tools to address these gaps. Defining the biology of Long COVID may yield broader insights into host-pathogen interactions and mechanisms of chronic illness.}, }
@article {pmid41349894, year = {2025}, author = {Tang, H and Chen, X and Huang, J and Yang, Q and Liang, K and Qiu, X and Tang, J and Tian, C and Luo, N and Lin, M and Zhang, X and Wu, S and Deng, X and Lin, H and Hong, J and Wen, J and Jiang, L and Chen, P and Lin, W and Chen, W and Zhang, Y and Tan, X and Chen, Y}, title = {Characterizing patterns in causes, risk factors, and life expectancy among the oldest old (aged 95+ years).}, journal = {Ageing research reviews}, volume = {}, number = {}, pages = {102985}, doi = {10.1016/j.arr.2025.102985}, pmid = {41349894}, issn = {1872-9649}, abstract = {BACKGROUND: The global population is aging rapidly, extending into the oldest old. However, increased longevity does not always translate into enhanced health. While genetic and environmental factors influence lifespan, evidence indicates that targeted interventions can substantially enhance the likelihood of reaching 100 years. This study aimed to characterize disease and risk factor patterns among the oldest-old to identify actionable targets for promoting health and functional capacity in this rapidly growing population.<br><br>METHODS: This study identified 18 countries with the largest populations aged 95 years and older using data from the Global Burden of Disease (GBD) 2023 study and the United Nations World Population Prospects 2024. Disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) from 1990 to 2023 were quantified, ranked, and visualized across three major cause categories (non-communicable, communicable and nutritional diseases, and injuries) and risk factors (behavioral, environmental/occupational, and metabolic) by using the GBD 2023 estimates. Temporal trends were assessed using estimated annual percentage change derived from log-linear regression models, calculated separately for periods before and after the COVID-19 pandemic peak. K-means clustering was employed to identify cross-country burden patterns, with the optimal number of clusters determined via the silhouette method. Temporal trends in health-adjusted life expectancy (HALE) were examined, and frontier analysis was applied to estimate the potential for further HALE improvement across countries.<br><br>RESULTS: From 1990 to 2023, the absolute disease burden among individuals aged 95+ years increased more than fivefold, primarily driven by non-communicable diseases, accounting for ~86% of the total DALYs. Ischemic heart disease remained the leading cause, particularly for YLLs, followed by Alzheimer's disease and other dementias, which predominated in YLDs, followed by stroke and chronic kidney disease. During the COVID-19 pandemic peak (2019-2021), mental health disorders, including depression and anxiety, demonstrated a marked increase. Cluster analysis in 2023 revealed two distinct national patterns: one dominated by acute cardiovascular conditions and the other by chronic multi-system diseases. Absolute burdens of metabolic, behavioral, and environmental/occupational risk factors increased over time, although their relative contributions declined; high systolic blood pressure (YLLs), high fasting plasma glucose (YLDs), and kidney dysfunction remained the leading risk factors. The average HALE increased from 1.86 years in 1990 to 2.16 years in 2019, declined during the pandemic, and partially recovered by 2023. Frontier analysis indicated nearly a twofold potential for further HALE improvement under current socioeconomic conditions.<br><br>CONCLUSION: The 95+-year-old population exhibits distinctive patterns of disease burden that have shifted substantially over the past three decades. Despite cross-national differences, cardiometabolic diseases and risk factors, along with multisystem comorbidities from the brain and kidneys, remain the primary drivers. Integrated strategies addressing biological, social, and environmental factors may enhance intrinsic capacity and promote healthy aging in the oldest old.}, }
@article {pmid41349781, year = {2025}, author = {Rota, M and Torresan, I and Palmerio, S and Tasselli, E and Rossi, A and Zivi, A and Zacchi, F}, title = {The role of therapeutic cancer vaccines in the modern immunotherapy era: State of the art with recent progress and future challenges.}, journal = {Critical reviews in oncology/hematology}, volume = {217}, number = {}, pages = {105068}, doi = {10.1016/j.critrevonc.2025.105068}, pmid = {41349781}, issn = {1879-0461}, abstract = {Therapeutic cancer vaccines represent a promising frontier in precision oncology, aiming to elicit durable and tumor-specific immune responses. Recent advances in nucleic acid-based platforms, particularly mRNA and DNA vaccines, have accelerated clinical translation, especially following the success of mRNA vaccines against SARS-CoV-2. These innovations have enabled improved antigen delivery, immunogenicity, and flexibility through structural modifications such as self-amplifying or chemically modified mRNAs. In parallel, peptide-based vaccines have evolved through the incorporation of long synthetic peptides and the identification of tumor-specific neoantigens. Other strategies include dendritic cell-based vaccines and whole tumor cell approaches. Neoantigen vaccines have demonstrated a favorable safety profile and the ability to elicit robust CD4[+] and CD8[+] T cell responses across various cancer types and disease stages. Optimal efficacy, however, depends on careful antigen selection, favoring clonal, driver mutations, and timely administration, ideally in early-stage or minimal residual disease settings to circumvent immune evasion and systemic immunosuppression. The tumor microenvironment (TME) critically shapes vaccine responsiveness, influenced by both tumor-intrinsic factors (e.g., antigen presentation defects, HLA loss) and extrinsic immunosuppressive cells. High tumor mutational burden and inflamed TMEs correlate with stronger responses, but encouraging outcomes have also been observed in "cold" tumors. Combining vaccines with ICIs, chemotherapy, or cytokine therapies can enhance efficacy by overcoming immune resistance. Optimizing clinical trial design and ensuring cost-effectiveness will be essential for translating personalized cancer vaccines into routine clinical practice.}, }
@article {pmid41349462, year = {2025}, author = {Eksteen, C and Asja, LC and Rass, A and Riedemann, J and Engelbrecht, AM}, title = {Post COVID-19 pandemic Inflammatory Insights into Cancer: Consequences for immunotherapy.}, journal = {Cytokine &amp; growth factor reviews}, volume = {87}, number = {}, pages = {10-18}, doi = {10.1016/j.cytogfr.2025.12.002}, pmid = {41349462}, issn = {1879-0305}, abstract = {The COVID-19 pandemic has reshaped the landscape of global health, revealing novel interactions between infectious diseases and chronic conditions such as cancer. Beyond acute infection, growing evidence suggests that persistent exposure to SARS-CoV-2 spike protein, whether through infection or vaccination, may sustain inflammatory pathways that contribute to tumour progression and immune modulation. This review explores the overlap between post-COVID inflammation, particularly in Long-COVID syndromes and the tumour microenvironment (TME), focusing on key mediators such as IL-6, TNF-α, IL-1β, and NF-κB. We revisit the concept of the cytokine storm in the context of persistent inflammation, spike protein immunogenicity and immune exhaustion, proposing a model in which chronic inflammatory signalling may disrupt tumour immune surveillance, reawaken dormant cancer cells and compromise the efficacy of immunotherapies. Comparative analysis with other cancer types highlights shared pathways of oncogenic inflammation. Lastly, we outline emerging therapeutic strategies to mitigate these effects, including cytokine-targeted interventions and immunomodulatory screening in post-COVID cancer patients. These post-pandemic insights call for urgent translational research to ensure effective and safe cancer immunotherapy in the evolving inflammatory landscape.}, }
@article {pmid41349247, year = {2025}, author = {Halma, M and Varon, J}, title = {Metabolic modulation as a therapeutic strategy for post-acute vaccination syndrome (PACVS): A review of pathomechanisms and existing therapeutic components.}, journal = {Biomedicine &amp; pharmacotherapy = Biomedecine &amp; pharmacotherapie}, volume = {193}, number = {}, pages = {118864}, doi = {10.1016/j.biopha.2025.118864}, pmid = {41349247}, issn = {1950-6007}, abstract = {Post-Acute Vaccination Syndrome (PACVS) is a post-vaccination disorder marked by persistent fatigue, cognitive impairment, and exercise intolerance. Current research identifies interconnected pathophysiological processes, including persisting spike protein, mitochondrial dysfunction, decreased tissue oxygenation, and impaired metabolism. Emerging treatments rely on metabolic regulation and therapeutic agents promoting mitochondrial and vascular function. These therapies stimulate cellular energy generation, reduce oxidative stress, and regulate inflammatory pathways. This review examines metabolic and mitochondrial mechanisms underlying PACVS, evaluates existing therapeutic strategies targeting these pathways, and synthesizes current evidence for future research and clinical management.}, }
@article {pmid41348590, year = {2025}, author = {Zinaic, R and Wong, JP}, title = {Understanding COVID-19 Vaccine Hesitancy in Black, East Asian, and Eastern European Diasporic Communities in Toronto: A Scoping Review.}, journal = {International journal of social determinants of health and health services}, volume = {}, number = {}, pages = {27551938251400901}, doi = {10.1177/27551938251400901}, pmid = {41348590}, issn = {2755-1946}, abstract = {Canada achieved COVID-19 vaccination coverage of 83.2% in the total population (at least one dose). However, only 49.6% of Canadians completed the primary series plus one booster (which defines one as fully vaccinated). Inconsistent uptake of COVID-19 vaccines impeded pandemic response and led to increased demands in a stretched health care system. To advance pandemic preparedness, a critical understanding of vaccine access and hesitancy is needed. We undertook a scoping review to identify the primary reasons for vaccine hesitancy in Toronto's East Asian, Black, and Eastern European diaspora. A total of 5548 articles were retrieved from PubMed, OVID, JSTOR, ERIC and 27 and 43 from Google Scholar and Google respectively. De-duplication left us with 42 relevant sources for data extraction, including 19 news articles, 9 commentaries, 11 pieces of grey literature and 3 peer reviewed articles that were not identified via academic databases. Our review results revealed four factors for COVID-19 vaccine hesitancy among East Asian, Black, and Eastern European diasporas in Toronto: (a) access barriers; (b) mistrust; (c) racism; and (d) misinformation. These factors can create conditions of re-racialization by stereotyping entire ethnoracial groups or convincing members of these groups to become vaccine skeptics.}, }
@article {pmid41348159, year = {2025}, author = {Mik, V and Benz, LS and Voller, J and Dunzendorfer-Matt, T and Weiss, MS and Kryštof, V}, title = {A patent review of Mpro protease inhibitors for the treatment of COVID-19 infections (2020 - present).}, journal = {Expert opinion on therapeutic patents}, volume = {}, number = {}, pages = {1-19}, doi = {10.1080/13543776.2025.2588773}, pmid = {41348159}, issn = {1744-7674}, abstract = {INTRODUCTION: The SARS-CoV-2 main protease (Mpro, also known as 3CLpro or nsp5) is essential for viral replication. As there are no close human homologs, it represents an attractive and specific target for antiviral therapy against COVID-19. Its well-defined active site and conserved substrate specificity have enabled structure-guided drug design with high precision.<br><br>AREAS COVERED: This review examines the patent landscape for small-molecule inhibitors of SARS-CoV-2 Mpro published between 2020 and early 2025. Compounds were grouped by scaffold type and mechanism of action, covering covalent and non-covalent inhibitors, orthosteric and allosteric binders and unique modalities such as PROTACs. Clinically advanced agents including nirmatrelvir, ensitrelvir, simnotrelvir, zevotrelvir and leritrelvir are highlighted alongside structurally novel leads and broad-spectrum candidates.<br><br>EXPERT OPINION: A number of Mpro inhibitors have progressed into preclinical and clinical stages, underscoring the rapid advancement in this field. The accumulation of structural knowledge, chemical diversity and mechanistic insight has laid a robust foundation for future antiviral development and may further enhance the utility of Mpro inhibitors against evolving coronaviruses.}, }
@article {pmid41348012, year = {2025}, author = {La Rosée, P and Machowicz, R}, title = {Hemophagocytic lymphohistiocytosis: do we have a solution for TMI (too much inflammation)?.}, journal = {Hematology. American Society of Hematology. Education Program}, volume = {2025}, number = {1}, pages = {206-214}, doi = {10.1182/hematology.2025000707}, pmid = {41348012}, issn = {1520-4383}, mesh = {Humans ; *Lymphohistiocytosis, Hemophagocytic/diagnosis/therapy ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Inflammation/therapy/diagnosis ; Cytokine Release Syndrome/diagnosis/therapy ; Adult ; Hematologic Neoplasms/therapy/complications ; Macrophage Activation Syndrome/therapy/diagnosis ; Graft vs Host Disease/therapy ; Diagnosis, Differential ; }, abstract = {Hemophagocytic lymphohistiocytosis (HLH) and the related HLH-spectrum disorders macrophage activation syndrome, macrophage activation-like syndrome, and treatment-associated immune-effector-cell-associated HLH-like syndrome are extreme forms of too much inflammation (TMI). Adult patients with HLH associated with hematologic malignancies have a 70% to 80% mortality rate due to delayed diagnosis, prolonged immunosuppression with associated secondary infections, and disease recurrence. In recent years, educational efforts and epidemiological evolution have increased diagnostic awareness. This has been catalyzed by the COVID-19 pandemic, the first approved anti-interferon gamma antibody for primary relapsed/refractory HLH, advancements in the treatment of posttransplant graft-versus-host disease, and the broad availability of T-cell-engaging therapeutics. These truly challenging-to-diagnose entities under the cytokine storm umbrella confer TMI, causing multiorgan dysfunction and early death. Novel prognostic models, differential diagnosis with the help of advanced diagnostic algorithms, preemptive therapeutic interventions, and more individualized cytokine-directed treatment options have moved this previously neglected area in adult hematology to the forefront of the hematologist's daily practice.}, }
@article {pmid41347672, year = {2025}, author = {Zou, Y and Kamoi, K and Zong, Y and Zhang, J and Yang, M and Ohno-Matsui, K}, title = {Systematic Review of Postvaccination Ocular Adverse Events: A Comprehensive Analysis of Published Reports.}, journal = {Journal of medical virology}, volume = {97}, number = {12}, pages = {e70747}, pmid = {41347672}, issn = {1096-9071}, support = {//This study was supported by JSPS KAKENHI (Grant JP 20K09824), a Grant on Rare and Intractable Diseases from the Ministry of Health, Labour, and Welfare of Japan (Grant 22FC0201), a Research Program on Emerging and Re-emerging Infectious Diseases grant from the Japan Agency for Medical Research and Development, AMED (Grants 23fk0108671h0001, 23fk0108672h0001), a High-risk Emerging Infectious Diseases Research Grant from the Takeda Science Foundation (FY2023), and JST SPRING (Grant No. JPMJSP2120)./ ; }, mesh = {Humans ; *Vaccination/adverse effects ; Uveitis/etiology/chemically induced ; Hepatitis B Vaccines/adverse effects ; Papillomavirus Vaccines/adverse effects ; *Eye Diseases/etiology/chemically induced ; *COVID-19 Vaccines/adverse effects ; }, abstract = {Ocular adverse events following COVID-19 vaccination are well described; however, systematic analyses of non-COVID antiviral vaccines remain limited. This review aimed to evaluate ocular complications associated with non-COVID antiviral immunizations, including influenza, varicella-zoster (VZV), human papillomavirus (HPV), and hepatitis B (HBV) vaccines. A systematic search (PROSPERO CRD4202450873) identified 122 patients (184 eyes) from 8,487 publications, including case reports, case series, and observational studies. Uveitis was the most common (92/184 eyes; 50.0%, 95% CI 42.8%-57.2%), frequently following influenza vaccination (35/122; 28.7%, 95% CI 20.7%-36.7%). Most patients (95/122; 77.9%, 95% CI 70.5%-85.3%) required systemic corticosteroids, reflecting predominant inflammation. Ocular symptoms occurred within 30 days in 84.4% (103/122)of cases, with peak onset at 7-30 days (62/122; 50.8%, 95% CI 42.0%-59.6%). Despite appropriate treatment, 18 patients (20.0%, 95% CI 13.0%-29.4%) experienced persistent inflammation or required therapy beyond 1 month, categorized as "long-vax", defined as ocular symptoms persisting for ≥ 4 weeks after vaccination. Although rare, antiviral vaccine-associated ocular complications may persist, posing a risk of long-term visual morbidity and emphasizing the importance of clinician awareness, postvaccination surveillance, and counseling for patients receiving repeated or combined vaccine exposures.}, }
@article {pmid41347658, year = {2025}, author = {McVoy, MA and Kummarapurugu, AB}, title = {The Role of ACE2 in SARS-CoV-2 Infection, Pathogenesis, and Antiviral Interventions.}, journal = {Journal of medical virology}, volume = {97}, number = {12}, pages = {e70721}, pmid = {41347658}, issn = {1096-9071}, support = {//This study is funded by Child Health Research Institute and Commonwealth Health Research Board./ ; }, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism/genetics ; *COVID-19/virology/pathology ; *SARS-CoV-2/pathogenicity/drug effects ; *Antiviral Agents/therapeutic use/pharmacology ; Spike Glycoprotein, Coronavirus/metabolism ; COVID-19 Drug Treatment ; Virus Internalization/drug effects ; Animals ; }, abstract = {The devastating clinical, psychological, and economic impact of the COVID-19 pandemic, caused by global spread of the second Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), has engendered a massive response from the scientific community to rapidly understand the biology of SARS-CoV-2 and to develop interventions to prevent infection or progression to life-threatening disease. Angiotensin converting enzyme-2 (ACE2) and its interaction with the SARS-CoV-2 Spike glycoprotein, which mediates fusion of the virion envelope with the target cell membrane, have emerged as a major pharmacological target, as disruption of the Spike-ACE2 interaction prevents cells from becoming infected and hence from producing viral progeny. Moreover, the dysregulation of ACE2 that occurs in the context of SARS-CoV-2 infection may have broader implications for COVID-19 pathogenesis. Here we summarize the role of ACE2 as a physiologic regulator of human health, as a facilitator of SARS-CoV-2 infection, as a factor in COVID-19 disease, and as a target for pharmacological interventions.}, }
@article {pmid41346576, year = {2025}, author = {Guimarães, GN and Brunetti, NS and De Lima, DG and Proenca-Modena, JL and Farias, AS}, title = {Vaccination and COVID-19: impact on long-COVID.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1686572}, pmid = {41346576}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/prevention &amp; control ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; *SARS-CoV-2/immunology ; *Vaccination ; Post-Acute COVID-19 Syndrome ; }, abstract = {Long- and post-COVID-19 syndromes have emerged as a significant global health challenge, with millions of individuals experiencing persistent or the development of new symptoms after a long period of an initial SARS-CoV-2 infection. These symptoms are multisystemic and may indicate changes in the respiratory, neurological, cardiovascular and gastrointestinal systems, in addition to prolonged fatigue. Vaccination has played a crucial role in reducing severe disease and mortality, but the impact of the different vaccine combinations on the development and resolution of Long COVID remains a topic of debate. This review synthesizes current evidence on how different vaccine platforms, dosing strategies and booster doses influence the immunological response, protection, incidence, severity, and persistence of Long COVID symptoms. We discuss key immunological mechanisms by which vaccination may modulate and protect post-COVID syndrome outcomes, including its effects on viral clearance, immune response reprogramming, inflammation, and autoimmunity, seeking to combat misinformation and concepts spread by fake news. The review also highlights controversies and research gaps, such as variability in vaccine response among different populations and the role in the selection of more transmissible and virulent SARS-CoV-2 variants, as well as the potential differences between vaccine-induced and infection-induced immunity, and the role of pre-existing immune conditions in this scenario.}, }
@article {pmid41346074, year = {2026}, author = {Hamdy, R and Barakat, AZ and Abuzaid, EJ and Elsayed, TM and Husseiny, MI}, title = {COVID-19 in Diabetic Patients: Mechanisms, Risks, and Therapeutic Considerations.}, journal = {Reviews in medical virology}, volume = {36}, number = {1}, pages = {e70085}, doi = {10.1002/rmv.70085}, pmid = {41346074}, issn = {1099-1654}, mesh = {Humans ; *COVID-19/complications/immunology/virology/epidemiology ; SARS-CoV-2 ; *Diabetes Mellitus/drug therapy/immunology/virology ; Hypoglycemic Agents/therapeutic use ; Risk Factors ; COVID-19 Drug Treatment ; *Diabetes Complications ; Comorbidity ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has had a profound global impact. Diabetes mellitus is a major comorbidity associated with higher infection risk, severe disease, and mortality in COVID-19 patients. This review examines the bidirectional relationship between COVID-19 and diabetes, focussing on immunometabolic mechanisms, post-COVID metabolic effects, and therapeutic implications. A comprehensive literature search was conducted in PubMed, Scopus, and Web of Science for articles published until May 2025 using the terms "COVID-19," "SARS-CoV-2," "diabetes," and "immunometabolism." Peer-reviewed studies addressing clinical, molecular, or therapeutic interactions between the two diseases were included. Evidence shows that SARS-CoV-2 infection aggravates metabolic dysfunction through immune dysregulation, cytokine-mediated inflammation, and β-cell injury. Hyperglycemia promotes viral replication and inflammatory damage, creating a vicious cycle that worsens outcomes. Reports also indicate an increased risk of new-onset and post-COVID diabetes. Certain antidiabetic agents, such as metformin and GLP-1 receptor agonists, may improve prognosis via anti-inflammatory and metabolic effects. Diabetes significantly amplifies the severity of COVID-19 through intertwined metabolic and immune mechanisms. Understanding these interactions provides new insights into disease management and supports the development of targeted immunometabolic therapies for improving outcomes in diabetic patients affected by COVID-19.}, }
@article {pmid41343284, year = {2026}, author = {Arieli, M and Ngo, V and Jeyakumar, S and Balakumar, N and Baig, N and Nurgitz, M and Rotenberg, S}, title = {The Role of Information and Communication Technologies in Social Participation of Older Adults: A Scoping Review.}, journal = {The American journal of occupational therapy : official publication of the American Occupational Therapy Association}, volume = {80}, number = {1}, pages = {}, doi = {10.5014/ajot.2025.051273}, pmid = {41343284}, issn = {0272-9490}, mesh = {Humans ; *Social Participation ; Aged ; *COVID-19/epidemiology ; Social Media ; *Information Technology ; Text Messaging ; Electronic Mail ; *Communication ; SARS-CoV-2 ; }, abstract = {IMPORTANCE: Social participation is essential for healthy aging, supporting older adults' health and well-being. Although information and communication technologies (ICTs) offer promising opportunities, a focused summary of the literature on ICT use for social participation, a distinct aspect of digital engagement, has been lacking.<br><br>OBJECTIVE: To summarize existing literature on ICT use for social participation among older adults and identify gaps by examining study characteristics, ICT classifications, and associated health variables.<br><br>DATA SOURCES: PsycINFO, MEDLINE, Embase, and CINAHL were searched for quantitative, nonexperimental studies published from 2016 through 2024.<br><br>The authors followed the Joanna Briggs Institute scoping review methodology.<br><br>FINDINGS: Of 9,795 screened articles, 85 met the inclusion criteria. The number of relevant publications has increased over time, with nearly half (47.1%) related to the COVID-19 pandemic. Modes of interaction included social media (72.4%), email (64.5%), text messaging (60.5%), and video calls (53.9%). Most studies assessed communication frequency with family and friends (72.9%), whereas fewer explored meeting new people online (7.1%) or the quality of online participation (5.9%). Social well-being (56.5%) and mental health (43.4%) were the most frequently examined health variables.<br><br>CONCLUSIONS AND RELEVANCE: The growing body of research highlights ICTs' role in social participation in later life but reveals key gaps. Research on underrepresented populations, ICTs' potential for expanding social networks, and the quality of online participation remains limited. Inconsistent measurement practices hinder ability to draw conclusions. These gaps point to critical opportunities for future occupational therapy research and practice. Plain-Language Summary: Staying socially connected is important for older adults' health, well-being, and overall quality of life. This review explored how older adults use digital technologies, such as video calls, email, text messaging, and social media, to stay in touch and participate socially. Interest in these technologies has grown in recent years, especially during the COVID-19 pandemic. Most research focused on communication with family and friends; fewer studies examined forming new relationships online or the quality of online interactions. Digital tools can reduce loneliness and support participation, particularly when in-person contact is limited. However, more research is needed to understand usage patterns and the adoption of these tools in daily life, especially among underrepresented groups. This knowledge can help occupational therapy practitioners better support older adults in using technology to promote meaningful social connections.}, }
@article {pmid41341810, year = {2025}, author = {Breckling, MN and Tobey-Moore, L and Parsons, A and Butera, M and Annichiarico, C and Ali, M}, title = {Telemedicine Use Among Older Adults During COVID-19: A Narrative Literature Review of Utilization Patterns.}, journal = {Telemedicine reports}, volume = {6}, number = {1}, pages = {371-381}, pmid = {41341810}, issn = {2692-4366}, abstract = {BACKGROUND: With the rapid expansion of telemedicine services during the COVID-19 pandemic, concerns have emerged about equitable access for vulnerable populations, including older adults. This narrative literature review aims to examine patterns of telemedicine use among older adults during the COVID-19 pandemic in the United States (U.S.).<br><br>METHODS: A comprehensive review of 55 articles published between 2020 and 2024 was conducted to analyze disparities in older adult telemedicine use around the COVID-19 pandemic. Data from electronic health records and medical claims data were compiled for analysis. Variations based on visit modalities, geographic regions and divisions, age categorization, and medical specialties were explored.<br><br>RESULTS: Most studies found lower use among older adults, with 23 reporting significantly reduced usage compared with younger groups. Only 11 showed higher use, while 12 found no difference or had inconclusive results, and 11 did not include an in-person comparison group. A total of 26 studies used a single cross-sectional design, and 29 used multiple cross-sectional designs. Research was primarily conducted in the Northeast and West, U.S., with most studies analyzing telephone, video, and in-person visits (n = 35) and electronic health record data (n = 48).<br><br>CONCLUSIONS: This review reveals persistent disparities in telemedicine use among older adults during the COVID-19 pandemic, highlighting the need for research into contributing factors and targeted strategies to improve access. Policymakers should consider initiatives such as financial support, broadband expansion, and digital literacy programs to promote equity.}, }
@article {pmid41341037, year = {2025}, author = {Abdollahzadeh Mirali, R and Ramazannia Toloti, SS and Bigdeli, Y and Ebrahimi, A and Roointanpour, Y and Ghasemi Gorji, M}, title = {Surgical and Endovascular Management of Aortic Thrombosis in COVID-19 and Vaccine-Induced Immune Thrombotic Thrombocytopenia.}, journal = {Vascular health and risk management}, volume = {21}, number = {}, pages = {1007-1016}, pmid = {41341037}, issn = {1178-2048}, mesh = {Humans ; *COVID-19/complications/diagnosis ; *Thrombosis/surgery/etiology/diagnosis/mortality/diagnostic imaging ; *Endovascular Procedures/adverse effects/mortality ; *Aortic Diseases/surgery/etiology/mortality/diagnostic imaging/diagnosis ; *COVID-19 Vaccines/adverse effects ; Treatment Outcome ; Risk Factors ; Anticoagulants/adverse effects/therapeutic use ; *Thrombectomy/adverse effects/mortality ; *Purpura, Thrombocytopenic, Idiopathic/diagnosis/etiology ; }, abstract = {BACKGROUND: COVID-19 has been associated with a hypercoagulable state, leading to various thrombotic complications, including aortic thrombosis, a rare but severe manifestation requiring surgical intervention. Additionally, vaccine-induced immune thrombotic thrombocytopenia (VITT), linked to adenoviral vector vaccines, presents unique surgical challenges due to a heightened risk of thrombosis and bleeding. This review focuses on the surgical management of COVID-19-associated aortic thrombosis and VITT-related large-vessel occlusions.<br><br>RESULTS: Surgical intervention in COVID-19-associated aortic thrombosis depends on thrombus burden, patient stability, and associated comorbidities. Open thrombectomy, aortic bypass, and hybrid endovascular techniques have been employed, with perioperative anticoagulation being critical to prevent recurrence. High thrombus burden cases often require open repair, while endovascular approaches are preferred in high-risk patients. Mortality rates remain elevated (up to 30%), with post-surgical complications including recurrent thrombosis and limb loss. In VITT cases, surgical revascularization is complicated by thrombocytopenia and a prothrombotic state, necessitating non-heparin anticoagulation and close hematologic monitoring. Delayed diagnosis and inappropriate anticoagulation significantly worsen outcomes.<br><br>CONCLUSION: The surgical management of aortic thrombosis in COVID-19 and VITT patients requires a multidisciplinary approach, incorporating vascular surgery, hematology, and intensive care. Early intervention with individualized surgical and anticoagulation strategies is crucial in optimizing outcomes. Further research is needed to refine surgical decision-making, improve postoperative anticoagulation protocols, and enhance patient survival in these complex thrombotic conditions.}, }
@article {pmid41341021, year = {2025}, author = {Araújo, TP and Luz, GVDS and Gomes, MMF and Araújo, ALS and Silva, W}, title = {Changes on computed tomography in post-acute COVID-19 syndrome: systematic review and meta-analysis.}, journal = {Radiologia brasileira}, volume = {58}, number = {}, pages = {e20250012}, pmid = {41341021}, issn = {0100-3984}, abstract = {The objective of this systematic review and meta-analysis of observational studies was to estimate the prevalence of residual alterations in the lung parenchyma on computed tomography (CT) after coronavirus disease 2019 (COVID-19), correlating those alterations with the severity of the acute phase of the disease. We reviewed data related to adult patients evaluated at 3, 6, and 12 months after the diagnosis of moderate-to-critical COVID-19. We performed structured searches of 14 databases, encompassing works published between January 2020 and January 2024. Thus, 44 primary studies were selected. Data on mild cases of COVID-19 were excluded, as were those related to assessment of the acute phase of the disease. The results were analyzed descriptively, and meta-analyses were conducted to estimate prevalence. The estimated prevalence of altered CT scans at post-diagnosis months 3, 6, and 12 was 69.0% (95% CI: 60.0-77.6%; I [2] = 86%; p < 0.001), 62.0% (95% CI: 52.0-71.5%; I [2] = 77%; p < 0.001), and 54.0% (95% CI: 40.0-67.5%; I [2] = 88%; p < 0.001), respectively. There was no correlation between severity of the acute phase and the persistence of alterations on CT in general. Among the CT scans acquired at post-diagnosis month 3, alterations indicative of fibrosis were observed in 22% (95% CI: 13-30%; I [2] = 85%; p < 0.001), and no reduction in that prevalence was observed at the subsequent time points (rho-s = 0.952; p < 0.000). The severity of the acute phase showed a positive correlation with the presence of lesions indicative of pulmonary fibrosis on CT scans acquired at 3 months after the diagnosis of COVID-19.}, }
@article {pmid41338067, year = {2025}, author = {Lei, Y and Xu, J and Ma, Y}, title = {The association between psychological distress and internet addiction: A systematic review and three-level meta-analysis.}, journal = {Clinical psychology review}, volume = {123}, number = {}, pages = {102684}, doi = {10.1016/j.cpr.2025.102684}, pmid = {41338067}, issn = {1873-7811}, abstract = {Internet addiction has emerged as a global public health concern, with psychological distress recognized as a key contributing factor. Numerous studies have investigated the association between psychological distress and Internet addiction; however, their findings have remained inconsistent, and the moderating factors influencing this relationship have not been comprehensively examined. To address these gaps, the present study conducted a three-level meta-analysis to systematically assess the association between psychological distress and Internet addiction, as well as to explore potential moderators. In total, 135 studies involving 263,780 participants and 632 effect sizes were identified by a systematic literature search. The results revealed a significant positive correlation between psychological distress and Internet addiction. Furthermore, several variables significantly moderated this relationship, including study design, publication year, COVID-19 pandemic context, gender, age group, educational stage, country, living arrangement, measurement of Internet addiction, dimensions of Internet addiction, and types of Internet addiction. These findings provide more comprehensive insights to understand the complex link between psychological distress and Internet addiction and offer theoretical guidance for the development of targeted prevention and intervention strategies.}, }
@article {pmid41337665, year = {2025}, author = {Filippo, LD and Terenzi, U and Giustina, A}, title = {Vitamin D in the elderly: the phil-rouge in preventing bone, muscle and adipose deterioration?.}, journal = {Archives of endocrinology and metabolism}, volume = {70}, number = {Spe1}, pages = {e250281}, pmid = {41337665}, issn = {2359-4292}, mesh = {Humans ; *Vitamin D Deficiency/complications/epidemiology/physiopathology ; *Vitamin D/therapeutic use/physiology/metabolism ; Aged ; *Sarcopenia/prevention &amp; control/etiology ; *Adipose Tissue/metabolism ; *Aging/physiology ; }, abstract = {The pleiotropic role of vitamin D in human health has been implicated in modulating bone metabolism and other several extraskeletal areas, including muscle and adipose tissues regulation, and in influencing general and systemic outcomes. In the elderly, vitamin D deficiency is considered as an emerging public health issue affecting 40%-70% of older adults worldwide with higher rates occurring in institutionalized individuals or patients with multiple chronic comorbidities. The pathophysiology of vitamin D deficiency in the elderly is multifactorial and includes age-related reduced skin synthesis, limited sun exposure, declined renal and liver function, and long-term use of interfering medications. Given its pleiotropic effects, vitamin D deficiency in the elderly has been consistently associated with progressive bone deterioration and muscle and adipose dysfunctions, concurring to the occurrence of the osteosarcopenic obese phenotype. This multifaced deleterious scenario is strongly correlated with an increasing risk of fragility fractures, falls, functional and metabolic decline, all of which contribute to higher morbidity and mortality. Early diagnosis and screening with individualized criteria, targeted and personalized strategies for supplementation, and structured follow-up monitoring are required to reduce the clinically significant impact of vitamin D deficiency in this highly vulnerable population.}, }
@article {pmid41334985, year = {2025}, author = {McNulty, MA and Agosto, ER}, title = {Infection Risk From Humans and Animals in the Anatomy Laboratory: A Scoping Review.}, journal = {Clinical anatomy (New York, N.Y.)}, volume = {}, number = {}, pages = {}, doi = {10.1002/ca.70049}, pmid = {41334985}, issn = {1098-2353}, abstract = {Whole-body dissection is a cornerstone of anatomy education. During and following the COVID-19 pandemic, exposure to infectious agents and other risks of dissection were highlighted. To identify potential risks, one must have the data outlining these risks in specific situations. However, information regarding the risks of encountering an infectious pathogen in donors is not readily available for educators and anatomical programs and there are presently no universal guidelines for lowering the risk of exposure to such pathogens. Therefore, this scoping review aims to provide information regarding infectious pathogens that one may encounter in the anatomy lab when engaging in dissection of both humans and animals, including zoonoses (e.g., rabies), blood-borne pathogens (e.g., HIV, HPV), and pathogens that pose a relatively less serious risk to the health of dissectors (e.g., fungal infections). A systematic and comprehensive search across PubMed/MEDLINE, Scopus, and ERIC databases without date restrictions was performed. When data were available, the prevalence of these pathogens within the worldwide population, viability in cadavers and the surrounding laboratory environment, and effects of formaldehyde fixation on pathogen infectivity are provided. This review also provides examples of mitigation methods and their effectiveness in reducing the risk of exposure to pathogens in the anatomy laboratory as published in the literature. A summary of potential toxicological hazards encountered in the lab is also included. Overall, this scoping review charts existing literature to provide information that anatomy programs worldwide can utilize to identify potential risks and identify mitigation methods to reduce such risks while dissecting.}, }
@article {pmid41334208, year = {2025}, author = {Kim, HK and Ryu, B and Yoo, MG and Kim, J and Min, KD}, title = {[Analysis of Coronavirus Disease 2019 Prediction Studies in the Republic of Korea].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {18}, number = {34}, pages = {1261-1276}, pmid = {41334208}, issn = {2586-0860}, abstract = {OBJECTIVES: During the initial outbreak of coronavirus disease 2019 (COVID-19), numerous predictive studies were conducted amid high uncertainty regarding the characteristics of the virus, and the study results were considered in the policymaking process.<br><br>METHODS: This study systematically analyzed research papers that predicted the spread of COVID-19 in the Republic of Korea. Focusing on 138 studies published between 2020 and October 15, 2024, it examined the data and methodologies employed and explored ways to enhance the utility of predictive outcomes in managing infectious disease outbreaks.<br><br>RESULTS: These methodologies included mathematical models, statistical models, and machine learning-based approaches to predict COVID-19 spread patterns. Beyond forecasting future outbreak trends, these predictive models were also instrumental in evaluating existing measures and proposing effective policies through scenario-based assumptions.<br><br>CONCLUSIONS: This study's findings highlight the importance of multidisciplinary collaboration in developing predictive models to effectively prepare for and respond to infectious diseases. By doing so, it aims to minimize the public health impacts of infectious diseases.}, }
@article {pmid41333612, year = {2025}, author = {Pan, Q and Sun, Y and Bai, H and Wang, W and Liu, B and Li, M and Gao, A and Zheng, D and Jiang, W and Hu, H and Zhang, H and Xiang, Y and Wei, Z and Zheng, L}, title = {Design of Mucosal Vaccines Against Swine Enteric Coronaviruses: From Antigen Delivery to Immune Activation.}, journal = {Transboundary and emerging diseases}, volume = {2025}, number = {}, pages = {3230453}, pmid = {41333612}, issn = {1865-1682}, mesh = {Animals ; Swine ; *Viral Vaccines/immunology/administration &amp; dosage ; *Swine Diseases/prevention &amp; control/virology/immunology ; *Immunity, Mucosal ; *Coronavirus Infections/veterinary/prevention &amp; control/immunology/virology ; *Coronavirus/immunology ; Antigens, Viral/immunology/administration &amp; dosage ; }, abstract = {Swine enteric coronaviruses (SeCoVs) cause acute enteritis and high mortality in neonatal piglets, posing a significant threat to the swine industry. Injectable vaccines often fail to induce effective mucosal immunity, and their efficacy is further compromised by maternally derived antibodies. Oral and intranasal mucosal vaccines offer promising alternatives, enabling localized and durable protection. This review summarizes recent advances in mucosal vaccines against SeCoVs, focusing on antigen delivery platforms and mucosal immune activation. Novel antigen delivery platforms, including nanoparticles (NPs), hydrogels, engineered probiotics, recombinant viral vectors, and eukaryotic expression systems, have improved antigen stability and facilitated transport across the epithelium to mucosal inductive sites. Moreover, targeting strategies that focus on microfold cells (M cells) and dendritic cells (DCs) enhance antigen uptake and presentation. These delivery systems promote mucosal immune activation by inducing secretory IgA (sIgA), maintaining Th1/Th2 balance, and promoting the generation of T and B cells. In addition, the incorporation of adjuvants further strengthens these responses, resulting in more robust and durable protection. By synergistically integrating advanced mucosal vaccine delivery systems with rational adjuvant strategies, this review provides theoretical and practical perspectives for the development of safe, effective, and broadly protective mucosal vaccines targeting SeCoVs infections.}, }
@article {pmid41333533, year = {2026}, author = {Cheng, EY and Mirzaei, A}, title = {Is COVID-19 infection an independent etiologic factor in osteonecrosis development beyond corticosteroid exposure?.}, journal = {Journal of orthopaedics}, volume = {72}, number = {}, pages = {27-32}, pmid = {41333533}, issn = {0972-978X}, abstract = {INTRODUCTION: An increased incidence of non-traumatic osteonecrosis has been reported during the COVID-19 pandemic. Corticosteroid therapy, particularly dexamethasone, has often been implicated as a major risk factor. However, emerging evidence suggests that the pathogenesis of osteonecrosis in COVID-19 patients may extend beyond corticosteroid exposure.<br><br>HYPOTHESIS: COVID-19 infection itself may serve as an independent etiologic factor in osteonecrosis, with virus-induced pathogenic mechanisms synergizing with corticosteroid exposure to heighten risk, even at lower doses and shorter treatment durations.<br><br>METHODS: This review synthesizes available literature on COVID-19, corticosteroid therapy, and osteonecrosis pathogenesis. Evidence from clinical observations, mechanistic studies, and prior models of corticosteroid-induced osteonecrosis were examined to identify overlapping and distinct pathways contributing to disease development.<br><br>RESULTS: Findings indicate that COVID-19 and corticosteroids converge on common pathogenic pathways-lipid dysregulation, impaired bone homeostasis, endothelial dysfunction, and coagulopathy. COVID-19 additionally promotes osteonecrosis through cytokine storm-driven inflammation. The combined effects of viral infection and corticosteroid therapy amplify disease risk, explaining reported cases of osteonecrosis even under reduced corticosteroid exposure.<br><br>CONCLUSION: COVID-19 may represent an independent etiologic factor for osteonecrosis, with intrinsic viral effects potentiating the impact of corticosteroids. Recognition of this dual risk underscores the need for preventive and therapeutic strategies tailored to COVID-19-associated osteonecrosis.}, }
@article {pmid41333147, year = {2025}, author = {Ahn, YJ and Jung, C and Rhee, JE and Kim, EJ}, title = {[Overview of PCR-based Diagnostic Assays for Emerging Infectious Disease Pathogens].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {18}, number = {45}, pages = {1813-1832}, pmid = {41333147}, issn = {2586-0860}, abstract = {OBJECTIVES: Continuous genetic variation in pathogens enhances their infectious potential and promotes the emergence of infectious disease outbreaks, highlighting the need for diagnostic technologies capable of broad-range detection. Herein, we introduce pan-polymerase chain reaction (pan-PCR) and multiplex PCR assays to identify the causative agents of emerging or unknown infectious diseases.<br><br>METHODS: To introduce the research, development, and practical applications of pan-PCR and multiplex PCR assays for pathogen diagnosis, a comprehensive review was conducted. The review focused on recent domestic and international institutional reports and academic literature on public health and PCR-based diagnostic methods. Literature published since the coronavirus disease 2019 pandemic was included.<br><br>RESULTS: Both technologies have been recognized as core diagnostic approaches to effectively respond to emerging and unknown infectious diseases. Pan-PCR uses conserved gene regions for the initial screening of unknown pathogens, whereas multiplex PCR is used to simultaneously identify specific pathogens, including co-infection cases. These two technologies could be utilized complementarily to identify the causative agents of emerging infectious diseases.<br><br>CONCLUSIONS: Pan-PCR and multiplex PCR show promise as key diagnostic platforms to facilitate proactive responses in the face of infectious disease threats in the future. The simultaneous use of both technologies, capitalizing on their respective strengths in versatility and specificity, is likely to improve diagnostic capabilities for emerging or unknown infectious diseases and strengthen public health surveillance.}, }
@article {pmid41332800, year = {2024}, author = {Lee, JH and Park, HJ and Yi, H and Chung, YS}, title = {[Application and Significance of Wastewater-based Pathogen Monitoring in Infectious Disease Surveillance: Insights from International Case Studies].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {48}, pages = {2134-2146}, pmid = {41332800}, issn = {2586-0860}, abstract = {Wastewater-based monitoring of pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as a highly effective tool for infectious disease surveillance systems. Wastewater surveillance systems can detect emerging infectious diseases or new viral variants in a community earlier than hospital-based clinical surveillance systems, thereby preventing the spread of infections. In particular, it provides a foundation for rapid response to variants with higher transmissibility and virulence. This study aims to examine how wastewater-based pathogen surveillance can be applied to monitor pathogen mutations through case studies from various countries worldwide. Moreover, wastewater surveillance is more cost-effective than mass testing in areas with low clinical testing rates and large populations. Genomic analysis of wastewater can detect several pathogens that may not be captured by clinical surveillance, thereby providing critical information for predicting the emergence of potential variants. In conclusion, wastewater-based pathogen surveillance is a valuable tool in public health management to respond to infectious diseases. It enables the monitoring of infectious disease spread and pathogen mutation trends. In addition, it can function as an early warning system through the analysis of wastewater from communities.}, }
@article {pmid41331990, year = {2025}, author = {Haensler, J and Even, L and Wils, P and Bensaid, F and Dias, A and Deng, H and Karve, S and DeRosa, F}, title = {Not so cold! Improving the thermostability of mRNA vaccines.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {1149-1162}, doi = {10.1080/14760584.2025.2596674}, pmid = {41331990}, issn = {1744-8395}, mesh = {*COVID-19 Vaccines/chemistry/immunology/administration &amp; dosage ; Drug Stability ; Humans ; *Vaccines, Synthetic/immunology/chemistry ; *COVID-19/prevention &amp; control ; *mRNA Vaccines/chemistry ; *RNA, Messenger/chemistry/immunology ; SARS-CoV-2/immunology ; Temperature ; }, abstract = {INTRODUCTION: One of the biggest challenges in the mRNA-LNP vaccine field is product stabilization to overcome the logistical hurdles linked to the ultra-cold distribution chain associated with first-generation mRNA SARS-CoV-2 vaccines. Despite recent progress in the field, many R&amp;D efforts remain focused on the development of mRNA-LNP vaccines that would be as stable as liquid formulations for storage at refrigerated or room temperatures.<br><br>AREAS COVERED: After an overview of the underlying mechanisms of mRNA-LNP instability, this review provides an update on the different approaches that are currently explored to improve mRNA-LNP thermostability, encompassing mRNA sequence optimization, nucleotide modification and mRNA-LNP design strategies as well as formulation process optimization. Alternative approaches for mRNA-LNP stabilization such as lyophilization, dual-vial formulations and the replacement of water with deep eutectic solvents in the mRNA-LNP process and products are also discussed.<br><br>EXPERT OPINION: Achieving robust thermostability of mRNA vaccines will require a multifactorial optimization strategy, integrating advances in sequence engineering, novel formulation designs, buffer composition, excipient selection and manufacturing processes.}, }
@article {pmid41331441, year = {2025}, author = {Iseme-Ondiek, R and Ogero, M and Odhiambo, R and Barr, BT and Kabudula, C and Bashingwa, JJH and Ngugi, AK}, title = {Pre- and during -COVID-19 pandemic mortality trends and drivers in rural, coastal Kenya: findings from the Kaloleni-Rabai Health and Demographic Surveillance System.}, journal = {Population health metrics}, volume = {23}, number = {Suppl 2}, pages = {69}, pmid = {41331441}, issn = {1478-7954}, support = {INV-030309/GATES/Gates Foundation/United States ; INV-050361//Bill and Melinda Gates Foundation/ ; }, mesh = {Humans ; *COVID-19/mortality/epidemiology ; Kenya/epidemiology ; Male ; Female ; Adult ; Middle Aged ; *Rural Population/statistics &amp; numerical data ; *Mortality/trends ; Adolescent ; Young Adult ; SARS-CoV-2 ; Population Surveillance ; Aged ; Pandemics ; Child ; Child, Preschool ; Proportional Hazards Models ; Infant ; Cohort Studies ; }, abstract = {BACKGROUND: There is contradicting information regarding the effect of COVID-19 on mortality in African settings. Knowledge of the complete direct and indirect burden of COVID-19 on mortality is heavily reliant on the availability of a population-based surveillance system. Here we provide robust data on the effect of COVID-19 on mortality trends in a rural, coastal, Kenyan community.<br><br>METHODS: A historical cohort study using data from the Kaloleni Rabai Health and Demographic Surveillance System was conducted with special focus on two discernible time periods representing the pre-COVID-19 (2018-2019) and COVID-19 (2020-2021) periods. Mortality rates were estimated as the total number of deaths divided by the person-time (years) at risk, accounting for attrition, and calculated separately for the two periods. A cox proportional hazards model was used to estimate the impact of COVID-19 on mortality.<br><br>RESULTS: 1191 deaths occurred between 2018 and 2021. There was no significant change in overall mortality rates between pre-COVID-19 and COVID-19 periods (3.7 and 3.6 per 1000 person years at risk respectively, p&#x2009;=&#x2009;0.74). Older age was significantly associated with mortality (a_HR: 1.05, 95% CI: 1.05-1.06; p&#x2009;<&#x2009;0.001). However, an interaction term between age and time-period appeared to reverse this association (a_HR: 0.99, 95% CI: 0.99-1.00; p&#x2009;<&#x2009;0.001).<br><br>CONCLUSIONS: Our findings suggest that although overall COVID-19 did not directly impact mortality rates within this rural population, the onset of the pandemic did appear to reverse and/or attenuate the impact of several risk factors on mortality. It is possible that COVID-19 brought health and wellness into sharp focus, making people more vigilant about their health, hygiene and associated preventive measures.}, }
@article {pmid41331333, year = {2025}, author = {Alsaikhan, F and Farhood, B}, title = {Phytochemical-Based Immunomodulation: A Promising Therapeutic Approach for Viral Infections.}, journal = {Phytotherapy research : PTR}, volume = {}, number = {}, pages = {}, doi = {10.1002/ptr.70143}, pmid = {41331333}, issn = {1099-1573}, support = {PSAU/2024/03/30823//Prince Sattam bin Abdulaziz University/ ; }, abstract = {Viral diseases, whether pandemic, endemic, or epidemic, are a leading cause of global mortality and disability. Consequently, developing effective viral inhibitors is a critical public health priority. Beyond antiviral drugs, a promising therapeutic strategy involves using immunomodulators, which are antiviral agents that enhance the host's immune system against infection. Phytochemicals (PCHs) derived from plants exhibit diverse bioactive properties, including significant antioxidant and immunomodulatory effects. Notably, PCHs have attracted considerable attention due to their broad-spectrum inhibitory actions against numerous viruses, including SARS-CoV-2, dengue virus, hepatitis viruses, and herpes viruses. Recent research has shown how PCHs may target specific signaling pathways implicated in a cytokine storm, a potentially fatal clinical syndrome characterized by an excessive production of pro-inflammatory cytokines and immune cell activation. Numerous studies have investigated the immunomodulatory effects of PCHs on immune function, specifically their ability to regulate key cellular and molecular interactions within the immune system. Additionally, by modulating host immunity, PCHs can enhance the antiviral response. Furthermore, these substances interfere with complex cellular signaling networks, emphasizing their efficacy in preventing viral infections. This review examines the significant and advanced mechanisms PCHs influence immune function during viral illnesses. We subsequently evaluate the potential applications of PCHs as immunomodulatory agents for treating viral infections and discuss their current clinical limitations.}, }
@article {pmid41329625, year = {2025}, author = {Ben-Shoshan, D and Rodriguez-Imbarlina, M and Singer, A and Abrams, E and Protudjer, JLP}, title = {Transforming Access to Asthma Care in Underserved Communities- A Scoping Review.}, journal = {International archives of allergy and immunology}, volume = {}, number = {}, pages = {1-17}, doi = {10.1159/000549580}, pmid = {41329625}, issn = {1423-0097}, abstract = {INTRODUCTION: Asthma is a complex chronic illness with significant morbidity and costs that can be prevented by effective management. The COVID-19 pandemic introduced large-scale changes in healthcare delivery from in-person, to virtual delivery, providing the opportunity to explore telemedicine and asthma management. We aimed to conduct a scoping review on telemedicine and asthma management and accessibility to treatment in underserved population groups.<br><br>METHODS: We performed a scoping review per the Arksey and O'Malley framework. Search terms included asthma, telehealth, telemedicine, virtual care. Searches were performed on four databases (OVID Medline; CINAHL; World of Science; Embase) in publications from 2010 onward, followed by double-blinded, full-text screening using Covidence.<br><br>RESULTS: Our initial search yielded 811 articles, of which after de-duplication and abstract screening, 171 articles remained. We adjusted our inclusion criteria to include articles which discussed asthma telemedicine accessibility only in underserved/vulnerable patient cohorts. Based on these articles, we stratified results into main population categories. These categories were found to be "rural communities" (n=3); "lower-income rural communities" (n=2); "non-rural populations, lower-income" (n=1); "Black, Indigenous, People of Colour (BIPOC) patient populations "(n=4); "English-as-a-Second-Language (ESL) patients" (n=1). Each article was placed in its own, respective category and was not repeated in more than one category. Most articles (n=9, 69%) reported a positive association between telehealth use however with reported barriers such as the "digital divide" (n=3, 21%).<br><br>CONCLUSION: While telemedicine may have a positive effect on asthma care, inaccessibility continues to persist as barriers are not fully bridged by telemedicine.}, }
@article {pmid41328522, year = {2025}, author = {Powis, M and Ali, A and Salmini, J and Hack, S and Fazelzad, R and Barbara, L and Berlin, A and Cheung, M and DeVera, M and Edwards, A and McTaggart-Cowan, H and Olson, R and Peacock, S and Sayani, A and Singh, S and Krzyzanowska, MK}, title = {Virtual Care, What Are We Measuring and What Should We Measure? Scoping Review of Reviews.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e65312}, doi = {10.2196/65312}, pmid = {41328522}, issn = {1438-8871}, mesh = {Humans ; COVID-19/epidemiology ; *Telemedicine ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Virtual care is here to stay; however, there remains no comprehensive measurement framework to guide evaluation of its impacts, to inform policy decisions, and to support optimization of practice.<br><br>OBJECTIVE: This study aimed to conduct a scoping review of reviews to synthesize measures related to virtual care evaluation across clinical conditions and contexts to identify gaps in current evaluation measures and to inform the development of recommendations for future work.<br><br>METHODS: Citations published from 2015 to 2023 were retrieved from MEDLINE, Cochrane Database of Systematic Reviews, Embase, Emcare, Scopus, CINAHL, and Web of Science using search terms grouped by key concepts (virtual care and evaluation or quality measurement). Measures were defined as any quantitative or qualitative evaluation of performance or impact of virtual care on processes, outcomes, or systems. Articles were excluded if they were not a literature review (eg, primary results, commentaries, letters, protocols), dealt exclusively with pediatric populations, were published in a language other than English, or were abstracts only. Measures from retained articles (1233) were thematically grouped against the Proctor Implementation Research Outcomes framework. The study was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline extension for scoping reviews.<br><br>RESULTS: There has been substantial growth in the virtual care literature, particularly since the start of the COVID-19 pandemic. The majority of articles (900/1233, 73.0%) evaluated client outcomes, including satisfaction with virtual care, usability or functionality of platforms, or clinical outcomes. Relative to the other domains of the Proctor framework, implementation measures were poorly defined, and many of the measures were proxy rather than direct measures. Despite the potential impacts of virtual care on health equity, most studies examining health equity were purely qualitative. Measures of safety, privacy, and security of virtual care were sparse and poorly defined. Caregivers play an important role in facilitating virtual visits and providing informal technical support; however, few studies examined implementation or satisfaction with virtual care from the perspective of caregivers. Additionally, clinician experience and acceptance of virtual care have implications for availability and adoption; however, relative to patients, few articles examined this perspective.<br><br>CONCLUSIONS: Our study highlights gaps in current evaluations of virtual care. Work is needed to improve the quality and standardization of virtual care evaluation to ensure reproducibility, generalizability, and comparability of findings. Additionally, compliance with existing measure definitions and conventions should extend to virtual care. Finally, additional theoretical work is needed to standardize and conceptually frame future virtual care evaluations. Future studies should include both the caregiver and clinician as unique perspectives in evaluations and should embed systematic evaluations of the impact of social determinants of health on virtual care access, adoption, and perceptions of care.}, }
@article {pmid41326937, year = {2025}, author = {Li, MQC and Wang, S and Lin, SR and Ting, LEN and Wan, ZH and Xie, G and Zhang, J}, title = {Advantages and Limitations of AlphaFold in Structural Biology: Insights from Recent Studies.}, journal = {The protein journal}, volume = {}, number = {}, pages = {}, pmid = {41326937}, issn = {1875-8355}, abstract = {Over the past three years, AlphaFold-a deep learning-based protein structure prediction system-has transformed structural biology by providing near-experimental accuracy models directly from amino acid sequences. This narrative review synthesizes applications reported in the 2022-2025 literature across human, microbial, and viral systems, drawing on peer-reviewed studies as our data source. Representative examples include modeling of SARS-CoV-2 spike and nucleocapsid proteins in virology, assisting cryo-EM interpretation of bacterial ribosomal and membrane-protein complexes in microbiology, and refining conformational hypotheses for human GPCRs in biomedicine. Across these cases, AlphaFold predictions have complemented experimental workflows by accelerating hypothesis generation, improving model fitting within ambiguous density regions (poorly resolved areas of cryo-EM maps), and guiding mutagenesis strategies to probe dynamic conformational states. We also summarize recent method extensions: AlphaFold-Multimer improves multi-chain complex assembly prediction, while molecular dynamics (MD) simulations augment AlphaFold's static models by sampling conformational flexibility and testing stability. Despite these advances, important limitations remain-particularly for intrinsically disordered regions, protein-ligand and protein-cofactor interactions, and very large or transient assemblies-and current community benchmarks indicate that approximately one-third of residues may lack atomistic precision, underscoring uncertainty in flexible or modified segments. Framed within a clear chronological window and evidence base, our analysis highlights both the practical impact and the remaining challenges of integrating AlphaFold with experiment, outlining priorities where further methodological innovation and orthogonal validation are needed.}, }
@article {pmid41325621, year = {2025}, author = {Soumare, A and Kapfer, T and Botrel, T and Adda, L and Renaux, M and Blot, PL and Constantin, JM and James, A and Braïk, R}, title = {Systemic Corticosteroids, Mortality, and Infections in Pneumonia and Acute Respiratory Distress Syndrome : A Systematic Review and Meta-analysis.}, journal = {Annals of internal medicine}, volume = {}, number = {}, pages = {}, doi = {10.7326/ANNALS-25-03055}, pmid = {41325621}, issn = {1539-3704}, abstract = {BACKGROUND: The benefit-risk profile of systemic corticosteroids in non-COVID-19 pneumonia and acute respiratory distress syndrome (ARDS) remains debated.<br><br>PURPOSE: To assess corticosteroid effects on mortality and infection-related complications in adults with severe pneumonia or ARDS.<br><br>DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform through September 2025.<br><br>STUDY SELECTION: Randomized controlled trials comparing systemic corticosteroids with placebo and usual care. Primary analysis: severe pneumonia or ARDS with corticosteroids 3 mg/kg[-1] of body weight per day[-1] or less (prednisone-equivalent) for 15 days or less, initiated within 7 days.<br><br>DATA EXTRACTION: Paired reviewers; consensus for disagreements.<br><br>DATA SYNTHESIS: From 16&#x2009;831 screened records, 20 studies (15 severe pneumonia, 5 ARDS) including 3459 participants met criteria. Low-dose, short-course corticosteroids probably reduce short-term mortality in severe pneumonia (15 studies, 2445 participants; risk ratio [RR], 0.73 [95% CI, 0.57 to 0.93]; I [2&#x2009;]= 14%; moderate certainty) and ARDS (5 studies, 1014 participants; RR, 0.77 [CI, 0.61 to 0.99]; I [2&#x2009;]= 23%; moderate certainty). Corticosteroids may reduce secondary shock in severe pneumonia (9 studies, 1690 participants; RR, 0.49 [CI, 0.26 to 0.92]; I [2&#x2009;]= 55%; low certainty). They probably result in little to no difference in hospital-acquired infections (severe pneumonia: 7 studies, 1665 participants; RR, 0.99 [CI, 0.82 to 1.20]; I [2&#x2009;]= 0%; moderate certainty; ARDS: 4 studies, 677 participants; RR, 0.97 [CI, 0.59 to 1.59]; I [2&#x2009;]= 0%; low certainty) or secondary pneumonia (severe pneumonia: 4 studies, 1011 participants; RR, 0.96 [CI, 0.66 to 1.39]; I [2&#x2009;]= 0%; ARDS: 4 studies, 677 participants; RR, 0.88 [CI, 0.43 to 1.79]; I [2&#x2009;]= 0%; both low certainty). Evidence is very uncertain for catheter-related and bloodstream infections. Long-term mortality evidence is very uncertain for severe pneumonia.<br><br>LIMITATION: Heterogeneous pneumonia severity classification limiting subgroup precision.<br><br>CONCLUSION: In severe pneumonia and ARDS, adjunct corticosteroids probably reduce short-term mortality. In severe pneumonia, they may reduce secondary shock. In both conditions, corticosteroids may have little or no effect on hospital-acquired infections.<br><br>PRIMARY FUNDING SOURCE: None. (PROSPERO: CRD42024536301).}, }
@article {pmid41325566, year = {2025}, author = {Malagón-Rojas, J and Chen, K}, title = {Health effects of wildfire PM2.5 in Latin American cities: A rapid systematic review and comparative synthesis.}, journal = {Biomedica : revista del Instituto Nacional de Salud}, volume = {45}, number = {Sp. 2}, pages = {41-55}, doi = {10.7705/biomedica.8068}, pmid = {41325566}, issn = {2590-7379}, mesh = {Humans ; Latin America/epidemiology ; *Particulate Matter/adverse effects/toxicity/analysis ; *Wildfires ; *Air Pollutants/adverse effects ; COVID-19/epidemiology ; Cities ; *Smoke/adverse effects ; Urban Health ; Air Pollution/adverse effects ; Environmental Exposure/adverse effects ; Cardiovascular Diseases/mortality/etiology ; }, abstract = {INTRODUCTION: Wildfire activity is intensifying in Latin America due to climate and land-use changes, but the health impacts of wildfire-derived PM2.5 in urban areas remain poorly quantified and recognized.<br><br>OBJECTIVE: To assess the evidence on wildfire-related PM2.5 and its association with mortality and morbidity in Latin American cities.<br><br>MATERIALS AND METHODS: We conducted a rapid systematic review and meta-analysis following PRISMA guidelines, using data from PubMed, Scopus, and Bireme. One reviewer independently screened 163 articles and extracted data from 14 eligible studies. A risk of bias assessment was conducted using the Newcastle-Ottawa Scale.<br><br>RESULTS: Most studies were conducted in Brazil (n = 12) and used time-series or modelling designs to estimate health risks. Wildfire-specific PM2.5 exposure was associated with allcause, cardiovascular, and respiratory mortality. Reported effect estimates ranged from 1.7 to 7.7% increases in risk per 10 &#x3bc;g/m&#xb3; of exposure. Other studies assessed preterm birth, COVID-19 outcomes, and site-specific cancers. While two studies provided harmonized RR estimates for all-cause mortality, high heterogeneity and methodological differences prevented formal meta-analysis.<br><br>CONCLUSION: Wildfire smoke contributes measurably to premature mortality in Latin America, but current evidence is unevenly distributed across regions, time periods, and population subgroups. Studies rarely capture the disproportionate risks faced by indigenous and rural communities or the intraurban disparities linked to poverty and geography. Future research should focus on the health burden of morbidity linked to wildfire PM2.5.}, }
@article {pmid41324875, year = {2025}, author = {Vargas-Zambrano, JC and Abrudan, S and Macina, D}, title = {Understanding the Epidemiology and Contributing Factors of Post-COVID-19 Pertussis Outbreaks: A Narrative Review.}, journal = {Infectious diseases and therapy}, volume = {}, number = {}, pages = {}, pmid = {41324875}, issn = {2193-8229}, abstract = {Pertussis or whooping cough, caused by the bacteria Bordetella pertussis, is a highly contagious respiratory disease. Over the past century, whole-cell pertussis (wP) and acellular pertussis (aP) vaccines were developed and widely adopted, leading to a substantial reduction in the number of pertussis cases. Currently, various strategies are employed to protect different segments of the population, including primary immunization, toddler and school-age boosters, adult boosters, and vaccination in pregnancy (ViP). Nonetheless, pertussis remains a global health challenge with periodic outbreaks occurring every 2-5 years. The non-pharmacological measures implemented during the COVID-19 pandemic resulted in a drastic reduction in the circulation of B. pertussis. However, post-pandemic, there has been a resurgence in pertussis cases. This review aims to explore the post-pandemic global pertussis outbreaks and identify underlying trends to gain insights into the potential contributing factors. As of June 2025, pertussis outbreaks with diverse epidemiological patterns have been reported in at least 42 countries, including 30 aP and 12 wP vaccine-using countries. Some common observations among these countries include low infant immunization rates and an absence of vaccination programs for specific populations such as school-aged children, adults, and pregnant individuals. Additionally, in countries with extensive immunization schedules and high vaccination uptake, outbreaks have occurred in regions with low vaccination coverage rates (VCRs). Multiple interrelated factors may have contributed to the post-pandemic pertussis outbreaks, such as the cyclic epidemiology of pertussis, low VCR, waning vaccine-derived immunity, low uptake of boosters, and lack of lifelong protection through regular boosters. To effectively mitigate the incidence of pertussis outbreaks, it is crucial to administer regular booster vaccinations throughout an individual's lifetime, with particular emphasis on at-risk populations and pregnant individuals. A Graphical Abstract is available for this article.}, }
@article {pmid41324846, year = {2025}, author = {Jing, S and Meng, H and Dong, C and Li, B}, title = {Therapeutic effects and molecular mechanisms of isorhamnetin against pulmonary diseases.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41324846}, issn = {1568-5608}, support = {20220303001SF//Department of Science and Technology of Jilin Province/ ; }, abstract = {Pulmonary diseases are still a serious threat to human health today, particularly in light of the recent rise of novel viruses such as SARS, influenza A, and COVID-19, which have made the situation even more dire by worsening the disease's effects on global public health. Isorhamnetin (ISO), as the active component of many medicinal plants and preparations, exhibits good antiviral, anti-inflammatory, antioxidant, and anti-tumor effects. ISO has been proven to have both preventive and treatment efficacy against pulmonary diseases. This review summarizes the effects of ISO in different pulmonary diseases, including COVID-19, pneumonia, acute lung injury/acute respiratory distress syndrome, lung cancer, asthma, pulmonary arterial hypertension, and pulmonary fibrosis, highlighting its specific molecular mechanisms against various pulmonary diseases, which is helpful for providing new perspectives on the preclinical trial and clinical application of ISO.}, }
@article {pmid41324110, year = {2025}, author = {Issa, M and Lagare, A and Bachir, GAM and Bowo-Ngandji, A and Hassane, F and Magagi, LH and Mahamadou, D and Seini, H and Adehossi, E and Zoubeirou, AM}, title = {Respiratory Syncytial Virus Epidemiology During and After Covid-19 Pandemic in Africa: Systematic Review and Meta-Analysis.}, journal = {Health science reports}, volume = {8}, number = {12}, pages = {e71583}, pmid = {41324110}, issn = {2398-8835}, abstract = {BACKGROUND AND AIMS: Respiratory syncytial virus (RSV) is a major agent of acute respiratory infections in children and the elderly. RSV epidemiology has been changed by the since Covid-19 pandemic and this review aimed to assess the extent of this change in Africa.<br><br>METHODS: We searched Medline, Embase, Global Health, Web of Science, and Africa Index Medicus for studies reporting RSV epidemiology during and after the pandemic. We assessed heterogeneity using the I&#xb2; statistic and evaluated study quality with the Hoy et al. checklist for prevalence studies. Publication bias was assessed with the Egger test. Pooled estimates of prevalence and incidence were calculated using a random-effects model. Analyses were stratified by pandemic era.<br><br>RESULTS: Nineteen studies from 12 African countries, including 53,550 patients, met the inclusion criteria. The pooled prevalence of RSV infection was 13.0% (95% CI 9.5-17.1), with substantial heterogeneity (I&#xb2;&#x2009;=&#x2009;99.2% [99.1-99.3]). The Egger test showed no evidence of publication bias (p&#x2009;=&#x2009;0.745). Prevalence was highest in children (29.8% [18.8-42.1]) compared with all-age populations (5.9%; p&#x2009;<&#x2009;0.001), and in hospitalized patients compared with outpatients (21.3% vs. 11.3%; p&#x2009;<&#x2009;0.001). In the post-pandemic period, prevalence rose significantly to 30.6% (12.4-52.5), compared with 8.8% (3.7-15.7) during the pandemic (p&#x2009;=&#x2009;0.071). The overall incidence of RSV infection was 3.0 per 1000 (1.8-4.2) person-year.<br><br>CONCLUSION: This systematic review highlights a marked resurgence of RSV in Africa following the easing of COVID-19 restrictions, particularly among children. These findings underscore the urgent need for strengthened RSV surveillance, targeted prevention strategies, and expanded access to new vaccines and monoclonal antibodies.}, }
@article {pmid41323193, year = {2025}, author = {Papadopoulos, A and Duerden, EG}, title = {Coping styles, strategies and psychological distress amongst perinatal individuals during the COVID-19 pandemic: a rapid review.}, journal = {Frontiers in global women's health}, volume = {6}, number = {}, pages = {1666741}, pmid = {41323193}, issn = {2673-5059}, abstract = {INTRODUCTION: Perinatal individuals are at an increased risk of experiencing psychological distress, which often manifests in a combination of co-occurring symptoms of anxiety, depression, and stress. During the COVID-19 pandemic, the rates of psychological distress experienced by perinatal women dramatically increased, in some cases doubling or even tripling. This increase is concerning as psychological distress can impact the health and wellbeing of mothers and their offspring, including an offspring's neurocognitive, physical, mental, and socio-emotional development. The strategies a perinatal individual uses to cope with psychological distress are modifiable and, therefore, can be targeted to help improve outcomes for mothers and their offspring.<br><br>METHODS: This rapid review describes and synthesizes the literature related to coping with perinatal psychological distress during the COVID-19 pandemic. This review included twenty-four cross-sectional studies.<br><br>RESULTS: Perinatal individuals reported using various coping strategies to deal with the COVID-19 pandemic, including social strategies (e.g., connecting with others); physical strategies (e.g., exercising); cognitive strategies (e.g., positive re-appraisal); and spiritual strategies (e.g., prayer). An avoidant style of coping and its accompanying behaviours, including disengagement, substance use, and distraction via screen time/social media use, were significantly associated with higher levels of psychological distress. Strategies associated with lower levels of psychological distress included sleep and social support.<br><br>DISCUSSION: Future studies should address the impact of technology on coping and the long-term impact of coping styles used during the COVID-19 pandemic on the wellbeing of mothers and their offspring. Although this rapid review centered on the COVID-19 context, its findings are broadly relevant to women worldwide who continue to experience prolonged stressors such as climate change, poverty, and conflict.}, }
@article {pmid41322938, year = {2025}, author = {Aldaher, H and Alsaadi, FA and Bashier, S and Ali, A}, title = {Home-Based Visual Field Monitoring Devices in Glaucoma Management: A Review of Current Evidence and Barriers to Adoption.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e95680}, pmid = {41322938}, issn = {2168-8184}, abstract = {Glaucoma, which is a leading cause of irreversible blindness, along with many other conditions, relies on visual field testing, which is crucial for diagnosing, monitoring disease progression, and guiding treatment decisions. The COVID-19 pandemic accelerated the development of home-based visual field monitoring tools within telemedicine. This review summarizes the current evidence on these devices, compares them to standard automated perimetry, and discusses barriers to adoption and future directions for clinical integration.}, }
@article {pmid41321786, year = {2025}, author = {Wan, C and Tang, H and Zhu, YT and He, FF and Zhang, C}, title = {Lessons from the COVID-19 Pandemic Era: Vulnerabilities, Interventions, and Vaccination Strategies in Kidney Replacement Therapy Populations.}, journal = {Kidney diseases (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {684-694}, pmid = {41321786}, issn = {2296-9381}, abstract = {BACKGROUND: Although the World Health Organization no longer classifies coronavirus disease 2019 (COVID-19) as a global health emergency, its long-term sequelae continue to affect survivors physically, psychologically, and socially.<br><br>SUMMARY: This review focuses on a vulnerable population - patients receiving kidney replacement therapy (KRT) - and summarizes their COVID-19-associated epidemiological characteristics, clinical manifestations, clinical outcomes, interventions, and vaccination challenges.<br><br>KEY MESSAGES: KRT patients faced markedly higher severe acute respiratory syndrome coronavirus 2 infection risks, atypical clinical presentations, and high mortality rates. Specialized management strategies for patients on KRT were recommended. COVID-19 vaccination formed the cornerstone of controlling COVID-19 but also raised concerns over its long-term safety and immunogenicity profiles.}, }
@article {pmid41321678, year = {2025}, author = {Macheka, L and Kanter, R and Lawrence, M and Dernini, S and Naja, F and Oenema, S}, title = {Sustainable diets: where from and where to?.}, journal = {Journal of nutritional science}, volume = {14}, number = {}, pages = {e78}, pmid = {41321678}, issn = {2048-6790}, mesh = {Humans ; *Diet ; *Food Supply ; *Sustainable Development ; *Diet, Healthy ; *Conservation of Natural Resources ; Nutrition Policy ; Public Health ; Diet, Mediterranean ; Culture ; }, abstract = {The multilevel dimensions of sustainable diets associating food systems, public health, environmental sustainability, and culture are presented in this paper. It begins by defining sustainable diets as those that are healthful, have low environmental impacts, are affordable, and culturally acceptable. The discussion includes the history of research on sustainable diets, from initial studies focused on environmental impacts to more recent, comprehensive frameworks that integrate affordability, cultural relevance, and nutritional adequacy as key dimensions of diet sustainability. In addition, the paper highlights recent innovations, such as the Planetary Health Diet of EAT-Lancet and the SHARP model, and the conflicts and optimum trade-offs between sustainability and nutrition, particularly within low- and middle-income countries. Case descriptions of Mediterranean Diet with a focus on Traditional Lebanese Diet, and African Indigenous Foods demonstrate culturally confined dietary patterns associated with sustainability objectives. These examples show that sustainable diets are not a single set of prescriptions, but a series of multiple pathways that are shaped by local food environments, ecological belts, and sociocultural heritages. The paper also describes major policy and governance activities necessary to promote sustainable diets. Finally, the paper addresses measurement challenges and advocates for better indicator options to measure sustainable food systems in all their facets and for participatory and context-specific approaches. The discussion concludes that fairer and culturally diverse inclusion strategies, system change, and political determination are imperative in achieving sustainable diets. Diets able to sustain are posited as agents capable of driving the 2030 agenda, enhancing planetary health and social integrity.}, }
@article {pmid41321431, year = {2025}, author = {Honeyman, DA and Heslop, DJ and Lim, S and MacIntyre, CR}, title = {Chemical Warfare Through the Ages: A Systematic Review From Antiquity to the Present.}, journal = {Journal of toxicology}, volume = {2025}, number = {}, pages = {7363632}, pmid = {41321431}, issn = {1687-8191}, abstract = {Chemical warfare means the use of chemical agents that have direct toxic effects on animals, plants and humans, as weapons. The first documented use of a chemical agent for warfare purposes occurred in ancient times around 10,000 BCE in South Africa when weapons were dipped in chemicals and then used to attack and defend from enemies. However, much of the evidence lacks detail to provide thorough accounts of such events. Nevertheless, we aimed to systematically gather the most comprehensive account of all publicly known incidents involving chemical weapons throughout history. We identified 121 instances of chemical weapon use between 10,000 BCE and October 2023 spanning 49 countries and causing at minimum 2,110,360 injuries and 2,930,769 deaths. Across the 121 incidents, at least 165 chemical agents were used. Of the known chemical agents, the top three were sulphur mustard (n = 16, 12.1%), hydrogen cyanide (n = 12, 7.3%) and chlorine gas (n = 11, 6.7%). Of the known chemical classes, the top three used were vesicants (blistering agents) (n = 31, 18.8%), choking (pulmonary) agents (n = 18, 10.9%) and nerve agents (n = 18, 10.9%). If a chemical agent was not reported, the chemical class was reported as unknown (n = 35, 21.2%). A small number of chemical weapons were used that fell outside of the main categories of agents (n = 20, 12.1%). Chemical weapons remain a serious concern locally and globally, and there are few data on the global epidemiology of such incidents. Prevention, early detection and rapid response are key and can be enabled by global surveillance for chemical incidents.}, }
@article {pmid41321157, year = {2025}, author = {Aamir, J and Afridi, MK and Sajid, M and Khan, TM and Qureshi, S and Ahmed, R and Fonarow, GC and Minhas, AMK and Waqas, SA}, title = {Obesity mortality on the rise: A 54-year US perspective.}, journal = {Diabetes, obesity &amp; metabolism}, volume = {}, number = {}, pages = {}, doi = {10.1111/dom.70342}, pmid = {41321157}, issn = {1463-1326}, abstract = {Obesity has emerged as a significant public health concern in the US over the past five decades. This study analyses obesity mortality trends from 1968 to 2021, focusing on disparities across age, sex, race, and geographic regions. This population-based descriptive study used national mortality data from the CDC WONDER. Obesity deaths among individuals aged ≥25 years, recorded as the underlying cause, were identified using ICD codes from 1968 to 2021. Age-adjusted mortality rates (AAMRs) per 100 000 individuals were calculated. Temporal trends were analysed using Joinpoint regression. From 1968 to 2021, 174 625 obesity deaths were recorded. AAMRs increased from 1.15 (95% CI: 1.09-1.22) in 1968 to 3.39 (95% CI: 3.31-3.46) in 2019; AAMR rates increased from 3.39 (95% CI: 3.31-3.46) in 2019 to 4.54 (95% CI: 4.45-4.62) in 2021. The decline was noted from 1968 to 1985, followed by an increase until 2019; there was a substantial increase from 2019 to 2021 during the COVID-19 pandemic. Males had higher AAMRs than females during the latter part of the study period. Racial disparities persisted, with Black or African American individuals having higher AAMRs than White individuals during the study period. Between 1999 and 2019, obesity mortality rates ranged from 1.62 (95% CI: 1.44-1.80) in Hawaii to a high of 4.46 (95% CI: 4.21-4.72) in West Virginia. After a decline from 1968 to 1985, obesity AAMRs rose until 2019, and spiked during the pandemic, reaching their highest recorded level in 2021. Disparities persist across sex, race, and geography, warranting targeted public health strategies.}, }
@article {pmid41321098, year = {2025}, author = {Lee, SK and Kim, JH and Kim, HS}, title = {Seasonal Trends of Major Respiratory, Gastrointestinal, and Other Viral Infections in Korea: An Analysis Before, During, and After the Coronavirus Disease 2019 Pandemic.}, journal = {Annals of laboratory medicine}, volume = {}, number = {}, pages = {}, doi = {10.3343/alm.2025.0226}, pmid = {41321098}, issn = {2234-3814}, abstract = {Some viral infections display distinct seasonal patterns influenced by factors such as climate, human behavior, and viral characteristics. In this review, we investigated the seasonality of 15 viral infections in Korea. We analyzed viruses for which national surveillance data are available from the Korea Disease Control and Prevention Agency, including influenza virus, respiratory syncytial virus (RSV), rhinovirus, parainfluenza virus, metapneumovirus, human bocavirus, seasonal coronaviruses, enterovirus, adenovirus, norovirus, rotavirus, Japanese encephalitis virus, Hantaan virus, varicella-zoster virus, and mumps virus. In temperate climates, such as that in Korea, winter peaks are commonly observed for influenza, RSV, and norovirus infections, whereas enteroviruses are more prevalent in summer and early autumn. Parainfluenza viruses exhibit type-specific seasonality (circulating in warmer months from spring to autumn). During the coronavirus disease 2019 pandemic (2020-2021), the incidence of most respiratory and gastrointestinal viral infections analyzed in this study declined substantially owing to non-pharmaceutical interventions, such as social distancing and mask-wearing. After the preventive measures were relaxed, many viruses initially exhibited delayed or atypical seasonal peaks. However, by 2024, the seasonality of most, but not all, viral infections had largely returned to their pre-pandemic patterns. We also reviewed factors influencing viral seasonality, including climatic conditions, vector activity, human behavior, immunity, and viral genetic variation. These findings highlight the dynamic nature of viral seasonality and reinforce the importance of timely surveillance and flexible public health responses tailored to each country's epidemiological landscape.}, }
@article {pmid41320267, year = {2025}, author = {Uemura, K}, title = {[2-Thiouridine is a Broad-spectrum Antiviral Ribonucleoside Analogue Against Positive-strand RNA Viruses].}, journal = {Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan}, volume = {145}, number = {12}, pages = {937-944}, doi = {10.1248/yakushi.25-00139}, pmid = {41320267}, issn = {1347-5231}, mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; Animals ; *Thiouridine/pharmacology/analogs &amp; derivatives/therapeutic use/chemistry ; Virus Replication/drug effects ; RNA-Dependent RNA Polymerase/antagonists &amp; inhibitors ; *Ribonucleosides/pharmacology ; *Positive-Strand RNA Viruses/drug effects ; SARS-CoV-2 ; Dengue Virus/drug effects ; Mice ; }, abstract = {Emerging and reemerging viral infections, such as the dengue virus (DENV), continue to cause public health concerns, affecting millions of people worldwide annually. The recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak resulted in significant morbidity and mortality worldwide, seriously impacting human health and the global economy. Given the lack of effective and specific therapeutics against most emerging or reemerging viruses, the development of effective therapeutic measures against such viruses is urgently needed. Most RNA viruses have RNA-dependent RNA polymerase (RdRp), which is indispensable for the replication and transcription of viral genomes. Moreover, the core structural features of viral RdRps are functionally essential and conserved across a wide range of viruses. Thus, viral RdRp serves as a promising target for broad-spectrum antivirals. In this study, we screened nucleoside analogues from a compound library of Hokkaido University, identifying 2-thiouridine (s2U) as a broad-spectrum antiviral ribonucleoside analogue. In particular, s2U exhibited potent antiviral activity against several positive-strand RNA [ssRNA(+)] viruses, including orthoflaviviruses such as DENV and coronaviruses such as SARS-CoV-2. s2U inhibited RNA synthesis catalyzed by viral RdRp, thereby reducing viral RNA replication and improving the survival rate of mice challenged with lethal DENV2 or SARS-CoV-2 in our animal models. In addition to the potent antiviral activities in vitro and in vivo, s2U exhibited no significant toxicity, suggesting its potential as a broad-spectrum antiviral agent against ssRNA(+) viruses, including orthoflaviviruses and coronaviruses.}, }
@article {pmid41320199, year = {2025}, author = {Emdin, F and Orubu, ESF and Rogers Van Katwyk, S and Strong, K and Shaver, N and Abdullah, K and Asamoah, G and Skidmore, B and Chan, E and Poirier, MJP}, title = {COVID-19 impact on AMR: a rapid scoping review, equity analysis and evidence gap map study.}, journal = {BMJ global health}, volume = {10}, number = {11}, pages = {}, pmid = {41320199}, issn = {2059-7908}, support = {/WT_/Wellcome Trust/United Kingdom ; }, mesh = {Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Health Equity ; Pandemics ; Evidence Gaps ; }, abstract = {INTRODUCTION: The COVID-19 pandemic is expected to have impacted many drivers of antimicrobial resistance (AMR) and compounded existing societal and health inequities. This rapid scoping review examined how three selected healthcare system factors, which we have called 'drivers'-antimicrobial use, infection prevention and control and health system use-were affected by COVID-19 and how they have impacted resistance.<br><br>METHODS: Peer-reviewed searches were performed in MEDLINE, Embase and Cochrane on 19 December 2022 and updated on 25 February 2023 and 1 September 2023. Results of these searches were integrated with an initial search run on 19 October 2022, using the WHO COVID-19 Research Database. References of included studies were also searched to identify any additional relevant studies. Data on the three drivers from included studies were assessed to determine whether they influenced the emergence, spread or number of resistant infections due to antimicrobial-resistant organisms. Studies were then mapped to identify literature gaps and assessed for equity considerations and quality of evidence.<br><br>RESULTS: 63 studies were analysed. Reported COVID-19 changes to antimicrobial use were associated with increased AMR burden in hospital settings. Conversely, the infection prevention and control measures implemented to reduce COVID spread may have decreased resistance in community settings. Differences in health system use during the COVID-19 pandemic may have increased resistance, although we identified knowledge gaps on COVID-19-related changes in health system use. Few studies considered equity in their analyses and no studies directly mentioned equity. All included studies had a moderate to high risk of bias.<br><br>CONCLUSIONS: COVID-19 led to mixed effects on AMR, which depended on the setting and context. There is a need for more rigorous studies that examine how COVID-19 impacted the health system as well as socioeconomic determinants to provide evidence for future pandemics or health crises. Our findings also underscore the importance of integrating antimicrobial stewardship, robust infection prevention and equity-focused surveillance into pandemic preparedness to mitigate AMR risks in future public health emergencies.}, }
@article {pmid41319634, year = {2025}, author = {Xu, R and Ying, S and Luo, Y and Cao, M and Xuan, M and Guan, R and Liu, Z and Zhang, H}, title = {Triclosan in contaminated environment: A comprehensive review of source, distribution, toxic effects and removal technologies.}, journal = {Journal of environmental management}, volume = {396}, number = {}, pages = {128127}, doi = {10.1016/j.jenvman.2025.128127}, pmid = {41319634}, issn = {1095-8630}, abstract = {Triclosan (TCS) is an effective antibacterial agent widely used in personal care products and medical items. With the outbreak of the COVID-19 pandemic, the usage of TCS has significantly increased, leading to a growing pollution issue that has attracted considerable attention. Therefore, assessing the current TCS pollution status is vital. This review discusses distribution and migration of TCS across various environmental matrices and wastewater treatment systems. Especially, the study summarizes the concentration differences of TCS in human and biological tissues across different countries, finding higher TCS pollution levels in economically developed and densely populated regions. TCS detection methods provide technical support for assessing the distribution of TCS pollution. This paper evaluates the advantages and disadvantages of various pretreatment methods while exploring the development of different detection techniques. Optimized methods are now capable of analyzing TCS in complex matrices, with some methods achieving detection limits in the nanogram range. Notably, TCS has toxic hazards, and can be transformed into more toxic substances in the environment. It induces adverse effects on organismal growth, development, and reproduction, including inhibiting photosynthesis, reducing hatch rates, and increasing cancer incidence. Therefore, developing effective TCS removal technologies is important for environmental protection and human health. This paper systematically analyzes degradation pathways and removal efficiencies of various TCS removal technologies, offering theoretical guidance for TCS pollution management. In summary, this study offers new theoretical insights and practical solutions for tackling TCS pollution, supporting environmental management and public health policy development.}, }
@article {pmid41319443, year = {2025}, author = {Miller, M and Almomani, Y and Hopwood, P and Haghighi, P and Davis, A and Littler, E and Daly, TJ and Foebel, AD and MacEachen, E}, title = {The impact of staffing structures in long-term care homes on the quality of work-life and work outcomes of care-workers: A narrative scoping review.}, journal = {International journal of nursing studies}, volume = {174}, number = {}, pages = {105304}, doi = {10.1016/j.ijnurstu.2025.105304}, pmid = {41319443}, issn = {1873-491X}, abstract = {BACKGROUND: Chronic underfunding of the long-term care sector, coupled with increased complexity of care, has deteriorated working conditions and contributed to severe staffing shortages of healthcare workers globally. While previous reviews have examined the association between long-term care staffing and care outcomes for residents, none have examined specifically how staffing structures affect the care-workers themselves.<br><br>OBJECTIVE: The aim of this review is to investigate how staffing structures impact the quality of work-life, work-related outcomes of care-workers and the context that affects staffing decisions.<br><br>METHODS: A narrative scoping review of primary empirical peer-reviewed literature was conducted to examine how long-term care staffing structures impact quality of work-life and work outcomes of care-workers in OECD countries. PubMed, CINAHL, and Scopus databases were searched for relevant articles published within the past 10&#xa0;years. Searches yielded 4561 unique articles, which were independently screened by pairs of reviewers, of which 76 articles were included. Data were extracted and synthesized to examine the ways in which staffing structures impact the workforce, what structures existed, and how they came to be.<br><br>RESULTS: Contextual factors shaped staffing decisions in long-term care, including both organizational/regulatory practices and external issues. These included market-based ideologies, increased care complexity, regulatory requirements, COVID-19, and organizational fiscal austerity, which affected the quality of work-life and work outcomes for care-workers. These factors contributed to chronic understaffing, restructuring of skill mix, and greater reliance on agency workers. Consequences for care-workers included work intensification, unpaid labour, and strained team dynamics, particularly where registered nurse oversight was limited. While some homes developed adaptive strategies to buffer these effects, inadequate staffing often eroded job quality, undermined teamwork, and contributed to job dissatisfaction, turnover, presenteeism, and adverse physical and psychological health outcomes.<br><br>CONCLUSIONS: This review shows that staffing structures have consequences for quality of work-life and work outcomes. A reliance on lean staffing eventually destabilizes the workforce, perpetuating recruitment and retention issues. This review suggests that to create and maintain a strong long-term care workforce, sufficient staffing with the right skills and competencies need to be a priority in improvement initiatives.<br><br>REGISTRATION: Not registered.}, }
@article {pmid41318861, year = {2025}, author = {Yadav, JP and Yadav, S and Dubey, NK and Yadav, IP and Pathak, P and Verma, A}, title = {Lingering echoes of SARS-CoV-2: mechanistic insights and management of long COVID syndrome.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41318861}, issn = {1568-5608}, abstract = {Throughout the world-wide COVID-19 pandemic, there has arisen a significant and a sustained public-health issue, whereby a significant proportion of individuals report persistent symptoms, well beyond the acute period of infection. The non-united array of chronic, multisystemic events, such as fatigue, cognitive deficit, respiratory dysfunction, cardiovascular abnormalities, and neuropsychiatric disorders characterize this sequela, which is referred to as LCS. LCS is much more than the starting viral insult, as it causes long-term complications that impact various organ systems. The current review questions the pathophysiological mechanisms of LCS, including scrutinizing the importance of the dysregulation of immunity, the persistence of viral reservoirs, endothelial dysfunction, autonomic imbalance, and mitochondrial injury. We highlight the heterogeneity of the syndrome and the associated diagnostic and treatment difficulties. In addition, we stress the urgency of powerful biomarkers that will be used to diagnose LCS as early as possible and monitor it over time. Present treatment strategies, including pharmacologic therapy (immunomodulators, anticoagulants, antiviral medications, etc.) and non-pharmacologic treatment (rehabilitative programs, etc.) are discussed against the backdrop of recent clinical findings. This review incorporates the recent literature and presents a review of potential treatment options that alleviate symptoms and improve the quality of life of LCS patients. Finally, this integrated synthesis can be used by both clinicians and researchers to gain practical information on the diagnosis, treatment, and future treatment directions of LCS.}, }
@article {pmid41318508, year = {2025}, author = {Wild, U and Herman, S and König, M and Erren, TC and Lewis, P}, title = {Burnout, anxiety and depression in secondary school teachers in Europe during the COVID-19 pandemic: a systematic scoping review &amp; perspective of preventive occupational medicine.}, journal = {Journal of occupational medicine and toxicology (London, England)}, volume = {20}, number = {1}, pages = {44}, pmid = {41318508}, issn = {1745-6673}, abstract = {BACKGROUND: The COVID-19 pandemic added another layer of burden to what is already a demanding occupation; namely, secondary school teacher.<br><br>OBJECTIVE: To review the published literature concerning burnout, anxiety, and depression in secondary school teachers in Europe during the COVID-19 pandemic and to discuss the findings from the perspective of preventive occupational medicine.<br><br>METHODS: A systematic scoping review using the Medline and Web of Science databases with narrative synthesis of findings.<br><br>RESULTS: We identified 16 articles from seven European countries (Belgium, Bosnia and Herzegovina, Italy, Germany, Greece, Spain, Portugal) though results from one study were uninterpretable. Of the 15 remaining, seven assessed burnout or emotional exhaustion, seven assessed anxiety, and seven assessed depression (there was overlap). Only two studies were longitudinal and they focussed on burnout; the remaining 13 were cross-sectional in design. Questionnaires were used to assess severity scores. Mean severity scores for all outcomes appear to fluctuate across the pandemic, but are always high. Loss-to-follow up &#x2013; indicated in the longitudinal studies &#x2013; could mean a healthy worker effect (e.g. workers who fall ill and drop out of the study) biases both severity scores per se and their associations with other factors toward null in studies. Differences in- and associations with- outcome scores are reported for sex, age, job experience, cognitive-, personality-, and emotional intelligence-associated factors (e.g. extraversion, presenteeism, openness, resilience, clarity, repair), work-related factors (e.g. student issues, professional support, technology), and COVID-19 associated factors (e.g. family member vulnerability). There are differences in some findings across studies.<br><br>DISCUSSION: The COVID-19 pandemic presented a unique situation in which to study factors that contribute to -or provide protection against- burnout, anxiety, and depression. Female teachers may be a higher-risk group for depression. Potential factors that could be modified to mitigate outcomes, albeit identified as associating factors from mostly cross-sectional studies, include emotional intelligence training at the individual level and professional support at a systems level. Given the importance of the teaching profession and the high demands placed on teachers, future studies should consider interventions on such modifiable factors toward reducing health burden.}, }
@article {pmid41317233, year = {2025}, author = {Rafique, QT and Gogoi, V and Barah, P}, title = {Beyond the Gut: Integrating Oral Microbiota into the Microbiota-Brain Axis in Depression.}, journal = {Molecular neurobiology}, volume = {63}, number = {1}, pages = {207}, pmid = {41317233}, issn = {1559-1182}, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Brain/microbiology ; *Depression/microbiology ; *Mouth/microbiology ; *Microbiota/physiology ; Dysbiosis ; Depressive Disorder, Major/microbiology ; Animals ; COVID-19 ; }, abstract = {Depression, a major contributor to years lived with disability (YLD), affects nearly 300 million people worldwide. In the aftermath of the COVID-19 pandemic, cases of major depressive disorder (MDD) or clinical depression have risen by 28% particularly among women and young adults. Characterized by persistent low mood, cognitive impairment, suicidal ideation, sleep disturbances, appetite changes, and fatigue, depression continues to impose a profound public health burden, compounded by the limited efficacy of current treatments and the lack of reliable diagnostic or predictive biomarkers. While the gut microbiota has been extensively implicated in depression's pathophysiology, emerging evidence indicates that the oral microbiome which ranks second only to the gut in microbial diversity also plays a significant role in neuropsychiatric health. Oral microbial dysbiosis may contribute to depression through immune, inflammatory, and neuroactive pathways, positioning the oral microbiome as both a potential non-invasive biomarker and a novel therapeutic target. Incorporating oral microbial profiling into clinical research could not only refine our understanding of depression's underlying mechanisms but also facilitate the development of microbiome-based strategies in precision psychiatry. This growing recognition highlights the importance of expanding research beyond the gut-brain axis to encompass the oral-brain axis as an integral component in the quest for effective diagnostics and interventions.}, }
@article {pmid41316932, year = {2025}, author = {Moghoofei, M and Pajavand, H and Shahbazi, R and Rezaei, M and Taki, E}, title = {The Role of Viral and Bacterial Infections in the Etiology of Behçet's Disease.}, journal = {Journal of clinical laboratory analysis}, volume = {}, number = {}, pages = {e70133}, doi = {10.1002/jcla.70133}, pmid = {41316932}, issn = {1098-2825}, abstract = {BACKGROUND: Behçet's disease (BD) is a complex systemic vasculitis with a poorly understood etiology that involves genetic, environmental, and immunological factors. Increasing evidence suggests that viral and bacterial infections may trigger or exacerbate BD through immune-mediated pathways. This review aims to clarify how different infectious agents may contribute to BD pathogenesis.<br><br>METHODS: For this review, articles addressing microbial involvement in BD were collected from established databases such as PubMed, Scopus, and Web of Science. Priority was given to studies evaluating classical pathogens-including Herpes simplex virus and Streptococcus spp.-as well as more recent agents such as SARS-CoV-2, Borrelia burgdorferi, and Helicobacter pylori. Findings from immunological, molecular, and clinical research were integrated to highlight shared mechanisms related to host-pathogen interactions.<br><br>RESULTS: The reviewed literature shows that microbial infections may influence BD through multiple interconnected mechanisms. A central concept is the possible cross-reactivity between microbial and human heat shock proteins (HSPs), which may activate Th1/Th17 cytokine pathways and enhance neutrophil activity. The review also highlights the dual functions of TRIM proteins in antiviral responses and inflammatory dysregulation, as well as the involvement of inflammasome activation and pattern recognition receptors (PRRs). These combined processes may help explain how infections initiate or intensify immune responses in BD.<br><br>CONCLUSION: By synthesizing current microbial and immune evidence, this review provides an updated perspective on BD immunopathogenesis and outlines testable mechanisms for future research. Understanding these links may support the development of more targeted therapeutic strategies.}, }
@article {pmid41316236, year = {2025}, author = {Siva, N and Samantaray, KK and Krishnapriya, K and Priya, B and Vasudevan, NJ and Tanaya, K and Das, S and Sahoo, J}, title = {Health-seeking behavior and healthcare utilization among patients with non-communicable diseases in India: insights from a systematic review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1548}, pmid = {41316236}, issn = {1472-6963}, mesh = {Humans ; India/epidemiology ; *Noncommunicable Diseases/therapy/epidemiology/economics ; *Patient Acceptance of Health Care/statistics &amp; numerical data ; }, abstract = {OBJECTIVE: Non-communicable diseases (NCDs) remain the leading cause of mortality in India, imposing a significant healthcare and economic burden. This study evaluates the health-seeking behaviour, healthcare utilization, and financial impact of major NCDs hypertension, diabetes, ischemic heart disease, and chronic kidney disease (CKD).<br><br>METHODS: A systematic search was conducted across global health databases, including PubMed, EMBASE, CINAHL, Scopus, Web of Science, ProQuest, and J-Gate. Simultaneously, searches were performed on Indian databases, journal websites, and Google Scholar for studies published between January 2014 and December 2024. A total of 1,462 studies were identified and exported to Rayyan software for screening. Two independent reviewers screened the studies based on predefined eligibility criteria. The quality of included studies was assessed using the Joanna Briggs Institute checklist, while data extraction was performed using Cochrane data collection forms. Meta-analysis was not conducted due to heterogeneity in the included studies. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<br><br>RESULTS: A total of 44 observational survey-based studies were included in this review. Financial constraints, geographical barriers, and awareness gaps influenced healthcare utilization for NCDs. While 60.5% relied on government services for affordability, 39.4% preferred private care for faster access. Out-of-pocket expenses, particularly for hemodialysis and cardiac interventions, posed a major financial burden. Treatment adherence varied by 70.1% among diabetic patients but only 32.4% among hypertensive women. Stockouts of essential medications in public hospitals and high costs of branded drugs in private facilities further restricted access. Emergency care utilisation was high for ischemic heart disease, while CKD patients faced long-term financial strain due to dialysis and frequent hospitalisations. Despite an increase in telemedicine use during COVID-19, accessibility challenges persisted. Systemic inefficiencies, cultural beliefs, and transportation issues further delayed timely care.<br><br>CONCLUSION: This review highlights critical gaps in NCD care in India, particularly in treatment adherence, financial accessibility, and healthcare infrastructure. Strengthening public healthcare services, expanding insurance coverage for long-term NCD management, and integrating community-based interventions are key policy directions. Additionally, targeted strategies to improve health literacy and promote early disease detection are essential to improving health outcomes and reducing inequities in NCD care in India.<br><br>TRIAL REGISTRATION: PROSPERO registration number CRD42024576994.}, }
@article {pmid41316159, year = {2025}, author = {Ibrahim, SA and Ghosh, I and Lai, SY and Harris, B and Ayorinde, A}, title = {Health and wellbeing experiences of women informal workers during the COVID-19 pandemic: a qualitative systematic review.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-025-25728-z}, pmid = {41316159}, issn = {1471-2458}, abstract = {BACKGROUND: Lacking social safety nets, women informal workers were adversely affected during the COVID-19 pandemic, particularly with their over-representation in hard-hit sectors and poor prospect of alternative employment. Differential needs of women informal workers during the pandemic must be explored to address health inequalities and inform pandemic preparedness. This systematic review aimed to synthesise qualitative evidence on the health and wellbeing experiences of women informal workers during the recent pandemic.<br><br>METHODS: MEDLINE, Web of Science, Scopus and PsycINFO were systematically searched in November 2024, along with supplementary searches in Google Scholar and WHO COVID-19 research database. Citation tracking of included studies and grey literature search were also performed. Eligible studies explored first-person accounts of women informal workers about their health and wellbeing during the pandemic, and collected data using interviews, focus groups, or observations. Quality assessment of included studies was completed using Mixed Methods Appraisal Tool. Drawing from the concept of determinants of health, thematic approach was used to synthesise findings, taking a holistic perspective of health and wellbeing experiences during the pandemic.<br><br>RESULTS: Fifty-three studies were included, majority conducted in low-and middle-income countries. Studies explored the experiences of women in various forms of informal work including sex workers, domestic workers, traders/vendors and home-based workers. Four themes were generated: (1) exacerbation of existing vulnerabilities; (2) negotiation of risks and resilience; (3) interconnectedness of health and wellbeing stressors; and (4) variable experiences across social locations. Financial strain from livelihood loss was the primary stressor during the pandemic, and through cascading effect impacted other health and wellbeing domains. Stressors experienced were deeply interrelated and shaped by structural determinants - socioeconomic, political and cultural - as well as pandemic response policies. The experiences of women informal workers were mediated by intersecting social identities such as occupation type, caste/class and migration status, which influenced both their vulnerabilities and capacities to respond, resulting in diverse and unequal outcomes.<br><br>CONCLUSIONS: The COVID-19 pandemic has taken a toll on the health and wellbeing of woman informal workers. In the groundwork for future development and pandemic planning, equity-centred approach informed by intersectionality must be applied.}, }
@article {pmid41315893, year = {2025}, author = {Mautner Wizentier, M and Williams, D and Choi, J and Goodman, MS and Guilamo-Ramos, V and Hagan, H}, title = {COVID-19 Prevention Behaviors and Mistrust Among Black and Latino Public Housing Residents in NYC.}, journal = {Health education &amp; behavior : the official publication of the Society for Public Health Education}, volume = {}, number = {}, pages = {10901981251393179}, doi = {10.1177/10901981251393179}, pmid = {41315893}, issn = {1552-6127}, abstract = {Preventive measures against COVID-19 played a crucial role in mitigating transmission. Social and structural factors influence individuals' trust in health care and engagement in health-promoting behaviors. This study investigates racial-ethnic differences in COVID-19 prevention behaviors and beliefs among public housing residents in the South Bronx, NYC. Data come from the Nurse-Community-Family Partnership study, a randomized controlled trial conducted during the COVID-19 pandemic. The analytic sample (n = 200) was limited to adult participants who identified as non-Hispanic Black, Hispanic Black, Hispanic White, or Hispanic Other. Multilevel logistic regression models estimated odds ratios and 95% confidence intervals, adjusted for sex, age, and education. The odds of receiving a COVID-19 vaccine were 3.8 times greater for Hispanic White participants and 2.5 times greater for Hispanic Other participants than for non-Hispanic Black participants. In addition, the odds of practicing social distancing were 2.2 times greater for Hispanic Other participants than for non-Hispanic Black counterparts. COVID-19-related government mistrust was associated with an 88% decrease in the odds of vaccinating, a 58% decrease in the odds of practicing social distancing, and a 77% decrease in the odds of mask-wearing. COVID-19 vaccine mistrust was associated with a 93% decrease in the odds of vaccination. When adjusted for mistrust, differences in vaccination rates by racial-ethnic groups were no longer significant. Addressing mistrust is pivotal for improving public health outcomes. Interventions that enhance trust in health institutions through cultural competence, community engagement, and greater representation in health care can help bridge the gap in prevention behaviors among racially minoritized groups.}, }
@article {pmid41314370, year = {2025}, author = {Lin, Y and Choi, Y and Park, W}, title = {Mapping the Knowledge Landscape of Mobile Teledentistry: A Bibliometric Analysis Based on the Web of Science Database.}, journal = {Journal of dentistry}, volume = {}, number = {}, pages = {106265}, doi = {10.1016/j.jdent.2025.106265}, pmid = {41314370}, issn = {1879-176X}, abstract = {BACKGROUND: Teledentistry has rapidly grown; yet, the role of mobile devices remains under-investigated. We performed an analysis of mobile teledentistry to elucidate its historical development, collaboration networks, thematic hotspots, and future directions.<br><br>METHODS: We searched the Web of Science; 99 articles, published between January 2013 and April 2025, were included. Publication trends, collaboration networks, and research themes were analysed using co-occurrence, clustering, and co-citation analyses with CiteSpace and VOSviewer.<br><br>RESULTS: The COVID-19 pandemic accelerated mobile teledentistry research, primarily in high-income countries. A core group of prolific authors and institutions is not yet established; however, some nations have emerged as significant contributors. Keyword analysis revealed three primary research hotspots: diagnostic accuracy, care accessibility, and oral hygiene applications. Eleven thematic clusters revealed three principal research themes: comparisons with traditional methods, investigations of specific time periods or populations, and studies of mobile dental products. Co-citation analysis identified a foundational literature base centred on the feasibility and validity of mobile teledentistry diagnostics.<br><br>CONCLUSIONS: The static panorama and dynamic evolution of mobile teledentistry were comprehensively elucidated, highlighting the urgent need for international collaboration to support implementation, especially in low- and middle-income countries. Future research should further evaluate diagnostic accuracy and explore sustainable strategies that may enhance health equity and help reduce global dental disparities.<br><br>CLINICAL SIGNIFICANCE: Existing studies on mobile teledentistry consistently report the potential to support diagnostic accuracy and suggest improved access to care, particularly in underserved settings. Evidence from the analysed studies reflects the use of mobile devices for remote screening, diagnosis, and monitoring. Therefore, this cumulative evidence base suggests the possibility of integrating mobile teledentistry into routine clinical practice, intending to reduce health disparities and improve patient outcomes pending further validation.}, }
@article {pmid41313968, year = {2026}, author = {Gloyn, T and Seo, C and Godinho, A and Rahul, R and Phadke, S and Fotheringham, H and Wegier, P}, title = {Using artificial intelligence to predict patient wait times in the emergency department: A scoping review.}, journal = {Artificial intelligence in medicine}, volume = {171}, number = {}, pages = {103316}, doi = {10.1016/j.artmed.2025.103316}, pmid = {41313968}, issn = {1873-2860}, mesh = {*Emergency Service, Hospital/organization &amp; administration ; Humans ; *Artificial Intelligence ; *Waiting Lists ; COVID-19/epidemiology ; Time Factors ; SARS-CoV-2 ; Machine Learning ; Crowding ; }, abstract = {OBJECTIVE: The purpose of this review was to comprehensively explore the landscape of recently published literature on the applications of artificial intelligence (AI) in predicting individualized patient waiting times in an emergency department (ED) and identify pertinent considerations for practitioners and hospital decision-makers.<br><br>INTRODUCTION: ED overcrowding is being experienced by hospitals around the globe and has worsened in the post COVID-19 era. The negative patient and staff experiences and poor clinical outcomes from overcrowding are evident and necessitate solutions to address this ongoing problem. Hospitals providing ED waiting time estimates to patients and staff are becoming popular; however, the more common methods, such as using rolling averages, suffer from an inability to capture the nuanced relationships within an ED. Recent applications of AI and machine learning (ML) in healthcare raises the possibility of applying these techniques to individualized waiting time predictions in the ED; although, literature on the topic is sparse.<br><br>METHODS: A systematized search was conducted on November 10th, 2025, using the electronic databases CINAHL, EMBASE (OVID), Medline (OVID), PsychINFO, Web of Science, and PubMed. Articles were considered for review if written in English, peer-reviewed, published after 2014, and used AI techniques. Descriptive analysis was performed on the final extracted data to facilitate the identification of common themes across studies. Themes were inferred from the proportional usage among studies, of different data preparation, feature selection, and modeling strategies.<br><br>RESULTS: The search identified 8613 citations that, after a rigorous screening process and critical appraisal, were narrowed down to 15 studies for final review. Most included studies were observational, using historical medical record data to compare modeling techniques or demonstrate a proof of concept. Studies commonly used one or more of ED queue-based, staff/resource-based, patient-based, and time-based feature categories. Incorporated AI methods included Random Forest, Linear Regression, and Least Absolute Shrinkage and Selection Operator (LASSO) techniques, among several others. All forms of AI and ML outperformed traditional rolling average estimates used by hospitals.<br><br>CONCLUSIONS: This review identified applications of AI in predicting individualized patient waiting times in the ED that outperform current waiting time estimate strategies. The use of nonlinear techniques, such as the Random Forest method, or incorporating queue-based feature categories, appeared to provide better performance in predictive estimates. Depending on the end user and modality in which the wait time estimate is conveyed, the importance of model selection is highlighted as a consideration to be made if overestimates or underestimates are preferred.}, }
@article {pmid41313176, year = {2025}, author = {Huang, G and Hung, WK and Ngolombe, R and Maona, C and Chiona, BC and Banda, KJ}, title = {Overview of the prevalence of job satisfaction and turnover intention among emergency medical services personnel: a meta-analysis.}, journal = {Journal of global health}, volume = {15}, number = {}, pages = {04320}, pmid = {41313176}, issn = {2047-2986}, mesh = {*Job Satisfaction ; Humans ; *Personnel Turnover/statistics &amp; numerical data ; *Emergency Medical Technicians/psychology/statistics &amp; numerical data ; COVID-19/epidemiology ; Prevalence ; *Emergency Medical Services ; *Firefighters/psychology/statistics &amp; numerical data ; Intention ; }, abstract = {BACKGROUND: Emergency medical services (EMS) personnel, including paramedics, emergency medical technicians (EMTs), and firefighters are subjected to substantial occupational stressors that diminish job satisfaction and increase turnover rate, ultimately affecting efficient delivery of pre-hospital emergency care. Therefore, we performed the first meta-analysis to determine the prevalence of job satisfaction and turnover intention among EMS personnel, including paramedics, emergency medical technicians (EMTs), and firefighters.<br><br>METHODS: We comprehensively searched Web of Science, PubMed, Cochrane Library, Embase, and EBSCOhost until March 2025. The pooled prevalence of job satisfaction and turnover intention was analysed using the Freeman-Tukey double-arcsine transformation model in R software. Cochran's Q and statistics assessed heterogeneity and subgroup analysis explored moderator variables.<br><br>RESULTS: A total of 25 studies with 59&#x2009;562 EMS personnel were included. The pooled prevalence of job satisfaction was 63% (95% confidence interval (CI)&#x2009;=&#x2009;53%, 72%), with estimates of 71% for EMTs, 62% for firefighters, and 54% for paramedics. Job satisfaction was 56% during the COVID-19 pandemic and 65% in the pre-pandemic period. The pooled prevalence of turnover intention was 29% (95% CI&#x2009;=&#x2009;24%, 36%), with estimates of 28% for paramedics, 22% for EMTs, and 17% for firefighters. Turnover intention was 34% during COVID-19 pandemic and 27% in the pre-pandemic period.<br><br>CONCLUSIONS: Approximately, 63% of EMS personnel report job satisfaction, while 29% express intent to leave the profession. Mental health support, workload management, and professional development opportunities should be promoted among EMS personnel to further enhance job satisfaction and mitigate turnover intention.<br><br>REGISTRATION: PROSPERO: CRD420251027283.}, }
@article {pmid41313153, year = {2025}, author = {Malden, S and McGill, K and Guthrie, B and Frost, H and Shenkin, SD and Ezike, A and Bareham, BK and Mercer, SW and Pearce, C and Wilson, C and Underwood, I and Vines, J and Lewis, S and O'Donnell, A}, title = {Patient and Carer-Related Facilitators and Barriers to the Adoption of Assistive Technologies for the Care of Older Adults: Systematic Review.}, journal = {JMIR aging}, volume = {8}, number = {}, pages = {e73917}, pmid = {41313153}, issn = {2561-7605}, mesh = {Humans ; *Self-Help Devices/statistics &amp; numerical data ; *Caregivers/psychology ; Aged ; *COVID-19/epidemiology ; Telemedicine ; *Patient Acceptance of Health Care ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Assistive technologies (ATs) are used increasingly in community settings to assist in the care of older adults. Despite a rapid increase in the capabilities and uptake of these technologies, gaps remain in understanding the main barriers to their usage.<br><br>OBJECTIVE: This systematic review investigated the barriers and facilitators to the use of AT in the care of older adults.<br><br>METHODS: Six electronic databases were searched from January 2011 to March 2024. Primary studies were included if they used qualitative methods reporting findings related to barriers or facilitators to the implementation of AT (eg, ambient and wearable sensors, alarms, telehealth or mobile health [mHealth]) for older adults (from the perspective of either carers or older adults) in community settings. All data were screened independently by two reviewers. Study quality was assessed using the Critical Appraisal Skills Program (CASP). Data from each included study were synthesized using thematic synthesis, before barriers were mapped against the domains of the Technology Acceptance Model (TAM).<br><br>RESULTS: Ninety-five studies were included in the review. The number of studies published in the field of barriers to AT use has increased 3-fold post-COVID-19 in comparison to the previous decade. Ten barriers-privacy, cost, insufficient knowledge, fear of misuse, usability, poor functionality, perceived lack of need, stigma, and lack of human interaction-were identified, as well as three facilitators-awareness of health benefits, targeted training, and user-centered design. Persistent barriers relating to all domains of the TAM were identified, with the majority of these relating to the "behavioral intention to use" domain (cost, privacy, stigma, and fear of misuse). The majority of studies had a moderate/high risk of bias.<br><br>CONCLUSIONS: There remain distinct barriers to sustained usage of AT for the care of older adults, particularly concerning adoption as defined by the TAM. Further studies investigating the acceptability of ATs are needed to increase the understanding of optimization strategies.}, }
@article {pmid41312797, year = {2025}, author = {Dinnes, J and Berhane, S and Walsh, J and Reidy, P and Doherty, A and Hillier, B and Scandrett, K and Hettiarachchi, D and Islam, F and Mathangasinghe, Y and Nyaaba, N and Taylor, M and Weeratunga, P and Wickramasinghe, D and van Wyk, SS and Cunningham, J and Davenport, C and Dittrich, S and Emperador, D and Hooft, L and Leeflang, MM and McInnes, MD and Spijker, R and Verbakel, JY and Takwoingi, Y and Taylor-Phillips, S and Van den Bruel, A and Deeks, JJ and , }, title = {Rapid, point-of-care antigen tests for diagnosis of SARS-CoV-2 infection.}, journal = {The Cochrane database of systematic reviews}, volume = {11}, number = {11}, pages = {CD013705}, pmid = {41312797}, issn = {1469-493X}, mesh = {Humans ; *COVID-19/diagnosis ; Sensitivity and Specificity ; *SARS-CoV-2/immunology ; *Antigens, Viral/blood ; *COVID-19 Serological Testing/methods ; *Point-of-Care Testing ; Asymptomatic Infections ; Bias ; *COVID-19 Testing/methods ; }, abstract = {BACKGROUND: Accurate rapid diagnostic tests for SARS-CoV-2 infection could help manage the COVID-19 pandemic by potentially increasing access to testing and speed detection of infection, as well as informing clinical and public health management decisions to reduce transmission. Previous iterations of this review provided clear and conclusive evidence of superior test performance in those experiencing possible signs and symptoms of Covid-19. However, test performance in asymptomatic individuals and sensitivity by setting and indication for testing remains unclear. This is the fourth iteration of this review, first published in 2020.<br><br>OBJECTIVES: To assess the diagnostic accuracy of rapid, point-of-care antigen tests (Ag-RDTs) for diagnosis of SARS-CoV-2 infection in asymptomatic population groups.<br><br>SEARCH METHODS: We searched the COVID-19 Open Access Project living evidence database from the University of Bern (which includes daily updates from MEDLINE and Embase and preprints from medRxiv and bioRxiv) on 17 February 2022. We included independent evaluations from national reference laboratories, FIND and the Diagnostics Global Health website. We did not apply language restrictions.<br><br>SELECTION CRITERIA: We included test accuracy studies of any design that evaluated commercially produced, rapid antigen tests in asymptomatic people tested because of known or suspected contact with SARS-CoV-2 infection, known SARS-CoV-2 infection or known absence of infection, or those who were being screened for infection. We included evaluations of single applications of a test (one test result reported per person). Reference standards for presence or absence of infection were any laboratory-based molecular test (primarily reverse transcription polymerase chain reaction (RT-PCR)).<br><br>DATA COLLECTION AND ANALYSIS: We used standard screening procedures with three reviewers. Two reviewers independently carried out quality assessment (using the QUADAS-2 tool) and extracted study results. Other study characteristics were extracted by one review author and checked by a second. We present sensitivity and specificity with 95% confidence intervals (CIs) for each test, and pooled data using the bivariate model. We investigated heterogeneity by including indicator variables in the random-effects logistic regression models. We tabulated results by test manufacturer and compliance with manufacturer instructions for use and according to symptom status.<br><br>MAIN RESULTS: We included 146 study cohorts (described in 130 study reports). The main results relate to 164 evaluations of single test applications including 144,250 unique samples (7104 with confirmed SARS-CoV-2) obtained from asymptomatic or mainly asymptomatic populations. Studies were mainly conducted in Europe (85/146, 58%), and evaluated 41 different commercial antigen assays (test kit). Only six studies compared two or more brands of test. Nearly all studies (96%) used RT-PCR alone to define presence or absence of infection. Risk of bias was high because of participant selection (13, 9%); interpretation of the index test (3, 2%); weaknesses in the reference standard for absence of infection (3, 2%); and participant flow and timing (46, 32%). Characteristics of participants (11, 8%) and index test delivery (117, 80%) differed from the way in which and in whom the test was intended to be used. Estimates of sensitivity varied considerably between studies, with consistently high specificities. Average sensitivity was 55.0% (95% CI 50.9%, 59.0%) and average specificity was 99.5% (95% CI 99.5%, 99.6%) across the 147 evaluations of Ag-RDTs reporting both sensitivity and specificity (149,251 samples, 7636 cases). Average sensitivity was higher when epidemiological exposure to SARS-CoV-2 was suspected (58.6%, 95% CI 51.4% to 65.5%; 43 evaluations; 15,516 samples, 1483 cases) compared to where COVID-19 testing was reported to be widely available to anyone on presentation for testing (53.0%, 95% CI 48.4% to 57.5%; 103 evaluations; 129,032 samples, 5660 cases); however CIs overlapped, limiting the inference that can be drawn from these data. Average specificity was similarly high for both groups (99.4% and 99.6%). Sensitivity was generally lower when used in a screening context (summary values from 40.6% to 42.1% for three of four screening settings) compared to testing asymptomatic individuals at Covid-19 test centres (56.7%) or emergency departments (54.7%). We observed a decline in summary sensitivities as measures of sample viral load decreased. Sensitivity varied between brands. When tests were used according to manufacturer instructions, average sensitivities by brand ranged from 36.3% to 78.8% in asymptomatic participants (14 assays with sufficient data for pooling). None of the assays met the WHO acceptable performance standard for sensitivity (of 80%) based on meta-analysis; however, sensitivities from individual studies (where meta-analysis was not possible) exceeded 80% for three assays. The WHO acceptable performance criterion of 97% specificity was met by all but four assays (based on individual studies or meta-analysis) when tests were used according to manufacturer instructions. At 0.5% prevalence using summary data for asymptomatic people, where testing was widely available and where epidemiological exposure to COVID-19 was suspected, resulting PPVs would be 40% and 33%, meaning that 3 in 5 or 2 in 3 positive results will be false positives, and between 1 in 2 and 2 in 5 cases will be missed.<br><br>AUTHORS' CONCLUSIONS: Evidence for antigen testing in asymptomatic cohorts has increased considerably since the publication of the previous update of this review. Average sensitivities remain lower for testing of asymptomatic when compared to symptomatic individuals; however, there is an indication that sensitivities may be higher where epidemiological exposure to SARS-CoV-2 is suspected compared to testing any asymptomatic individual regardless of indication. Sensitivities were particularly low when antigen tests were used in screening settings. Assays from different manufacturers also vary in sensitivity, indicating the need for appropriate clinical validation of a particular antigen test in a given intended use setting prior to more widespread deployment. Further research is needed to evaluate the effectiveness of screening programmes at reducing transmission of infection, whether mass screening or targeted approaches, including schools, healthcare setting and traveller screening.<br><br>FUNDING: This paper presents independent research supported by the NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust, and the University of Birmingham. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.<br><br>REGISTRATION: Protocol (2020) doi: 10.1002/14651858.CD013596.}, }
@article {pmid41312246, year = {2025}, author = {Sorrentino, M and Fiorilla, C and Rubba, F and Montuori, P and Palladino, R}, title = {Does COVID-19 vaccination affect risk perception and adherence to preventive behaviors? A systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1661015}, pmid = {41312246}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/administration &amp; dosage ; *Vaccination/psychology/statistics &amp; numerical data ; SARS-CoV-2 ; *Health Behavior ; Hand Hygiene ; Adult ; }, abstract = {INTRODUCTION: Since the COVID-19 pandemic onset, preventive measures (e.g., social distancing, hand hygiene, mask usage) and vaccines have been pivotal in mitigating transmission and reducing public health burdens. Although adherence to these measures, influenced by factors such as ventilation and exposure duration, has been extensively validated, their long-term sustainability faces socio-economic challenges.<br><br>OBJECTIVES: To investigate the association between risk perception and adherence to preventive behaviors and conduct a meta-analysis comparing these behaviors in vaccinated versus unvaccinated subgroups.<br><br>METHODS: A systematic review following PRISMA guidelines identified studies (2021-2024) analyzing risk perception and preventive behaviors. Potential biases were assessed using the MMAT tool. A meta-analysis calculated pooled effect sizes across subgroups.<br><br>RESULTS: Of 1,594 screened studies, 10 met inclusion criteria (six for meta-analysis, n =&#x202f;9,115). Populations included adults, students, and healthcare professionals across 24 countries. Most vaccinated individuals maintained preventive behaviors despite stable or declining risk perception, though social distancing and hand hygiene adherence decreased over time. Booster-vaccinated individuals exhibited higher compliance than partially vaccinated or unvaccinated counterparts. Unvaccinated individuals intending to vaccinate reported higher risk perception than those refusing vaccination. Meta-analysis revealed no significant difference in risk perception between vaccinated (70.3, 95% CI 60.8-79.8) and unvaccinated subgroups (70.8, 95% CI 61.9-79.6; I [2] =&#x202f;17.5%), suggesting limited influence on behavior maintenance.<br><br>CONCLUSION: While vaccination and preventive measures curbed COVID-19 transmission, risk perception alone does not robustly predict sustained adherence, potentially due to risk compensation. Future research should prioritize determinants of long-term behavioral retention in public health strategies.}, }
@article {pmid41312074, year = {2025}, author = {Hussain, D and Iqbal, MJ}, title = {Post-COVID-19 Barriers to Diabetic Retinopathy Screening Attendance: An Updated Systematic Review.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e96550}, pmid = {41312074}, issn = {2168-8184}, abstract = {Diabetic retinopathy (DR) is a preventable cause of vision loss; with screening, there is the capability to recognise and treat the condition early. However, screening compliance remains sub-optimal, and the COVID-19 pandemic caused widespread disruptions to the screening programme. This review aims to update prior systematic reviews to identify barriers that remain, as well as identify new barriers that may have occurred due to the pandemic. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, we searched seven databases (January 2020-July 2025) for English language primary studies on DR screening non-attendance, yielding 16 relevant studies across diverse regions. Key barriers fell into patient-related, health system, and environmental categories. Although there was evidence to suggest the same barriers remained, there is evidence to suggest the pandemic exacerbated prior barriers and introduced new barriers. These findings suggest the need for context-specific interventions to improve DR screening in the post-pandemic era.}, }
@article {pmid41311551, year = {2025}, author = {Khan, GA and Huwaikem, M and Chowdhury, K and Albugami, HF and Ghosh, A}, title = {The Role of Sterile Inflammation in Thrombosis: Consequences for Cardiovascular Disease and COVID-19.}, journal = {Mediators of inflammation}, volume = {2025}, number = {}, pages = {8054886}, pmid = {41311551}, issn = {1466-1861}, mesh = {Humans ; *COVID-19/complications/immunology ; *Thrombosis/etiology/immunology/metabolism ; *Cardiovascular Diseases/immunology/metabolism ; *Inflammation/metabolism/immunology/complications ; HMGB1 Protein/metabolism ; SARS-CoV-2 ; Immunity, Innate ; Alarmins/metabolism ; }, abstract = {Sterile inflammation (SI) is an inflammatory response triggered by the release of damage-associated molecular patterns (DAMPs) from dying cells, distinct from normal inflammation in its origin from tissue injury and necrosis rather than microbial invasion. Circulating nucleic acids (CNAs), high-mobility group box 1 (HMGB1), von Willebrand factor (vWF), and S100b protein are notable markers of SI, indicative of tissue damage and implicated in thrombotic disorders. Innate immunity, involving cells like macrophages and dendritic cells, recognizes DAMPs via pattern recognition receptors (PRRs) like Toll-like receptors and NOD-like receptors, initiating inflammatory signaling cascades central to SI and its cardiovascular consequences. Thrombosis, a common outcome of SI, underscores the intricate interplay between inflammation and hemostasis, with hypoxia exacerbating thrombotic risk through platelet activation and endothelial dysfunction. The established link between inflammation and thrombosis highlights the clinical significance of SI, where molecules like HMGB1, extracellular RNA (eRNA), and eDNA actively participate in thromboembolic disorders. SI's relevance is particularly evident in COVID-19-induced thrombotic disorders, where dysregulated immune responses and endothelial dysfunction contribute to systemic inflammation and heightened thrombotic risk. Understanding SI's mechanisms in these contexts is vital for developing targeted therapies to mitigate vascular complications and enhance patient outcomes in cardiovascular diseases and COVID-19-associated thrombosis.}, }
@article {pmid41310207, year = {2025}, author = {Baharlouei, Z and Aminjavaheri, S and Vajhadin, F and Nejatbakhsh, MM and Sarshar, FZ and Vali, H and Karimzadeh, F and Sanati, A and Presley, JF}, title = {Nano-engineered biomimetic materials: toward point-of-care diagnosis of infectious diseases.}, journal = {Mikrochimica acta}, volume = {192}, number = {12}, pages = {859}, pmid = {41310207}, issn = {1436-5073}, support = {4025988//Iran National Science Foundation/ ; 1401100//Isfahan University of Medical Sciences/ ; }, mesh = {Humans ; *Biomimetic Materials/chemistry ; SARS-CoV-2/isolation &amp; purification ; *Biosensing Techniques/methods ; *COVID-19/diagnosis ; *Point-of-Care Systems ; Nanostructures/chemistry ; *Communicable Diseases/diagnosis ; Point-of-Care Testing ; Electrochemical Techniques ; }, abstract = {This review emphasizes the advantages of nano-engineered antibodies (nanobodies), nanozymes, and nano-imprinted polymers (nano-MIPs) in point-of-care (POC) diagnostics for infectious diseases, with a particular emphasis on SARS-CoV-2 detection, compared to conventional receptors. Infectious diseases have led to significant economic and social challenges, prompting the urgent development of reliable and cost-effective diagnostic tools, particularly POC biosensors. Current POC biosensors utilizing enzymes and antibodies have proven useful, although limitations such as low sensitivity, stability, and complex fabrication affect their performance. With advancements in nanomaterials, biomimetic elements such as nanobodies, nanozymes, and nano-MIPs they have shown great potential as alternatives to natural receptors. Recent advances in these biomimetic element materials applied to POC sensing platforms, such as paper-based devices and microfluidics, as the physical platforms are reviewed and discussed. This work also highlights the integration of electrochemical and optical detection systems with novel readout technologies, including smartphone-based devices, and represents an updated overview that encompasses all the advancements in this domain. Emphasis is placed on COVID-19 as a pivotal case study. Key primary sensor performances, such as linear detection range and limit of detection, are evaluated and compared. Advantages and disadvantages of each approach are discussed to illustrate the potential impact of these nano-based materials on future biosensor applications.}, }
@article {pmid41308839, year = {2025}, author = {Wang, W and Wazny, VK and Mahadzir, MDA and Maier, AB}, title = {Multivitamin and mineral use: A rapid review of meta-analyses on health outcomes.}, journal = {Ageing research reviews}, volume = {114}, number = {}, pages = {102965}, doi = {10.1016/j.arr.2025.102965}, pmid = {41308839}, issn = {1872-9649}, abstract = {Multivitamin and mineral (MVM) supplements are among the most widely used dietary supplements globally, however, their role in promoting healthspan and longevity remains unclear. This review evaluated comprehensive findings from meta-analyses to clarify their health effects. A rapid review of MEDLINE and EMBASE identified 19 eligible meta-analyses published from 2000 to 2025, encompassing 5535,426 participants, including over 333,943 pregnancies and 904,947 children exposed to maternal MVM supplementation. Randomized controlled trials indicated that MVM use improved global cognition, episodic memory, and immediate recall in older or cognitively intact adults, reduced psychological symptoms in healthy individuals, and lowered systolic blood pressure in at-risk populations. However, no benefits were found for all-cause mortality, COVID-19 outcomes, visual acuity, or multiple cognitive domains, and a higher risk of age-related macular degeneration progression was reported. Observational studies found associations between MVM use and a reduced risk of colorectal cancer, coronary heart disease, cataracts, and fragility hip fractures, but not breast or prostate cancer, stroke, or overall mortality. During pregnancy, MVM supplementation was linked to reduced risks of small-for-gestational-age births and pediatric cancers, but not to preterm birth, stillbirth, or low birth weight. Overall, the findings revealed a lack of consistency in the definition of MVM supplementation, and substantial variability in MVM effectiveness depending on population, age, and health status. These results highlighted the importance of shifting from generalized supplementation approaches to more targeted, personalized nutritional strategies to support healthspan and longevity.}, }
@article {pmid41308474, year = {2025}, author = {Parr, J and Chen, YF and Damery, S and Chaudhuri, P and Grove, A}, title = {Sub-national public health intelligence responses to disease outbreaks: A mixed-methods systematic review.}, journal = {Public health}, volume = {250}, number = {}, pages = {106055}, doi = {10.1016/j.puhe.2025.106055}, pmid = {41308474}, issn = {1476-5616}, abstract = {OBJECTIVES: COVID-19 provided an impetus to improve infectious disease emergency preparedness. Provision of public health intelligence (PHI) during outbreaks by sub-national public health authorities (PHAs) supports decision making during these events. We synthesised studies describing such responses to elucidate transferable influencing factors.<br><br>STUDY DESIGN: This was a mixed methods systematic review.<br><br>METHODS: Literature searches of eight databases (PubMed, Embase, Applied Social Sciences Indexes and Abstracts [ASSIA], Scopus, Health Management Information Consortium [HMIC], WHO Global Health Library, Health Systems Evidence, and PDQ Evidence) were undertaken in March 2022. We selected peer-reviewed, primary research in English, published in or after January 2019 relating to sub-national PHA PHI activities during a disease outbreak. Studies were quality assessed using appropriate tools and analysed by thematic analysis and pillar integration.<br><br>RESULTS: Forty studies from 24 countries, 31 COVID-19 related, were included. Six themes summarise factors influencing responses: 1) appropriate data infrastructure, 2) effective intelligence products, 3) multisector collaboration, 4) obtaining public support, 5) strong and supportive management and leadership and 6) the capacity and capability to respond. Synthesis of empirical studies increases the review's reliability, but evidence mainly relates to countries with very high levels of human development limiting its transferability to countries with lower levels.<br><br>CONCLUSIONS: Public health systems should ensure adequate data infrastructure and PHI staff capability and capacity, plan for strong but supportive leadership and effective intelligence production, encourage multisector intelligence collaborations and ongoing communication with the public at a sub-national level. PROSPERO International Prospective Register of Systematic Reviews Ref. CRD42022308042.}, }
@article {pmid41308472, year = {2026}, author = {Sharma, S and Sharma, L and Gandhi, TK}, title = {Integration of quantum artificial intelligence in disease diagnosis: A review of methods and applications.}, journal = {Computer methods and programs in biomedicine}, volume = {274}, number = {}, pages = {109175}, doi = {10.1016/j.cmpb.2025.109175}, pmid = {41308472}, issn = {1872-7565}, mesh = {Humans ; *Artificial Intelligence ; *Quantum Theory ; Algorithms ; COVID-19/diagnosis ; *Diagnosis, Computer-Assisted/methods ; Neoplasms/diagnosis ; Machine Learning ; Cardiovascular Diseases/diagnosis ; Neurodegenerative Diseases/diagnosis ; }, abstract = {BACKGROUND AND OBJECTIVE: Accurate disease diagnosis is vital for effective treatment and improved patient outcomes. While artificial intelligence (AI) has advanced medical diagnostics, conventional AI approaches often face limitations in real-time data processing, scalability, and managing high-dimensional biomedical data. Quantum Artificial Intelligence (QAI) integrates quantum computing with AI to address these challenges. This study explores QAI models in disease diagnosis, highlighting their advantages over classical AI, their applications across diseases, and integration possibilities within diagnostic workflows.<br><br>METHODS: A structured literature review was conducted using Scopus, PubMed, IEEE Xplore, and Google Scholar databases. A total of 37 peer-reviewed articles were selected based on relevance, methodological quality, and focus on QAI applications in diagnostics. The review analyzed key quantum machine learning (QML) models, including hybrid and quantum inspired techniques.<br><br>RESULTS: The findings indicate that QAI demonstrates promising applications in diagnosing cancer, neurodegenerative disorders, cardiovascular diseases, COVID-19, and other conditions. Quantum algorithms enable faster and more accurate pattern recognition in complex medical datasets. Additionally, QAI can be integrated into various stages of the diagnostic pipeline, from feature engineering to optimization to provide clinical decision support. However, technical challenges such as quantum noise, hardware instability, and limited algorithm maturity were frequently noted.<br><br>CONCLUSIONS: QAI has the potential to revolutionize disease diagnosis by overcoming many limitations of classical AI systems. While significant progress has been made, real-world clinical integration requires further advancements in algorithm development and hardware scalability. Future research should focus on closing the gap between theoretical models and clinical implementation to fully realize the benefits of QAI in healthcare.}, }
@article {pmid41307946, year = {2025}, author = {Wong, AKC and Zhou, SY and Tao, X and Tsui, NY and Kwok, VWY and Wang, RM and Bayuo, J}, title = {The Effectiveness of Nurse-Led Telecare Consultations Among Patients Who Have Experienced a Stroke: Systematic Review and Meta-Analysis.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e74149}, doi = {10.2196/74149}, pmid = {41307946}, issn = {1438-8871}, mesh = {Humans ; *Stroke/nursing/therapy ; *Telemedicine ; COVID-19/epidemiology ; Quality of Life ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Nurse-led telecare consultations have emerged as a promising approach for the long-term management of stroke survivors, particularly in the context of COVID-19 pandemic-related disruptions. While several studies have explored its use, the effectiveness of nurse-led telecare consultations in post-acute stroke care remains unclear.<br><br>OBJECTIVE: This study aimed to evaluate the effectiveness of nurse-led telecare consultation for poststroke management among stroke survivors who were discharged from the hospital and lived in the community.<br><br>METHODS: A systematic search was conducted across 6 databases-CINAHL, MEDLINE, PsycINFO, PubMed, Embase, and CENTRAL-for randomized controlled trials published from inception to February 2025. Included studies examined nurse-led telecare consultations compared to usual care among stroke survivors living in the community. Studies involving individuals who were hospitalized or institutionalized were excluded, along with reviews, abstracts without full texts, non-English or non-Chinese articles, and studies not meeting the criteria for randomized controlled trials. Primary and secondary outcomes included blood pressure (BP), psychological burden, quality of life, medication adherence, health care service use, stroke recurrence, survivor functioning, and coping. Continuous outcomes were analyzed using mean differences (MDs) or standardized MDs with 95% CIs under a random-effects model and dichotomous outcomes using odds ratios with 95% CIs via the Mantel-Haenszel method. Heterogeneity was assessed using the chi-square test and I[2] statistics.<br><br>RESULTS: In total, 9 studies involving 2524 participants were included. Ischemic stroke was the most common type (n=1568, 62.13%) of stroke. Meta-analysis showed that nurse-led telecare significantly increased the likelihood of achieving target BP (odds ratio 2.33, 95% CI: 1.83-2.98; P<.001). For continuous outcomes, pooled analyses showed nonsignificant but directionally favorable reductions in systolic BP (MD -4.83, 95% CI -12.51 to 2.85; I[2] =92%), diastolic BP (MD -6.41, 95% CI -13.76 to 0.93; I[2]=97%), and low-density lipoprotein cholesterol (MD 0.01, 95% CI -0.08 to 0.09; I[2]=97%). Heterogeneity was substantial for several key outcomes (I[2]>90% for systolic BP and diastolic BP). Some outcomes, such as medication adherence and stroke recurrence, were reported by only 1 (11.11%) study. Additional benefits were observed in coping ability and reduced hospital readmissions, but findings for psychological well-being and quality of life were mixed.<br><br>CONCLUSIONS: Nurse-led telecare consultations may support better BP management and coping and reduce hospital readmissions among community-dwelling stroke survivors. However, the pooled effects for continuous outcomes were inconclusive, and heterogeneity remained high. Therefore, these findings should be interpreted with caution, and further high-quality trials with standardized outcome measures and longer-term follow-up are warranted to confirm effectiveness.<br><br>TRIAL REGISTRATION: PROSPERO CRD42023492692; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023492692.}, }
@article {pmid41307506, year = {2025}, author = {Fishman, A and Grinin, P and Riljak, V}, title = {The (un-)Social Brain in Isolation.}, journal = {Physiological research}, volume = {74}, number = {5}, pages = {711-727}, pmid = {41307506}, issn = {1802-9973}, mesh = {Humans ; *Social Isolation/psychology ; *Brain/physiology/physiopathology ; Animals ; *COVID-19/psychology ; *Social Behavior ; *Stress, Psychological/psychology ; }, abstract = {The Social Brain is a distributed network of neuroanatomical regions and neurochemical systems that underpins the human capacity for social cognition, empathy, and interpersonal behavior. Social isolation (SI), defined as the objective reduction in social interaction, poses a significant threat to the integrity of this system. In this review, we synthesize evidence from human and animal studies to elucidate the biological, cognitive, and behavioral consequences of SI on the social brain. We describe how SI acts as a chronic stressor, disrupting structural connectivity, and altering neurotransmitter systems critical for social cognition. These disruptions manifest in altered social behavior, mentalization processes, and emotional reactivity, significantly contributing to increased vulnerability to psychiatric and neurodegenerative disorders, including depression, schizophrenia, substance use disorders, and Alzheimer's disease. Converging findings from studies of evolutionarily conserved mechanisms in rodent and primate models demonstrate that SI compromises neurodevelopment, attenuates neuroplasticity, and triggers maladaptive stress responses, highlighting that social deprivation has profound neurobiological and behavioral consequences that greatly overlap with the pathophysiological changes seen in neuropsychiatric disorders. Furthermore, we explore the role of indirect stressors resulting from SI such as touch deprivation and digital-era social disconnection as contemporary amplifiers of SI's neurobiological impact. In light of public health challenges such as the COVID-19 pandemic, we propose that SI should be recognized not only as a psychosocial condition but as a modifiable risk factor with transdiagnostic significance across psychiatry, neurology, and preventive medicine. Addressing SI through targeted interventions and policy measures is essential for promoting mental resilience and well-being. Key words Chronic Stress " Loneliness " Social Cognition " Socialization " Social Stress.}, }
@article {pmid41306864, year = {2025}, author = {Panico, F and De Biase, R and Catalano, L and Zappullo, I and D'Olimpio, F and Trojano, L and Sagliano, L}, title = {A systematic review on the psychological factors behind vaccine hesitancy in the COVID-19 era.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1711428}, pmid = {41306864}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/prevention &amp; control/psychology ; *Vaccination Hesitancy/psychology ; *COVID-19 Vaccines/administration &amp; dosage ; SARS-CoV-2 ; *Vaccination/psychology ; Personality ; }, abstract = {BACKGROUND: Vaccine hesitancy may represent a global threat because of its inherent consequences for health, social and economic systems. Understanding the factors associated with vaccine hesitancy is fundamental to developing effective healthcare policies. While previous studies have mainly focused on sociological and cultural variables and transient illness-specific fears and beliefs, the present systematic review focuses on the psychological factors (such as emotional dispositions, cognitive functioning and expectations, and stable personality traits) associated with vaccine hesitancy during the COVID-19 era.<br><br>METHODS: A systematic review using a systematic search of PubMed, PsychINFO and Web of Science databases was performed with a time frame ranging between 1 January 2020 to 31 January 2025 focusing on psychological factors and vaccine hesitancy. Studies targeting the general population and employing validated instruments to assess emotional, cognitive and personality factors and vaccine hesitancy were selected, while investigations on context-specific, psycho-social, cultural and political factors were excluded. Quality and risk of bias in the selected studies was assessed using an adapted version of the Newcastle-Ottawa Scale, and main studies' characteristics, variables and outcomes were synthesised using a narrative approach and table.<br><br>RESULTS: Fourteen studies were finally included in the qualitative synthesis. The results showed that some variables such as depressive and anxiety levels, as well as emotion regulation strategies may affect vaccination behaviour, although some cultural and generational differences were also observed. Differences in cognitive flexibility, decision-making, and personal expectations may influence vaccine hesitancy. Notably, some personality factors, like extraversion, openness, conscientiousness and dark personality traits, may influence hesitancy to vaccinate.<br><br>CONCLUSION: This review highlights emotional, cognitive, and personality factors associated with vaccine hesitancy, providing evidence for personalised, evidence-based interventions aimed at promoting adherence to national vaccination policies.}, }
@article {pmid41306452, year = {2025}, author = {Ross, KE and McMillan, KM and Bowell, V and Clements, DN and Mazeri, S}, title = {The canine welfare, public health and environmental impact of systemic under-regulation within the UK puppy trade: A scoping review.}, journal = {Animal welfare (South Mimms, England)}, volume = {34}, number = {}, pages = {e72}, pmid = {41306452}, issn = {2054-1538}, abstract = {Almost a decade has passed since a DEFRA consultation concluded that existing legislation governing the UK puppy trade was "outdated, inflexible, incompatible with current welfare legislation and cumbersome for both enforcers and businesses". The rapid outgrowth of the trade's governing legislature, fuelled by contemporary consumer culture and the high degree of trader anonymity provided by the internet, has enabled a high-volume, untraceable and profit-driven market to evolve. Increased demand for puppies, exacerbated by social media trends and the COVID-19 pandemic, is sustained by an online medium that both encourages and capitalises upon modern-day 'click-and-collect' purchase behaviour. Moreover, the internet has only intensified the demand for pedigree and designer crossbreeds, many of which are shown to suffer lifelong physiological disorders caused by the positive phenotyping selection necessary to achieve breed standards. These factors have made puppies an attractively lucrative, low-risk commodity. Evidence of multi-level fraud and organised crime involvement has been revealed along the supply chain, resulting in systemic canine health and welfare issues. Whilst large-scale breeding operations reportedly smuggle unvaccinated puppies onto the British market from endemic (rabies, Leishmania) countries, high densities of pet dogs in urban areas is reportedly leaving high faecal-saturation levels, spreading anthelmic- and antibiotic-resistant pathogens. Meanwhile, unsafe concentrations of ectoparasiticides are detected in rivers and lakes. This review collates evidence from available sources that illustrate the current nature and impact of inadequate regulation in the UK puppy trade, aiming to support stakeholders in their efforts for essential and comprehensive regulatory reform.}, }
@article {pmid41305838, year = {2025}, author = {Li, J and Xu, S and Guo, S}, title = {Exploring SARS-CoV-2 impact on blood-brain barrier and its composition: A review.}, journal = {Medicine}, volume = {104}, number = {47}, pages = {e46093}, pmid = {41305838}, issn = {1536-5964}, support = {(2022) No. 12//Overseas Talent Merit-based Funding Project of the Department of Human Resources and Social Security of Guizhou Province/ ; }, mesh = {Humans ; *Blood-Brain Barrier/virology/pathology/physiopathology/metabolism ; *COVID-19/physiopathology/complications ; *SARS-CoV-2 ; Endothelial Cells/virology ; Astrocytes/virology ; Microglia ; }, abstract = {Inflammatory responses including glial activation, and upregulated inflammatory factors occurred after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected central nervous system. Blood-brain barrier (BBB) disruption has been implicated in coronavirus disease 2019 (COVID-19) pathogenesis and may predispose to the long-lasting neurological damage even after the epidemic ends. The BBB is a highly selective dynamic interface to protects the brain from neurotoxins and the elimination of byproducts of brain metabolism via efflux transporters. The COVID-19 pandemic has introduced new challenges in managing neurological conditions, and understanding SARS-CoV-2 journey through BBB and the interconnections between the members of BBB is crucial. This review aims to summarize and elucidate the damage to the main constituent cells of BBB, including brain microvascular endothelial cells, astrocytes, and microglia and its contribution to COVID-19. Further understanding of these interactions may facilitate the development of improved treatment options and preventative measures of central nervous system injury due to COVID-19.}, }
@article {pmid41305564, year = {2025}, author = {Gamito, M and Pereira, DR and Delgado, M and Vicente, F and Silva, ML and Pereira, P}, title = {How Do Nutritionists/Dietitians Use Social Media to Communicate with Their Public? Global Perspectives on Social Media Practices: A Systematic Review.}, journal = {Nutrients}, volume = {17}, number = {22}, pages = {}, pmid = {41305564}, issn = {2072-6643}, mesh = {*Social Media/statistics &amp; numerical data ; Humans ; COVID-19/epidemiology ; *Nutritionists ; *Communication ; SARS-CoV-2 ; Health Literacy ; }, abstract = {Background: Social media has emerged as a powerful communication tool for healthcare professionals, including nutritionists and dietitians, particularly since the COVID-19 pandemic. Evidence suggests that their online presence can enhance nutritional literacy and play a crucial role in countering misinformation. Objective: This systematic review aims to investigate how and why Registered Nutritionists and Dietitians (RNDs) use social media in their professional practice, focusing on benefits, challenges, and impact. Methods: A systematic literature search was conducted between 1 January 2019 and 28 February 2024, in PubMed, Scopus, Scholar, and SciELO databases using terms such as 'nutritionist', 'dietitian', and 'social media'. Quality was assessed using the MMAT tool. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The included studies were analysed with respect to their content, professional practices, and patterns of social media use. Results: Of the 359 articles identified through the systematic search, 10 cross-sectional studies conducted using questionnaires were included in this review. Sample sizes ranged from 10 to 2542 participants across nine countries. Instagram and Twitter were the most frequently used platforms among RDNs, primarily for sharing evidence-based nutritional information, counselling content, and professional promotion. Reported usage ranged from 37.5% to 100%, with a marked increase during the COVID-19 pandemic, especially among younger professionals. Key enablers included enhanced communication, professional visibility, and cost-effective outreach, while main challenges involved limited digital literacy and difficulties replicating face-to-face counselling online. Although ethical concerns were reported, many RNDs maintained compliance with professional standards, particularly in regions with strict marketing regulations. Conclusions: This systematic review provides evidence that social media is a valuable tool for RNDs, particularly in the context of food and/or nutritional education. RNDs would benefit from training in content creation, knowledge dissemination and ethical digital communication. However, clearer guidelines from professional organisations are also recommended.}, }
@article {pmid41305530, year = {2025}, author = {Vitiello, F and Lan, R and Orsini, G and Bourgeois, D and Carrouel, F}, title = {The Role of Saliva and Mouthwashes in the Detection and Reduction of Oral Viral Load: A Scoping Review.}, journal = {Viruses}, volume = {17}, number = {11}, pages = {}, pmid = {41305530}, issn = {1999-4915}, mesh = {Humans ; *Mouthwashes/pharmacology ; *Saliva/virology ; *Viral Load/drug effects ; COVID-19/virology/prevention &amp; control/diagnosis ; *Mouth/virology ; SARS-CoV-2/drug effects/isolation &amp; purification ; Anti-Infective Agents, Local/pharmacology ; Cetylpyridinium ; }, abstract = {Background: The oral cavity is an entry site and a reservoir for viruses. Viral particles accumulate in saliva, which serves as a diagnostic fluid and vehicle for transmission (droplets and aerosols). Antiseptic mouthwashes were proposed as adjunctive measures to temporarily reduce oral viral load. Objectives: This scoping review aims to investigate the role of the oral cavity in viral infections, focusing on saliva and the use of antiseptic mouthwashes to reduce salivary viral load. Methods: Following the PRISMA-ScR guidelines, PubMed, EMBASE, and Web of Science were searched for human studies (2015-2025) investigating oral viral infections, saliva, or mouthwashes. Eligible studies were classified and analyzed for population, intervention, and outcomes. Results: Twenty-three studies met inclusion criteria (sixteen randomized controlled trials and seven systematic reviews). All included studies focused exclusively on SARS-CoV-2, as no clinical evidence on other oral viruses met the eligibility criteria. Saliva was consistently identified as a reliable, non-invasive specimen reflecting disease dynamics and transmission potential. Mouthwashes containing povidone-iodine, cetylpyridinium chloride, chlorhexidine, hydrogen peroxide or β-cyclodextrin-citrox produced measurable but short-lived reductions in salivary viral load. Heterogeneity and lack of standardized outcomes limited comparability. Conclusions: Antiseptic mouthwashes can provide a transient and complementary reduction in salivary viral load, particularly before aerosol-generating procedures; however, they should be regarded only as adjunctive measures and not as substitutes for standard infection-control protocols.}, }
@article {pmid41305504, year = {2025}, author = {Tana, C and Soloperto, M and Giuliano, G and Erroi, G and Di Maggio, A and Tortorella, C and Moffa, L}, title = {Artificial Intelligence for Predicting Lung Immune Responses to Viral Infections: From Mechanistic Insights to Clinical Applications.}, journal = {Viruses}, volume = {17}, number = {11}, pages = {}, pmid = {41305504}, issn = {1999-4915}, mesh = {Humans ; *Artificial Intelligence ; *Lung/immunology/virology ; *Virus Diseases/immunology ; Influenza, Human/immunology ; }, abstract = {Artificial intelligence (AI) is increasingly transforming biomedical research and patient care by integrating complex biological, radiological, and healthcare information. In the field of viral respiratory infections, AI-driven approaches have shown great promise in elucidating the complexity of lung immune responses and the dynamic interplay between host and pathogen. Applications include predicting cytokine storm and acute respiratory distress syndrome (ARDS), integrating imaging findings with immunological and laboratory data, and identifying molecular and cellular signatures through single-cell and multi-omics analyses. Similar methodologies have been applied to influenza and respiratory syncytial virus (RSV), providing insights into the mechanisms distinguishing protective from maladaptive pulmonary immunity. This narrative review summarizes current evidence on how AI can evolve into a form of translational intelligence, capable of bridging mechanistic immunology with clinical application. The review explores AI-based models for disease severity prediction, patient stratification, and therapeutic response assessment, as well as emerging approaches in drug repurposing and vaccine response prediction. By integrating biological complexity with clinical context, AI offers new opportunities to uncover immune signatures predictive of antiviral or immunomodulatory efficacy and to guide personalized management strategies.}, }
@article {pmid41305479, year = {2025}, author = {Cao, G and Xu, C and Wang, L and Chai, K and Wu, B}, title = {Global Surveillance and Biological Characterization of the SARS-CoV-2 NB.1.8.1 Variant: An Emerging VUM Lineage Under Scrutiny.}, journal = {Viruses}, volume = {17}, number = {11}, pages = {}, pmid = {41305479}, issn = {1999-4915}, mesh = {*SARS-CoV-2/genetics/classification/immunology/isolation &amp; purification ; Humans ; *COVID-19/epidemiology/virology/transmission/immunology ; Immune Evasion ; Genome, Viral ; Mutation ; Global Health ; Spike Glycoprotein, Coronavirus/genetics ; Phylogeny ; }, abstract = {The continuous evolution of SARS-CoV-2 and its variants poses persistent challenges to global public health. As a sublineage of the XDV.1 variant, NB.1.8.1 has rapidly emerged as a dominant strain worldwide, triggering a new wave of infections. Representing a product of viral adaptation, this variant has acquired several critical amino acid mutations-including A435S and T478I-which enhance its transmissibility and immune evasion capabilities compared to the ancestral XDV.1 lineage. This review systematically summarizes the genomic characteristics, epidemiological features, and immune escape potential of NB.1.8.1. It emphasizes that sustained genomic surveillance and serological assessments are crucial for informing public health response strategies, guiding vaccine development, and optimizing containment measures.}, }
@article {pmid41305454, year = {2025}, author = {Miftahof, J and Bernauer, B and Tan, CS}, title = {Neurological Manifestations of SARS-CoV-2.}, journal = {Viruses}, volume = {17}, number = {11}, pages = {}, pmid = {41305454}, issn = {1999-4915}, mesh = {Humans ; *COVID-19/complications/pathology/virology ; Animals ; *SARS-CoV-2/pathogenicity ; Disease Models, Animal ; Brain/virology/pathology ; *Nervous System Diseases/virology/pathology/etiology ; Central Nervous System/virology/pathology ; }, abstract = {Neurocognitive symptoms have emerged as notable sequelae of SARS-CoV-2 infection (COVID-19). Although primarily a respiratory virus, SARS-CoV-2 has been associated with central nervous system (CNS) changes observed in both clinical and experimental settings. To better understand these effects and their pathological mechanisms, we conducted a systematic literature search of published studies and employed a qualitative, analytical approach to identify and synthesize key findings from peer-reviewed studies, including large-scale retrospective clinical cohorts, human autopsy reports, animal models (murine, non-human primate), and in vitro brain organoid systems. While viral components were detected in post mortem central nervous system tissues, COVID-19 neuropathology appears to stem primarily from immune-mediated inflammation and vascular injury rather than direct CNS infection. Persistent glial activation and BBB disruption may underlie the long-term neurological symptoms reported in long COVID-19. Although animal models offer mechanistic insight, species-specific differences necessitate cautious extrapolation to human pathology. Further investigation into the chronic effects of SARS-CoV-2 on the brain is essential to guide long-term clinical management and therapeutic development.}, }
@article {pmid41305428, year = {2025}, author = {Chiang, KC and Chiu, CEN and Altaf, M and Cheng, MTK and Gupta, RK}, title = {Mechanisms of Cell-Cell Fusion in SARS-CoV-2: An Evolving Strategy for Transmission and Immune Evasion.}, journal = {Viruses}, volume = {17}, number = {11}, pages = {}, pmid = {41305428}, issn = {1999-4915}, mesh = {Humans ; *SARS-CoV-2/immunology/physiology/pathogenicity/genetics ; *COVID-19/transmission/immunology/virology ; *Immune Evasion ; Cell Fusion ; *Virus Internalization ; Giant Cells/virology ; Animals ; Antibodies, Neutralizing/immunology ; }, abstract = {Early studies on the evolution of SARS-CoV-2 revealed mutations that favored host transmission of the virus and more efficient viral entry. However, cell-free virus spread is vulnerable to host-neutralizing antibodies. As population immunity developed, mutations that confer escape from neutralization were selected. Notably, cell syncytia formation wherein an infected cell fuses with a noninfected cell is a more efficient route of transmission that bypasses humoral immunity. Cell syncytia formation has been implicated in the pathogenicity of SARS-CoV-2 infection whilst compromising host transmission due to impaired whole virion release. Therefore, understanding the mechanisms of virus-mediated cell-cell fusion will aid in identifying and targeting more pathogenic strains of SARS-CoV-2. Whilst the general kinetics of cell-cell fusion have been known for decades, the specific mechanisms by which SARS-CoV-2 induces fusion are beginning to be elucidated. This is partially due to emergence of more reliable, high throughput methods of quantifying and comparing fusion efficiency in experimental models. Moreover, the ongoing inflammatory response and emerging health burden of long COVID may point to cell-cell fusion in the pathogenesis. In this review, we synthesize current understanding of SARS-CoV-2-mediated cell-cell fusion and its consequences on immune escape, viral persistence, and the innate immune response.}, }
@article {pmid41305372, year = {2025}, author = {Chen, L and Meng, QH}, title = {Advancing Laboratory Diagnostics for Future Pandemics: Challenges and Innovations.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {11}, pages = {}, pmid = {41305372}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/diagnosis/epidemiology ; *Pandemics ; SARS-CoV-2/genetics/isolation &amp; purification ; *Molecular Diagnostic Techniques/methods ; Nucleic Acid Amplification Techniques/methods ; }, abstract = {Since the beginning of the 21st century, major epidemics and pandemics such as SARS, H1N1pdm09, Ebola, and COVID-19 have repeatedly challenged global systems of disease diagnostics and control. These crises exposed the weaknesses of traditional diagnostic models, including long turnaround times, uneven resource distribution, and supply chain bottlenecks. As a result, there is an urgent need for more advanced diagnostic technologies and integrated diagnostics strategies. Our review summarizes key lessons learned from four recent major outbreaks and highlights advances in diagnostic technologies. Among these, molecular techniques such as loop-mediated isothermal amplification (LAMP), transcription-mediated amplification (TMA), recombinase polymerase amplification (RPA), and droplet digital polymerase chain reaction (ddPCR) have demonstrated significant advantages and are increasingly becoming core components of the detection framework. Antigen testing plays a critical role in rapid screening, particularly in settings such as schools, workplaces, and communities. Serological assays provide unique value for retrospective outbreak analysis and assessing population immunity. Next-generation sequencing (NGS) has become a powerful tool for identifying novel pathogens and monitoring viral mutations. Furthermore, point-of-care testing (POCT), enhanced by miniaturization, biosensing, and artificial intelligence (AI), has extended diagnostic capacity to the front lines of epidemic control. In summary, the future of epidemic and pandemic response will not depend on a single technology, but rather on a multi-layered and complementary system. By combining laboratory diagnostics, distributed screening, and real-time monitoring, this system will form a global diagnostic network capable of rapid response, ensuring preparedness for the next global health crisis.}, }
@article {pmid41304894, year = {2025}, author = {Calvo, H and Islas-Díaz, D and Hernández-Laureano, E}, title = {Pattern Recognition Algorithms in Pharmacogenomics and Drug Repurposing-Case Study: Ribavirin and Lopinavir.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {11}, pages = {}, pmid = {41304894}, issn = {1424-8247}, abstract = {Pattern recognition and machine learning algorithms have become integral to modern drug discovery, offering powerful tools to uncover complex patterns in biomedical data. This article provides a comprehensive review of state-of-the-art pattern recognition techniques-including traditional machine learning (e.g., support vector machines), deep learning approaches, genome-wide association studies (GWAS), and biomarker discovery methods-as applied in pharmacogenomics and computational drug repurposing. We discuss how these methods facilitate the identification of genetic factors that influence drug response, as well as the in silico screening of existing drugs for new therapeutic uses. Two antiviral agents, ribavirin and lopinavir, are examined as extended case studies in the context of COVID-19, illustrating practical applications of pattern recognition algorithms in analyzing pharmacogenomic data and guiding drug repurposing efforts during a pandemic. We highlight successful approaches such as the machine learning-driven prediction of responders and the AI-assisted identification of repurposed drugs (exemplified by the case of baricitinib for COVID-19), alongside current limitations, including data scarcity, model interpretability, and translational gaps. Finally, we outline future directions for integrating multi-omics data, improving algorithmic interpretability, and enhancing the synergy between computational predictions and experimental validation. The insights presented highlight the promising role of pattern recognition algorithms in advancing precision medicine and accelerating drug discovery, while recognizing the challenges that must be addressed to fully realize their potential.}, }
@article {pmid41304300, year = {2025}, author = {Kayembe-Mulumba, B and N'gattia, AK and Belizaire, MRD}, title = {One Health, Many Gaps: Rethinking Epidemic Intelligence in Resource-Limited Settings to Prepare for the Global Threat of Disease X.}, journal = {Microorganisms}, volume = {13}, number = {11}, pages = {}, pmid = {41304300}, issn = {2076-2607}, abstract = {The emergence of high-threat pathogens-such as Ebola, Lassa fever, and most recently SARS-CoV-2-has highlighted critical weaknesses in global surveillance systems, particularly in resource-limited settings where many zoonotic spillovers originate. Despite the World Health Organization's (WHO) prioritization of these diseases for research and development (R&amp;D), the current surveillance infrastructures in these regions remain under-resourced, fragmented, and often reactive rather than anticipatory. This narrative review explored the literature and structured relevant findings in three key dimensions: (i) the structural and operational limitations of existing surveillance systems for the WHO priority diseases in resource-limited settings including challenges in data integration, laboratory capacity, workforce, and community engagement; (ii) how these surveillance gaps could delay detection and hinder the response to future emerging threats, particularly a hypothetical but inevitable Disease X; and (iii) innovative and context-adapted strategies to strengthen epidemic intelligence including integrated One Health surveillance, digital and genomic tools, participatory approaches, and regional data-sharing mechanisms. We argue that building agile, equity-centered, and decentralized surveillance systems is not only essential for managing known threats, but also foundational to the early detection and rapid containment of the next public health emergency in resource-limited settings. This review uniquely frames surveillance limitations in resource-limited settings as a global security concern and outlines context-adapted, equity-centered innovations to strengthen epidemic intelligence in preparation for Disease X.}, }
@article {pmid41304256, year = {2025}, author = {Mateescu, DM and Ilie, AC and Cotet, I and Guse, C and Muresan, CO and Pah, AM and Badalica-Petrescu, M and Iurciuc, S and Craciun, ML and Avram, A and Margan, MM and Enache, A}, title = {Gut Microbiome Dysbiosis in COVID-19: A Systematic Review and Meta-Analysis of Diversity Indices, Taxa Alterations, and Mortality Risk.}, journal = {Microorganisms}, volume = {13}, number = {11}, pages = {}, pmid = {41304256}, issn = {2076-2607}, support = {"Victor Babes" University of Medicine and Pharmacy Timisoara//"Victor Babes" University of Medicine and Pharmacy Timisoara/ ; }, abstract = {COVID-19 is associated with gut microbiome alterations that may influence disease outcomes through immune and inflammatory pathways. This systematic review and meta-analysis evaluated global evidence on gut dysbiosis in COVID-19. We searched PubMed/MEDLINE, Embase, Web of Science, Scopus, and Cochrane Library up to 5 October 2025 (PROSPERO CRD420251160970). Alpha-diversity indices and microbial taxa log-fold changes (logFC) were analyzed using random-effects models. The pooled standardized mean difference (SMD) for the Shannon index was -0.69 (95% CI -0.84 to -0.54; I[2] = 42%), confirming reduced microbial diversity. Faecalibacterium prausnitzii showed a significant pooled depletion (logFC = -1.24; 95% CI -1.68 to -0.80; k = 10; I[2] = 74%), while Enterococcus spp. was increased (logFC = 1.45; 95% CI 1.12-1.78). Egger's test did not suggest publication bias (p = 0.32). Gut dysbiosis was consistently associated with reduced microbial diversity and enrichment of pathogenic taxa, correlating with increased disease severity and mortality (HR = 1.67). These findings highlight the potential of microbiome profiling as a prognostic tool in COVID-19, although clinical translation requires further validation.}, }
@article {pmid41304215, year = {2025}, author = {Arruda, ISA and Cavalcante, CDS and Rubens, RS and Castro, LNPF and Nóbrega, YKM and Dalmolin, TV}, title = {Changes in the Gut Microbiota of Patients After SARS-CoV-2 Infection: What Do We Know?.}, journal = {Microorganisms}, volume = {13}, number = {11}, pages = {}, pmid = {41304215}, issn = {2076-2607}, support = {DPI/BCE n&#xba; 01/2025//University of Brasilia/ ; FAPDF n&#xba; 09/2023//Funda&#xe7;&#xe3;o de Apoio &#xe0; Pesquisa do Distrito Federal/ ; }, abstract = {COVID-19 can cause long-term symptoms, such as a post-infection syndrome, known as Long-COVID. Among the symptoms present during this period, the most reported are gastrointestinal symptoms. This study discusses the effects of changes in the gut microbiota of post-COVID-19 patients. SARS-CoV-2 infection is associated with significant alterations in gut microbial composition, disturbing its homeostasis and promoting a reduction in the abundance of beneficial symbiotic bacteria and an increase in the abundance of opportunistic pathogens. Furthermore, the composition of the gut microbiota may play a role in the prognosis of patients with post-COVID-19 infection. The microbiota of the intestinal tract and the respiratory tract influence each other; therefore, the gut-lung axis has attracted increasing interest in understanding COVID-19. Moreover, the brain-gut axis has been studied, since there have been reports of anxiety and depression along with post-COVID-19 gastrointestinal symptoms. Treatments options for intestinal dysbiosis in Long-COVID patients include probiotics, prebiotics, and fecal microbiota transplantation. These treatments may serve as an approach to improve gastrointestinal symptoms during Long-COVID, increasing microbiome diversity, strengthening the integrity of intestinal barrier functions, and consequently influencing the treatment of COVID-19.}, }
@article {pmid41304130, year = {2025}, author = {Yazici, O and Vanetti, C and Clerici, M and Biasin, M}, title = {Experimental Models to Investigate Viral and Cellular Dynamics in Respiratory Viral Co-Infections.}, journal = {Microorganisms}, volume = {13}, number = {11}, pages = {}, pmid = {41304130}, issn = {2076-2607}, support = {PNRR-Spoke 13-CUP-G43C2200260007-INF-ACT//Ministero dell'universit&#xe0; e della ricerca/ ; }, abstract = {Respiratory viral co-infections by viruses such as influenza virus, SARS-CoV-2, and respiratory syncytial virus (RSV) are a significant clinical issue in high-risk populations such as children, elderly patients, and immunocompromised individuals. Sequential and simultaneous co-infections exacerbate disease severity, leading to acute respiratory distress syndrome (ARDS), prolonged hospitalization, and increased mortality. Molecular and immunological interactions are complex, context-dependent, and largely unknown. Experimental models of infection that accurately mimic human respiratory physiology are required for the study of viral dynamics, virus-virus interactions, and virus-host interactions. This review outlines a range of complex in vitro and ex vivo models, including organoids, air-liquid interface cultures, lung-on-a-chip platforms, and in vivo animal models, highlighting their ability to simulate the complexity of respiratory co-infections and their limitations. The field has developed significantly, despite challenges like variability across viral strains, timing of infection, and non-standardization of models. Integration of multi-omics technologies and application of highly translational models such as non-human primates and lung-on-a-chip technology are promising avenues to uncover the molecular determinants of co-infection and guide development of targeted therapeutic strategies. Interrelatedness of experimental models and clinical outcomes is highly critical to improve prevention and treatment of respiratory viral co-infections mainly among high-risk populations.}, }
@article {pmid41304121, year = {2025}, author = {Ramirez-Plascencia, HHF and Colima-Fausto, AG and Licona-Lasteros, KC and Díaz-Zaragoza, M and Cazarez-Navarro, G and Macias-Barragan, JG and Rodriguez-Preciado, SY}, title = {Presence of Microorganisms in the Environment: One Health Approach.}, journal = {Microorganisms}, volume = {13}, number = {11}, pages = {}, pmid = {41304121}, issn = {2076-2607}, abstract = {The One Health approach offers an integrative framework to understand infectious threats, environmental factors, antimicrobial resistance (AMR) and how their interactions affect the human-animal-environment interface. This review examines the epidemiology, transmission pathways, and mechanisms of microorganisms of public health importance (bacteria, fungi, parasites, and viruses). It highlights the interconnectedness of ecosystems, where the environment plays a central role in the dissemination of pathogens, driven by climate change, globalization, agricultural intensification, and habitat degradation. AMR is a major concern, driven by the indiscriminate use of pharmaceuticals in human, veterinary, and agricultural settings, horizontal gene transfer through mobile genetic elements, and microbial evolution. The study of different pathogens is of great importance due to their high prevalence in different ecosystems, their virulence, clinical interest, and mortality rates produced. Some of them are ESKAPE bacteria, Candida auris, Plasmodium falciparum, and emerging viruses such as SARS-CoV-2, which present complex transmission dynamics influenced by ecological and health determinants. The review also addresses the effects of climate change on the persistence and geographic spread of pathogens. Successful implementation of the One Health program requires intersectoral policies, integrated surveillance systems, prudent use of antimicrobials and investment in translational science. Coordinating these strategies is essential to limit the spread of pathogens, protect biodiversity, and save global health in the face of the growing threat of infectious diseases.}, }
@article {pmid41303627, year = {2025}, author = {Styczeń, A and Krysa, M and Mertowska, P and Grywalska, E and Urbanowicz, T and Krasiński, M and Grobelna, M and Topyła-Putowska, W and Rahnama-Hezavah, M and Tomaszewski, M}, title = {The Role of Toll-like Receptors and Viral Infections in the Pathogenesis and Progression of Pulmonary Arterial Hypertension-A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {22}, pages = {}, pmid = {41303627}, issn = {1422-0067}, support = {DS640//Medical University of Lublin/ ; //Poznan University of Medical Sciences/ ; }, mesh = {Humans ; *Toll-Like Receptors/metabolism ; *Pulmonary Arterial Hypertension/metabolism/pathology/etiology/virology ; *Virus Diseases/complications/metabolism ; Animals ; Signal Transduction ; Disease Progression ; }, abstract = {Aberrant activation of innate immunity promotes the development of pulmonary arterial hypertension (PAH); however, the role of pattern recognition by Toll-like receptors (TLRs) within the pulmonary vasculature remains unclear. To consolidate knowledge (as of June 2025) about TLRs and their interactions with viruses in PAH and to identify therapeutic implications. A narrative review of experimental and clinical studies investigating ten TLRs in the context of the pulmonary vascular microenvironment and viral infections. Activation of TLR1/2, TLR4, TLR5/6, TLR7/8, and TLR9 converges on the MyD88-NF-κB/IL-6 axis, thereby enhancing endothelial-mesenchymal transition, smooth muscle proliferation, oxidative stress, thrombosis, and maladaptive inflammation, ultimately increasing pulmonary vascular resistance. Conversely, TLR3, through TRIF-IFN-I, preserves endothelial integrity and inhibits vascular remodeling; its downregulation correlates with PAH severity, and poly (I:C) restitution has been shown to improve hemodynamics and right ventricular function. HIV-1, EBV, HCV, endogenous retrovirus K, and SARS-CoV-2 infections modulate TLR circuits, either amplifying pro-remodeling cascades or attenuating protective pathways. The "TLR rheostat" is shaped by polymorphisms, ligand biochemistry, compartmentalization, and biomechanical forces. The balance between MyD88-dependent signaling and the TRIF-IFN-I axis determines the trajectory of PAH. Prospective therapeutic strategies may include TLR3 agonists, MyD88/NF-κB inhibitors, modulation of IL-6, and combination approaches integrating antiviral therapy with targeted immunomodulation in a precision approach.}, }
@article {pmid41303587, year = {2025}, author = {Kononova, SV and Bobkova, NV and Poltavtseva, RA and Leonov, S and Sukhikh, GT}, title = {ACE2: Friend or Foe in Post-COVID-19 Neurodegeneration?.}, journal = {International journal of molecular sciences}, volume = {26}, number = {22}, pages = {}, pmid = {41303587}, issn = {1422-0067}, support = {24-25-00465//Russian Science Foundation/ ; }, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/metabolism ; *COVID-19/complications/metabolism/virology ; SARS-CoV-2/metabolism ; *Neurodegenerative Diseases/metabolism/etiology/virology ; Spike Glycoprotein, Coronavirus/metabolism ; Renin-Angiotensin System ; Animals ; Alzheimer Disease/metabolism ; Brain/metabolism/pathology/virology ; }, abstract = {Angiotensin-converting enzyme 2 (ACE2) is a key component of the renin-angiotensin system's counter-regulatory pathway. ACE2 is a multifunctional protein whose location and form determine its catalytic and non-catalytic functions, including amino acid transport, the creation of structural complexes, adhesion, and involvement in signaling pathways. In addition, ACE2 influences neurotransmitter systems in the brain. As the main receptor for SARS-CoV-2, ACE2 has been the subject of increasing research interest. Although ACE2 levels in the brain are low, brain damage from SARS-CoV-2 increases the risk of neurodegenerative diseases. This review aims to clarify an important issue: does the temporary inactivation of ACE2 by the SARS-CoV-2 spike protein play a role in Alzheimer-like neurodegeneration, meaning that the protein may serve as a biomarker or therapeutic target?}, }
@article {pmid41303146, year = {2025}, author = {Wilkinson, L and Arjomandi Rad, A and Oliver, J and Kourliouros, A}, title = {From Pandemic to Practice: How COVID-19 Has Reshaped Haemostasis in Cardiac Surgery: A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {22}, pages = {}, pmid = {41303146}, issn = {2077-0383}, abstract = {The utilisation of cardiopulmonary bypass (CPB) during cardiac surgery is often associated with complex haemostatic perturbations, frequently manifesting as a paradoxical risk of both bleeding and thrombosis. This is postulated to be driven by systemic inflammation, endothelial activation and contact activation of the coagulation cascade due to extracorporeal circulation. However, the coronavirus disease 2019 (COVID-19) pandemic revealed a unique hypercoagulable state, termed COVID-19-associated coagulopathy (CAC), also observed in those vaccinated against COVID-19. CAC displays similar physiological manifestations to those of disseminated intravascular coagulation (DIC), characterised by elevated fibrinogen and D-dimer values. The precise pathogenesis of CAC requires further elucidation though proposed mechanisms include: an exaggerated inflammatory response to COVID-19 infection or antibody proliferation due to vaccination, direct epithelial cell damage mediated by angiotensin converting enzyme 2, and 'hypoxithrombosis'. CAC has since provided a unique framework to understand and potentially mitigate coagulation complications encountered during CPB in the post-pandemic era, as it is no longer sufficient to view COVID-19 as a transient influence on surgical risk. Rather, it must be recognized as a persistent modifier of the haemostatic environment across the population, with direct implications upon patient selection, intraoperative management and postoperative care in cardiac surgery. This review examines the pathological drivers behind CAC alongside the insights obtained from CAC management during ECMO deployment, to investigate the potential translation of such knowledge into improved anticoagulation strategies and monitoring during cardiac surgery. The use of alternative anticoagulants including factor XI inhibitors and the modulation of heparinase activity offers promising avenues to attenuate coagulopathies more commonly observed during CPB in the post-pandemic climate, whilst anti-Xa assays and viscoelastic testing have offered applicability to modern perfusion practices. By bridging the knowledge gained during the pandemic with that of conventional CPB, this review aims to inform future strategies for haemostasis management in cardiac surgery in a novel cohort of surgical patients.}, }
@article {pmid41302665, year = {2025}, author = {Adegoke, K and Kayode, T and Singh, M and Gusmano, M and Knapp, KA and Steger, AM}, title = {Remote Work, Well-Being, and Healthy Labor Force Participation Among Older Adults: A Scoping Review.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {11}, pages = {}, pmid = {41302665}, issn = {1660-4601}, mesh = {Humans ; Aged ; Middle Aged ; COVID-19/epidemiology ; *Employment/statistics &amp; numerical data ; *Teleworking ; SARS-CoV-2 ; Male ; *Healthy Aging ; Female ; }, abstract = {Background: Aging populations make expanded workforce participation among older adults an economic and public health priority. The COVID-19 pandemic accelerated the growth of virtual work, providing new opportunities for healthy aging in the workplace through increased flexibility and less physical strain. However, digital exclusion, ergonomically challenging tasks, and social isolation can limit these opportunities for older populations. Objective: This scoping review aimed to synthesize interdisciplinary research on the relationship between remote work and labor force participation among adults aged 45 years and older, focusing on health-related outcomes, barriers, and facilitators. Methods: Following the JBI Manual for Evidence Synthesis and PRISMA-ScR guidelines, we conducted a comprehensive search across seven databases for peer-reviewed and gray literature published between 2000 and 2025. Of 2108 records screened, 33 studies met the inclusion criteria. Data were extracted using a standardized charting tool and analyzed thematically. Results: Most studies were published after 2020 and originated in North America (45%) and Europe (40%). Core barriers included digital exclusion, ageism, and adverse ergonomic environments. Facilitators involved flexible working hours, a supportive organizational environment, and digital skills. Health-related outcomes such as stress reduction and improved well-being were commonly reported. However, only 18% of studies assessed policy effects, and very few examined intersectionality (e.g., gender, socioeconomic status). Conclusions: Remote and flexible work options can improve the health and participation of older adults in the workforce, but technology, infrastructure, and social barriers remain. Age-inclusive policies, digital equity efforts, and inclusive workplace practices are necessary to maximize the benefits of remote arrangements for aging populations.}, }
@article {pmid41302566, year = {2025}, author = {Sui, SX and Yu, L}, title = {Patient and Professional Perspectives on Long COVID: A Systematic Literature Review and Meta-Synthesis.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {11}, pages = {}, pmid = {41302566}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/psychology ; *Health Personnel/psychology ; SARS-CoV-2 ; Qualitative Research ; }, abstract = {BACKGROUND: Post-COVID-19 condition ('long COVID') involves fluctuating symptoms across multiple organ systems and disability or functional loss, which may be episodic, continuous, or permanent. Qualitative research is essential to capture lived experiences and explain how social and health system contexts may influence improvement, recovery, and service use. We synthesised perspectives from people living with long COVID and healthcare professionals to inform service design and policy.<br><br>METHODS: We conducted a systematic review and qualitative meta-synthesis. MEDLINE, Embase, PsycINFO, CINAHL, Scopus, and Web of Science were searched for studies published between 1 January 2020 and 19 August 2025. Eligible studies reported qualitative data from adults with long COVID (&#x2265;12 weeks after acute infection) and/or healthcare professionals in any setting. We excluded non-qualitative, non-primary, or non-English reports. Two reviewers independently screened, extracted, and appraised studies using the Critical Appraisal Skills Programme checklist. Data were synthesised thematically. The protocol was registered with the Open Science Framework.<br><br>FINDINGS: Of 1544 records screened, 49 studies met the inclusion criteria: 41 involving patients, two involving professionals, and six involving both. Eight patient themes (including symptom burden, identity disruption and stigma) and four professional themes (including recognition, care coordination and holistic care models) were identified. Recognition emerged as a cross-cutting mechanism: validation and consistent pacing guidance facilitated engagement and safer activity, whereas invalidation and inconsistent advice were associated with distress, avoidance, and disengagement. Trajectories showed gradual expansion of multidisciplinary care models, but major capacity and equity gaps persisted. Most studies had low methodological concerns, although heterogeneity in populations and settings was substantial.<br><br>INTERPRETATION: Long COVID is a chronic, biological condition that also intersects with social and psychological dimensions, and may present with episodic, continuous, or progressive trajectories. Healthcare services must prioritise early validation, provide consistent pacing and relapse prevention guidance, expand access to multidisciplinary and peer-supported rehabilitation, integrate mental healthcare, strengthen coordinated pathways, and support graded return to work. Explicit attention to equity is required to avoid widening disparities.}, }
@article {pmid41302253, year = {2025}, author = {Nikolova, S and Aleksandrova, T}, title = {Geospatial Insights into Healthcare Accessibility in Europe: A Scoping Review of GIS Applications.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {22}, pages = {}, pmid = {41302253}, issn = {2227-9032}, support = {BG-RRP-2.004-0009-C02//European Union-NextGenerationEU/ ; }, abstract = {Background: Geographic Information Systems (GIS) have emerged as a critical tool in healthcare research, facilitating the assessment of healthcare accessibility through spatial analysis and data visualisation. This scoping review synthesises literature published between 2020 and 2024, a period marked by the COVID-19 pandemic and rapid methodological innovation, providing a timely overview of how GIS has been applied to evaluate healthcare access across European countries. Methods: The review underscores the role of GIS methodologies in identifying geographic disparities, optimising resource distribution, and informing policy decisions. Results: Key findings highlight significant urban-rural differences in healthcare access, shaped by factors such as transportation infrastructure, population density, and healthcare facility distribution. Additionally, GIS has proven valuable in examining the link between healthcare accessibility and utilisation, with better access generally correlating with higher service use. Conclusions: Despite its potential, challenges including data availability, methodological variability, and uneven adoption across regions limit its broader implementation. The review emphasises the need for integrating advanced technologies to foster more equitable healthcare access throughout Europe.}, }
@article {pmid41301889, year = {2025}, author = {Ivanovska, M and Homadi, MS and Angelova, G and Taskov, H and Murdjeva, M}, title = {Differential Characteristics and Comparison Between Long-COVID Syndrome and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).}, journal = {Biomedicines}, volume = {13}, number = {11}, pages = {}, pmid = {41301889}, issn = {2227-9059}, abstract = {Long-COVID and Myalgic Encephalomyelitis/Chronic Fatigue Syndrome are disabling diseases characterised by ongoing fatigue, post-exertional malaise, cognitive impairment, and autonomic dysfunction. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome typically follows viral infections, whereas Long-COVID exclusively follows SARS-CoV-2 infection, with overlapping but distinct features. This review uses comprehensive searches of online databases to compare their clinical presentations, pathophysiologies, and treatments. Both Long-COVID and ME/CFS appear to involve multifactorial mechanisms, including viral persistence, immune dysregulation, endothelial dysfunction, and autoimmunity, though their relative contributions remain uncertain. Symptom management strategies are consistent, however. Cognitive behaviour therapy has been successful, and there are minimal drug treatments. Graded exercise therapy occupies a contested place, recommending individualised pacing and multidisciplinary rehabilitation. Common and exclusive mechanisms must be identified to formulate valuable therapies. A more significant body of research focusing on immune dysfunction as a pathogenic mechanism for advancing the disease and enabling more effective therapies and diagnostics is needed.}, }
@article {pmid41301448, year = {2025}, author = {Silva-Ríos, AA and Mora-Ornelas, CE and Flores-Medina, LG and Muñoz-Valle, JF and Díaz-Palomera, CD and García-Chagollan, M and Vizcaíno-Quirarte, AM and Viera-Segura, O}, title = {Beyond Processing: Furin as a Central Hub in Viral Pathogenesis and Genetic Susceptibility.}, journal = {Biomolecules}, volume = {15}, number = {11}, pages = {}, pmid = {41301448}, issn = {2218-273X}, support = {CF-2023-I-1011, Ciencia B&#xe1;sica y de Frontera 2023-2024//Secretar&#xed;a de Ciencia Tecnolog&#xed;a e Innovaci&#xf3;n/ ; }, mesh = {*Furin/genetics/metabolism ; Humans ; *SARS-CoV-2/pathogenicity ; *COVID-19/genetics/virology ; *Genetic Predisposition to Disease ; Polymorphism, Single Nucleotide ; *Virus Diseases/genetics ; Virus Internalization ; }, abstract = {Furin, a calcium-dependent serine endoprotease of the proprotein convertase family, plays a pivotal role in both physiological homeostasis and viral pathogenesis. By cleaving polybasic motifs within viral glycoproteins, furin enables the maturation of structural proteins essential for viral entry, fusion, and replication. This mechanism has been documented across a broad spectrum of human pathogens, including SARS-CoV-2, influenza virus, human immunodeficiency virus, human papilloma virus, hepatitis B virus, flaviviruses, herpesviruses, and paramyxoviruses, highlighting furin as a conserved molecular hub in host-virus interactions. Genetic variability within the FURIN gene further modulates infection outcomes. Several single-nucleotide polymorphisms (SNPs), such as rs6226 and rs1981458, are associated with altered COVID-19 severity, whereas variants like rs17514846 confer protection against human papilloma virus infection. Conversely, mutations predicted to reduce enzymatic activity have been linked to attenuated SARS-CoV-2 pathogenesis in certain populations. These findings underscore the importance of considering population genetics when evaluating viral susceptibility and disease progression. Despite advances, unresolved questions remain regarding furin's non-canonical roles in viral life cycles, tissue-specific regulation, and interactions with other host proteases and immune modulators. Targeted inhibition of furin and related convertases represents a promising avenue for broad-spectrum antiviral interventions. Collectively, current evidence positions furin as a central node at the intersection of viral pathogenesis, host genetic variability, and translational therapeutic potential.}, }
@article {pmid41301407, year = {2025}, author = {Yamamoto, Y and Noguchi, K}, title = {Structural Insights into the SARS-CoV-2 Spike Protein and Its Implications for Antibody Resistance.}, journal = {Biomolecules}, volume = {15}, number = {11}, pages = {}, pmid = {41301407}, issn = {2218-273X}, support = {JP22K15284//Japan Society for the Promotion of Science/ ; 21fk0108568h0001//Japan Agency for Medical Research and Development/ ; }, mesh = {*Spike Glycoprotein, Coronavirus/chemistry/immunology/genetics/metabolism ; Humans ; *SARS-CoV-2/immunology/chemistry/genetics ; *Antibodies, Neutralizing/immunology ; *COVID-19/immunology/virology ; *Antibodies, Viral/immunology ; Mutation ; }, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has profoundly affected global health and the economy. The emergence of variants with spike mutations, particularly within the receptor-binding domain (RBD), has reduced the efficacy of many neutralizing antibodies (nAbs), and recent variants, including KP.3 and other circulating strains, show partial escape from infection- or vaccine-induced immunity. To overcome this, developing broad-spectrum nAbs that target the conserved S2 subunit of the spike protein is crucial. Unlike the highly mutable RBD, the S2 region remains structurally conserved, providing a promising foundation for universal protection. Deeper insight into S2 structure and function, together with advances in bispecific antibody design, could facilitate the development of next-generation therapeutics resilient to viral evolution. This review examines the structural evolution of the SARS-CoV-2 spike, focusing on the therapeutic potential of S2-targeting antibodies and strategies to overcome antibody resistance.}, }
@article {pmid41301003, year = {2025}, author = {Codru, IR and Vecerzan, L}, title = {When and for Whom Does Intensive Care Unit Admission Change the Prognosis in Oncology?-A Scoping Review.}, journal = {Cancers}, volume = {17}, number = {22}, pages = {}, pmid = {41301003}, issn = {2072-6694}, abstract = {Background: The intersection between oncology and intensive care has shifted from predominantly end-of-life care to a therapeutic bridge that can preserve anticancer trajectories in carefully selected patients. Yet, criteria separating benefit from futility remain fragmented. Objective: This paper seeks to map contemporary evidence (2015-2025) on outcomes after Intensive Care Unit (ICU) admission in adults with cancer and to identify clinical constellations in which ICU-level care still changes prognosis. Methods: PRISMA-ScR scoping review (PCC framework). PubMed search (2015-2025), dual screening, standardized extraction; narrative/thematic synthesis across six clusters (hematologic, solid tumors, sepsis/non-COVID-19 infection, COVID-19/viral pneumonia, novel/targeted-therapy toxicities, end-of-life/aggressive ICU) were used. No meta-analysis given heterogeneity. Results: Seventy-three studies (>170,000 ICU admissions) were included, mostly cohort designs across 27 countries. ICU mortality ranged 8-72% (weighted mean ≈ 41%); hospital ≈ 38%; 90-day ≈ 46%; 1-year ≈ 62%. About one third of ICU survivors resumed systemic therapy. Benefit concentrated in early admissions, single-organ failure, controlled/remission disease, postoperative/elective monitoring, and reversible treatment-related toxicities (e.g., ICI pneumonitis, CAR-T CRS/ICANS). Futility clustered around ≥3 organ supports, RRT > 7 days, refractory/progressive disease, and ECOG ≥ 3. Sepsis outcomes averaged 45-55% ICU mortality but improved with rapid recognition and source control; COVID-19 mortality was particularly high in hematologic malignancies early in the pandemic, with subsequent declines post-vaccination. Conclusions: In modern oncologic practice, ICU care changes prognosis when the acute physiological insult is reversible and cancer control remains plausible; conversely, high organ-support burden and refractory disease define practical futility thresholds. These signals support time-limited ICU trials, earlier ICU involvement for sepsis/irAEs, and embedded palliative care to align intensity with goals.}, }
@article {pmid41300871, year = {2025}, author = {Kardjadj, M}, title = {Advances in Point-of-Care Infectious Disease Diagnostics: Integration of Technologies, Validation, Artificial Intelligence, and Regulatory Oversight.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {22}, pages = {}, pmid = {41300871}, issn = {2075-4418}, abstract = {Point-of-care (POC) infectious disease diagnostics are reshaping global health by delivering rapid, decentralized, and clinically actionable results that link bedside testing to population-level surveillance. Valued at approximately USD 53 billion in 2024 and projected to nearly double by 2033, the global POC diagnostics market is driven by infectious disease assays and accelerated by innovations in molecular amplification, biosensors, microfluidics, and artificial intelligence (AI). This review integrates current evidence across technological, clinical, regulatory, and public health domains. Immunoassays remain the backbone of volume deployment, while molecular nucleic acid amplification tests (NAATs) and emerging CRISPR-based platforms achieve laboratory-grade sensitivity at the point of care. AI has transitioned from an experimental tool to an embedded analytical layer that enhances image interpretation, multiplex signal deconvolution, and automated quality control. Rigorous validation, including analytical accuracy, clinical performance in intended-use settings, and usability testing under CLIA guidance, remains central to ensuring reliability in decentralized environments. Regulatory frameworks are adapting in parallel: FDA's lifecycle oversight of AI-enabled devices, the European IVDR's expanded evidence requirements, and the WHO Prequalification all emphasize continuous post-market surveillance. From a public health perspective, POC diagnostics have improved early case detection, treatment initiation, and outbreak containment for HIV, tuberculosis, malaria, influenza, RSV, and COVID-19. Yet persistent challenges (including limited harmonization of standards, uneven reimbursement, and scarce real-world data from low- and middle-income countries) continue to constrain equitable adoption. POC infectious disease diagnostics are thus entering a pivotal phase of digitization and regulatory maturity. Addressing remaining gaps in validation, lifecycle monitoring, and implementation equity will determine whether these technologies achieve their full promise as clinical accelerators and as cornerstones of global infectious disease preparedness.}, }
@article {pmid41300616, year = {2025}, author = {Chung, A and Chong, S and Chung, D and Gee, A and Stanton-Koko, M and Huang, KY}, title = {Addressing Social Determinants of Health Service Gaps in Chinese American Caregivers During the COVID-19 Pandemic.}, journal = {Children (Basel, Switzerland)}, volume = {12}, number = {11}, pages = {}, pmid = {41300616}, issn = {2227-9067}, support = {K01HL169419-01//National Heart Lung Blood Institute/ ; }, abstract = {Background/Objectives: This study aims to understand gaps and strategies in Chinese Americans' utilization of SDOH services in the pediatric primary care context in Sunset Park, Brooklyn, from a patient-provider partnership perspective. Methods: The study was guided by an integrated Patient-Provider Partnership, Engagement, and Collaboration (PEC) framework that influenced patient-provider interaction during the provision of SDOH services. A qualitative study design was applied, and eight quality improvement interviews with healthcare providers were conducted to understand the existing community and health service system context. Six in-depth interviews were conducted with Mandarin-speaking Chinese American caregivers. Interviews were transcribed and coded in Mandarin and then translated into English. Results: Consistent with the PEC framework, we identified cognitive, affective, and communication gaps from both the patient and provider. Caregivers reported unaddressed needs in food, financial security, and mental health. Providers identified gaps in patient workflow, staffing, and the intake form process. Conclusions: Addressing social determinants of health among Chinese American immigrant populations is crucial for mitigating poor health outcomes in children and families. Multi-level community-engaged strategies are needed to alleviate the challenges facing this community. Recommendations for future research should consider the importance of language and cultural affinity, digital intake forms translated into the patient's language, and regular on-site staffing during SDOH screenings.}, }
@article {pmid41300198, year = {2025}, author = {Dong, T and Lucifora, C and Massimino, S and Ferraioli, F and Falzone, A and Tomaiuolo, F and Travaglino, G and Vicario, CM}, title = {Fight, Flight, or Vote Right? A Systematic Review of Threat Sensitivity in Political Conservatism.}, journal = {Brain sciences}, volume = {15}, number = {11}, pages = {}, pmid = {41300198}, issn = {2076-3425}, abstract = {BACKGROUND: Within the framework of social cognition, conservatism can be conceptualized as a strategy for addressing fundamental psychological needs. Therefore, it is hypothesized that individuals with conservative orientations exhibit stronger reactions to perceived threats compared to their less conservative counterparts.<br><br>AIM: To perform an exploratory scoping systematic review of existing literature examining behavioral, physiological, neurophysiological, and emotional responses associated with the relationship between conservatism and threat perception.<br><br>METHOD: Following PRISMA guidelines, a systematic search was conducted using PubMed and Google Scholar primary databases, resulting in the inclusion of 19 relevant articles.<br><br>RESULTS: Approximately three-fifths (11 of 19 studies; 57.9%) provided empirical support for the hypothesis that conservatism is positively associated with threat sensitivity. These findings reveal a complex and nuanced relationship between conservatism and threat perception, with recent evidence-including large-scale longitudinal data and experimental manipulations of COVID-19-related threats-indicating weak or context-dependent associations. The overall pattern highlights substantial heterogeneity across methodological approaches, with mixed results particularly among physiological and priming studies.<br><br>CONCLUSIONS: While the majority of evidence supports a relationship between political conservatism and threat sensitivity, the magnitude of this association appears modest, emphasizing the importance of considering moderating variables such as cultural context, the type of threat, and methodological variations in measurement in future research.}, }
@article {pmid41299695, year = {2025}, author = {Mishra, N and Goel, T and Gangani, N and Chugh, H and Kevadiya, B and Tiwari, M and Singh, S and Sharma, JG and Chandra, R}, title = {The virology of Omicron: pathophysiology, immune regulation, and clinical impact of SARS-CoV-2 sub variants.}, journal = {Virology journal}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12985-025-03020-1}, pmid = {41299695}, issn = {1743-422X}, abstract = {Since its emergence in late 2019, SARS-CoV-2 has evolved into multiple variants with distinct genetic and clinical features. Among them, the Omicron variant (B.1.1.529) and its sublineages BA.2.75, JN.1.8, and KP.2 have shown enhanced transmissibility and immune evasion, while generally exhibiting reduced lower respiratory tract pathogenicity compared to earlier variants, thereby continuing to pose significant challenges to public health. In India, these variants have significantly shaped the trajectory of the pandemic, necessitating focused evaluation of their biological and clinical impact. This review aims to provide a comprehensive study on the virology, pathophysiology, and systemic manifestations of Omicron and its emerging subvariants upto July 2025. We discuss their mechanisms of entry and replication, interaction with ACE2 and TMPRSS2 receptors, and evasion of host immune responses. Particular emphasis is placed on multi-organ involvement beyond the respiratory system, including neuro-respiratory dysregulation, cardiovascular complications, hepatic injury, gastrointestinal disturbances, and renal dysfunction. Furthermore, we evaluate the effectiveness of available vaccines, antiviral therapies, and diagnostic tools, alongside emerging clinical strategies such as vagus nerve stimulation, thermal modulation, and respiratory muscle training. By integrating molecular insights with clinical outcomes, this review highlights the multifaceted and systemic nature of Omicron-induced disease. We underscore the urgent need for variant-specific immunisation, early intervention strategies, and robust genomic surveillance to mitigate long-term sequelae and guide preparedness for future outbreaks.}, }
@article {pmid41299411, year = {2025}, author = {Lee, H and Kim, Y and Chung, MA and Nam, EW}, title = {Effectiveness and strategies of social prescribing in Korea using a machine learning topic modeling.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1530}, pmid = {41299411}, issn = {1472-6963}, support = {NRF-2021R1C1C2005464//National Research Foundation of Korea/ ; 2025-RISE-10-006//Ministry of Education/ ; }, abstract = {BACKGROUND: Social prescribing, a non-medical approach linking individuals to community-based services to improve health and well-being, has expanded globally, including Korea. Despite their increasing adoption, there is limited systematic evidence evaluating the effectiveness, implementation strategies, and policy implications of social prescriptions in the Korean context.<br><br>METHODS: This study conducted a scoping review of the literature related to social prescriptions in Korea. English- and Korean-language articles were retrieved from five databases (Google Scholar, Web of Science, PubMed, Scopus, and KCI) without time restrictions. The studies were screened and selected based on predefined criteria. Machine learning-based topic modeling (LDA, NMF, and BERTopic) was applied to extract the latent thematic structures from the included studies. The evaluation metrics included coherence score, perplexity, topic diversity, and topic balance-guided model selection. The NMF model was selected for final analysis because of its superior performance.<br><br>RESULTS: Six key thematic categories were identified from 16 studies: (1) Mental Health, (2) evaluation, (3) program, (4) Social Issues, (5) COVID-19, and (6) international comparisons. Mental health and social isolation have emerged as major concerns, particularly in aging rural populations. Programs focusing on gardening, music, and digital platforms have been reported to be effective in improving psychological wellbeing and community engagement. The analysis also highlights the necessity of localized models tailored to Korea&#x2019;s demographic and policy landscape.<br><br>CONCLUSIONS: This study emphasized the need for a comprehensive policy framework for social prescriptions in South Korea. The integration of digital technology for remote delivery, adaptation to rural health gaps, and benchmarking from established international models is recommended. This study demonstrates the utility of AI-driven text mining as an innovative approach for evidence synthesis and policy planning for public health.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13711-8.}, }
@article {pmid41299209, year = {2025}, author = {Trombetta, CM and Montomoli, E}, title = {High-dose influenza vaccine: enhanced protection for the elderly.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {1111-1127}, doi = {10.1080/14760584.2025.2596673}, pmid = {41299209}, issn = {1744-8395}, mesh = {Humans ; *Influenza Vaccines/administration &amp; dosage/immunology ; *Influenza, Human/prevention &amp; control/immunology ; Aged ; Middle Aged ; Vaccines, Inactivated/immunology/administration &amp; dosage ; COVID-19/prevention &amp; control ; Immunogenicity, Vaccine ; Aged, 80 and over ; Vaccination/methods ; Age Factors ; }, abstract = {INTRODUCTION: Seasonal influenza causes up to 50 million symptomatic cases and 15,000 - 70,000 deaths annually within the European Union. While influenza affects all age groups, adults aged ≥65 years disproportionately experience high rates of influenza-related hospitalizations and complications. Vaccination remains the cornerstone of influenza prevention and the most effective intervention for reducing morbidity and mortality.<br><br>AREA COVERED: This review focuses on the high-dose inactivated influenza vaccine, an enhanced formulation recommended for the immunization of adults aged 60/65 and older. The high dose vaccine contains four times the hemagglutinin antigen compared to the standard dose vaccine, resulting in significantly higher and more sustained antibody responses. This increased immunogenicity is especially pronounced in adults aged &#x2265;75&#x2009;years and in those with cardiopulmonary diseases or immunocompromised states.<br><br>EXPERT OPINION: Expanding the use of the high-dose vaccine to adults aged 50-64&#x2009;years may proactively address immunosenescence and enhance protection in this population. Moreover, the development of multicomponent vaccines targeting both influenza and COVID-19 within a single formulation could enhance vaccine uptake and streamline immunization programs. Ultimately, the high-dose vaccine has the potential to replace the standard-dose formulation in older adults, thereby optimizing influenza prevention and reducing disease burden.}, }
@article {pmid41299184, year = {2025}, author = {Warke, S and Katari, O and Jain, S}, title = {Current Status on the Convergence of Artificial Intelligence and Formulation Development in Industry: A Review.}, journal = {AAPS PharmSciTech}, volume = {27}, number = {1}, pages = {44}, pmid = {41299184}, issn = {1530-9932}, mesh = {*Artificial Intelligence/trends ; *Drug Industry/methods/trends ; Humans ; *Drug Development/methods/trends ; Machine Learning ; Chemistry, Pharmaceutical/methods ; *Drug Compounding/methods ; }, abstract = {Since Pfizer developed the mRNA vaccine for COVID-19 by leveraging artificial intelligence (AI) for designing the vaccine, integrating AI and allied domains in the drug development process has escalated at an unimaginable rate. Owing to the complex and time-consuming process of drug development, many firms, including big pharma and medium-scale industries, are constantly looking for ways to reduce the time for providing lifesaving medications to patients in need without compromising the safety and efficacy of the product. Formulation of novel drug products in a pharmaceutical R&amp;D and scaling up the process to a large-scale production involves a huge investment and an eye for detail in the intricacies of the processes. Intervention of AI and machine learning (ML) can solve many problems in this aspect. With the rise of Industry 4.0, the relative shift of industry towards process automation, accelerated development has become vital in all domains. The investments in R&amp;D by the large pharmaceutical companies reached up to $190 bn in 2024, according to a report by IQVIA. There is a noted upsurge in investments in the domains interlinking AI and ML with pharmaceutical research. Pharmaceutical formulation development can excel in the early stages, and the productivity can witness a steady growth if AI and ML tools are utilized. Most of the research in this domain remains in the budding stages, and its adoption in the industry needs further refinement by delineating structured guidance from the experts and regulatory agencies. The current review speaks about the current studies reported in the arena of formulation development and also sheds light on some of the areas where the pharmaceutical product development on a larger scale can benefit from AI and ML.}, }
@article {pmid41298303, year = {2025}, author = {Hedrich, CM}, title = {Importance and Potential of Rare Disease Research in Pediatric Rheumatology and Beyond: Pushing Frontiers.}, journal = {ACR open rheumatology}, volume = {7}, number = {12}, pages = {e70138}, pmid = {41298303}, issn = {2578-5745}, abstract = {Although individually occurring in less than 1 in 2,000 people, cumulatively, more than 7,000 rare diseases affect approximately 6% of the population worldwide. Children and young people are disproportionally challenged in number and severity, which may be explained by the large proportion of genetic conditions among rare diseases (70%-80%). Indeed, an estimated 30% of children with rare diseases do not survive past their fifth birthday. Because rare diseases are frequently missed or diagnosed with a delay of several years and <5% of rare diseases have a licensed treatment, the impact of rare diseases on the indivual affected (independent of age) and wider society is significant. To address these challenges sufficiently, rare disease expert centers combining research activity with patient care are needed to develop diagnostic tests, prognostic tools, and new treatments. This expert-driven approach promises expedited diagnosis and efficacious treatment and care. Although restricted by chronic underfunding, rare disease research keeps delivering new exciting treatment options and technologies, some of which have revolutionized care not only in niche areas of medicine but also common diseases (the use of interleukin-1 blockers in gout or COVID-19-associated hyperinflammation, etc). However, rare disease research and care will only be successful in collaborative, mutidisciplinary and multiprofessional teams that involve patients and families as equal partners and span across institutional and national borders. Lastly, the use of state-of-the-art computational approaches to share knowledge and associate molecular with clinical phenotypes, treatment responses, and disease outcomes will amplify our ability to serve patients and the society.}, }
@article {pmid41297861, year = {2025}, author = {Kumar, R and Kommineni, N and Aadil, KR and Desai, N and Bunekar, N and Salave, S and Bulusu, R and Kumar, D and Vora, LK}, title = {Lipid Nanoparticle-based mRNA Therapeutics for Infectious Diseases.}, journal = {International journal of pharmaceutics}, volume = {687}, number = {}, pages = {126420}, doi = {10.1016/j.ijpharm.2025.126420}, pmid = {41297861}, issn = {1873-3476}, abstract = {Infectious diseases remain one of the most pressing global health challenges, despite decades of therapeutic research. Many existing treatments are constrained by limited efficacy, adverse effects, and reduced adaptability to rapidly evolving pathogens. The COVID-19 pandemic marked a turning point in vaccine development, leading to the swift creation of mRNA vaccines delivered via lipid nanoparticles (LNP-mRNA). Developed within a year and deployed globally, these vaccines demonstrated exceptional safety, efficacy, and scalability. Their success has driven significant interest in LNP-mRNA platforms for a broader range of infectious diseases. This manuscript presents a comprehensive overview of recent progress in LNP-mRNA therapeutics targeting Herpes Simplex Virus (HSV), Respiratory Syncytial Virus (RSV), Zika virus, Rabies virus, and SARS-CoV-2. Key strategies to enhance mRNA stability, improve intracellular delivery, and enable controlled or targeted release are discussed. Advances in lipid nanoparticle formulation and mRNA sequence engineering are also examined, with emphasis on cell-specific and tissue-specific targeting. The manuscript further outlines current translational challenges, including optimization of LNP composition, biocompatibility, immune system interactions, and clinical development hurdles, supported by recent preclinical and clinical findings. Collectively, the findings discussed highlight the transformative potential of LNP-mRNA therapeutics for development of next-generation, personalized treatments for infectious diseases.}, }
@article {pmid41297579, year = {2025}, author = {Hempel, H and Xue, H and La Shu, S and Jain, S and Kemp, TJ and Pinto, LA}, title = {Cancer and COVID-19: A review of Immune Insights and Partnerships to Inform Public Health Strategy.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {}, number = {}, pages = {108252}, doi = {10.1016/j.ijid.2025.108252}, pmid = {41297579}, issn = {1878-3511}, abstract = {Cancer populations are highly vulnerable to respiratory viral infections (RVIs) due to disease- and treatment-related immunosuppression. SARS-CoV-2 is a particularly severe threat in this population and COVID-19 is associated with higher rates of hospitalization and mortality compared to immunocompetent individuals. Vaccination remains the most effective preventive method. However, immune responses to vaccination in cancer patients are often heterogeneous and weaker than healthy populations. While booster doses can improve the protection, vaccine effectiveness wanes over time, and some patients may not respond well, with significant variability across cancer types, cancer status and treatment regimens. These observations highlight the importance of more personalized vaccination strategies informed by a thorough understanding of immune correlates of protection, including humoral, cellular, and mucosal immunity. Assessing different layers of immunity requires different experimental approaches, robust assay standardization and data harmonization. The collaborative efforts of consortia and the development of large, well-annotated biospecimen repositories can support high-resolution immune profiling, advance next-generation vaccine strategies and improve sustained protection against SARS-CoV-2 and other respiratory viruses in cancer populations.}, }
@article {pmid41295579, year = {2025}, author = {Malebana, LF and Sepadi, MM and Mokgobu, MI}, title = {Communicable Disease Surveillance in South Africa and LMICs: A Systematic Review of Systems, Challenges, and Integration with Environmental Health.}, journal = {Tropical medicine and infectious disease}, volume = {10}, number = {11}, pages = {}, pmid = {41295579}, issn = {2414-6366}, support = {Departmental Research Funds L292//Tshwane University of Technology/ ; }, abstract = {Communicable disease surveillance systems are crucial for global health security, particularly in low- and middle-income countries (LMICs) where infectious disease burdens remain high. Despite disease surveillance systems being in place, the evidence on their implementation, challenges, and integration with environmental health remains fragmented. This systematic review assesses the design, implementation, and challenges of these systems across LMICs, with a focus on South Africa and the broader Sub-Saharan African region. Using PRISMA guidelines and the PICOS framework, searches across four databases identified 325 articles published between 2010 and 2025, of which 56 (17%) were included for analysis. Thematic synthesis revealed key trends, disease priorities, and surveillance tools. South Africa contributed the highest number of articles (25%), while Sub-Saharan Africa accounted for 54% overall. COVID-19 was the most frequently studied disease (20%), followed by cholera, typhoid, and measles. The Integrated Disease Surveillance and Response (IDSR) framework appeared in 25% of articles, while District Health Information Systems 2 (DHIS2) was referenced in 11%, reflecting modest adoption of digital platforms. Reported challenges included underreporting, inconsistent case definitions, limited digital infrastructure, and weak feedback mechanisms. Although integration of environmental health was widely recommended, it was marginally implemented. Overall, LMICs surveillance systems remain constrained by operational and structural limitations, underscoring the need for digital investment, environmental indicators integration, and community-based approaches to strengthen epidemic preparedness.}, }
@article {pmid41295541, year = {2025}, author = {Zhang, B and Liu, Y and Chen, T and Lai, J and Liu, S and Liu, X and Zhu, Y and Rao, H and Peng, H and Ma, X}, title = {Current Status and Challenges of Vaccine Development for Seasonal Human Coronaviruses.}, journal = {Vaccines}, volume = {13}, number = {11}, pages = {}, pmid = {41295541}, issn = {2076-393X}, support = {GZNL2024A01017//Major Project of Guangzhou National Laboratory/ ; GZNL2023A01009//Major Project of Guangzhou National Laboratory/ ; 82572540//National Natural Science Foundation of China (NSFC)/ ; 2024B1515020068//Guangdong Basic and Applied Basic Research Foundation/ ; GZNL2025C01018//Major Talent Project of Guangzhou National Laboratory/ ; }, abstract = {Seasonal human coronaviruses (HCoVs), including HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1, circulate globally in an epidemic pattern and account for a substantial proportion of common cold cases, particularly in infants, the elderly, and immunocompromised individuals. Although clinical manifestations are typically mild, these HCoVs exhibit ongoing antigenic drift and have demonstrated the potential to cause severe diseases in certain populations, underscoring the importance of developing targeted and broad-spectrum vaccines. This review systematically examines the pathogenesis, epidemiology, genomic architecture, and major antigenic determinants of seasonal HCoVs, highlighting key differences in receptor usage and the roles of structural proteins in modulating viral tropism and host immunity. We summarize recent advances across various vaccine platforms, including inactivated, DNA, mRNA, subunit, viral-vectored, and virus-like particle (VLP) approaches, in the development of seasonal HCoV vaccines. We specifically summarize preclinical and clinical findings demonstrating variable cross-reactivity between SARS-CoV-2 and seasonal HCoV vaccines. Evidence indicates that cross-reactive humoral and cellular immune responses following SARS-CoV-2 infection or vaccination predominantly target conserved epitopes of structural proteins, supporting strategies that incorporate conserved regions to achieve broad-spectrum protection. Finally, we discuss current challenges in pathogenesis research and vaccine development for seasonal HCoVs. We propose future directions for the development of innovative pan-coronavirus vaccines that integrate both humoral and cellular antigens, aiming to protect vulnerable populations and mitigate future zoonotic spillover threats.}, }
@article {pmid41295513, year = {2025}, author = {Guedes-da-Silva, FH and Roncaglia-Pereira, VA and Torres, S and García, MCE and Viana, KF and Silva, JL and Oliveira, AC and Gomes, AMO}, title = {Antiviral Inactivated Vaccines: Looking to the Past to Face the Future-A Narrative Review.}, journal = {Vaccines}, volume = {13}, number = {11}, pages = {}, pmid = {41295513}, issn = {2076-393X}, support = {E-26/200.340/2023//Funda&#xe7;&#xe3;o Carlos Chagas Filho de Amparo &#xe0; Pesquisa do Estado do Rio de Janeiro/ ; CNPq awards and INCT Program//National Council for Scientific and Technological Development/ ; (CAPES)//Coordena&#xe7;&#xe3;o de Aperfeicoamento de Pessoal de N&#xed;vel Superior/ ; }, abstract = {Throughout human history, contagious infectious diseases have significantly impacted societies, shaping the fate of great dynasties and challenging economic and political systems, social relations, and the overall well-being of the human species. The SARS-CoV-2 pandemic brought unprecedented challenges, emerging in the context of extreme globalization and rapid technological development. The speed of viral spread, the highest absolute mortality rate caused by a viral agent in the last 100 years, and the severe economic and social consequences imposed an urgent need for vaccine development on a previously unimaginable timescale. The proven safety and efficacy of inactivated vaccines enabled the development and large-scale application of the first immunizer against SARS-CoV-2 in less than a year after the World Health Organization (WHO) declared the pandemic. In this review, we discuss the importance of inactivated antiviral vaccines and their historical impact in containing highly harmful diseases affecting humanity. We also explore the cellular mechanisms by which inactivated vaccines may induce immunogenic responses against viral pathogens. In addition, we bring to light a discussion about a fast, cost-effective, potentially efficient technology for large-scale immunizer production: High hydrostatic pressure (HHP), a method long supported by decades of preclinical studies and which is especially effective in the context of enveloped viruses. Finally, we discuss the role of inactivated antiviral vaccines in the face of advances in biotechnology and, therefore, the emergence of vaccines that use genetic engineering in their production, such as RNA, DNA and viral vaccines, which have gained special prominence during the COVID-19 pandemic.}, }
@article {pmid41295511, year = {2025}, author = {Iwu-Jaja, C and Nkereuwem, O and Iwu, CD and Mazingisa, AV and Jaca, A and Ndwandwe, D and Wiysonge, CS}, title = {Mapping Eight Decades of Vaccination Social Science: Bibliometric Analysis of Global Research Trends.}, journal = {Vaccines}, volume = {13}, number = {11}, pages = {}, pmid = {41295511}, issn = {2076-393X}, support = {T32 ES015459/ES/NIEHS NIH HHS/United States ; }, abstract = {BACKGROUND: Despite growing recognition of vaccination social science as essential to immunization strategies, the field's evolution, geographic distribution, and research patterns remain poorly characterized. This study provides the first comprehensive mapping of the social science literature on vaccination over eight decades.<br><br>METHODS: We conducted a bibliometric analysis of peer-reviewed publications indexed in PubMed from their inception, using a systematic search strategy that combined vaccination and social science terms. Publications were analyzed using the Bibliometrix R package (version 5.0) to examine temporal trends, author productivity, institutional contributions, geographic distribution, and thematic evolution globally.<br><br>RESULTS: We retrieved 8005 eligible publications. Analysis highlighted three chronological research phases: sporadic early work (1945-1980, n = 85), sustained growth (1981-2019, n = 2743), and unprecedented expansion since the COVID-19 era (2020-2024, n = 4563). Annual publications reached a peak in 2022 (n = 1686). Research spans 146 countries but remains concentrated in high-income countries, with the United States (n = 10,230), China (n = 3796), and Canada (n = 2288) leading production. The top 20 institutions were from the United States (n = 8), United Kingdom (n = 4), and Canada (n = 3), with a few institutions from African countries. International collaboration was moderate (19.44%). Thematic analysis revealed a clear evolution from biological science (1963-1999) to socio-behavioural science, with an emphasis on vaccine hesitancy, trust, communication, and health equity (2015-2024).<br><br>CONCLUSIONS: Vaccination social science has grown steadily over the decades, with a sharp rise in research during the COVID-19 pandemic. Most studies were from high-income countries, underscoring the need for enhanced social science capacity in low- and middle-income countries. As the focus of immunization efforts shifts toward issues like vaccine hesitancy and trust, broader collaboration and inclusion will be key to improving vaccine uptake worldwide.}, }
@article {pmid41295485, year = {2025}, author = {Peng, M and Wang, Z}, title = {Vaccine-Associated Autoimmunity: From Clinical Signals to Immune Pathways.}, journal = {Vaccines}, volume = {13}, number = {11}, pages = {}, pmid = {41295485}, issn = {2076-393X}, abstract = {COVID-19 vaccination has played a pivotal role in mitigating the global health crisis and reducing morbidity and mortality associated with SARS-CoV-2 infection. While its public health benefits are unequivocal, the unprecedented scale of vaccination-reaching billions worldwide-has also enabled the detection of rare autoimmune events, including systemic lupus erythematosus, rheumatoid arthritis, type 1 diabetes, and Guillain-Barré syndrome. Although such events occur in only a small subset of individuals, often influenced by genetic, environmental, or dosage-related factors, they underscore the importance of understanding immune tolerance mechanisms in vaccination. This review synthesizes clinical observations and immunological findings from the COVID-19 vaccination era, highlighting key mechanisms such as molecular mimicry, adjuvant-induced inflammation, bystander activation, epitope spreading, and polyclonal B cell activation. We also consider how novel vaccine platforms, particularly mRNA-based technologies, may influence immune regulation and self-tolerance. Importantly, we discuss the therapeutic management of vaccine-associated autoimmunity, including the use of corticosteroids, intravenous immunoglobulin (IVIG), plasma exchange, disease-modifying anti-rheumatic drugs (DMARDs), and other immunosuppressive agents, many of which have led to favorable clinical outcomes. By integrating mechanistic insights with treatment strategies, this review emphasizes that the overall benefits of COVID-19 vaccination overwhelmingly outweigh the risks, while advocating for continued surveillance, mechanistic research, and risk stratification to inform safer and more targeted vaccination strategies in future pandemics.}, }
@article {pmid41294924, year = {2025}, author = {Wang, Q and Nader, A and Peppercorn, A and Skingsley, A and Lloyd, E and Stella, AO and Walker, J and Garner, C}, title = {Clinical Pharmacology Approaches to Predict Efficacy of Monoclonal Antibodies Against Emerging SARS-CoV-2 Variants.}, journal = {Clinical and translational science}, volume = {18}, number = {12}, pages = {e70421}, pmid = {41294924}, issn = {1752-8062}, mesh = {Humans ; *SARS-CoV-2/drug effects/immunology/genetics ; *Antibodies, Monoclonal/pharmacology/therapeutic use/administration &amp; dosage ; *COVID-19 Drug Treatment ; *COVID-19/virology/immunology ; *Antibodies, Viral/administration &amp; dosage/therapeutic use/immunology/pharmacology ; Pharmacology, Clinical/methods ; Antibodies, Neutralizing ; }, abstract = {The onset of the global COVID-19 pandemic created an urgent need for therapeutic monoclonal antibody (mAb) development, while the rapid mutation of the SARS-CoV-2 virus and emergence of new variants presented a moving target for validation of efficacy. Since it is virtually impossible to conduct randomized controlled trials in the context of a continually evolving variant landscape, other sources of data can inform ongoing effectiveness and appropriate dosing of existing treatments against new variants. This may include data from in vitro neutralization testing, real-world studies, and clinical pharmacology studies. There are various clinical pharmacology approaches available to aid in dose selection of COVID-19 mAbs, and the approach used for initial dose selection may differ from that used to justify dose modifications in light of new variants. At present, there is no universally accepted approach that has been shown to work in all circumstances, and most of the available methods lack validation against clinical data. Here, we provide an overview of the different pharmacological approaches available for mAb dose selection or dose adjustments, outlining advantages and limitations of each as well as assumptions, data requirements, and key learnings for each method based on experiences with COVID-19 mAb development over the last 4 years. Future mAb development programs for COVID-19 or other viral infections with pandemic potential should take into consideration lessons learned from the COVID-19 pandemic and devise clinical development programs that generate data to help address new emerging variants of concern in a rapidly evolving virus landscape.}, }
@article {pmid41294845, year = {2025}, author = {Kutumova, E and Akberdin, I and Lavrik, I and Kolpakov, F}, title = {Mathematical Modeling of Cell Death and Survival: Toward an Integrated Computational Framework for Multi-Decision Regulatory Dynamics.}, journal = {Cells}, volume = {14}, number = {22}, pages = {}, pmid = {41294845}, issn = {2073-4409}, support = {24-14-20031//Russian Science Foundation/ ; }, mesh = {Humans ; COVID-19/virology/pathology ; *Cell Death ; Signal Transduction ; Apoptosis ; Pyroptosis ; Cell Survival ; Necroptosis ; *Models, Theoretical ; *Models, Biological ; Animals ; Autophagy ; SARS-CoV-2 ; Ferroptosis ; }, abstract = {Mathematical modeling is essential for understanding the complex regulatory pathways governing cell death and survival, including apoptosis, necroptosis, pyroptosis, ferroptosis, autophagy, and immunogenic cell death (ICD)-a functional category comprising diverse morphological types capable of activating immune responses. The growing number of models describing individual signaling pathways poses the challenge of integrating them into a cohesive framework. This review aims to identify common components across existing ordinary differential equation models that could serve as key nodes to merge distinct signaling modalities. Proposed models highlight Bcl-2, Bax, Ca[2], and p53 as shared regulators linking autophagy and apoptosis. Necroptosis and apoptosis are interconnected via TNF signaling network and modulated by caspase-8, c-FLIP, and NFκB, with RIPK1 acting as a critical hub directing pathway choice. Pyroptosis and apoptosis are co-regulated by NFκB, tBid, and caspases, while ferroptosis is modeled exclusively as an independent process, separate from other forms of cell death. Furthermore, existing models indicate that ICD intersects with necroptosis during oncolytic virotherapy, with pyroptosis in SARS-CoV-2 infection, and with apoptosis in the context of chemotherapy. Although several models address crosstalk between pairs of cell fate decisions, creating comprehensive frameworks that encompass three or more death modes remains an open challenge.}, }
@article {pmid41294766, year = {2025}, author = {Kumar, A and Goel, S and Chaudhary, A and Dutt, S and Mishra, VK and Kumar, R}, title = {Artificial Intelligence-Based Wearable Sensing Technologies for the Management of Cancer, Diabetes, and COVID-19.}, journal = {Biosensors}, volume = {15}, number = {11}, pages = {}, pmid = {41294766}, issn = {2079-6374}, mesh = {Humans ; *COVID-19/diagnosis/therapy ; *Wearable Electronic Devices ; *Artificial Intelligence ; *Diabetes Mellitus/diagnosis/therapy ; *Neoplasms/diagnosis/therapy ; SARS-CoV-2 ; *Biosensing Techniques ; Monitoring, Physiologic ; }, abstract = {Integrating artificial intelligence (AI) with wearable sensor technologies can revolutionize the monitoring and management of various chronic diseases and acute conditions. AI-integrated wearables are categorized by their underlying sensing techniques, such as electrochemical, colorimetric, chemical, optical, and pressure/stain. AI algorithms enhance the efficacy of wearable sensors by offering personalized, continuous supervision and predictive analysis, assisting in time recognition, and optimizing therapeutic modalities. This manuscript explores the recent advances and developments in AI-powered wearable sensing technologies and their use in the management of chronic diseases, including COVID-19, Diabetes, and Cancer. AI-based wearables for heart rate and heart rate variability, oxygen saturation, respiratory rate, and temperature sensors are reviewed for their potential in managing COVID-19. For Diabetes management, AI-based wearables, including continuous glucose monitoring sensors, AI-driven insulin pumps, and closed-loop systems, are reviewed. The role of AI-based wearables in biomarker tracking and analysis, thermal imaging, and ultrasound device-based sensing for cancer management is reviewed. Ultimately, this report also highlights the current challenges and future directions for developing and deploying AI-integrated wearable sensors with accuracy, scalability, and integration into clinical practice for these critical health conditions.}, }
@article {pmid41293155, year = {2025}, author = {Cao, J and He, K and Chen, Z and Xu, H and Wei, J and Yan, X and Song, B}, title = {Interleukin-37 in respiratory diseases: molecular mechanisms and immune modulation.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1675791}, pmid = {41293155}, issn = {1664-3224}, mesh = {Humans ; *Interleukin-1/immunology/metabolism ; Animals ; SARS-CoV-2/immunology ; Immunomodulation ; COVID-19/immunology ; }, abstract = {Interleukin-37 (IL-37) is a potent anti-inflammatory cytokine that plays a crucial protective role in cancer, autoimmune diseases, and inflammatory diseases though its unique dual intracellular and extracellular action pathways. This review highlights the significance of IL-37 in common respiratory diseases. Specifically, IL-37 can alleviate asthma by inhibiting Th2/Th17 immune responses, inhibiting the release of epithelial-derived alarmins (TSLP and IL-33), and attenuating airway remodeling. In pulmonary infections, IL-37 modulates host responses by mitigating virus-induced hyperinflammation and inhibiting viral replication, as observed in COVID-19 and influenza, while also regulating immunopathology in Mycobacterium tuberculosis and fungal infections. Moreover, in non-small cell lung cancer (NSCLC), IL-37 directly suppresses tumor proliferation and migration, and restrains tumor progression through immunomodulation and angiogenesis regulation. In pulmonary fibrosis, IL-37 reduces collagen deposition and promotes autophagy, thereby counteracting interstitial fibrosis. Collectively, these findings demonstrate that IL-37 serves as a crucial immunomodulator in respiratory diseases, and targeting IL-37 offers novel insights and strategic opportunities for clinical intervention. This review systematically summarizes the molecular mechanisms of IL-37 and discusses its clinical therapeutic potential.}, }
@article {pmid41292679, year = {2025}, author = {Ellis Sandoval, N and Peña Martinez, MI and Fernandez Cea, AB and Hernandez Rincon, EH}, title = {Effects on Prolonged Screen Time on Postural Health and Visual Health in Children and Adolescents: A Scoping Review.}, journal = {Orthopedic research and reviews}, volume = {17}, number = {}, pages = {553-562}, pmid = {41292679}, issn = {1179-1462}, abstract = {PURPOSE: To explore the long-term impact of prolonged screen exposure on postural and visual health in children and adolescents.<br><br>PATIENTS AND METHODS: A scoping review was conducted in December 2024 using PubMed, Scopus, and BIREME, focusing on articles from 2019 to 2024 in English and Spanish. The studies were categorized into visual and postural health domains and synthesized through graphs and tables. A total of 27 articles were analyzed. The snowball method was used to complement the literature search.<br><br>RESULTS: The studies revealed a 55.3% increase in the use of portable electronic devices following the COVID-19 pandemic. Reported consequences included eye strain, computer vision syndrome, and musculoskeletal pain, especially in the cervical and lumbar regions. These effects were more prevalent in urban populations in Asia.<br><br>CONCLUSION: Prolonged screen time significantly affects children's visual and postural health. These findings highlight the need for public health policies to guide and regulate screen use in young populations and to educate parents, caregivers, and healthcare professionals.}, }
@article {pmid41292053, year = {2025}, author = {Recker, F and Neubauer, R and Adams, J and Ludwig, S and Taran, FA and Groten, T}, title = {Medical education in obstetrics and gynecology: A global update from 2025.}, journal = {Acta obstetricia et gynecologica Scandinavica}, volume = {}, number = {}, pages = {}, doi = {10.1111/aogs.70105}, pmid = {41292053}, issn = {1600-0412}, abstract = {As medical knowledge and technologies rapidly evolve, curricula have become increasingly dense, and designing effective OB-GYN education that prepares learners for diverse medical careers within limited timeframes is a global challenge. This review provides an international overview of contemporary medical education in obstetrics and gynecology (OB-GYN) across undergraduate, postgraduate, and continuing professional development levels. A narrative review of recent peer-reviewed literature, international guidelines, and global initiatives (2023-2025) was conducted, identifying key innovations, trends, and challenges in OB-GYN education worldwide, with a focus on curriculum reforms, competency-based education, simulation, telemedicine, AI applications, global standardization, and equity-oriented initiatives. Undergraduate OB-GYN curricula are increasingly standardized, integrating core competencies, early clinical exposure, and reproductive health. Postgraduate training adopts competency-based frameworks, enhanced by simulation, virtual reality, and tele-education, while continuing medical education has shifted toward flexible digital platforms and structured credentialing. Innovations, such as AI-driven learning tools, simulation drills, and telemedicine-based training, have improved skill acquisition, and global bodies, such as FIGO, RCOG, and ACOG, promote curriculum harmonization and equity. The COVID-19 pandemic accelerated digital adoption but revealed gaps in surgical training and support. Overall, OB-GYN education is in a transformative phase, marked by technology, standardization, and equity, yet significant disparities persist, especially in resource-limited settings. Continued global collaboration, investment in educational infrastructure, and adaptive curriculum development are essential to prepare OB-GYN professionals for evolving clinical demands and healthcare inequities in the postpandemic era.}, }
@article {pmid41291773, year = {2025}, author = {Howes, E and Smith, SG and Gillies, K and Zhang, L and Farrin, AJ}, title = {'Lessons learned' from trialists who adapted a complex intervention for remote delivery within a trial as a result of the COVID-19 pandemic: a scoping review.}, journal = {Trials}, volume = {26}, number = {1}, pages = {548}, pmid = {41291773}, issn = {1745-6215}, support = {MR/W006049/1/MRC_/Medical Research Council/United Kingdom ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Randomized Controlled Trials as Topic/methods ; Telemedicine ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, complex interventions being evaluated in randomised controlled trials were often rapidly adapted from in-person to remote delivery. Such adaptations to intervention delivery have the potential to cause unintended consequences and affect important aspects of trial generalisability and interpretation. This scoping review aimed to identify the 'lessons learned' from trialists who adapted and remotely delivered a complex intervention within a trial because of the COVID-19 pandemic. Gaining a better understanding of trialists' experiences of adapting interventions for remote delivery will identify where more in-depth investigation and guidance is needed.<br><br>METHODS: The Joanna Briggs Institute (JBI) scoping review guidelines were followed. The search was developed for MEDLINE and adapted for Web of Science, PsycINFO, EMBASE, and Cochrane. Data were extracted on study characteristics, methods reported to adapt interventions, and the challenges and facilitators of the process of adaptation and remote intervention delivery. Data on remote intervention delivery were organised using the upper level of the Behaviour Change Intervention Ontology.<br><br>RESULTS: Fifteen articles were eligible for inclusion describing insights from 16 randomised controlled trials, across a range of populations and trial designs. Most discussion focused on challenges and facilitators of the remote delivery of the complex intervention. These included privacy and safety concerns of intervention delivery within the home setting, and technological issues of remote delivery via video call. The most frequently reported facilitator was the use of an environmental inventory before intervention delivery to check the space in which participants were located, and the materials available to them.<br><br>CONCLUSION: Suitability of an intervention for remote delivery depends not only on whether it is originally delivered via a digital technology, but also the extent to which it requires human facilitation and support. Privacy and safety concerns in the home environment could impact trial participation in a remotely delivered intervention. Further research is needed to explore how trialists can effectively prepare for and manage the challenges of remote intervention delivery. Guidance developed to support adaptation of an intervention for remote delivery within a trial should be specific to the mode of delivery used.}, }
@article {pmid41291364, year = {2025}, author = {Roedl, K and Warnke, K and Hardel, T and Haar, M and Jarczak, D and Karakas, M and Kluge, S and , }, title = {[Awake prone position in critically ill patients-a practice recommendation].}, journal = {Medizinische Klinik, Intensivmedizin und Notfallmedizin}, volume = {}, number = {}, pages = {}, pmid = {41291364}, issn = {2193-6226}, abstract = {In cases of severe pneumonia, prone positioning therapy has been shown to have a positive effect in patients receiving invasive mechanical ventilation. In addition, during the COVID-19 pandemic, a positive effect was demonstrated in patients who did not yet require mechanical ventilation (endotracheal intubation) and who received prone positioning therapy before these measures were taken (awake prone positoning). Currently, the influence of awake prone positioning therapy in patients without COVID-19 has not been sufficiently investigated. This recommendation aims to explain the indications, side effects, contraindications, and implementation of awake prone positioning in conscious critically ill patients.}, }
@article {pmid41289884, year = {2025}, author = {Liu, C and Yang, Q and Shen, Y and Xu, M}, title = {Multidimensional review of viral infectious ocular diseases: Post-Pandemic epidemiology and future directions for control.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101428}, doi = {10.1016/j.mam.2025.101428}, pmid = {41289884}, issn = {1872-9452}, abstract = {Viral Infectious Ocular Diseases (VIODs) remain a major global cause of vision loss, ranging from highly transmissible conjunctivitis to blinding keratitis and complex neuro-ophthalmic syndromes. Furthermore, the Coronavirus Disease 2019 (COVID-19) pandemic and subsequent reported ocular diseases have fundamentally changed the landscape of VIOD epidemiology and management. Epidemiological data indicate heterogeneous effects on common infections such as Adenoviral conjunctivitis due to varying compliance with hygiene measures. Concurrently, systemic immunological events, notably those induced by COVID-19 infection or certain vaccinations, have been linked to the reactivation of latent Alphaherpesviruses, including Herpes Simplex Virus (HSV) and Varicella Zoster Virus (VZV). The metagenomic next-generation sequencing (mNGS) offers a significantly improved diagnostic yield (up to 92.7 % in some cohorts) for complex infectious keratitis compared to conventional methods, providing an unbiased tool crucial for timely, targeted treatment. Therapeutic challenges are defined by the persistent threat of antiviral resistance, primarily driven by mutations in the viral Thymidine Kinase (TK) gene. To overcome poor ocular bioavailability, novel drug delivery systems (NDDS), such as Acyclovir-loaded Niosomes and Cubosomes, show promise by enabling sustained drug release and enhanced corneal permeation. Effective future VIOD control requires a multi-pronged strategy integrating robust global surveillance, rapid deployment of advanced molecular diagnostics, and the clinical implementation of resistance-beating therapies delivered via optimized nanocarrier platforms. This review provides the current understanding of VIODs, focusing on the epidemiological shifts observed post-2020, advancements in molecular diagnostics, challenges posed by antiviral resistance, and the emergence of next-generation therapeutic strategies.}, }
@article {pmid41288892, year = {2025}, author = {Okoli, GN and Askin, N and Rabbani, R}, title = {Treatment of Non-severe COVID-19 with Molnupiravir: A Systematic Review with Meta-analysis and Trial Sequential Analysis of the Evidence from Randomized Controlled Trials.}, journal = {Clinical drug investigation}, volume = {}, number = {}, pages = {}, pmid = {41288892}, issn = {1179-1918}, abstract = {UNLABELLED: BACKGROUND AND OBJECTIVE: The evidence on molnupiravir for the treatment of adults with nonsevere coronavirus disease 2019 (COVID-19) remains underexplored. We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) of clinically relevant outcomes from randomized controlled trials (RCTs) of molnupiravir for treatment of nonsevere COVID-19 in adults.<br><br>METHODS: We searched for publications of RCTs of molnupiravir for nonsevere COVID-19 in appropriate bibliographic databases up to 1 February 2025. We pooled appropriate data utilizing an inverse variance, random-effects model, with results expressed as relative risk (RR) with associated 95% confidence intervals (CIs), and statistical heterogeneity between pooled estimates calculated using the I[2] statistic. We appropriately conducted risk of bias assessment for the included RCTs and graded the quality of pooled evidence for each outcome using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.<br><br>RESULTS: Out of 680 screened literature citations, nine RCTs involving a total of 30,971 patients met the eligibility criteria for inclusion in this review. The majority (78%) of these RCTs were of a low risk of bias. We determined that there was more viral clearance with molnupiravir treatment compared with placebo or no treatment (RR 1.08 [95% CI 1.01-1.16], I[2] 40.8%, five RCTs, 1785 patients, moderate quality evidence) and that treatment with molnupiravir did not reduce the risk of hospitalization (RR 0.73 [95% CI 0.47-1.14], I[2] 58.3%, five RCTs, 28,626 patients; high quality evidence), and all-cause mortality (RR 0.51 [95% CI 0.15-1.69], I[2] 36.8%, four RCTs, 27,445 patients; high quality evidence). We also determined that molnupiravir did not increase adverse or serious adverse reactions. However, TSA suggested more RCTs should be conducted before any conclusions can be reached for viral clearance, all-cause mortality, and adverse reactions, but that further RCTs on the risk of hospitalization and serious adverse reactions may not be needed.<br><br>DISCUSSION: Notwithstanding a paucity of RCTs, our findings suggest that molnupiravir may only be efficacious for clearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; the virus responsible for COVID-19) in adults with nonsevere COVID-19 although the evidence is not sufficient for conclusions to be drawn. More high quality RCTs are needed for a stronger evidence base.}, }
@article {pmid41288547, year = {2025}, author = {Medina-Inojosa, JR and Chacin Suarez, AS and Murtala, AB and Hicks, JB and Harris, K and Bennett, J and Sperling, LS}, title = {COVID-19 Pandemic: Wake-up Call and Accelerator for Cardiac Rehabilitation.}, journal = {The Canadian journal of cardiology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cjca.2025.10.002}, pmid = {41288547}, issn = {1916-7075}, abstract = {Cardiac rehabilitation (CR) is a cornerstone of secondary prevention in cardiovascular care, improving survival, reducing rehospitalization, and enhancing quality of life. Despite robust evidence and strong guideline support, CR remains markedly underutilized in Canada and globally, with significant disparities by sex, race, geography, and socioeconomic status. The COVID-19 pandemic disrupted more than three-quarters of CR programs worldwide, exposing deep-rooted limitations in access, infrastructure, and delivery models. At the same time, the pandemic served as a catalyst for innovation. Rapid implementation of virtual, home-based, and hybrid models demonstrated that CR could be delivered flexibly and effectively beyond traditional settings. This review synthesizes emerging evidence and policy responses, highlighting opportunities to modernize CR delivery while embedding equity, patient-centeredness, and digital innovation into routine care. We conclude that the future of CR must be inclusive, technology-enabled, and integrated into the broader continuum of preventive care. The lessons of the pandemic offer a roadmap-and a renewed imperative-to close longstanding gaps and reimagine cardiac rehabilitation for all who need it.}, }
@article {pmid41288364, year = {2025}, author = {Casadevall, A and Mattoon, ER and Sullivan, D and Joyner, MJ and Franchini, M and Focosi, D}, title = {Convalescent plasma for COVID-19: planning for the next pandemic using the worldwide experience.}, journal = {Clinical microbiology reviews}, volume = {}, number = {}, pages = {e0006024}, doi = {10.1128/cmr.00060-24}, pmid = {41288364}, issn = {1098-6618}, abstract = {SUMMARYCOVID-19 convalescent plasma (CCP) was the first specific therapy deployed for treating SARS-CoV-2 infection. CCP was successfully deployed in both resource-poor and resource-rich countries, establishing that convalescent plasma (CP) is a feasible option for combating the next pandemic. CCP reduced mortality and progression to hospitalization when used early in the disease with high-titer units. This knowledge was gained from a worldwide effort that included more than 50 countries. However, the deployment of CCP was haphazard and varied among countries. Clinical studies suffered from a lack of standardization regarding study design, CCP antibody dosing, timing of administration, and participant disease severity. Unfortunately, the hard-won knowledge from the serum therapy era in the early 20th century, which indicated that effective antibody therapy requires early use in the disease with a sufficient antibody dose, was largely forgotten. Many studies tested CCP late in the disease or without sufficient antibody titer and thus reported negative findings. Trial heterogeneity made it difficult to combine the results of studies. However, despite tremendous heterogeneity in study design and participant populations, meta-analysis revealed strong signals of efficacy when given early with high antiviral-specific antibody levels. When the next pandemic occurs, humanity is likely to resort to CP again. To avoid another chaotic rollout, planning for CP use should begin well before that emergency arrives and must involve both physician education on the principles of antibody therapy and clinical trial designs that test its efficacy in optimal conditions, which include early use with sufficient antibody doses.}, }
@article {pmid41287814, year = {2025}, author = {Sirjohn, N and Sharma, G and Chand, D and Choi, KY and Thakur, P and Thakur, V and Thakur, MS and Kulshreshtha, S and Patel, SKS and Kumar, P}, title = {Harnessing microbial factories for withaferin-a: the future of plant-based oncotherapeutics.}, journal = {3 Biotech}, volume = {15}, number = {12}, pages = {446}, pmid = {41287814}, issn = {2190-572X}, abstract = {Withania somnifera (Ashwagandha), a member of the Solanaceae family, produces bioactive metabolites known as withanolides, predominantly synthesized in its leaves and roots. Among these, Withaferin-A is a major pharmacologically active compound with demonstrated efficacy across diverse preclinical models. It exhibits anti-cancer, anti-diabetic, anti-viral (including COVID-19), and neuroprotective activities through modulation of oncoproteins and cell signalling pathways. Notably, its specificity toward tumour-associated antigens and immune regulators positions Withaferin-A as a potential alternative to conventional therapies such as chemotherapy and radiotherapy, which often present severe side effects and resistance issues. This review critically explores the biosynthetic routes of Withaferin-A, encompassing chemical synthesis, natural extraction, and microbial production, while also emphasizing strategies for yield optimization through biotechnological interventions. Furthermore, we discuss the bioavailability and pharmacokinetic challenges of Withaferin-A, highlighting formulation and delivery strategies aimed at enhancing its clinical applicability. Overall, the review outlines its translational potential and provides a roadmap for future therapeutic and clinical integration.}, }
@article {pmid41287121, year = {2025}, author = {Maher, LC and Ryan, PM and Caplice, NM}, title = {Adipose Tissue in SARS-CoV-2 Viral Tropism, Viral Replication, and the Concept of a Viral Reservoir: An Update.}, journal = {Obesity (Silver Spring, Md.)}, volume = {}, number = {}, pages = {}, doi = {10.1002/oby.70093}, pmid = {41287121}, issn = {1930-739X}, abstract = {Since the onset of the COVID-19 pandemic, obesity has been consistently associated with worse clinical outcomes. In 2020, we hypothesized that adipose tissue (AT) might serve as a viral reservoir and amplifier of immune responses in SARS-CoV-2 infection. Five years on, accumulating evidence supports this hypothesis. Recent autopsy and in vitro studies support that SARS-CoV-2 disseminates to and may replicate within human adipocytes. While several studies have detected SARS-CoV-2 RNA and proteins in AT, the recovery of infectious virus from this tissue has not yet been demonstrated. This remains a critical gap in our understanding of SARS-CoV-2 viral tropism and replication within adipocytes. Viral entry is mediated via angiotensin-converting enzyme-2 and neuropilin-1 receptors. Infected AT exhibits immune cell infiltration and cytokine activation, implicating it in systemic inflammation. Persistent viral RNA in AT correlates with prolonged metabolic dysfunction. These findings highlight the dual role of AT as a potential viral reservoir and immunometabolic organ. Understanding these mechanisms is critical to mitigating the long-term impact of COVID-19 and guiding responses to future pandemics involving metabolically active tissues.}, }
@article {pmid41286802, year = {2025}, author = {Felgner, S and Handrock, JF and Schroll, CC and Schütte, F and Henschke, C}, title = {Decision-making regarding dental treatments - What factors matter from patients' perspective? A systematic review.}, journal = {BMC oral health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12903-025-07032-9}, pmid = {41286802}, issn = {1472-6831}, abstract = {BACKGROUND: Achieving oral health for the population should be a concern of public health care systems, as it may affect their expenditures in the long term. Patients often face individual challenges in dental care. Why patients decide for or against dental treatments can be determined by many factors, e.g., their own financial resources, preferences, and external circumstances. This cross-country study aims to identify those factors.<br><br>METHODS: We systematically searched for literature in the biomedical databases PubMed (including MEDLINE), the Cochrane Library, and Web of Science to identify factors influencing dental treatment decisions across different countries. Factors of choice were extracted from relevant articles to develop a codebook for subsequent qualitative analysis using an inductive thematic analysis approach. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT). This systematic review followed the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Synthesis Without Meta-analysis (SWiM) statements.<br><br>RESULTS: After multistage screening of N&#x2009;=&#x2009;4,226 publications by two reviewers, N&#x2009;=&#x2009;233 relevant articles of different study designs (qualitative (N&#x2009;=&#x2009;42), quantitative (N&#x2009;=&#x2009;177), and mixed-methods (N&#x2009;=&#x2009;14)) were included in the analysis. Data collection was realized across different settings (e.g., dental practices (N&#x2009;=&#x2009;18)) and approaches (e.g., interviews) in 49 countries. Included articles focused on specific treatments (e.g., caries treatment) or treatments in general (e.g., dental tourism). Across the countries, various factors of choice (n&#x2009;=&#x2009;101) were identified, divided into three categories: (I) "Dentist &amp; dental institution" (e.g., communication), (II) "Patient" (e.g., dental fear), and (III) "Treatment" (e.g., durability). The factors 'out-of-pocket payment' and 'dental fear' were identified in most of the articles (N&#x2009;=&#x2009;136, N&#x2009;=&#x2009;64) and were mentioned most frequently (code frequencies: n&#x2009;=&#x2009;151, n&#x2009;=&#x2009;73). In countries with the most articles (e.g., the UK (N&#x2009;=&#x2009;28), Saudi Arabia (N&#x2009;=&#x2009;23), the USA (N&#x2009;=&#x2009;22), India (N&#x2009;=&#x2009;19), and Brazil (N&#x2009;=&#x2009;14)), also 'out-of-pocket payment' was identified most often (e.g., the UK: in 56% of the articles; India: 68%). Frequency of the factor 'dental fear' varied by country. One publication addressed the COVID-19 pandemic. It reported that treatment appointments were postponed and canceled by patients due to their fear of infection with SARS-CoV-2. The quality of the included studies varied considerably.<br><br>CONCLUSIONS: A range of factors influence patients' choice regarding dental treatments. Understanding patients' motivation for seeking dental care can guide the development of interventions (e.g., awareness campaigns and health literacy efforts) that support proactive dental care. To improve oral health outcomes and reduce access barriers, tailored regulatory and informational strategies are essential.}, }
@article {pmid41286694, year = {2025}, author = {Leite, A and Kislaya, I and Machado, A and Aguiar, P and Nunes, B and Dias, CM}, title = {Use of quasi-experimental studies to evaluate causal effects of public health interventions in Portugal: a scoping review.}, journal = {BMC medical research methodology}, volume = {25}, number = {1}, pages = {263}, pmid = {41286694}, issn = {1471-2288}, mesh = {Humans ; Portugal/epidemiology ; *Public Health/methods/statistics &amp; numerical data ; *COVID-19/prevention &amp; control/epidemiology ; *Research Design ; SARS-CoV-2 ; Interrupted Time Series Analysis ; }, abstract = {BACKGROUND: Quasi-experimental designs are a valid option to assess causal effects of public health interventions when randomized studies are unfeasible, but not widely used in Portugal. We identified and reviewed characteristics of studies employing quasi-experimental designs to evaluate causal effects of public health interventions in Portugal.<br><br>METHODS: PubMed, Scopus, Web of Science and CINHAL were searched, alongside grey literature, reference mining and contact of authors of eligible studies. We extracted information on the intervention assessed, study design, outcomes assessed, statistical analysis and reporting guidelines.<br><br>RESULTS: We identified 1143 studies; 25 were eligible. Studies assessed interventions in various areas, mainly healthcare services (28.0%), drugs/tobacco consumption policy (20.0%), and COVID-19 related restrictions (20.0%). Studies employed interrupted time series (56.0%) and difference-in-differences designs (44.0%). Analyses utilised regression-based models, namely linear (48.0%), negative binominal (20.0%) and logistic (12.0%). Studies analysed 53 outcomes, with two outcomes per study on average. No reporting guidelines were mentioned.<br><br>CONCLUSIONS: There is a limited number of studies using quasi-experimental designs to estimate the causal effects of public health interventions in Portugal, mainly interrupted time series and difference-in-differences. Training in this area might promote the adequate use and dissemination of quasi-experimental studies.}, }
@article {pmid41285857, year = {2025}, author = {Green, R and Marjenberg, Z and Lip, GYH and Banerjee, A and Wisnivesky, J and Delaney, BC and Peluso, MJ and Wynberg, E and Abduljawad, S}, title = {A systematic review and meta-analysis of the impact of vaccination on prevention of long COVID.}, journal = {Nature communications}, volume = {16}, number = {1}, pages = {10326}, pmid = {41285857}, issn = {2041-1723}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology/virology/epidemiology ; *COVID-19 Vaccines/administration &amp; dosage/immunology ; Immunization, Secondary ; *SARS-CoV-2/immunology ; *Vaccination ; Odds Ratio ; }, abstract = {Long COVID affects millions worldwide and its prevention is a critical public health strategy. While prior analyses show primary vaccination prevents long COVID in subsequent infections, the effect of booster vaccination on long COVID after Omicron infections is unclear. This systematic review identifies 31 observational studies, of which 11 are suitable for pairwise meta-analyses. The pooled odds ratio (OR) of long COVID in those vaccinated (any dose) versus unvaccinated is 0.77 (95% confidence interval [CI] 0.70-0.85; p < 0.0001; 10 studies). ORs were also lower for primary course vaccination versus unvaccinated (OR 0.81; 95% CI 0.79-0.83; p < 0.0001; 3 studies), booster vaccination versus unvaccinated (OR 0.74; 95% CI 0.63-0.86; p = 0.0001; 4 studies), and booster vaccination versus primary course vaccination (OR 77; 95% CI 0.65-0.92; p = 0.0044; 3 studies). These findings indicate that booster vaccination can provide additional protection against long COVID, highlighting the importance of seasonal vaccination against new SARS-CoV-2 variants. They should, however, be interpreted cautiously, given the small number of studies and the low quality of evidence.}, }
@article {pmid41285208, year = {2025}, author = {Lou, J and Wu, Z and Cheng, Y and Li, M and Liu, N and Wang, Z and Gao, X and Zheng, A and Zhang, H}, title = {Recent advances in freeze-drying technologies for mRNA vaccines against infectious diseases.}, journal = {International journal of pharmaceutics}, volume = {687}, number = {}, pages = {126426}, doi = {10.1016/j.ijpharm.2025.126426}, pmid = {41285208}, issn = {1873-3476}, abstract = {Currently, the storage and transportation of mRNA vaccines typically rely on ultra-low temperature conditions. To improve their stability and extend shelf life, recent studies have been devoted to converting liquid formulations into solid forms using drying technology. Among them, freeze-drying (lyophilization) is an effective strategy that freezes samples and removes moisture through primary (sublimation) and secondary (desorption) drying stages, maximally preserving the structural integrity and biological activity of mRNA vaccines. The significant reduction in moisture content effectively inhibits the rate of hydrolysis of mRNA, which is considered the primary factor contributing to the instability of mRNA vaccines. However, the freeze-drying process itself and its accompanying stresses pose key challenges, involving many critical variables closely related to formulation composition, process parameters, and manufacturing environment. This paper systematically reviews the application of different freeze-drying technologies in mRNA vaccines and the optimization strategies of lyophilized mRNA vaccines, aiming to provide theoretical foundation and guidance for optimizing freeze-drying processes, enhancing vaccine stability and expanding their application scope.}, }
@article {pmid41284960, year = {2025}, author = {Matthews, R and Ellul, MA and McKeever, S and Pollack, T and Houlihan, C and Thakur, KT and Hsiang-Yi Chou, S and Frontera, JA and Saylor, DR and Chomba, M and Moro, E and Ray, STJ and Semple, MG and Smith, CJ and Turner, MR and Bullmore, E and Carson, A and Buchan, I and Breen, G and Solomon, T and Nicholson, TR and Pett, S and Thomas, RH and Michael, BD}, title = {Global &amp; Community Health: What Did the COVID-19 Pandemic Teach Us About Neurologic Surveillance Approaches, and How Should We Be Better Prepared?.}, journal = {Neurology}, volume = {105}, number = {12}, pages = {e214431}, pmid = {41284960}, issn = {1526-632X}, mesh = {Humans ; *COVID-19/epidemiology ; *Global Health ; *Nervous System Diseases/epidemiology/diagnosis ; Pandemics ; *Population Surveillance/methods ; SARS-CoV-2 ; }, abstract = {It is well recognized that many pandemic viruses are associated with neurologic complications, most recently with COVID-19. After the outbreak of the COVID-19 pandemic, neurologic surveillance platforms were implemented to characterize the complications of COVID-19. Surveillance platforms are invaluable in providing timely data, informing clinical practice, and directing future research. Lessons learned from recent neurologic surveillance networks include the importance of global and cross-specialty collaboration. It is critical for future surveillance systems to consider these aspects, as it will also serve to improve representation of low and middle-income countries (LMICs) and communities. Trainees played a critical role in the success of neurologic surveillance networks; as frontline health care workers, they were able to provide timely data collection, and their fresh insights are important for future pandemic surveillance system development. In this article, we review the methods of recent neurologic surveillance networks and discuss their strengths and limitations. We explore the outlook for pandemic surveillance platforms and the crucial role global collaboration plays in ensuring that LMICs are represented. We review the role of trainees in pandemic surveillance networks and discuss how it is vital to encourage their continued involvement to ensure that, as future health care leaders, they are prepared to manage future pandemics effectively.}, }
@article {pmid41284385, year = {2025}, author = {Pineda, RC and Martin, P and Khor, K and Regino, JM and Smith, L and Ramirez, RF and Sy, MP}, title = {Interprofessional collaboration competency development in healthcare students during clinical placements in the time of COVID-19: a mixed methods systematic review.}, journal = {Journal of interprofessional care}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/13561820.2025.2576239}, pmid = {41284385}, issn = {1469-9567}, abstract = {The COVID-19 pandemic triggered unprecedented challenges to the clinical education of healthcare students. Although alternative clinical placements were developed and introduced, it is unclear whether students successfully acquired interprofessional competencies required to be collaborative practice-ready healthcare workers. We examined interprofessional collaboration competency acquisition from adapted and alternative clinical placements that were made available to pre-qualification healthcare students during the COVID-19 pandemic. Information searches from online databases and supplementary sources identified 20 articles that met criteria. Student perceptions indicate that these alternative placements supported the learning of interprofessional collaboration competencies. Outcomes mapped against the updated Canadian Interprofessional Health Collaborative Competency Framework indicate that the most frequently reported interprofessional collaboration competency was team communication and the least reported were collaborative leadership and team differences/disagreements processing. Although gains in interprofessional collaboration competencies were reported across the studies, their methodological shortcomings make it difficult to determine whether alternative placements (e.g. online and telephone-based) were better or comparable to traditional placements (i.e. with face-to-face interactions), for interprofessional collaboration competency development. These findings suggest the need for further research assessing the effectiveness and sustainability of alternative placement models. A greater understanding of clinical placement alternatives could inform educational practices in future pandemics or other unprecedented events.}, }
@article {pmid41284231, year = {2025}, author = {Patra, S and Rajadurai, R and Fayyaz, S and Hagan, G}, title = {Silent Threats: Understanding the Impact of Respiratory Viruses on the Ageing Population.}, journal = {British journal of hospital medicine (London, England : 2005)}, volume = {86}, number = {11}, pages = {1-31}, doi = {10.12968/hmed.2024.0918}, pmid = {41284231}, issn = {1750-8460}, mesh = {Humans ; *Respiratory Tract Infections/virology/diagnosis/epidemiology/therapy ; *COVID-19/epidemiology ; Aged ; SARS-CoV-2 ; *Aging ; *Virus Diseases/epidemiology/diagnosis ; }, abstract = {Respiratory viruses are an important cause of acute respiratory illnesses in older adults. The spectrum of illness may range from pneumonia to an exacerbation of underlying respiratory disease or acute bronchitis. Respiratory viruses can account for a significant proportion of chest infections. However, respiratory viruses, either acting as primary pathogens or in conjunction with bacterial infections, are often underdiagnosed due to less frequent viral testing compared to bacterial infections. Hitherto neglected, the coronavirus disease 2019 (COVID-19) pandemic has brought into sharp focus and generated interest in respiratory viruses and their burden in all age groups. This article addresses this interest and summarises the most prevalent and emerging respiratory viruses affecting the elderly. There is a general overview as well as specific information on how to approach, identify, and treat these viruses. We will also discuss the latest guidance on vaccination, as well as adjunctive tests like procalcitonin and point-of-care testing and the niche that these occupy in the diagnosis and management of chest infections.}, }
@article {pmid41284008, year = {2025}, author = {Pinar Kuzucu, E and Ates, MB and Agbas, A and Yilmaz, EK and Saygili, S and Ozluk, Y and Canpolat, N}, title = {Viral tubulointerstitial nephritis in children: A narrative review with a focus on adenovirus.}, journal = {Pediatric nephrology (Berlin, Germany)}, volume = {}, number = {}, pages = {}, pmid = {41284008}, issn = {1432-198X}, abstract = {Viral infections are well-known causes of systemic illness in children, but their kidney involvement, particularly acute tubulointerstitial nephritis (TIN), remain underdiagnosed and clinically underestimated. A wide range of viruses has been implicated in pediatric TIN, including Epstein-Barr virus, cytomegalovirus, BK virus, parvovirus B19, respiratory syncytial virus, and SARS-CoV-2. Among these, adenovirus stands out for its potential to cause severe kidney injury. Delayed diagnosis remains a challenge due to nonspecific symptoms and limited use of kidney biopsy. Heightened clinical suspicion and early virologic work-up are essential to enable timely intervention and improve outcomes. This narrative review aims to raise awareness of viral-associated TIN in the pediatric population, with a specific focus on adenovirus. In addition to summarizing cases identified from the existing literature, we present two pediatric cases with biopsy-confirmed TIN: one in a kidney transplant recipient and the other in a previously healthy infant, illustrating the broad clinical spectrum of the disease.}, }
@article {pmid41283508, year = {2025}, author = {Castañeda-Casimiro, J and Vallejo-Castillo, L and Peregrino, ES and Hernández-Solis, A and Vázquez-Flores, L and Chacón-Salinas, R and Wong-Baeza, I and Serafín-López, J}, title = {N-Glycosylation of Antibodies: Biological Effects During Infections and Therapeutic Applications.}, journal = {Antibodies (Basel, Switzerland)}, volume = {14}, number = {4}, pages = {}, pmid = {41283508}, issn = {2073-4468}, abstract = {Antibodies are produced by cells of the adaptive immune response and recognize epitopes of microbial structures with high affinity and specificity. Antibodies are recognized by Fc fragment receptors (FcRs) found on the surface of phagocytic cells (neutrophils, monocytes, macrophages) and NK cells, among others. Hence, antibodies link the adaptive immune response with the innate immune response. The functions of antibodies are related to the N-glycosylation profile of these proteins. In this review, we describe how N-glycosylation of the Fc fragment of the different antibody classes is carried out, and which oligosaccharides are most commonly found in these antibodies. Subsequently, we summarize the biological effects of N-glycosylation of antibodies: on the binding of antibodies to FcRs (which affects various functions, such as antibody-dependent cellular cytotoxicity, antibody-dependent phagocytosis, and the production of pro- or anti-inflammatory chemokines and cytokines), on the ability of antibodies to activate complement and on the ability of some antibodies to directly neutralize the adhesion of bacteria and viruses to host cells (independently of Fab recognition). We describe how the N-glycosylation profile of antibodies is modified during certain infections (such as tuberculosis, COVID-19, influenza and dengue) and in response to vaccination, and the potential use of this profile to identify the stage and severity of an infection. Finally, we review the importance of N-glycosylation for the pharmacokinetic, pharmacodynamic and safety profiles of therapeutic monoclonal antibodies.}, }
@article {pmid41283262, year = {2025}, author = {Zar, LA and Hamran, S and Alremawi, I and Elahtam, M and Abdelmaksoud, A and Arif, R and Chivese, T}, title = {Exit Meta-Analysis on the Effect of HIV on COVID-19 Mortality, Hospitalization, and ICU Admission.}, journal = {Medical sciences (Basel, Switzerland)}, volume = {13}, number = {4}, pages = {}, pmid = {41283262}, issn = {2076-3271}, mesh = {Humans ; *COVID-19/mortality/therapy ; *HIV Infections/mortality/complications/epidemiology ; *Intensive Care Units/statistics &amp; numerical data ; *Hospitalization/statistics &amp; numerical data ; SARS-CoV-2 ; }, abstract = {Purpose: The COVID-19 pandemic has led to the publication of numerous primary studies and meta-analyses; however, conclusive evidence on whether HIV infection influences COVID-19 outcomes among people living with HIV (PLHIV) is still lacking. This research uses a novel technique, the exit meta-analysis, to conclusively update the evidence of HIV's impact on COVID-19-related mortality, hospitalization, and need for Intensive Care Unit (ICU) admission in severe disease. Methods: A search of PubMed, EMBASE, Cochrane Reviews (CDSR), SCOPUS, CINAHL reviews and Google Scholar databases was conducted up to the 18 January 2024 for meta-analyses and observational studies that reported adjusted associations for the effect of HIV on COVID-19 related mortality, hospitalization, and ICU admission. Evidence from existing meta-analyses was summarized narratively, and an updated meta-analysis was carried out using a bias-adjusted inverse variance heterogeneity model. Subgroup analysis was carried out for age groups and geographical regions. Results: Of 3153 records identified, 20 meta-analyses and 56 primary studies, with a total of 27,936,428 participants, including 655,882 PLHIV, were included. A review of the meta-analyses showed conflicting results for all outcomes. In the updated synthesis, HIV was associated with higher odds of mortality (aOR 1.43, 95% CI: 1.01-1.86, I[2] = 90.7%) and ICU admission (aOR 1.49, 95% CI: 0.67-2.30, I[2] = 88.8%), but not hospitalization (aOR 1.11, 95% CI: 0.78-1.48, I[2] = 97.5%). The results for both ICU admission and hospitalization include the null value, leading to lower certainty. The exit meta-analysis suggested conclusive results for mortality (DAts score = -0.012) and hospitalization (DAts score = -0.014), but not for ICU admission. Conclusions: This exit meta-analysis provides conclusive evidence that HIV increases mortality in people with COVID-19; however, more studies may be required to address ICU admission and hospitalization.}, }
@article {pmid41282609, year = {2025}, author = {Zheng, S and Xue, T and Li, S and Qi, W and Zao, X and Zhang, P and Cheng, FE and Ye, Y and Dong, P}, title = {Mechanistic insights into traditional Chinese medicine for viral pneumonia treatment: signaling pathway perspectives.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1577580}, pmid = {41282609}, issn = {1663-9812}, abstract = {Since December 2019, the World Health Organization declared COVID-19 outbreak in the World as a highly contagious respiratory disease poses a significant challenge to the world. The main symptoms of patients are cough, fever, diarrhea, etc. In addition, the COVID-19 genome has strong plasticity, and there is a risk of cross-species transmission. The use of western medicine antibiotics brings good therapeutic effects, but also accompanied by many adverse reactions of physical and mental damage. At present, TCM has achieved remarkable results in the treatment of COVID-19. In addition to enriching the cognitive theories of traditional Chinese medicine in the treatment of COVID-19, studies on the cell signal transduction mechanism of TCM in the treatment of COVID-19 have developed rapidly from the perspective of molecular biology. Through literature search, it is found that the occurrence of COVID-19 is closely related to cellular inflammatory response, immune response, apoptosis, proliferation and other physiological and pathological processes. This study systematically elucidates the molecular mechanisms by which traditional Chinese medicine treats COVID-19 by regulating key signaling pathways such as PI3K/Akt, NF-κB, JAK/STAT, and mTOR. It not only effectively alleviates COVID-19 symptoms and suppresses pulmonary inflammation but also reduces complications and drug-related adverse reactions. The integrated traditional Chinese and Western medicine model demonstrates significant synergistic effects in antiviral treatment and overall regulation. Future research should further explore the cross-mechanisms of signaling pathways, strengthen evidence-based medical validation, promote the modernization of traditional Chinese medicine, and provide safer and more effective treatment strategies for global pandemic control.}, }
@article {pmid41281926, year = {2025}, author = {Irigoyen-Amparan, CW and Gonzalez, KD and Pennathur, A and Mancera, B and Pennathur, PR}, title = {Organizational challenges persist, and new research directions emerge in the study of burnout in healthcare: Bibliometric analysis.}, journal = {Journal of public health research}, volume = {14}, number = {4}, pages = {22799036251395259}, pmid = {41281926}, issn = {2279-9028}, abstract = {BACKGROUND: Between 35% and 45% of nurses and 40%-54% of physicians in the United States experienced burnout over the past decade, underscoring the need to examine trends and patterns in healthcare burnout research to identify contributors and formulate recommendations. Our objectives were to (1) understand whether the problem of burnout is widespread and studied globally, (2) assess the extent of research collaboration, (3) examine the focus of healthcare burnout themes prior to 2019 and after 2019 and assess similarities between themes to identify persistent problems, and (4) assess differences in themes to identify new research directions triggered by COVID-19.<br><br>DESIGN AND METHODS: We performed a literature search in Web of Science, followed by bibliometric and manual comparative analyses of publications data. We analyzed trends in publications, countries, and organizations where healthcare burnout was studied, constructed co-authorship networks, and evaluated theme similarities and differences between the periods.<br><br>RESULTS: Studies have investigated longstanding system and organizational problems, including poor workplace conditions and unsupportive leadership and management, as contributors to burnout. Research collaborations on healthcare burnout across countries have increased post-pandemic. Studies conducted after 2019 have investigated new research directions, including workplace adaptations, workplace aggression, and emerging technologies such as virtual reality.<br><br>CONCLUSIONS: Our findings indicate that workplace conditions and organizational factors such as leadership and management remain persistent challenges, with workplace violence and workplace aggression increasingly associated with burnout. Design improvements to the work system and emerging technologies hold promise as interventions for preventing and mitigating burnout.}, }
@article {pmid41281392, year = {2025}, author = {Leivaditis, V and Mulita, F and Baikoussis, N and Liolis, E and Tchabashvili, L and Tasios, K and Antzoulas, A and Dahm, M}, title = {Forged in conflict: how wars and crises shaped cardiovascular surgery.}, journal = {Indian journal of thoracic and cardiovascular surgery}, volume = {41}, number = {12}, pages = {1733-1747}, pmid = {41281392}, issn = {0970-9134}, abstract = {Wars and crises have historically acted as powerful catalysts for advances in cardiovascular surgery. Throughout the twentieth and twenty-first centuries, periods of armed conflict and global emergencies have driven surgical innovation, accelerated technological development, and reshaped clinical priorities. This review explores how wartime conditions, with their urgent need for effective treatment of vascular and cardiac injuries, fostered the emergence of new techniques such as arterial repair, cardiopulmonary bypass, and heart valve replacement. It also examines how public health crises, including the coronavirus disease 2019 (COVID-19) pandemic, further transformed cardiovascular surgical practice by introducing new protocols, technologies, and logistical frameworks. Drawing on historical milestones, surgical breakthroughs, and lessons learned under extreme conditions, this article highlights the enduring impact of crises on the evolution of cardiovascular surgery and reflects on how these experiences continue to influence contemporary surgical strategies.}, }
@article {pmid41278042, year = {2025}, author = {Parmar, V and Arias Castro, A and Singh, I and Garcia Santiago, G and Singh, M}, title = {Prevalence of Suicide Among Adolescents Before and After the COVID-19 Pandemic.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97166}, pmid = {41278042}, issn = {2168-8184}, abstract = {This systematic review examines the prevalence of adolescent suicide before and after the COVID-19 pandemic and analyzes associated changes and contributing factors. A literature search was conducted for studies published between 2019 and 2023 in PubMed, Scopus, and Web of Science, focusing on populations aged 12-19 years that reported suicide prevalence both before and during the pandemic. Only peer-reviewed studies meeting the inclusion criteria were analyzed. A total of 20 studies met the criteria and were included. The findings indicate a significant increase in suicidal ideation and suicide attempts among adolescents, particularly females. Major contributing factors included social isolation, academic stress, and reduced access to mental healthcare. Overall, the COVID-19 pandemic has had a substantial negative impact on adolescent mental health. This highlights the urgent need for targeted interventions and strengthened support systems to prevent suicide and promote resilience in this vulnerable population.}, }
@article {pmid41278035, year = {2025}, author = {Zulla, RT and Nicholas, DB and Sutherland, S and Cohen, E and Birnie, K and Anthony, S and Robeson, P and Selkirk, E and Killackey, T and Mohabir, V and Stinson, J}, title = {Synchronous virtual care in children's health care: a scoping review.}, journal = {Frontiers in pediatrics}, volume = {13}, number = {}, pages = {1610407}, pmid = {41278035}, issn = {2296-2360}, abstract = {OBJECTIVE: Synchronous virtual care comprises real-time, online-mediated healthcare. This approach has increasingly been used in pediatrics, largely implemented in the COVID-19 pandemic. Evidence is limited on the impacts of this mode of care delivery on patient and family experience and care quality. To our knowledge, this is the first scoping review to amalgamate existing knowledge about the perceived impact of synchronous virtual care as it is experienced by children and their families across multiple disciplines.<br><br>METHODS: Following guidance from the Joanna Briggs Institute, a search of the peer reviewed, published literature was conducted employing multiple databases: APA PsycInfo, CINAHL, EBSCO, Embase, and OVID. Reviewed articles were published in English from January 1, 2013 to December 31, 2023, and addressed virtual care for children and their families. The initial search generated 1,079 articles, which underwent abstract and then full-text screening. A total of 157 full text articles were screened, yielding 117 articles from which data was extracted.<br><br>RESULTS: Virtual care interventions, generally appearing in the last decade (2013-2023), have been largely studied using quantitative approaches. They tend to be positively viewed by youth and parents as indicated by identified benefits and general satisfaction. However, articles report both facilitating and hindering elements of virtual care, and barriers are reported that reflect inequities associated with social determinants of health. Such barriers are shown to impede the use of virtual care among some marginalized communities. The review indicates that effective virtual care approaches require (a) program/organizational infrastructure support, (b) training for both service providers and users, and (c) tailoring to clinical needs.<br><br>CONCLUSION: Considering virtual care "fit" for target patients and families is important. Implications for clinical care as well as guidelines for future research are offered.}, }
@article {pmid41277681, year = {2025}, author = {Chen, Y and Mollayeva, T and Fitzpatrick, R and Tylinski Sant'Ana, T and Farina, F and Swiatek, D and Sopidou, K and Tabilo, E and Betka, M and Leroi, I and Leon, T and Peeters, G and , }, title = {The Global Impact of COVID-19 Control Measures on People With Dementia Living at Home and Their Carers: A Systematic Review of Quantitative and Qualitative Research Across 27 Countries.}, journal = {Brain and behavior}, volume = {15}, number = {11}, pages = {e71100}, pmid = {41277681}, issn = {2162-3279}, support = {/CAPMC/CIHR/Canada ; //EU Joint Programme - Neurodegenerative Disease Research/ ; }, mesh = {Humans ; *COVID-19/prevention &amp; control ; *Dementia/psychology ; *Caregivers/psychology ; Global Health ; Qualitative Research ; SARS-CoV-2 ; }, abstract = {BACKGROUND: COVID-19 control measures have had a unique impact on people with dementia (PWD) and their carers living at home. Yet, uncertainty exists regarding the global impact of such measures and whether differences exist between countries and global regions. We aimed to synthesize evidence on this topic.<br><br>METHODS: We searched Medline, PsycINFO, EMBASE, Web of Science, CINAHL, Latin American and Caribbean Health Literature (LILACS), Scientific Electronic Library Online (SciELO), and EM Premium from the start of the pandemic to July 2022. At least two researchers independently screened citations and performed quality assessment following recommended criteria for critical appraisal according to study methodology. We analyzed data by country and region and synthesized results descriptively.<br><br>RESULTS: Sixty-nine studies met inclusion criteria (74% quantitative and 26% qualitative; 22% included PWD, 44% carers of PWD, and 4% dyads), with a total of 209,738 participants. Most studies were conducted in Europe (59%), followed by Asia and North America (15% each), South America (7%), and Oceania (1%). Two studies presented data from multiple regions (3%). The quality of the studies varied, with the majority (62%) being of moderate quality. Across the study populations and global regions, COVID-19 control measures had implications for PWD and carers' access to health services, physical and mental health and daily routine, cognition, behavior, with accompanying social and economic costs. The impact on mental health for PWD and on loneliness and well-being for carers were the two most frequently studied outcomes.<br><br>CONCLUSION: People with dementia and their carers represent a heterogeneous group of people across countries and communities; despite that, the impacts of COVID-19 control measures on PWD and their carers were broadly consistent across regions. Our evidence synthesis highlights the critical need for decision-makers to account for the needs of PWD and their carers when designing and implementing public health measures.<br><br>OTHER: This work was funded by the JPND Call for Expert Working Groups: The Impact of COVID-19 on Neurodegenerative Diseases in partnership with the CIHR-Institute of Aging and the Public Health Agency (CIHR #02342-000). PROSPERO CRD42024554701.}, }
@article {pmid41277211, year = {2025}, author = {Pugazhenthi, DP and Ramya, A and Murugavel, D and Krishnan, K and Palani, S}, title = {A Review of the Efficacy of Nanodrug Delivery Systems: Is It Worth the Hype?.}, journal = {The Journal of the Association of Physicians of India}, volume = {73}, number = {11}, pages = {80-82}, doi = {10.59556/japi.73.1205}, pmid = {41277211}, issn = {0004-5772}, mesh = {Humans ; *Drug Delivery Systems/methods ; *Nanoparticles ; *Nanoparticle Drug Delivery System ; COVID-19 ; }, abstract = {Nanodrug delivery systems are gradually becoming the current "talk of the town" due to their efficiency in treating different diseases in a more advanced manner when compared to conventional drug-delivery systems. It is well known that drugs can be given through various routes of administration, such as the popular oral, subcutaneous, and intravenous routes. It is quite surprising that formulating these same drugs as nanoparticles (NPs) and administering them to the patient could produce better results. Different studies have shown the effects of nanodrug delivery systems in targeting cancer cells, ameliorating pulmonary arterial hypertension, and providing improved treatments for ophthalmic conditions such as glaucoma. In most studies, nanodrug delivery systems have been shown to exhibit targeted action at the desired site or organ, low toxicity, and fewer systemic side effects. These new insights can provide an enhanced understanding of the benefits of NP formulations of drugs, as well as open up new pathways for future creative techniques in addressing emerging medical conditions. Furthermore, these formulations generally consist of polymer- or liposome-based or coated NPs, as they are easily biodegradable, meaning they have a higher ability to disintegrate and, at the same time, are not harmful to living tissues, thereby displaying greater compatibility. New connections can be established through the utilization of NPs in the treatment of emerging diseases worldwide. Data from these studies could provide a foundation for groundbreaking and innovative strategies in coping with or fighting even the recent COVID-19 pandemic.}, }
@article {pmid41276835, year = {2025}, author = {Kaboré, BWO and Gouba, N and Ilboudo, AK and Lingani, M and Savadogo, M and Ouedraogo, E and Cissé, A and Simonis, V and Tarnagda, Z}, title = {Viral etiology of acute respiratory infections in Sub-Saharan Africa during the pre-COVID-19 period (2006-2019): a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12879-025-12122-8}, pmid = {41276835}, issn = {1471-2334}, }
@article {pmid41276789, year = {2025}, author = {Thomas, SJ and Dulek, DE and Gans, HA and Masaki, Y and Michaels, MG}, title = {Updates on Vaccine-Preventable Respiratory Viral Infections in Pediatric Solid Organ Transplant Recipients.}, journal = {Pediatric transplantation}, volume = {29}, number = {8}, pages = {e70231}, doi = {10.1111/petr.70231}, pmid = {41276789}, issn = {1399-3046}, mesh = {Humans ; *Organ Transplantation ; *Respiratory Tract Infections/prevention &amp; control/virology ; Child ; *Transplant Recipients ; *Virus Diseases/prevention &amp; control ; Child, Preschool ; COVID-19/prevention &amp; control ; Influenza, Human/prevention &amp; control ; *Vaccine-Preventable Diseases/prevention &amp; control ; Infant ; }, abstract = {The global burden of acute lower respiratory tract infections, including viral etiologies, equated to 725 557 deaths in 2021 in children under 4 years of age. Community-acquired respiratory viral infections (RVI) also carry a high burden among pediatric solid organ transplant recipients (PSOTR), accounting for 14.5% of hospitalizations in the first year post-transplant in an American cohort. This mini review on behalf of the International Pediatric Transplant Association (IPTA) infectious diseases committee discusses novel preventative and prophylactic strategies and includes pertinent updates for vaccine-preventable RVI including influenza, SARS-CoV-2, and RSV in PSOTR.}, }
@article {pmid41275995, year = {2025}, author = {Flasbeck, V and Engler, H and Marková, V and Schedlowski, M and Brüne, M}, title = {Between care and contagion: Insights from the endotoxin model into the social facets of sickness.}, journal = {Neuroscience and biobehavioral reviews}, volume = {180}, number = {}, pages = {106486}, doi = {10.1016/j.neubiorev.2025.106486}, pmid = {41275995}, issn = {1873-7528}, abstract = {The ability to recognize sick and potentially contagious conspecifics is crucial for survival, particularly in social species where close contact increases the risk for disease transmission. This creates an evolutionary trade-off between avoiding infection and maintaining care for sick group members. This narrative review summarizes research using bacterial endotoxin (lipopolysaccharide, LPS) to experimentally induce sickness, focusing on its effects on social behavior in animals and humans. LPS-treated animals generally show reduced social exploration of healthy conspecifics, while healthy conspecifics tend to avoid them. Such avoidance behavior is influenced by environmental factors such as housing conditions, health status, and social hierarchy. Some species, when sick, show a preference for familiar individuals, and exhibit more affiliative, less aggressive behaviors. In humans, LPS-induced sickness leads to heightened sensitivity to both positive and negative social cues, which may reflect an adaptive response to increased vulnerability. Individuals under LPS also demonstrate an enhanced ability to regulate emotional responses and reduced empathy for others' psychological pain, suggesting a shift towards a more self-focused, energy-conserving state. Sick individuals additionally tend to seek care from those with a history of supportive behavior. Humans can detect sickness in others through olfactory and visual cues, such as odor, facial expressions and posture. As observed during the COVID-19 pandemic, prolonged social isolation negatively affects both infected individuals and their caregivers. Future research should therefore investigate the impact of sickness on higher level social cognitive functioning, as well as the role of modulating variables such as familiarity, sickness severity and sample demographics.}, }
@article {pmid41275494, year = {2025}, author = {Wadhwa, R and Tang, E and Wong, LYR and Wong Fok Lung, T}, title = {Airway immunometabolic responses during pulmonary bacterial and viral infections.}, journal = {Cell reports}, volume = {44}, number = {12}, pages = {116614}, doi = {10.1016/j.celrep.2025.116614}, pmid = {41275494}, issn = {2211-1247}, abstract = {Airway infections caused by viral and bacterial pathogens pose a significant threat to human health, with the COVID-19 pandemic serving as a stark reminder of their detrimental impact. This review explores the critical role of metabolism in determining the outcome of respiratory infections. It covers fundamental concepts in immunometabolism and details how common pathogens exploit the host metabolism to dysregulate immune responses or evade immune clearance. We further consider how immune-signaling metabolites can directly drive pathogen evolution, emphasizing the importance of a better understanding of host-pathogen metabolic interactions in developing effective new therapies.}, }
@article {pmid41275176, year = {2025}, author = {Fakherpour, A and Jahangiri, M and Haghighi, A}, title = {A systematic review of fit improvement strategies for respirators: lessons learned from the COVID-19 pandemic.}, journal = {BMC public health}, volume = {}, number = {}, pages = {}, doi = {10.1186/s12889-025-24867-7}, pmid = {41275176}, issn = {1471-2458}, support = {23984//Shiraz University of Medical Sciences/ ; 23984//Shiraz University of Medical Sciences/ ; 23984//Shiraz University of Medical Sciences/ ; }, abstract = {INTRODUCTION: The use of respirators and masks has increased dramatically during outbreaks of respiratory infections, such as the COVID-19 pandemic. Both filtration efficiency and respirator fit testing influence the provision of effective respiratory protection to users. If healthcare workers (HCWs) do not have access to tight-fitting N95 filtering facepiece respirators (FFRs) or if fit testing procedures are not feasible, some cost‒benefit fit improvement strategies (FISs) could benefit HCW respiratory protection against respiratory infection pandemics.<br><br>OBJECTIVE: The objective of this systematic review is to investigate the importance of fit testing and to identify the optimal factors influencing respirator or mask fit characteristics, particularly in emergency situations.<br><br>METHODS: We searched four databases, including PubMed, Scopus, Web of Science, and Science Direct from February 5, 2020, to December 7, 2024, covering the COVID-19 pandemic period. Finally, a gray literature search was conducted to ensure that no further studies were missed. Additionally, quality assessment of the included studies was performed according to the Newcastle-Ottawa Scale.<br><br>RESULTS: A total of 39 full texts were included in the systematic review. Seven categories of FISs included fitters or braces, double masking with cloth or medical masks over FFRs, ear loop knotting and tucking or using ear guards (hooks, clips), adhesive tape, skin protectants/dressings, wearing goggles over FFRs, and using cloths over facial hair to improve fit. Each FIS has its own advantages and disadvantages. Overall, there was an improvement in fitting after the application of the FISs.<br><br>CONCLUSIONS: Among all, mask frame, ear loop strap modification, medical tape, thin dressings, double masking, and goggles donning modification are considered as pleasant FISs during performing the occupational activity. Among all, the mask frame and medical tape outperformed the other FISs. It is crucial that all respirators modified with FISs undergo standard fit testing procedures to avoid a false sense of security and prevent exposure to hazardous respiratory substances. Both safety and ergonomic factors are of great importance when applying each FIS.}, }
@article {pmid41274005, year = {2025}, author = {Ning, YX and Liang, S and Cai, XM and Song, SL and Zhao, ZR and Yu, WB}, title = {Mental health among athletes: A bibliometric and visual analysis of research hotspots and trends.}, journal = {Acta psychologica}, volume = {261}, number = {}, pages = {106002}, doi = {10.1016/j.actpsy.2025.106002}, pmid = {41274005}, issn = {1873-6297}, mesh = {Humans ; *Athletes/psychology ; *Bibliometrics ; *Mental Health ; COVID-19/psychology ; }, abstract = {BACKGROUND: Mental health among elite athletes is a critical and growing focus, recognized for its profound impact on their well-being and performance trajectories.<br><br>OBJECTIVE: This study provides a comprehensive bibliometric and visual analysis of athlete mental health research from 2015 to 2024, aiming to identify key contributors, established hotspots, and emerging trends to guide future investigations and interventions.<br><br>METHODS: Articles published between 2015 and 2024 were systematically retrieved from Web of Science and Scopus databases. CiteSpace and VOSviewer software were utilized for bibliometric and visual analysis.<br><br>RESULTS: A corpus of 2508 unique articles revealed an upward publication trend. The United States, Harvard Medical School, and Gouttebarge were identified as leading contributors. Co-citation analysis yielded 20 primary research clusters, encompassing common psychological challenges (e.g., depression, eating disorders), positive psychological traits (e.g., mindfulness, mental toughness), specific stressors (e.g., concussion, overtraining, career uncertainty), and social support systems. Keyword burst detection highlighted emerging directions: the long-term mental health impacts of COVID-19, mental health in student athletes and competitive contexts, methodological trends like retrospective studies, and the interplay of physiological stress, distress, and attention.<br><br>CONCLUSION: This study offers valuable, data-driven insights into the evolving landscape of athlete mental health research. By mapping key hotspots and emerging trends, it provides a crucial roadmap for future investigations, enhancing understanding and guiding the development of effective interventions to safeguard athletes' overall well-being and optimize their performance.}, }
@article {pmid41272854, year = {2025}, author = {Morton, S and Surman, K and Bayliss, R and Storey, H and Gray, E and Gant, A and Morris, A and Forbes, A and Cowan, S and Stevenson, E and Hardy, P and Williams, R and , }, title = {FPHC Wellbeing Charter: The 'Whys' and 'Hows' of the Charter.}, journal = {Scandinavian journal of trauma, resuscitation and emergency medicine}, volume = {33}, number = {1}, pages = {187}, pmid = {41272854}, issn = {1757-7241}, mesh = {Humans ; *COVID-19/epidemiology ; Focus Groups ; Surveys and Questionnaires ; *Emergency Medical Services/organization &amp; administration ; SARS-CoV-2 ; }, abstract = {BACKGROUND: In 2022 the Faculty of Pre-hospital Care (FPHC) report on "Valuing Staff, Valuing Patients" was published, outlining the need to "seek out and remedy secondary stressors", such as training burdens or financial costs. Since that original publication, COVID-19 and the increased demand for healthcare have presented additional challenges, and staff wellbeing remains an increasing concern. The aim of the FPHC Wellbeing Group was to develop a FPHC Wellbeing Charter, to put the recommendations of the report into practice in a document that outlines achievable measures for all pre-hospital organisations to improve their staff and volunteers' wellbeing.<br><br>METHODS: Questionnaires and focus groups, alongside a literature search and the original FPHC report were utilised to develop the Charter. This was led by the FPHC Wellbeing Group. Participants were sought from a range of pre-hospital organisations including National Health Service ambulance trusts, air ambulance organisations and voluntary organisations such as Mountain Rescue. The Charter has been reviewed by the FPHC Executive Committee.<br><br>RESULTS: Two hundred eighty-one responses to the questionnaire were obtained and six focus groups were held representing the majority of pre-hospital organisations. As a result of this a FPHC Wellbeing Charter has been developed with four main sections: policies for a good organisation; facilities for a good organisation; support for colleagues in a good organisation and continued professional development, study leave and examination support in a good organisation. Within the policies section there are four sub-sections: rotas and rest; illness/return to work; patient outcome follow-up and parental leave (including maternity policies).<br><br>CONCLUSION: The FPHC Wellbeing Charter outlines 'why' and 'how' organisations can take measures to improve their staff and volunteer's wellbeing. Much of the emphasis of the Charter is on reducing secondary stressors by improving simple things, recognising that whilst pre-hospital clinicians and volunteers are often involved in difficult events, daily stresses have a significant cumulative impact. It is anticipated that this will not be a static document; however, a minimum baseline has been set.}, }
@article {pmid41272649, year = {2025}, author = {Dückers, MLA}, title = {Exposing the loci of bias: a taxonomical exploration of sources of bias in population mental health research.}, journal = {Population health metrics}, volume = {23}, number = {1}, pages = {64}, pmid = {41272649}, issn = {1478-7954}, mesh = {Humans ; Bias ; *Mental Health ; COVID-19/epidemiology ; SARS-CoV-2 ; *Population Health ; }, abstract = {All studies are inherently biased, but some are more biased than others. This variation on a key theme from George Orwell's Animal Farm underscores a significant issue in public health. Ultimately, optimizing public health begins with understanding population health-particularly when assessing the impact of specific health risks that are often intertwined with both benign and malign health determinants. The objective of this contribution is to provide an overview of sources of bias in epidemiological research, drawing inspiration from the work of Rudolph Agricola-Northern Europe's first humanist and a homo universalis. Agricola's methodological approach distinguished between different categories of informational sources, which he deliberately employed as instruments for structured argumentation. This article presents a contemporary variation of that approach in the form of a complementary taxonomy, outlining examples of material and procedural bias sources that, individually or in combination, can affect estimates of mental health problems. These include the nature of the outcome itself and the context of the sample-covering its vulnerability and exposure profile, as well as broader population characteristics-along with data collection methods and analytical techniques. The value of this structured approach to disentangling bias in modern population health research is illustrated with examples from recent studies on the impacts of disasters and the COVID-19 pandemic. Researchers are encouraged to be modest, to carefully consider "locations" or "origins" of bias, and to interpret study findings with caution-especially when using them to inform public health policy or to make arguments about the nature and severity of population health issues.}, }
@article {pmid41272382, year = {2025}, author = {Dornas, W and Reis, JP and Belilo, TE and Vaz, LG and Nasser, HH and de Souza Maia, ML and Figueiredo, A and Tcherniacovski, AG and Montenegro, LCC and Yang, X and C Santiago, H}, title = {Persistent inflammatory cytokine signature in long Covid-19 patients: a meta-analysis.}, journal = {Inflammopharmacology}, volume = {}, number = {}, pages = {}, pmid = {41272382}, issn = {1568-5608}, abstract = {Post-acute sequelae of Covid-19 (PASC) refer to persistent symptoms lasting weeks to months after acute SARS-CoV-2 infection. However, identifying biological mechanisms, potential therapeutic targets, and modifiable environmental risk factors remains necessary. Here, we analyzed cytokine levels in patients with PASC through a systematic literature search of the PubMed/MEDLINE, Web of Science, and Scopus databases, including articles published up to December 2024. A total of 33 studies (comprising 3294 patients) were included, addressing the long-term sequelae following acute Covid-19 infection. Levels of IL-6, IL-2, MCP-1/CCL2, TNF-α, IFN-γ, and IP-10/CXCL10 were higher in Covid-19 patients with PASC compared to those without PASC, suggesting an inflammatory basis for the persistence of symptoms. Conversely, little or no difference was observed for IL-1β, IL-7, IL-10, IL-4, IL-17A, IL-8, and IL-1α. To assess the duration of the sustained inflammatory response post-infection, cytokine measurements were categorized as < 6 months or ≥ 6 months after diagnosis. IL-6, MCP-1/CCL2, TNF-α, and IFN-γ remained elevated in both time windows, while IL-1β, IL-8, IP-10/CXCL10, IL-2, and IL-10 showed increased levels beyond 6 months post-Covid-19 diagnosis. Our findings indicate that persistent elevation of inflammatory cytokine is associated with PASC, contributing to a better understanding of the immune pathology underlying chronic dysfunction related to Covid-19.}, }
@article {pmid41271803, year = {2025}, author = {Bansal, A}, title = {Economic burden of long COVID: macroeconomic, cost-of-illness and microeconomic impacts.}, journal = {NPJ primary care respiratory medicine}, volume = {35}, number = {1}, pages = {53}, pmid = {41271803}, issn = {2055-1010}, mesh = {Humans ; *COVID-19/economics/epidemiology ; *Cost of Illness ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Global Health ; Unemployment ; }, abstract = {Long COVID, defined by symptoms persisting three months post-SARS-CoV-2 infection, presents a significant global health and economic challenge, with global prevalence estimated at 36% (ranging from 1-92%). This brief communication consolidates current knowledge on its economic impacts, including macroeconomic, cost-of-illness, and microeconomic impacts, which are estimated at an average annual burden of $1 trillion globally and $9000 per patient in the USA, with some individuals covering substantial out-of-pocket expenses. Annual lost earnings in the USA alone are estimated at approximately $170 billion. Long COVID was associated with increased unemployment, financial distress, and work impairment for up to three years post-infection. This paper highlights discrepancies in impact estimation methodologies and calls for standardised metrics especially in emerging economies. Key research gaps include the absence of comprehensive longitudinal studies on individual and aggregated economic burden, specific long COVID phenotypes and biomarkers, and cost-effectiveness evaluations of interventions.}, }
@article {pmid41271425, year = {2025}, author = {Cussen, A and Littler, K}, title = {Trial characteristics, methods and reported challenges of decentralised clinical trials: a scoping review.}, journal = {BMJ open}, volume = {15}, number = {11}, pages = {e106823}, pmid = {41271425}, issn = {2044-6055}, mesh = {Humans ; *Clinical Trials as Topic/methods ; COVID-19 ; *Research Design ; SARS-CoV-2 ; *Politics ; }, abstract = {OBJECTIVES: To map the landscape of decentralised clinical trials (DCTs) by summarising characteristics, methods and reported challenges of published DCTs.<br><br>DESIGN: Scoping review, reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist.<br><br>DATA SOURCES: Ovid MEDLINE and PubMed were searched through to 21 August 2024.<br><br>ELIGIBILITY CRITERIA: We included reports of completed DCTs (defined as a trial of an intervention, with a comparison arm, in which some or all trial activities occurred away from the trial centre). All intervention types were included.<br><br>DATA EXTRACTION AND SYNTHESIS: A single reviewer extracted data to a structured extraction sheet. Descriptive statistics (frequencies) are reported for study characteristics and the terminology used to describe trial methods. Decentralised methods used were coded separately for each trial stage.<br><br>RESULTS: 53 papers met inclusion criteria. Most studies (34/53) were conducted in the USA. Mental health (18 studies) and COVID-19 (11 studies) were the predominant research areas. 24 (of 53) studies investigated pharmaceutical interventions, while others examined nutritional interventions, medical devices and behavioural interventions. Recruitment, screening and consent were commonly conducted remotely. A range of methods, including online, in-person and telemedicine, was used to collect outcome measures. Several studies experienced challenges related to participant retention and biased recruitment. Terminology regarding decentralisation was inconsistent across studies.<br><br>CONCLUSIONS: DCTs are rapidly increasing in use, and commonly cited advantages include reduced costs and reduced participant burden. This review identifies key research areas using DCTs and highlights a need for standardised terminology, comprehensive reporting of methods and limitations, and robust regulatory frameworks. Development of formal ethical and reporting standards is essential to ensure effective and responsible implementation of DCTs in clinical research.}, }
@article {pmid41270290, year = {2025}, author = {Clark, JR and Maresso, AW}, title = {Sewers to Solutions: A Guide to Wastewater Pathogen Monitoring.}, journal = {Annual review of medicine}, volume = {}, number = {}, pages = {}, doi = {10.1146/annurev-med-062024-125121}, pmid = {41270290}, issn = {1545-326X}, abstract = {Wastewater-based epidemiology (WBE) is the analysis of wastewater to detect pathogen levels or activity for public health awareness or action. Pioneered in the 1940s, WBE underwent a resurgence during the COVID-19 pandemic, providing important information about number of cases, outbreaks, and seasonal impact. With advancements in detection technologies and growing interest in environmental surveillance, WBE is poised to become a standard practice in public health monitoring. Here, we provide an overview of the current state of the art of pathogen WBE, including methods of molecular detection, analysis of wastewater data, real-world applications and programs, public health interventions, and benefits and challenges for the field.}, }
@article {pmid41269748, year = {2025}, author = {Alvarez-Galvez, J and Carretero-Bravo, J and Lagares-Franco, C and Ramos-Fiol, B and Ortega-Martin, E}, title = {Development of a Conceptual Framework of Health Misinformation During the COVID-19 Pandemic: Systematic Review of Reviews.}, journal = {JMIR public health and surveillance}, volume = {11}, number = {}, pages = {e62693}, pmid = {41269748}, issn = {2369-2960}, mesh = {Humans ; *Communication ; *COVID-19/epidemiology ; Pandemics ; Social Media ; }, abstract = {BACKGROUND: Despite the wide variety of studies that have focused on the recent COVID-19 infodemic, defining health mis- or disinformation remains a challenge due to the dynamic nature of the social media ecosystem and, in particular, the different terminologies from different fields of knowledge.<br><br>OBJECTIVE: In this work, we aim to develop a conceptual framework of health misinformation during pandemic contexts that will enable the establishment of an interoperable definition of this concept and consequently a better management of these problems in the future.<br><br>METHODS: We conducted a systematic review of reviews to develop a conceptual framework for health misinformation during the pandemic context as a case study.<br><br>RESULTS: This review comprises 51 reviews from which we developed a conceptual framework that integrates 6 key domains-sources, drivers, content, dissemination channels, target audiences, and health-related effects of mis- or disinformation-offering a structured approach to analyze and categorize health misinformation. These 6 domains collectively form the basis of our proposed conceptual framework.<br><br>CONCLUSIONS: Our results highlight the complexity and multifaceted nature of health disinformation and underscore the need for a common language across disciplines addressing this global problem in order to use interoperable definitions and advance this evolving field of study. By offering a structured conceptual framework, we also provide a valuable foundation for interventions aimed at surveillance, public communication, and digital content moderation in future health emergencies.}, }
@article {pmid41269441, year = {2025}, author = {Marin, C and Alobid, I and López-Chacón, M and Rodríguez-VanStrahlen, C and Aguilera, P and Mullol, J}, title = {Olfactory Dysfunction and Cognitive Decline: Are They Related?.}, journal = {Current allergy and asthma reports}, volume = {25}, number = {1}, pages = {56}, pmid = {41269441}, issn = {1534-6315}, mesh = {Humans ; *Olfaction Disorders/complications ; *Cognitive Dysfunction/etiology ; Smell ; Disease Progression ; }, abstract = {PURPOSE OF REVIEW: Olfactory function is certainly associated with cognitive health, and the severity of loss of smell (LoS) has been associated with the rate of cognitive decline. In this review, we describe the relationship between olfactory dysfunction and cognitive decline, focusing on its relevance in type 2 and non-type 2 inflammatory upper respiratory diseases. We also highlight the relevant correlation between the alteration of the components of olfaction, such as odor identification, and the progression in cognitive decline leading to dementia.<br><br>RECENT FINDINGS: A relevant number of studies suggest that olfactory identification impairment may predict the progression of cognitive decline from normal aging to mild cognitive impairment and dementia. In this review, we describe the association between olfactory dysfunction and cognitive decline, focusing in its relevance in type 2 and non-type 2 inflammatory upper respiratory diseases.}, }
@article {pmid41269000, year = {2025}, author = {Harbsmeier, AN and Schultz, M and Ekenberg, C and Larsen, CS and Usinger, L and Harboe, ZB}, title = {[Vaccination of older adults].}, journal = {Ugeskrift for laeger}, volume = {187}, number = {46}, pages = {}, doi = {10.61409/V04250252}, pmid = {41269000}, issn = {1603-6824}, mesh = {Humans ; Aged ; *Vaccination ; Influenza Vaccines/administration &amp; dosage ; Denmark ; COVID-19 Vaccines/administration &amp; dosage ; COVID-19/prevention &amp; control ; Pneumococcal Vaccines/administration &amp; dosage ; Aged, 80 and over ; Influenza, Human/prevention &amp; control ; }, abstract = {This review presents vaccination as an effective measure in preventing hospitalisation and death in older adults. Older adults are at higher risk of severe infections due to several factors, including immunosenescence, multiple comorbidities and frailty. In Denmark, there is a free seasonal vaccination program against influenza and COVID-19 for individuals aged ≥ 65 years. Other relevant vaccines are available for this age group, including against pneumococcal disease, RSV and herpes zoster. Awareness of the benefits of vaccination in the elderly can help protect this vulnerable group from severe infections and their consequences.}, }
@article {pmid41268995, year = {2025}, author = {Moseholm, E and Weis, N}, title = {[Vaccination in pregnancy].}, journal = {Ugeskrift for laeger}, volume = {187}, number = {46}, pages = {}, doi = {10.61409/V03250236}, pmid = {41268995}, issn = {1603-6824}, mesh = {Humans ; Pregnancy ; Female ; Influenza Vaccines/administration &amp; dosage/adverse effects ; *Vaccination/adverse effects ; COVID-19 Vaccines/administration &amp; dosage/adverse effects ; *Pregnancy Complications, Infectious/prevention &amp; control ; Pertussis Vaccine/administration &amp; dosage/adverse effects ; COVID-19/prevention &amp; control ; Vaccines, Attenuated/administration &amp; dosage/adverse effects ; }, abstract = {Vaccination during pregnancy is an effective and safe way to protect both the pregnant individual and the child from serious infections as presented in this review. Influenza, COVID-19, and pertussis vaccines are routinely recommended and provide proven benefits for both mother and newborn. While inactivated and recombinant vaccines are safe to use, live-attenuated vaccines are contraindicated during pregnancy. Despite their importance, pregnant individuals are often excluded from clinical vaccine studies, highlighting the need for more research on maternal antibody transfer and optimal vaccination strategies in pregnancy.}, }
@article {pmid41268892, year = {2025}, author = {Dillman, RO and Nistor, GI and Keirstead, HS}, title = {A review of vaccinology and ex vivo antigen-loaded dendritic cells: A different approach to infectious disease vaccines.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2588861}, pmid = {41268892}, issn = {2164-554X}, mesh = {Humans ; *Dendritic Cells/immunology ; *COVID-19/prevention &amp; control/immunology ; *COVID-19 Vaccines/immunology ; *Vaccinology/methods ; SARS-CoV-2/immunology ; Animals ; Vaccines, DNA/immunology ; }, abstract = {Vaccinology originated with 18[th] century efforts to prevent smallpox by injecting healthy individuals with the infectious contents of cutaneous lesions from smallpox patients (variolation) or from individuals afflicted with cowpox (vaccination). In the late 19[th] century, vaccination was extended to other diseases after the development of chemical methods to kill pathogens (inactivation) and cell-culture passaging to decrease their virulence (attenuation). Since 1970, advances in immunology, cell subunit purification, and recombinant-DNA genetic engineering have enabled antigen-specific vaccines. During the SARS-CoV-2 pandemic, mRNA and DNA-based vaccines were introduced. Vaccinating with ex vivo-antigen-loaded autologous dendritic cells (DC) is appealing because DCs rapidly induce an adaptive immune response by circumventing the need for in vivo antigen-presenting cells to migrate to the injection site to load antigens. DC vaccines against HIV/AIDS, hepatitis B, and Herpes simplex have yielded encouraging results. During the SARS-CoV-2 COVID-19 pandemic, DC vaccines emerged as a viable vaccine platform against infectious diseases.}, }
@article {pmid41268373, year = {2025}, author = {Calleja-Conde, J and Echeverry-Alzate, V and Sánchez-Diez, S and Giné, E and Bühler, KM}, title = {Severe alcohol use and COVID-19: implications for physical and mental health.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1640207}, pmid = {41268373}, issn = {1664-0640}, abstract = {The COVID-19 pandemic has revealed and intensified the vulnerability of individuals with pre-existing medical and behavioral conditions, notably those related to substance use. Among these, chronic alcohol consumption represents a clinically significant, yet often under-addressed, vulnerability factor that may exacerbate both the acute severity and long-term consequences of SARS-CoV-2 infection. This narrative review examines the biological and clinical intersections between alcohol use and COVID-19, focusing on shared mechanisms of immune dysfunction, neuroinflammation, and disruption of the gut-brain axis. We synthesize current findings showing that both conditions compromise innate and adaptive immune responses, alter cytokine signaling, and weaken mucosal and blood-brain barriers. These changes contribute to cognitive and emotional dysregulation and may increase the risk of persistent neuropsychiatric symptoms, including those observed in Long COVID. In addition, we discuss how chronic alcohol use may alter host susceptibility to infection and affect the immune response to vaccination, with implications for treatment outcomes and recovery. Our findings highlight the need to integrate alcohol use disorder into COVID-19 risk assessments, clinical management, and long-term mental health care planning. A multidisciplinary approach is essential to address the overlapping biological pathways that link alcohol-related vulnerability to COVID-19 outcomes.}, }
@article {pmid41268099, year = {2025}, author = {Kundu, A and Feore, A and Abu-Zarour, N and Sanchez, S and Sutton, M and Sachdeva, K and Seth, S and Schwartz, R and Chaiton, M}, title = {Evidence update on the respiratory health effects of vaping e-cigarettes: A systematic review and meta-analysis.}, journal = {Tobacco induced diseases}, volume = {23}, number = {}, pages = {}, pmid = {41268099}, issn = {1617-9625}, abstract = {INTRODUCTION: In this review, we aimed to explore whether nicotine e-cigarette or vaping product use impact respiratory health.<br><br>METHODS: We searched CINAHL, Embase, MEDLINE, PsycINFO, PubMed and Cochrane library databases initially in January 2023 and updated the search in January 2024. We included peer-reviewed human, animal, cell/in vitro original studies published between July 2021 and December 2023 but excluded qualitative studies. Three types of e-cigarette exposure were examined: acute, short-to-medium term, and long-term.<br><br>RESULTS: We included 119 studies in the main analysis, and 5 in meta-analysis. Over half of the studies had low risk of bias. Non-smoker current vapers had higher incident risk of respiratory symptoms (relative risk, RR=1.90; 95% CI: 1.28-2.83) but statistically non-significant risk of chronic obstructive pulmonary disease (COPD) (RR=2.53; 95% CI: 0.96-6.67) compared to never users. They also had lower incident risk of respiratory symptoms compared to non-vaper current smokers (RR=0.75; 95% CI: 0.64-0.89) and dual users (dual use vs vaping, RR=1.26; 95% CI: 1.03-1.55). Dual users had higher risk of incidence of respiratory symptoms and prevalence of COPD compared to never users (RR=2.53; 95% CI: 1.44-4.45 and RR=3.86; 95% CI: 1.49-10.02, respectively), and the risk was statistically similar to non-vaper current smokers (RR=0.97; 95% CI: 0.84-1.14 and RR=1.15; 95% CI: 1.00-1.33, respectively). All meta-analysis findings were of 'very low' to 'low' certainty evidence. Of the studies not included in meta-analysis, we found 'moderate' certainty evidence of higher risk of respiratory symptoms, COPD, asthma, lung inflammation and damage in non-smoker current vapers compared to non-users, inconsistent findings on the risk of COVID-19 and other respiratory infections, and no significant association with e-cigarette associated lung injury.<br><br>CONCLUSIONS: E-cigarettes are associated with harms to the respiratory system. Further longitudinal research with special attention to measuring effects in different e-cigarette user populations are warranted.}, }
@article {pmid41267794, year = {2025}, author = {Mankayi, E and Chiliza, TE and Mvubu, NE}, title = {Novel Strategies to Profile SARS-CoV-2 and Human Lung Proteome: Inflammatory Pathways in the Spotlight.}, journal = {BioMed research international}, volume = {2025}, number = {}, pages = {5571277}, pmid = {41267794}, issn = {2314-6141}, mesh = {Humans ; *COVID-19/metabolism/virology/immunology ; *SARS-CoV-2/metabolism ; *Proteome/metabolism ; *Lung/metabolism/virology ; Inflammation/metabolism ; Host-Pathogen Interactions ; Proteomics/methods ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has caused widespread morbidity and mortality worldwide. SARS-CoV-2 infection triggers innate and adaptive immune responses, but excessive cytokine release can drive hyperinflammation, acute respiratory distress syndrome and poor clinical outcomes. Although serological and molecular assays, such as ELISA and RT-qPCR, remain central to COVID-19 diagnostics, they have limited capacity to reveal host-pathogen interactions at the tissue level. Therefore, profiling the human lung proteome offers a powerful strategy to identify molecular signatures associated with viral pathogenesis and disease severity. This review emphasises emerging technologies that advance lung proteome profiling during SARS-CoV-2 infection. Novel strategies include phage display for high-throughput identification of antibody-antigen interactions, yeast two-hybrid for mapping virus-host protein interactions and lateral flow immunoassays for rapid, point-of-care detection. Conversely, omics-based technologies such as single-cell RNA sequencing, microarrays and mass spectrometry are transforming our understanding of the lung proteome by revealing patterns of gene expression, protein abundance and immune heterogeneity. Therefore, comparing these conventional diagnostic assays with innovative approaches, we highlight their unique contributions to lung proteome research. These tools not only improve diagnostic precision but also hold the potential to uncover biomarkers for early risk stratification and therapeutic targeting. Prioritising integrative proteome-focused strategies may ultimately guide personalised interventions and enhance preparedness for future viral outbreaks.}, }
@article {pmid41267747, year = {2025}, author = {Zhou, X and Zhang, M and Hu, K}, title = {Research Trends in Health-Related Quality of Life Among Extracorporeal Membrane Oxygenation Survivors Between 2013 and 2024: A Bibliometric Analysis.}, journal = {Journal of multidisciplinary healthcare}, volume = {18}, number = {}, pages = {7459-7470}, pmid = {41267747}, issn = {1178-2390}, abstract = {PURPOSE: To analyze and summarize research hotspots and development trends in the health-related quality of life (HRQoL) of patients undergoing extracorporeal membrane oxygenation (ECMO), providing a reference for future studies on survivor outcomes.<br><br>METHODS: Articles published between 2013 and 2024 were retrieved from the Web of Science Core Collection. VOS viewer was used to assess contributions by countries, institutions, and authors in ECMO-related research. Collaboration networks, trending topics, and keyword patterns were analyzed using VOS viewer and Pajek.<br><br>RESULTS: A total of 164 publications from 22 countries were included, accumulating 2870 citations overall. Research on ECMO patients' health-related quality of life demonstrated an annual growth rate of approximately 15% over the past decade. The United States, Germany, and Australia were the primary contributors. High-frequency keywords included outcomes, survivors, and ARDS, with COVID-19 emerging prominently from 2020 to 2024.<br><br>CONCLUSION: This bibliometric analysis, the first to focus specifically on ECMO survivors' HRQoL, demonstrates steady progress in the field. The analysis highlights three major research hotspots: survivor outcomes, rehabilitation strategies, and the impact of COVID-19, offering concrete insights into evolving directions and areas requiring future investigation.}, }
@article {pmid41267648, year = {2025}, author = {Stenger, H and Oo, PP and Gan, CCR and Davies, SE and True, J}, title = {Impact of Social, Political, and Environmental Events on Violence Against Women in the Indo-Pacific.}, journal = {Trauma, violence &amp; abuse}, volume = {}, number = {}, pages = {15248380251381819}, doi = {10.1177/15248380251381819}, pmid = {41267648}, issn = {1552-8324}, abstract = {The Indo-Pacific region faces frequent and intense social, political, and environmental events (herein described as shocks), including conflicts, health emergencies, economic crises, and disasters, that can increase the risk of violence against women (VAW). Yet the region is underrepresented in global research that examines the impact of these events on VAW. This scoping review identifies and analyses published peer-reviewed literature on the impact of shocks on patterns of VAW in the Indo-Pacific region between 1993 and 2024. Our review includes 203 studies from 5 databases comprising books, research articles, and chapters. Health emergencies, particularly COVID-19, accounted for the largest portion of shocks studied, followed by armed conflict and earthquakes. The findings indicate that social, political, and environmental events consistently heighten all forms of VAW, especially domestic violence, intimate partner violence, and sexual violence. The review found limited research across the region with 7 countries (of 46) informing the majority of studies: These countries were not necessarily those countries most affected by these events however. Based on these main findings, we argue that localized research on the impacts of these events on VAW is urgently needed to inform gender-responsive policies that can enhance preparedness and protection in the most affected communities.}, }
@article {pmid41267613, year = {2025}, author = {Wang, R and Naeem, MA}, title = {COVID-19 Pandemic: A Comprehensive Meta-Review of Global Impacts, Responses, and Future Preparedness.}, journal = {The clinical respiratory journal}, volume = {19}, number = {11}, pages = {e70134}, pmid = {41267613}, issn = {1752-699X}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control/psychology ; *Global Health ; *Pandemics/prevention &amp; control ; SARS-CoV-2 ; Public Health ; }, abstract = {INTRODUCTION: The COVID-19 pandemic due to SARS-CoV-2 has initiated historically unparalleled global health, social, and economic impacts. Syntheses of the multivariable interdependent effects on the multiple clinical, immunologic, psychosocial, and health service realms are required to guide current and future public health preparedness and policy.<br><br>METHODS: A systematic review of a meta-analysis was conducted using the PubMed, Scopus, and Web of Science databases from December 2019 to 2025 to identify observational studies and randomized controlled trials. Quantitative reporting studies of COVID-19 outcomes were included. Random-effects model aggregated effect sizes were estimated and tested for heterogeneity with Cochran's Q, &#x3c4;[2], and I[2]. Subgroup, moderator, publication bias, sensitivity, and leave-one-out analyses were conducted for exploration and validation.<br><br>RESULTS: Twenty-four studies were classified into three categories: clinical outcomes (15 studies), immunogenicity (4 studies), and psychosocial/health service outcomes (5 studies). There was no statistically significant pooled effect (effect ratio 0.95, 95% CI: 0.55-1.62) with severe heterogeneity (I[2]&#x2009;>&#x2009;99%). Immunogenicity showed a statistically significant positive effect (pooled estimate 0.77, 95% CI: 0.38-1.16) with high heterogeneity (I[2] ~96%). Psychosocial effects were highly heterogeneous with non-significant overall effects (estimate -1.03, 95% CI: -5.74 to 3.69). Sample size was an influential moderator that explained significant between-group heterogeneity.<br><br>DISCUSSION: The outcomes reveal robust immunogenic vaccine impacts and indeterminate psychosocial and clinical impacts, consistent with the heterogeneity and complexity of COVID-19 effects. Great heterogeneity highlights methodological standardization and cautious interpretation. This present meta-analysis offers key lessons to guide subsequent study design and manufacture of fair health policy and pandemic readiness.}, }
@article {pmid41267122, year = {2025}, author = {da Costa Correia, A and Ribeiro, F and Amorim, FF and Giusti, PR and Peccin, MS and Imoto, AM}, title = {Effectiveness of inspiratory muscle training and multicomponent physical training in patients with post-COVID conditions: a systematic review and meta-analysis.}, journal = {Systematic reviews}, volume = {14}, number = {1}, pages = {230}, pmid = {41267122}, issn = {2046-4053}, support = {00064-00000330/2023-73//Funda&#xe7;&#xe3;o de Ensino e Pesquisa em Ci&#xea;ncias de Sa&#xfa;de/ ; }, mesh = {Humans ; *COVID-19/complications/rehabilitation ; *Breathing Exercises/methods ; *Dyspnea/etiology/rehabilitation/therapy ; *Respiratory Muscles/physiopathology ; *Fatigue/etiology/rehabilitation/therapy ; SARS-CoV-2 ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: There is evidence that fatigue and dyspnea are among the most frequently reported symptoms of post-COVID condition. Therefore, several studies have investigated respiratory muscle or global peripheral muscle training as strategies to manage those symptoms. Despite evidence of potential benefits, conflicting results persist due to the heterogeneity of rehabilitation protocols and assessment tools. Thereby, the objective of this systematic review was to evaluate the effectiveness of inspiratory muscle training and multicomponent physical training in adults with dyspnea and fatigue for at least 12 weeks after COVID-19.<br><br>METHOD: A search was conducted in September 2024, in the Cochrane Library (Cochrane Central Register of Controlled Trials), EMBASE, PubMed/MEDLINE, PEDro, Lilacs/BVS, Web of Science, Scopus, and Epistemonikos databases. The inclusion criteria were randomized clinical trials published in any language that evaluated the effectiveness of inspiratory muscle training and multicomponent physical training to improve fatigue, dyspnea, and/or physical function in adults with persistent post-COVID symptoms. The risk of bias of the included studies and the certainty of the evidence were assessed using the RoB 2 and GRADE tools, respectively.<br><br>RESULTS: After the screening process, seven randomized clinical trials were included. The total number of participants included in the studies was 449. Inspiratory muscle training significantly improved inspiratory muscle strength (maximal inspiratory pressure) (MD&#x2009;=&#x2009;22.70; 95% CI: 13.78 to 31.62), and cardiopulmonary capacity (V &#x2d9; O2max) (MD&#x2009;=&#x2009;4.49; 95% CI: 3.35 to 5.62). Multicomponent physical training significantly improved the upper and lower body muscle strength through the handgrip strength (MD&#x2009;=&#x2009;3.05; 95% CI: 1.68 to 4.42), sit-to-stand test (MD&#x2009;=&#x2009;3.55; 95% CI: 1.61 to 5.49), and timed up and go test (MD&#x2009;= -&#x2009;1.13; 95% CI:&#x2009;-&#x2009;1.49 to&#x2009;-&#x2009;0.77) and the physical functioning were assessed through post-COVID-19 functional scale (MD&#x2009;= -&#x2009;0.64; 95% CI:&#x2009;-&#x2009;1.13 to&#x2009;-&#x2009;0.16) and physical aspects through SF-12 and SF-36 (SMD&#x2009;=&#x2009;0.72; 95% CI: 0.29 to 1.15). No adverse events were reported among participants in the physical training group, and treatment adherence ranged from 78 to 100%.<br><br>CONCLUSION: Inspiratory muscle training improved cardiorespiratory outcomes, while multicomponent physical training improved muscle strength, physical functioning, and fatigue. Both types of training improve physical functioning. The certainty of evidence for the outcomes evaluated was low.<br><br>PROSPERO (CRD42023451057).}, }
@article {pmid41267112, year = {2025}, author = {Oxman, AD and Selstø, A and Helleve, A and Fretheim, A and Julin, CH and Holst, C and Rose, CJ and Munthe-Kaas, H and Elgersma, IH and Moberg, J and Bjørbæk, M and Elstrøm, P and Solberg, RB and Rosenbaum, SE and Flottorp, S and Bruun, T and Gopinathan, U}, title = {Informed decisions about public health and social measures.}, journal = {Health research policy and systems}, volume = {23}, number = {1}, pages = {153}, pmid = {41267112}, issn = {1478-4505}, mesh = {Humans ; *COVID-19/epidemiology ; *Public Health ; *Decision Making ; SARS-CoV-2 ; Pandemics ; Communication ; Community Participation ; Health Policy ; }, abstract = {Evidence, communication, critical thinking and participation are the cornerstones of informed decisions. In this article we discuss each of these in relation to decisions about public health and social measures (PHSM) during the coronavirus disease 2019 (COVID-19) pandemic and implications for future research. Reliable research evidence of the effects of interventions is particularly important for decisions about what to do because it provides the best basis for estimating the wanted and unwanted effects of doing something. There was little reliable research of the effects of PHSM during the pandemic. For research evidence to be useful to decision-makers, it must be effectively communicated, including how sure we can be about effects or other research findings. Research evidence is essential for making informed decisions, but it is not sufficient. Decision-makers and those affected by the decision must be able to think critically about what to believe and what to do. Many people lack competences and dispositions for thinking critically about PHSM or other interventions. Judgements about PHSM require democratic input, not just expert input. However, there was little public participation in deliberative or decision-making processes about PHSM during the pandemic. There are important uncertainties about the effects of PHSM, how to effectively communicate decisions and evidence about PHSM, how to foster critical thinking about PHSM and how to effectively engage the public in deliberative and decision-making processes about PHSM. Pandemic research and preparedness planning should address those uncertainties.}, }
@article {pmid41267076, year = {2025}, author = {Salahi Ardekani, O and Sajedifar, M and Letafati, A and Ashtiani, AJ and Jazayeri, SM}, title = {Risk factors associated with mental health symptoms among health care workers during the COVID-19 pandemic in EMRO countries: a systematic review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1501}, pmid = {41267076}, issn = {1472-6963}, abstract = {BACKGROUND AND AIMS: During the COVID-19 pandemic, healthcare workers (HCWs) have been psychologically impacted by SARS-CoV-2. The pandemic presented substantial challenges to healthcare systems globally. Given the limited data available from EMRO countries, our systematic review aimed to specifically examine risk factors correlated with mental health symptoms among HCWs within this region.<br><br>METHODS: We investigated PubMed, Scopus, and Embase databases from January 2020 to August 2024. Relevant research articles that examined risk factors correlated with mental health symptoms among HCWs during the COVID-19 pandemic in the EMRO region were included. We identified 21,126 studies in total. After eliminating 9,554 duplicates, 11,572 studies were screened. Records were excluded if they were from outside EMRO countries (n&#x2009;=&#x2009;11,220), unrelated to HCWs (n&#x2009;=&#x2009;12), lacked full-text access (n&#x2009;=&#x2009;2), or had only abstracts available (n&#x2009;=&#x2009;16). Following this, 322 reports were evaluated for eligibility, and 89 studies were ultimately included in the review. This study followed the guidelines set by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. This study was not preregistered in any protocol registry.<br><br>RESULTS: The included investigations were conducted in Bahrain, Emirates, Iran, Iraq, Jordan, Lebanon, Morocco, Oman, Pakistan, Palestine, Kuwait, Egypt, Qatar, Saudi Arabia, Sudan, Tunisia, and Yemen. We reviewed 89 studies which included 62,454 HCWs. Nurses and physicians constituting the majority of the participants. In these investigations, the most frequent mental health symptoms were anxiety (range: 3.4&#x2013;89.7%), depression (range: 12.4&#x2013;98%), insomnia (range: 24.5&#x2013;68.8%), and stress (range: 5.2&#x2013;95.7%). However, factors such as being female, younger age, fears of transmitting the virus to others, work-related sleep disturbances, and insufficient protective equipment could be associated with these mental health symptoms.<br><br>CONCLUSION: The COVID-19 pandemic has been associated with a significant mental health burden among HCWs in EMRO countries, as highlighted by the predominance of cross-sectional studies reviewed. These studies indicate a high prevalence of mental health problems, including anxiety, depression, and insomnia. Additionally, risk factors such as female sex and younger ages have been identified as being associated with more frequent or severe mental health symptoms. While the findings suggest significant mental health impacts, it is important to recognize that most of the studies are cross-sectional, providing only snapshots of the data. Consequently, future research should aim to explore long-term trends and causal relationships. The identified risk factors can guide policymakers in prioritizing mental health support for HCWs in the EMRO region.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13285-5.}, }
@article {pmid41266015, year = {2026}, author = {Lushniak, L and Jowell, A and Garbarino, S and Wilder, J}, title = {Disparities in Alcohol-Related Liver Disease.}, journal = {Clinics in liver disease}, volume = {30}, number = {1}, pages = {185-193}, doi = {10.1016/j.cld.2025.09.006}, pmid = {41266015}, issn = {1557-8224}, mesh = {Humans ; *Liver Diseases, Alcoholic/epidemiology/ethnology/therapy ; *Healthcare Disparities ; COVID-19/epidemiology ; *Health Status Disparities ; *Alcohol Drinking/epidemiology/adverse effects ; United States/epidemiology ; Liver Transplantation ; Socioeconomic Factors ; Sex Factors ; SARS-CoV-2 ; }, abstract = {Alcohol-associated liver disease has always been a significant health issue. During the coronavirus disease 2019 pandemic, there were higher rates of alcohol consumption, and these higher rates have persisted after pandemic. Given the significance of alcohol-associated liver disease, this article contextualizes disparities in alcohol-associated liver disease related to gender, socioeconomic status, and race/ethnicity. This article identifies a need for high-quality research on alcohol-associated liver disease, embedding of alcohol cessation metrics into hepatology quality measures, and colocation of social/psychosocial and addiction medicine resources into hepatology clinics as means of mitigating disparities and their impact on alcohol-associated liver disease and liver transplantation.}, }
@article {pmid41265758, year = {2025}, author = {Torrisi, SA and Geraci, F and Diolosà, L and De Luca, A and Falzone, L and Drago, F and Libra, M and Leggio, GM}, title = {RNA-based drugs: current, imminent and possible therapeutic applications.}, journal = {Pharmacology &amp; therapeutics}, volume = {277}, number = {}, pages = {108958}, doi = {10.1016/j.pharmthera.2025.108958}, pmid = {41265758}, issn = {1879-016X}, abstract = {In a relatively brief period, the mRNA COVID-19 vaccines have saved millions of lives and have considerably contributed to return to normality after the pandemic. More broadly, the development of RNA-based drugs represents a real paradigm shift with promising therapeutic applications. Besides their safety and efficacy, RNA-based drugs are essentially easy to design and manufactured and may therefore be cost effective. At the pharmacological level, the development of RNA-based drugs marks a breakthrough because these drugs can reach previously "undruggable" pharmacological targets. This clearly represents a step toward the possible establishment of personalized treatments for several difficult-to-treat diseases. This review provides an updated, critical, and comprehensive pharmacological analysis of the current RNA therapeutics landscape, including both approved RNA-based drugs and key investigational candidates. We summarize the state of clinical progress, highlighting pharmacological mechanisms, challenges in drug delivery, tolerability, and clinical outcomes. Our comprehensive overview emphasizes the versatility of RNA-based drugs, illustrating their therapeutic application across various diseases such as cancer, neurodegenerative, cardiovascular, metabolic, rare genetic, and infectious diseases. Also, we uniquely explore the concept of RNA-based drugs repurposing, which may leverage shared pathophysiological mechanisms across diseases to accelerate clinical impact.}, }
@article {pmid41265491, year = {2025}, author = {Gagnon, J and Naïmi, M and Bergeron, F and Longtin, Y and Villeneuve, J and Boudaoud, K and Jolicoeur-Ouellette, D and Xu, HH and Cormier, &#xc9; and Guertin, JR and Marx, T and Adadja, J and Bluteau, A and Berthelot, S}, title = {Effectiveness of using full personal protective equipment in reducing the transmission of SARS-CoV-2 in health care workers: A systematic review.}, journal = {American journal of infection control}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ajic.2025.11.013}, pmid = {41265491}, issn = {1527-3296}, abstract = {BACKGROUND: This systematic review aimed to assess the effectiveness of full personal protective equipment (PPE) in preventing COVID-19 transmission among health care workers.<br><br>METHODS: Studies published from December 2019 to August 2024 were searched in MEDLINE, Embase, Cochrane Library, CINAHL, Epistemonikos, ClinicalTrials.gov, MedRxiv, and Web of Science. Full PPE was defined as the combination of respiratory protection (surgical mask, N95, or equivalents), eye protection (visor or goggles), gown, and gloves, as recommended by the World Health Organization (WHO). The comparator was partial PPE or no PPE. Two reviewers independently performed screening, data extraction, and risk of bias assessment. The review was registered on PROSPERO (CRD4202230259).<br><br>RESULTS: Eight observational studies were included; 4 showed a significant reduction in transmission with full PPE. Seven studies compared full to partial PPE, and 1 compared full PPE to no protection. Among studies with significant results, odds ratios ranged from 0.03 to 0.6. Risk of bias was critical in 6 studies and serious in 2. No meta-analysis was performed due to study quality.<br><br>CONCLUSION: Full PPE appears protective for health care workers. The small number and low quality of studies limit the certainty of this conclusion. Further analyses are required to establish clear guideline for its use.}, }
@article {pmid41264992, year = {2025}, author = {Mohammed, A and Ibrahim, NA and Basher, NS}, title = {Innovations and challenges in vaccine development: Lessons from the SARS-CoV-2 pandemic and prospects.}, journal = {Biochemical and biophysical research communications}, volume = {792}, number = {}, pages = {152947}, doi = {10.1016/j.bbrc.2025.152947}, pmid = {41264992}, issn = {1090-2104}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology/immunology ; *COVID-19 Vaccines/immunology ; *Vaccine Development/methods/trends ; *SARS-CoV-2/immunology ; *Pandemics/prevention &amp; control ; Artificial Intelligence ; Vaccination ; }, abstract = {Vaccination stands as one of the most significant achievements in public health, dramatically reducing the incidence of infectious diseases worldwide. The COVID-19 pandemic has catalyzed revolutionary advancements in vaccinology, particularly through the rapid development of mRNA and viral vector technologies that enable fast and effective immunization against emerging pathogens. This review highlights the progress in these innovative platforms while addressing the multifaceted challenges, including the critical interplay between outbreak dynamics and vaccine development timelines, which result in safety and efficacy profile challenges, disparities in vaccine access for low- and middle-income countries (LMICs), and complex logistical considerations. Despite the potential of cutting-edge approaches such as nanoparticle-based vaccines, integration of artificial intelligence (AI), issues related to immunogenicity, safety, and public trust remain pressing and necessitate immediate attention. The review highlights the urgent need for adaptable regulatory frameworks that can evolve in response to scientific advancements, and underscores the importance of collaborative global initiatives in addressing disparities in vaccine distribution. By integrating insights from these innovative technologies and the challenges they present, this article aims to provide a comprehensive overview of the current landscape in vaccine development, informing future public health strategies and enhancing global preparedness for emerging infectious diseases.}, }
@article {pmid41263792, year = {2025}, author = {Tokarska-Domżałowicz, W and Zdżalik-Bielecka, D}, title = {[At the intersection of immunology and oncology: TAM receptors in the regulation of immune responses and tumorigenesis-related processes].}, journal = {Postepy biochemii}, volume = {71}, number = {3}, pages = {238-251}, doi = {10.18388/pb.2021_619}, pmid = {41263792}, issn = {0032-5422}, mesh = {Humans ; *Neoplasms/immunology/metabolism ; *Receptor Protein-Tyrosine Kinases/immunology/metabolism/antagonists &amp; inhibitors ; Axl Receptor Tyrosine Kinase ; Tumor Microenvironment/immunology ; c-Mer Tyrosine Kinase/immunology/metabolism ; Intercellular Signaling Peptides and Proteins/metabolism/immunology ; *Proto-Oncogene Proteins/immunology/metabolism ; Immunity, Innate ; Protein S/metabolism/immunology ; COVID-19/immunology ; }, abstract = {TAM receptor tyrosine kinases (TYRO3, AXL, MER) and their ligands, protein S (PROS1) and growth inhibition-specific protein 6 (GAS6), play a key role in maintaining homeostasis and regulating the immune response through involvement in efferocytosis, i.e., phagocytic removal of apoptotic cells and suppression of the innate immune response. Thus, their dysfunction leads, among others, to the development of autoimmune diseases. In turn, excessive production of TAM receptors correlates with the invasive phenotype of cancer cells, metastasis, drug resistance, and poor prognosis for patients with cancer. Moreover, activation of these receptors contributes to the promotion of an immunosuppressive tumor microenvironment and evading the immune response by cancer cells. Interestingly, recent studies suggest that these receptors are also involved in the cellular entry of viruses such as Zika or SARS-CoV-2. Therefore, in recent years, various therapeutic strategies targeting TAM receptors have been intensively developed, and their effectiveness has been assessed in numerous preclinical and clinical studies.}, }
@article {pmid41262872, year = {2025}, author = {Lv, X and Ji, L and Cao, W and Xue, Y and Dai, H and Zhang, S}, title = {Revisiting lung cancer immunotherapy in the era of long COVID: mechanistic insights and therapeutic implications.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1657691}, pmid = {41262872}, issn = {2235-2988}, mesh = {Humans ; *COVID-19/immunology/complications ; *Immunotherapy/methods ; *Lung Neoplasms/therapy/immunology ; SARS-CoV-2/immunology ; Tumor Microenvironment/immunology ; Immune Checkpoint Inhibitors/therapeutic use ; }, abstract = {In the post-COVID-19 era, understanding the long-term impact of Long COVID on the immune system is essential for deciphering its influence on lung cancer pathogenesis and immunotherapeutic efficacy. This review comprehensively examines how persistent COVID-19 sequelae-manifested as chronic inflammation, pulmonary fibrosis, cytokine dysregulation, and T-cell exhaustion can reshape the lung cancer microenvironment. In addition, the emerging roles of memory B cells and altered neutrophil function in promoting tumorigenesis are discussed. Importantly, we analyze recent clinical evidence suggesting that COVID-19 vaccination may enhance the efficacy of immune checkpoint inhibitors, potentially by modulating host immunity. By integrating mechanistic insights with clinical observations, this review aims to illuminate the challenges and opportunities at the intersection of Long COVID and lung cancer treatment, thereby fostering the development of personalized therapeutic strategies in the post-pandemic era.}, }
@article {pmid41262458, year = {2025}, author = {Gao, Z and Gao, Y and Wang, S and Li, X and Cao, W and Deng, W and Yao, L and Wei, X and Zhang, Z and Wang, S and Zhang, Y and Li, M and Xie, Y}, title = {Application progress and biosafety challenges of gene editing and synthetic biotechnology in diagnosis, treatment and prevention of infectious diseases.}, journal = {Biosafety and health}, volume = {7}, number = {5}, pages = {312-322}, pmid = {41262458}, issn = {2590-0536}, abstract = {Global infectious disease prevention faces escalating challenges due to the continual emergence of novel pathogens and rapid viral mutations. Synthetic biology has revolutionized this field by enabling precise diagnostics, innovative vaccine platforms, and targeted therapeutics, yet it simultaneously raises concerns regarding dual-use potential, biosafety, and ethical governance. This systematic review (2015-2025, PubMed, Web of Science, Scopus) focuses on CRISPR-based diagnostics, synthetic vaccines, and engineered probiotics. CRISPR/Cas systems such as DETECTR (Cas12a) and SHERLOCK (Cas13a) demonstrate high sensitivity and rapid pathogen detection (e.g., SARS-CoV-2, Ebola), but their misuse could enhance pathogen virulence or enable bioweapon development. mRNA and viral vector vaccines offer flexible and rapid responses to emerging infections but encounter limitations in molecular stability, delivery system toxicity, and ecological safety. Engineered probiotics, designed as "living therapeutics," can detect pathogens and modulate immune responses, yet pose potential risks of horizontal gene transfer and host-specific variability. Overall, while synthetic biology provides transformative tools for infectious disease control, it necessitates robust global regulatory frameworks, standardized biosafety practices, and ethical oversight to ensure responsible and sustainable application.}, }
@article {pmid41260636, year = {2025}, author = {Adashi, EY and O'Mahony, DP and Cohen, IG}, title = {National Drug Shortages: Remedial Executive and Legislative Initiatives.}, journal = {Journal of the American Board of Family Medicine : JABFM}, volume = {38}, number = {4}, pages = {757-760}, doi = {10.3122/jabfm.2024.240327R2}, pmid = {41260636}, issn = {1558-7118}, mesh = {*Health Policy/legislation &amp; jurisprudence ; *Pharmaceutical Preparations/supply &amp; distribution ; United States ; }, abstract = {Medication shortages constitute an ongoing threat to patient care across the United States and affect nearly every aspect of health care. National drug shortages have been a recurring challenge of the US health care system but were markedly aggravated during the COVID-19 pandemic. Federal executive and legislative efforts to bolster the resiliency of the pharmaceutical supply chain have thus far fallen short. This Commentary reviews the leading executive and legislative initiatives proposed during the 118[th] Congress and the Biden administration to protect the national drug supply in the hope of avoiding future shortages. It will be up to the new (119th) Congress and presidential administration to take up this issue again and pursue remediation of the nation's drug shortage problem. The health of the nation demands action by policy makers to mitigate drug shortages that give rise to discontinuity of care and thereby to a compromise of the national state of health.}, }
@article {pmid41260170, year = {2025}, author = {Martins, AJE and Dos Santos, TP and Santos, WGS and Triozzi, E and Moraes-Vieira, PM}, title = {Host immunometabolic regulation through viral sensing pathways.}, journal = {Current opinion in microbiology}, volume = {88}, number = {}, pages = {102683}, doi = {10.1016/j.mib.2025.102683}, pmid = {41260170}, issn = {1879-0364}, mesh = {Humans ; *Host-Pathogen Interactions/immunology ; Receptors, Pattern Recognition/immunology/metabolism ; Animals ; Signal Transduction ; SARS-CoV-2/immunology ; *Viruses/immunology ; *COVID-19/immunology/virology ; *Virus Diseases/immunology/virology/metabolism ; }, abstract = {Viruses are intracellular pathogens that have profoundly influenced biological evolution and continue to threaten global health through outbreaks such as influenza and COVID-19. Their ability to evade host immunity stems from evolutionary adaptations that manipulate cellular defense mechanisms. A critical aspect of virus-host interactions involves cellular receptors, which facilitate viral entry and trigger immune signaling. Among these, pattern recognition receptors (PRRs) and other proteins serve as key sensors of viral components, coordinating immune responses while reprogramming host metabolism to sustain antiviral defenses. However, many viruses hijack these metabolic changes to enhance replication, evade immune surveillance, or dysregulate cytokine production. This review explores how host cell virus-sensitive proteins, particularly PRRs and metabolically active proteins, modulate cellular metabolism during infection, shaping immune outcomes and revealing potential therapeutic targets for antiviral intervention.}, }
@article {pmid41259978, year = {2025}, author = {Alfieri, L and Mariotti, I and Rossi, F}, title = {The twin transition and flexible work arrangements: A systematic literature review.}, journal = {Journal of environmental management}, volume = {395}, number = {}, pages = {127988}, doi = {10.1016/j.jenvman.2025.127988}, pmid = {41259978}, issn = {1095-8630}, mesh = {Humans ; *COVID-19 ; *Employment ; Workplace ; SARS-CoV-2 ; }, abstract = {The main idea behind the green and digital transition (twin transition) is to use technology to develop more efficient and productive systems, provide remote access to employment opportunities (Flexible Working Arrangements-FWAs), and broaden the structure of the labour market, while encouraging more sustainable production, workplaces, and society at large. Within this context, the paper systematically reviews literature on the interaction between FWAs and the twin transition (digital and green) using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, and paying special attention to their implications for the environment, society, and urban areas. This review fills a gap in the literature, showing how a growing but still limited number of scholars are approaching the topic. Most of the papers explore the impact of FWAs on energy use and the need for targeted policies to ensure a just transition that accounts for the social impact. Furthermore, the selected manuscripts place significant emphasis on the restructuring process of business models, on the complex and non-trivial relationship between digital tools and FWAs, and on the effects of work-life balance on employees. Many studies stem from the post-pandemic period, highlighting the Covid-19 pandemic as a catalyst for change. These findings underscore the emerging importance of FWAs in green and digital transition for a more resilient future.}, }
@article {pmid41259568, year = {2025}, author = {Santos, BJ and Nascimento, EAND and Reis, LOD and Lima, JB and Lima, BB and Ramos, LFP}, title = {Neurological manifestations associated with SARS-CoV-2 infection in pediatric patients: a systematic review.}, journal = {Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo}, volume = {43}, number = {}, pages = {e2024293}, pmid = {41259568}, issn = {1984-0462}, mesh = {Humans ; *COVID-19/complications ; Child ; *Nervous System Diseases/virology/etiology ; Adolescent ; Child, Preschool ; Infant ; Infant, Newborn ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To conduct a systematic review to identify neurological symptoms associated with SARS-CoV-2 in patients aged zero to 19 years, highlighting the main symptoms and addressing the existing gap in age range coverage in current studies.<br><br>DATA SOURCE: This study was registered in the International Prospective Register of Systematic Reviews - PROSPERO (CRD42024520151) and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA (2020) guidelines. Observational and interventional studies, including randomized clinical trials, investigating neurological manifestations in children and adolescents with confirmed SARS-CoV-2 infection were included. Searches were conducted in the United States National Library of Medicine/Medical Literature Analysis and Retrieval System Online (PubMed/MEDLINE), Cochrane Library, and Virtual Health Library (VHL) using Health Science Descriptors/Medical Subject Headings (DeCS/MeSH) terms in English, Spanish, and Portuguese, covering January 2020 to January 2024.<br><br>DATA SYNTHESIS: The search identified 1283 records, of which 302 were excluded (outside of scope), 688 were removed after title/abstract screening, and 95 duplicates were discarded. Fulltext analysis of 198 articles resulted in the selection of 25 eligible studies. The most frequently reported neurological manifestations included seizures, headache, altered levels of consciousness, olfactory and gustatory disturbances, encephalopathy, and acute cerebrovascular diseases.<br><br>CONCLUSIONS: Neurological manifestations of COVID-19 in children are relatively common, ranging from mild symptoms such as headache and taste/smell disturbances to severe complications like seizures, stroke, altered consciousness, and encephalopathy. Prevalence varies across studies, underscoring the need for further research to clarify underlying mechanisms.}, }
@article {pmid41258672, year = {2025}, author = {Oquendo, MA and Barrigon, ML and Baca-Garcia, E}, title = {Psychiatry at the turn of the century and a vision for future developments.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {}, number = {}, pages = {1-15}, doi = {10.1080/09540261.2025.2591200}, pmid = {41258672}, issn = {1369-1627}, abstract = {From 1995 to 2025, psychiatry evolved from a primarily syndromic discipline toward a field increasingly shaped by neuroscience, digital technology, globalization, and shifting social expectations surrounding mental health. This transformation included major advances in diagnostic frameworks, brain imaging and genomics, psychopharmacology, evidence-based psychotherapies, and global mental health initiatives. The COVID-19 pandemic accelerated the adoption of telepsychiatry and exposed critical gaps in mental health infrastructure, while growing recognition of health disparities brought social determinants and equity to the forefront of research and clinical priorities.}, }
@article {pmid41258629, year = {2025}, author = {Asiama, RK}, title = {An econometric examination of vaccine hesitancy among residents and their dependents in urban Ghana.}, journal = {Health economics review}, volume = {15}, number = {1}, pages = {100}, pmid = {41258629}, issn = {2191-1991}, abstract = {PURPOSE: Vaccine hesitancy among the population raises concern for health policymakers because it threatens the attainment of herd immunity, which is necessary to keep the society healthy and manage public health spending. However, a problem arises when there is hesitancy by economic agents and their dependents, even when the resource is freely available. This policy problem is analyzed in the context of Ghana's major urban area, Accra, where a cross-section of urban parents are surveyed regarding vaccine hesitancy and whether it extends to their children, with special reference to the COVID-19 vaccine.<br><br>METHODOLOGY: Data on preferences of residents regarding the choice for their dependents to receive the vaccine gathered in 2022. The data was obtained through a cross-sectional online survey of 2000 urban parents in Accra, Ghana. The paper estimates logit and probit regression models and their associated marginal effects to examine the willingness of respondents to allow their children to take the vaccine and the extent of influence of attitudinal and demographic characteristics of respondents.<br><br>FINDINGS: The results first show that urban respondents who had tested for COVID-19, taken the vaccine and were willing to pay for the COVID-19 vaccine are more likely to allow their children to take the vaccine. More so, urban respondents concerned about age group vulnerability of their children, not suffering permanently health conditions, and being infected by others are also more likely to allow their children to take the COVID-19 vaccine.<br><br>PRACTICAL IMPLICATIONS: Based on the findings, this paper recommends to policymakers to strengthen education efforts, with special encouragement for parents to get their children vaccinated. Vaccines are meant to provide immunity to the populace and its hesitancy among the population sets back the public health objective of achieving herd immunity and building a robust pharmaceutical industry while increasing the risk of poor public services and higher public health spending.<br><br>ORIGINALITY/VALUE: This paper offers a novel lens on the sustainability of public health expenditure by examining vaccine hesitancy during a pandemic that caught populations unprepared and distrustful. Using evidence from urban Ghana, it shows how reluctance to accept free vaccines reveals the hidden social costs and governance gaps in public health delivery-an overlooked dimension in discussions of health financing in developing countries.}, }
@article {pmid41258470, year = {2025}, author = {Oh, DY and Hölzer, M and Börnigen, D and Paraskevopoulou, S and Duwe, S and Budt, M and Kerber, R and Mikolajewska, A and Böttcher, S and Seifried, J and Haas, W and Dürrwald, R and Fuchs, S and Kröger, S and von Kleist, M and Wolff, T and Mielke, M and , }, title = {A public health perspective of SARS-CoV-2 evolution and surveillance strategies in Germany from 2020 to 2023.}, journal = {Communications medicine}, volume = {5}, number = {1}, pages = {468}, pmid = {41258470}, issn = {2730-664X}, support = {D82015, sub-projects C1.1 and C.1.2//Bundesministerium f&#xfc;r Gesundheit (Federal Ministry of Health, Germany)/ ; ECDC/HERA/2021/008 ECD.12222//European Centre for Disease Prevention and Control (ECDC)/ ; 101113012//European Centre for Disease Prevention and Control (ECDC)/ ; }, abstract = {This review summarizes key virological parameters of SARS-CoV-2, the clinical spectrum of COVID-19, antiviral options, resistance, and the evolution of SARS-CoV-2 during the first four years of the pandemic. It draws on evidence that has been continuously updated throughout the pandemic by the interdisciplinary working group 'SARS-CoV-2 Diagnostics and Evolution' at Robert Koch Institute (RKI), Germany's national public health institute. We describe basic SARS-CoV-2 characteristics and highlight notable virus variants from 2020 to mid-2023. During this period, the nationwide collection of SARS-CoV-2 genomes provided a substantial resource for monitoring viral lineage frequencies and mutations. We summarize this dataset to underscore the importance of virological surveillance in the context of public health and pandemic preparedness.}, }
@article {pmid41255507, year = {2025}, author = {Ibraheem, N and Mohamed, M and Abdelglil, M and Hasan, MR and Rahman, ME}, title = {Telemedicine-Based Virtual Stone Clinics for Renal Colic: Cost-Benefit Insights and Adoption Barriers.}, journal = {Cureus}, volume = {17}, number = {11}, pages = {e97028}, pmid = {41255507}, issn = {2168-8184}, abstract = {Telemedicine in urology has gained substantial attention, accelerating in adoption due to the COVID-19 pandemic and its potential to bridge significant gaps in healthcare access, particularly given that 62% of U.S. counties lack a urologist. This narrative review outlines its applications, cost benefits, and adoption barriers. Studies demonstrate high patient satisfaction, especially for postoperative consultations and prostate-specific antigen (PSA) tracking. Virtual care is highly effective for managing conditions like nephrolithiasis and benign ureteric colic; one quality improvement study focusing on ureteric colic successfully avoided 71.1% of face-to-face follow-ups while maintaining high safety and patient satisfaction (93.1%). The financial advantages are significant, with virtual stone clinics reducing waiting times and saving patients an average of $147 to $186 per visit by minimizing travel costs and time away from work. Despite these benefits, widespread adoption faces hurdles. Key challenges include a lack of patient trust in virtual sessions compared to in-person care, particularly among minority groups. Furthermore, technological barriers, such as inadequate digital literacy and a lack of broadband access, disproportionately affect elderly and ethnic minority populations, which risks exacerbating existing health disparities. Telemedicine is also limited by its unsuitability for conditions requiring a physical examination. Addressing these obstacles is essential to ensuring virtual care remains an affordable and equitable component of future healthcare.}, }
@article {pmid41254919, year = {2025}, author = {Li, Y and Liu, X and Guo, Z and Lai, L and Bryant, RA and Zhang, T and Song, H and Mi, T and Ren, Z}, title = {Comparative Efficacy and Attrition Rates of Psychosocial Interventions for Individuals Affected by the COVID-19 Pandemic: A Network Meta-Analysis.}, journal = {Stress and health : journal of the International Society for the Investigation of Stress}, volume = {41}, number = {6}, pages = {e70124}, doi = {10.1002/smi.70124}, pmid = {41254919}, issn = {1532-2998}, support = {22&amp;ZD187//Major Program of the National Social Science Foundation of China/ ; }, mesh = {Humans ; *COVID-19/psychology ; *Psychosocial Intervention/methods/statistics &amp; numerical data ; *Stress, Psychological/therapy ; *Anxiety/therapy ; *Depression/therapy ; *Patient Dropouts/statistics &amp; numerical data/psychology ; Yoga ; Cognitive Behavioral Therapy ; *Psychotherapy ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {The comparative examination of psychosocial interventions' efficacy and attrition rates in addressing COVID-19's psychological consequences is still limited. This study examined the efficacy and attrition rates of psychosocial interventions among individuals impacted by the COVID-19 pandemic. Systematic searches were conducted to identify randomised controlled trials targeting COVID-19-affected groups. Data on symptoms of anxiety, depression, and stress, as well as attrition rates, were analysed using frequentist random-effects network meta-analyses. One hundred and forty-two studies with 20,470 participants were included. Emotional freedom technique, art-based therapy, stress management, mindfulness- and acceptance-based intervention, positive psychotherapy, yoga therapy, and cognitive behavioural therapy showed significant effects in reducing anxiety symptoms compared with no treatment and treatment as usual. For depressive symptoms, positive psychotherapy, mindfulness- and acceptance-based intervention, cognitive behavioural therapy, and yoga therapy demonstrated significant superiority over no treatment or treatment as usual, with positive psychotherapy also outperforming expressive writing. Regarding stress symptoms, multi-component therapy and yoga therapy produced greater improvements than no treatment, and positive psychotherapy surpassed expressive writing. In terms of attrition rates, resilience training, art-based therapy and yoga therapy had higher dropout rates than no treatment and several other interventions. Sensitivity analyses yielded largely consistent results, confirming the robustness of the main findings. The confidence ranged from moderate to very low. Publication bias was not observed. This study illuminates and compares the efficacy and attrition rate of several psychosocial interventions in attenuating mental health symptoms among COVID-19-affected individuals. The impact of COVID-19 on people remains ongoing, and the findings of this study can also serve as a reference for selecting the best therapeutic options for mental health symptoms in future public health crises.}, }
@article {pmid41254751, year = {2025}, author = {Rezoagli, E and Nova, A and Carteaux, G and Giani, M and Grieco, DL and Pettenuzzo, T and Lucchini, A and Navalesi, P and Antonelli, M and Foti, G and Bellani, G and Piquilloud, L}, title = {A clinical guide to non-invasive respiratory support in acute respiratory failure: ventilation settings, technical optimization and clinical indications.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {496}, pmid = {41254751}, issn = {1466-609X}, support = {Institutional funds//Universit&#xe0; degli Studi di Milano-Bicocca/ ; }, mesh = {Humans ; *Noninvasive Ventilation/methods/standards ; COVID-19 ; *Respiratory Insufficiency/therapy ; Continuous Positive Airway Pressure/methods ; SARS-CoV-2 ; }, abstract = {Non-invasive respiratory support including high flow nasal therapy (HFNT), continuous positive airway pressure (CPAP) and Bilevel positive airway pressure (BiPAP), exerts distinct physiological effects and requires specific settings and technicalities. HFNT, delivered through dedicated nasal cannulas, provides low levels of positive airway pressure, anatomical dead space washout, allows good patient tolerance and can be used during CPAP or BiPAP breaks. CPAP and BiPAP, administered through various interfaces (e.g., facemasks, oro-nasal masks, or helmets), can deliver higher positive pressure, thereby increasing end-expiratory lung volume, reducing intrapulmonary shunt and oxygenation, with potential benefits on respiratory mechanics as well. BiPAP also delivers pressure support, aiding CO2 clearance and respiratory muscle unloading, which is especially useful in hypercapnic respiratory failure. Increased intrathoracic pressure also reduces right ventricle preload and left ventricle afterload, which is beneficial in patients with impaired left ventricular function. Non-invasive respiratory support indications depend on the cause of acute respiratory failure. In hypercapnic respiratory failure with respiratory acidosis, BiPAP via facemask is strongly recommended to prevent intubation and reduce mortality. In cardiogenic pulmonary edema, either CPAP or BiPAP is recommended, while HFNT can be useful for patients requiring prolonged support or when CPAP/BiPAP is not tolerated even after ventilator and interface settings optimization. In de-novo acute hypoxemic respiratory failure, HFNT should be considered as the first-line treatment, regardless of the aetiology: however, in COVID-19-related AHRF CPAP can be considered to avoid intubation. The choice of non-invasive respiratory support interface in both cardiogenic and non-cardiogenic AHRF should aim at minimizing leaks, optimizing CO2 clearance, and maximizing patient tolerance. Monitoring is essential during non-invasive respiratory support to assess patient's response to treatment and to avoid delaying invasive respiratory support when needed, particularly in hypoxemic patients to avoid intubation delays and prevent patient-self-inflicted lung injury: physiological parameters, clinical scores, and lung ultrasound may help assess the risk of NIV failure. Monitoring tidal volume is valuable but challenging because of leaks. Though not widely used, esophageal pressure monitoring can assess patient effort and transpulmonary pressure. Additionally, electrical impedance tomography is an emerging tool for detecting asynchronous breathing and pendelluft phenomena.}, }
@article {pmid41254702, year = {2025}, author = {Qin, J and Wang, G and Han, D}, title = {Methylprednisolone versus dexamethasone in hospitalized patients with severe COVID-19: a systematic review and meta-analysis of randomized controlled trials.}, journal = {Systematic reviews}, volume = {14}, number = {1}, pages = {228}, pmid = {41254702}, issn = {2046-4053}, mesh = {Humans ; *Dexamethasone/therapeutic use ; *COVID-19 Drug Treatment ; *Methylprednisolone/therapeutic use ; Randomized Controlled Trials as Topic ; Hospitalization ; COVID-19/mortality ; SARS-CoV-2 ; Length of Stay ; *Glucocorticoids/therapeutic use ; *Anti-Inflammatory Agents/therapeutic use ; }, abstract = {BACKGROUND: The aim of this systematic review was to compare the efficacy of methylprednisolone and dexamethasone in severe COVID-19 hospitalized patients.<br><br>METHODS: We conducted systematic searches of MEDLINE, Embase, the Cochrane Library, and clinicaltrials.gov without language restrictions. Randomized controlled trials (RCTs) on the treatment of severe COVID-19 with methylprednisolone, compared with dexamethasone, were included. Findings were summarized as risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI). The certainty of evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) framework, categorized as "high," "moderate," "low," or "very low" quality.<br><br>RESULTS: Five RCTs (enrolling 1102 participants) met the inclusion criteria. There was no statistically significant difference in 28-day mortality (RR 0.81, 95% CI 0.58 to 1.14; GRADE&#x2009;=&#x2009;high), length of hospital stay (MD 0.67&#xa0;days, 95% CI -1.77 to 3.10&#xa0;days; moderate), intensive care unit (ICU) admission (RR 1.20, 95% CI 0.85 to 1.69; high), and invasive ventilation (RR 0.87, 95% CI 0.42 to 1.79; high) between the two groups. Overall, using the GRADE framework, 3 pooled analyses were rated as high quality, with 1 rated as moderate quality.<br><br>CONCLUSIONS: Methylprednisolone demonstrated similar therapeutic effects compared to dexamethasone in hospitalized patients with severe COVID-19.}, }
@article {pmid41254586, year = {2025}, author = {Amini-Rarani, M and Rezaei, S and Azami-Aghdash, S and Bashzar, S and Allahverdi, S and Mohseni, M}, title = {The prevalence of stress during the COVID-19 pandemic: an umbrella review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {4022}, pmid = {41254586}, issn = {1471-2458}, abstract = {BACKGROUND: The COVID-19 pandemic has caused widespread mental health problems, with stress affecting a large porportion of the global population. To provide a comprehensive understanding of the need for post-pandemic mental health services, this umbrella review was conducted to accurately estimate the prevalence of stress during the COVID-19 pandemic.<br><br>METHODS: Web of Science, PubMed, Scopus, and Embase were searched for published meta-analyses using relevant keywords, such as prevalence, stress, COVID-19, and Meta-analysis up to January 1, 2025. Additional manual searches were performed in selected journals and through Google Scholar to identify further relevant articles. A random-effects model was used for the analyses. All analyses were conducted using STATA 17 software.<br><br>RESULTS: Of 3697 records screened, 45 meta-analyses were included. The pooled prevalence of stress was 41% [95% CI: 36&#x2013;45] with high heterogeneity (I[2]: 93.22%). The highest prevalence was observed in patients (56% [49&#x2013;63]) and health-care workers (45% [38&#x2013;52]). The prevalence of stress was higher in females (40% [18&#x2013;63]) compared with males (27% [3&#x2013;50]). In terms of severity, the highest percentage was related to moderate 29% [7&#x2013;50], mild 24% [6&#x2013;41], and severe 13% [5&#x2013;21].<br><br>CONCLUSIONS: Stress was highly prevalent during the COVID-19 pandemic, particularly among patients, healthcare workers, pregnant womens, and students. Policy responses should prioritize funding, advocacy and system-level interventions to mitigate the mental health impact of pandemics and strengthen resilience in preparation for future public health crises.}, }
@article {pmid41254571, year = {2025}, author = {Ma, K and Christensen, M and Turnbull, M}, title = {Comparative synthesis of sociocultural and political influences (SPIs) on COVID-19 vaccine hesitancy: an interdisciplinary systematic review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {4019}, pmid = {41254571}, issn = {1471-2458}, abstract = {BACKGROUND: COVID-19 vaccine hesitancy has been shaped by diverse sociocultural and political influences (SPIs), rendering it a multifaceted and context-specific issue. Various studies spanning different academic domains have endeavoured to dissect these diverse SPIs, revealing that the impact of a particular influencer can vary significantly depending on the context and disciplinary interpretation. However, prevailing review literature has predominantly focused on enumerating influential factors without providing in-depth contextual backgrounds or disciplinary interpretations. Additionally, a majority of these studies have been confined within specific disciplines, hindering the development of a holistic understanding of vaccine hesitancy. To broaden the scope of knowledge, this study aims to systematically review how SPIs on COVID-19 vaccine hesitancy have been approached and interpreted across disciplines.<br><br>METHODS: This systematic review adopted a qualitative comparative synthesis approach to explore how SPIs on COVID-19 vaccine hesitancy had been approached (including their selection and application) in each study across disciplines. Five databases (PubMed, PsycINFO, Web of Science, CINAHL, and Scopus) were searched to identify peer-reviewed studies that primarily focused on exploring SPIs on COVID-19 vaccine hesitancy among healthy adults. Out of 665 records initially retrieved, 28 studies&#xa0;met the eligibility criteria.<br><br>RESULTS: Studies that adopted theoretical frameworks explored SPIs from four approaches: 1) Social Cognitive, 2) Disposition-Environment Interaction, 3) Critical Medical anthropology/Medical Ecology, and 4) Social Structures. For studies without theoretical framework were synthesized into three main themes: 1) influences from political ideology, 2) interaction between political views and trust in science; and 3) contextual social cognitive determinants.<br><br>CONCLUSIONS: This qualitative comparative synthesis facilitated the comparison of diverse studies from multiple disciplines. The integration of theoretical and empirical evidence illustrated how different disciplines interpreted SPIs on COVID-19 vaccine hesitancy, enhancing interdisciplinary understanding and underscoring theoretical and practical research opportunities and gaps. These findings highlighted the complexity of COVID-19 vaccine hesitancy and emphasised the necessity of an interdisciplinary approach in advancing future vaccine research and communication. Additionally, the findings outlined promising avenues for future interdisciplinary research.<br><br>PROSPERO REGISTRATION: CRD42023440041.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25072-2.}, }
@article {pmid41253021, year = {2025}, author = {Ilboudo, DP and Simpore, A and Sawadogo, J and Ouattara, AK and Ouedraogo, AR and Zongo, L and Yonli, AT and Zouré, AA and Zohoncon, TM and Djigma, FW and Obiri-Yeboah, D and Ouedraogo, CM and Simpore, J}, title = {Acceptance, hesitancy, and ethical challenges of the COVID-19 vaccine in sub-Saharan Africa: a systematic review and meta-analysis.}, journal = {Vaccine}, volume = {69}, number = {}, pages = {127966}, doi = {10.1016/j.vaccine.2025.127966}, pmid = {41253021}, issn = {1873-2518}, abstract = {BACKGROUND: In light of the public health emergency brought about by the novel coronavirus, health authorities actively promoted vaccination against SARS-CoV-2. The COVID-19 pandemic has brought to the forefront critical questions concerning individual freedoms and the right to consent or decline vaccination. To better anticipate and manage future epidemics, it is essential to engage in thoughtful philosophical and ethical reflection-particularly regarding the legitimacy and implications of vaccine passport policies.<br><br>OBJECTIVES: This study aimed to assess COVID-19 vaccine acceptance and hesitancy in Sub-Saharan Africa, identify reasons for refusal, and examine the ethical legitimacy of imposing a "green pass" for vaccination for foreign travel.<br><br>METHODS: A meta-analysis was conducted from January 2021 to April 2025 in sub-Saharan African countries, in five databases (PubMed, Science Direct, Google Scholar, African Journal Online, and HINARI) to identify studies related to acceptance and hesitancy toward COVID-19 vaccines in the general population and among healthcare professionals. This study was registered under the PROSPERO database (CRD420251060375) and used the PRISMA guidelines. The "proportional effect size" of acceptance and hesitancy was calculated using a random-effects meta-analysis with STATA 17 software. Funnel plots and Egger's tests were used to assess publication bias.<br><br>RESULTS: A total of 40 studies involving 107,478 participants across 23 African countries were included. The pooled rates of vaccine acceptance and hesitancy were, respectively: 54.73 [95&#xa0;% CI: 50.54&#xa0;%-58.89&#xa0;%], and 34.96&#xa0;% [95&#xa0;% CI: 27.95&#xa0;%-42.30&#xa0;%]. Eastern Africa had the highest acceptance rate (60.44&#xa0;%), and lower rate observed in West Africa (52.22&#xa0;%). Reasons for hesitancy included misinformation, distrust of new vaccines, fear of side effects, suspicion of authorities, and opposition to mandatory vaccination certificates.<br><br>CONCLUSION: The pandemic has brought to the fore fundamental issues relating to the right to accept or refuse vaccination. To prepare for the management of future epidemics, it is necessary to reflect on the ethics of requiring a vaccine passport.}, }
@article {pmid41252782, year = {2026}, author = {Minari, TP}, title = {Repercussions of racial, gender, and class inequities on food and nutrition conditions: Implications for public health.}, journal = {Nutrition (Burbank, Los Angeles County, Calif.)}, volume = {142}, number = {}, pages = {112995}, doi = {10.1016/j.nut.2025.112995}, pmid = {41252782}, issn = {1873-1244}, mesh = {Humans ; *Public Health ; Food Insecurity ; Female ; Poverty ; Male ; COVID-19/epidemiology ; Nutritional Status ; *Health Status Disparities ; Racism ; Social Class ; Socioeconomic Factors ; *Food Supply ; *Health Inequities ; }, abstract = {BACKGROUND: Food and nutrition are shaped by power structures that perpetuate historical injustices. In marginalized and low-income contexts, racial, gender, and class inequities restrict access to adequate and culturally appropriate food, with serious public health impacts. These disparities are reinforced by colonial legacies, institutional racism, gender oppression, and neoliberal policies that commodify nourishment and erase traditional knowledge. This study examines how these intersecting oppressions shape global nutrition inequities and proposes transformative, justice-oriented approaches in public health.<br><br>METHODS: A critical review was conducted using an intersectional and decolonial framework informed by public health, sociology, feminist theory, and Southern epistemologies. Articles published between 2010 and 2025 were retrieved from Scopus, PubMed, SciELO, and Web of Science. A total of 46 studies of varying methodological designs were included in the final analysis.<br><br>RESULTS: Racialized poverty and structural racism are central drivers of food insecurity. Gendered care burdens and the feminization of food-related labor disproportionately affect marginalized women. Traditional and community-based food knowledge is often excluded from policy frameworks. Transgender and gender-diverse populations remain largely invisible in nutrition research. Obesity, malnutrition, and social inequality form a syndemic relationship, exacerbated by the COVID-19 pandemic and the fragility of social protection systems.<br><br>CONCLUSION: Recognizing food as a political and relational right is essential to advance social justice, epistemic diversity, and emancipatory futures. The findings underscore the urgency of transforming public health paradigms to confront structural determinants of malnutrition and obesity, promote food sovereignty, and center marginalized communities as co-creators of dignified and sustainable food systems.}, }
@article {pmid41251998, year = {2026}, author = {Kouroutzis, I and Tzenetidis, V and Papathanasiou, IV and Mantzaris, D and Apostolakis, I and Chandrinou, A and Gortzis, L and Sarafis, P and Malliarou, M}, title = {Telenursing and Telehealth. Navigating the Digital Transformation in Healthcare and Ethical Challenges: A Narrative Review.}, journal = {Advances in experimental medicine and biology}, volume = {1489}, number = {}, pages = {109-116}, pmid = {41251998}, issn = {0065-2598}, mesh = {Humans ; *Telemedicine/ethics ; *COVID-19/epidemiology ; Artificial Intelligence/ethics ; *Delivery of Health Care/ethics ; SARS-CoV-2 ; Confidentiality/ethics ; Informed Consent/ethics ; Computer Security/ethics ; Pandemics ; }, abstract = {INTRODUCTION: The COVID-19 pandemic has reinforced the need for digital transformation in health, bringing about the development of national strategies, new possibilities, but also challenges. The use of digital technologies and artificial intelligence enables accurate and personalized healthcare, while telenursing can provide groundbreaking services that enable the improvement of the quality of healthcare and the efficient resource management remotely.<br><br>THE AIM: Of this literature review is to present how telenursing can transform the delivery of healthcare and what the ethical challenges by its implementation.<br><br>METHODOLOGY: A narrative review was performed using key words of "telenursing" or "telehealth" and "ethical challenges" for free full text reviews published in PubMed, Web of Science, Scopus databases from 2004 to the present to encompass the most recent research findings, to summarize existing knowledge while focusing on answering the research question what are the ethical challenges that are presented by their implementation.<br><br>RESULTS: Several ethical issues in telenursing, telehealth, telecare, and artificial intelligence include informed consent, patient privacy and confidentiality, data protection and security, malpractice and liability, equitable access, quality of care, and the professional-patient relationship.<br><br>CONCLUSIONS: As artificial intelligence will progressively, part of nurses' clinical practice in their telenursing or telehealth services provision, it is crucial to address ethical considerations related to privacy, transparency, patient autonomy, and health equity to care provided using AI-driven telenursing and telehealth services.}, }
@article {pmid41251134, year = {2025}, author = {Braun, N}, title = {[A review of security, safety, and duality issues in the field of biology].}, journal = {Comptes rendus biologies}, volume = {348}, number = {}, pages = {265-274}, doi = {10.5802/crbiol.188}, pmid = {41251134}, issn = {1768-3238}, mesh = {Humans ; COVID-19/epidemiology ; *Security Measures ; France/epidemiology ; *Biology ; SARS-CoV-2 ; *Safety ; Pandemics ; Synthetic Biology ; }, abstract = {At a time when biological research is booming, driven by the explosion in synthetic biology and sequencing capabilities, as well as the phenomenal biological data these fields generate, debates are raging among experts and in society at large.The major pandemic crisis triggered by SARS-CoV-2 has resurrected debates about laboratory safety and our ability to respond to biological risks. Current geopolitical instability is also prompting us to take a closer look at the threats posed by the potential use of biological weapons.Therefore, the question of the acceptable risk of biological research arises, which must take into consideration, on the one hand, the importance of research for our health, environment and quality of life, and, on the other hand, our ability to take into account safety, security and dual-use issues. The aim of this review is to take stock of the risks identified and the measures taken in France to limit them.}, }
@article {pmid41251047, year = {2025}, author = {Jiang, S and Lu, Z}, title = {mRNA-LNP vaccines: rational design, delivery optimization, and clinical translation.}, journal = {Journal of materials chemistry. B}, volume = {}, number = {}, pages = {}, doi = {10.1039/d5tb01972a}, pmid = {41251047}, issn = {2050-7518}, abstract = {Messenger RNA (mRNA) vaccines face core challenges including low-delivery efficiency and immunogenicity, limiting their wide-ranging applications in infectious disease prevention and cancer therapy. Lipid nanoparticles (LNPs), the most clinically validated non-viral delivery platform, address these challenges by encapsulating and protecting mRNA, promoting cellular uptake, and mediating endosomal escape. mRNA-LNP vaccines leverage a "rapid design + flexible production" advantage, decisively demonstrated by the success of COVID-19 vaccines such as BNT162b2. This review systematically analyzes mRNA-LNP vaccine development, focusing on core optimization strategies: (1) mRNA sequence engineering (nucleoside modification and UTR/poly(A) tail optimization) to enhance stability and translation efficiency; (2) LNP formulation (component ratio optimization, SPOT strategies, etc.) to modulate immune responses and enable organ targeting; and (3) LNP surface functionalization (with small molecules, peptides, and antibodies) for precise specific cell or organ targeting. Although multiple candidate vaccines for infectious disease prevention and cancer treatment have entered clinical trials, their clinical translation is still limited by insufficient targeting accuracy, potential immunogenicity and toxicity, and the challenge of universal delivery systems. Future breakthroughs require the integration of multidisciplinary innovations, focusing on the development of degradable lipids and novel targeting ligands to improve delivery precision, the application of more biocompatible polymers (such as pSar and POx) to replace PEG to enhance safety, and the use of artificial intelligence (AI) to accelerate LNP formulation design and performance prediction. This review summarizes the key optimization strategies and clinical progress and explores future directions to overcome the existing bottlenecks and promote mRNA-LNP technology as the cornerstone of next-generation precision medicine.}, }
@article {pmid41250010, year = {2025}, author = {Warigon, C}, title = {Media reporting trends on disease outbreaks of COVID-19, polio, and cholera in Nigeria: a scoping review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {4005}, pmid = {41250010}, issn = {1471-2458}, mesh = {Nigeria/epidemiology ; Humans ; *COVID-19/epidemiology ; *Cholera/epidemiology ; *Disease Outbreaks/statistics &amp; numerical data ; *Mass Media/trends/statistics &amp; numerical data ; *Poliomyelitis/epidemiology ; }, abstract = {Disease outbreaks are ubiquitous and pose significant challenges to public health, especially in developing countries like Nigeria, which has a population of over 200 million people with a fragile healthcare system. The outbreak of COVID-19 in late 2019, which subsequently became a global pandemic, has had a profoundly adverse impact on Nigeria's public health system. Conversely, until its certification by the WHO African Region in 2020, Nigeria was considered a Polio-endemic country. Similarly, Cholera is a recurrent epidemic in Nigeria. It remains an incessant and seasonal public health issue, bedeviling Nigerian society, especially in regions that struggle with inadequate water and sanitation facilities, which are widespread. In Africa's most populous nation, the media have been indispensable and powerful during emergencies, such as disease outbreaks. Consequently, media coverage and reports of COVID-19, Polio, and Cholera in Nigeria are critical areas that provide clear perspectives and require attention, as the media can inform and shape public perception during such outbreaks. This study, therefore, explored the reporting trends on disease outbreaks of COVID-19, Polio, and Cholera in Nigeria. The study was guided by the Arksey and O'Malley framework for Scoping reviews. Out of 250 articles initially identified, 98 met the inclusion criteria, with 79 accessible for analysis. Findings reveal that 90% of studies focused on COVID-19, with comparatively less attention given to other significant outbreaks such as Cholera (6%) and Polio (4%). It was also found that the majority (76%) of the studies only paid little attention to the intervention strategies for managing Polio, Cholera, and COVID-19 19, which the Nigerian mass media dominantly reported, and that most of the studies were on conventional media (newspapers, magazines, radio, and TV) coverage. Significant gaps were found in the reporting of advocacy and behaviour change to mitigate the spread of diseases. There was inadequate evidence on the patterns and directions of media coverage of Polio and Cholera due to the under-coverage of the two diseases. The study concludes that media coverage of disease outbreaks, when sourced from top-rated journals, undoubtedly provides valuable insights into the media's coverage of public health interventions for managing future epidemics.}, }
@article {pmid41249967, year = {2025}, author = {Schöne, C and Sauter, M and Backé, EM and Prigge, M and Brendler, C and Hegewald, J}, title = {The impact of working from home on sedentary behaviour and physical activity compared to onsite work in the working population: a systematic review and meta-analysis.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3963}, pmid = {41249967}, issn = {1471-2458}, abstract = {BACKGROUND: Sedentary behaviour (SB) and the lack of physical activity (PA) are associated with negative health outcomes. Among desk-based workers, sitting at work contributes substantially to the daily time spent sedentary. Working environment can influence SB. Thus, we aimed to investigate the evidence on the impact of working from home/teleworking (WFH), which is now a common working environment versus working onsite on SB and PA.<br><br>METHODS: We conducted a systematic review comparing SB and PA of workers WFH compared to onsite work. We searched Pubmed, Embase and SPORTDiscus (last search: June 2025). At least two reviewers independently screened the studies and rated the of risk of bias based on adapted existing tools. We included studies on adult workers, which at least part-time WFH with comparison group working onsite, reporting SB or/and PA-outcomes per workday/work time. Data extraction was done by one reviewer and checked by two reviewers. Results were described qualitatively and random-effect meta-analyses for daily sedentary time (ST), sitting breaks, and steps were performed.<br><br>RESULTS: We included 38 studies (from 42 articles, with n&#x2009;=&#x2009;282,264 subjects) comparing WFH and onsite work. Four of these studies were rated as having a &#x201c;low&#x201d; risk of bias. SB was described in 23 studies (with n&#x2009;=&#x2009;209,267 subjects). A meta-analysis of studies reporting quantitative results suggests an increase in ST of 31&#xa0;min (95% CI 14 to 48; I[2]&#x2009;=&#x2009;57.5%; 7 studies) during work hours when WFH. PA was described in 36 studies (with n&#x2009;=&#x2009;270,617 subjects), and the meta-analysis found a decrease in daily steps of 2564 (mean difference: &#x2212;&#x2009;2564; 95% CI -3809 to -1320, 289; I[2]&#x2009;=&#x2009;91.4%; 7 studies) when WFH.<br><br>CONCLUSION: We found SB tends to increase and daily steps tend to decrease when WFH compared to onsite work. Studies of PA varied in their methods and results, and few studies measured movement. As most of the studies (n&#x2009;=&#x2009;31) were conducted during the COVID-19 pandemic, that may have influenced the results. Nevertheless, workplace interventions that aim to reduce SB and promote PA need to be adapted to the home working environment.<br><br>REGISTRATION NUMBER: CRD42022349442.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-24960-x.}, }
@article {pmid41249078, year = {2025}, author = {Banach, M and Toth, PP and Ahn, HJ and Bielecka-Dabrowa, A and Cicero, AFG and Covic, A and Dalakoti, M and Escobar, C and Fogacci, F and Gaita, D and Gaita, L and Jóźwiak, J and Latkovskis, G and Lewek, J and Ntaios, G and Okopień, B and Pećin, I and Pella, D and Penson, PE and Proietti, M and Sadowski, J and Solnica, B and Sosnowska, B and Viigimaa, M and Lip, GYH and , }, title = {Lipid management for primary and secondary stroke prevention consensus paper of the International Lipid Expert Panel (ILEP).}, journal = {Progress in cardiovascular diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pcad.2025.11.003}, pmid = {41249078}, issn = {1873-1740}, abstract = {Ischemic stroke is a significant global health challenge, accounting for approximately 66 % of all strokes worldwide. Recent data indicates that stroke was the third leading cause of death (10.7 % of all deaths), following ischemic heart disease and COVID-19. In 2021, nearly 94 million people were living with the consequences of a stroke, and about 12 million new cases were reported. Major risk factors for stroke include high systolic blood pressure, exposure to ambient particulate matter, smoking, and elevated levels of low-density lipoprotein cholesterol (LDL-C), with LDL-C contributing to nearly one-third of all ischemic strokes. In primary prevention, many at-risk individuals have undiagnosed or poorly managed lipid disorders, including elevated lipoprotein(a). The challenge persists in secondary prevention, where up to 40 % of individuals at risk of recurrent ischemic stroke experience a recurrence within five years. A key reason for this is the inadequate diagnosis and management of lipid disorders, underscoring the necessity for early and intensive (upfront) combination lipid-lowering therapy (LLT) to meet treatment goals promptly after an event. Unfortunately, data indicates that up to 40 % of post-stroke patients receive no LLT, and many more receive inadequate treatment. Additionally, existing guidelines for LLT in both primary and secondary stroke prevention are often inconsistent and outdated. Similarly, the understanding of the effects of LDL-C and LLT on the risks of haemorrhagic stroke and dementia remains limited, emphasizing the need for clear and practical guidance. Thus, within this Consensus Paper we aimed to provide consistent, easy-to-follow, and practical guidance on lipid targets, along with clear pathways for effectively treating patients with lipid disorders who are at risk for stroke and those who have experienced one. This approach is intended to help reduce the risk of recurrent ischemic strokes and their associated complications.}, }
@article {pmid41248320, year = {2025}, author = {Kim, C and Austin, R and Wurtz, R and Delaney, CW and Rajamani, S}, title = {Applications of Artificial Intelligence in the Control of Infectious Diseases in the Post-COVID Era: Scoping Review.}, journal = {JMIR nursing}, volume = {8}, number = {}, pages = {e84242}, pmid = {41248320}, issn = {2562-7600}, mesh = {Humans ; *Artificial Intelligence ; *COVID-19/epidemiology/prevention &amp; control ; *Communicable Disease Control/methods ; Pandemics/prevention &amp; control ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic exposed systemic vulnerabilities in public health infrastructure, underscoring the urgency for innovation in disease surveillance and emergency response. Artificial intelligence (AI) has emerged as a promising tool to enhance the accuracy, efficiency, and scalability of public health interventions. Yet, there remains a limited understanding of how AI has been applied in real-world infectious disease control and who is contributing to its development and implementation.<br><br>OBJECTIVE: This scoping review aimed to map current applications of AI in public health practice for infectious disease control since 2020. Specifically, it examined (1) the types of AI tools in use, (2) their purposes and implementation contexts, and (3) the professional and institutional actors leading these efforts, including the role of nurses.<br><br>METHODS: Using the Joanna Briggs Institute's population, concept, and context framework, a structured search in Ovid MEDLINE was conducted, which was guided by the "5Cs" framework for health emergency preparedness from the World Health Organization (WHO). The search focused on English-language, peer-reviewed studies from 2020 that used AI tools for infectious disease control within real-world public health practice. Nonoriginal articles, simulation-only studies, and studies that lacked real-world implementation were excluded.<br><br>RESULTS: Out of 600 screened studies in Ovid MEDLINE, 10 met the inclusion criteria. Two major AI types were identified: machine learning (ML) algorithms and language-based tools such as chatbots and large language models. ML tools supported outbreak detection, risk stratification, and resource allocation, while language-based tools promoted health communication, particularly around immunization and HIV prevention. Studies were conducted in a diverse range of countries, including several low- and middle-income countries, and used national datasets or surveillance systems. Despite nurses comprising half of the global health workforce, no nursing-affiliated authors were found among first or corresponding authors, and no nurses were represented in the broader authorship of the included studies.<br><br>CONCLUSIONS: AI technologies are being increasingly applied to support public health responses to infectious diseases, with applications ranging from predictive analytics to real-time public engagement. However, adoption remains limited in scale, scope, and professional diversity. The near-total absence of nursing participation in AI-related public health research is particularly striking and represents a missed opportunity for inclusive innovation. Strengthening implementation research and advancing informatics education among nursing professionals are critical next steps to ensure that AI tools reflect the realities of public health practice and promote equitable outcomes.}, }
@article {pmid41247781, year = {2025}, author = {Henrich, TJ and Montgomery, CP and Graf, J and Ismail, N and Mohandas, S and Suthar, MS and Brim, H and Coffin, JM and Pagaria, A and Guzmán Rivera, J and Vudali, U and Keim, P and Zhong, G and McGrath, R and Edwards, B and García-Sastre, A and Gennaro, ML}, title = {The role of co-infection in the pathogenesis of acute SARS-CoV-2 infection and development of post-acute sequelae: A perspective.}, journal = {eLife}, volume = {14}, number = {}, pages = {}, pmid = {41247781}, issn = {2050-084X}, mesh = {Humans ; *COVID-19/complications/pathology/virology ; *Coinfection/virology ; *SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Bacterial Infections/complications ; }, abstract = {A major health challenge resulting from the COVID-19 pandemic is the manifestation of post-acute sequelae of SARS-CoV-2 (PASC). PASC (or long COVID) is a collective term used for clinical symptoms, various pathologies, and life-quality-changing functional impairment that persist for months to years after the initial SARS-CoV-2 infection. The mechanisms underlying PASC are not understood, although advances have been made in identifying factors that may contribute to long-term pathology. Recent data have emerged, showing an association between SARS-CoV-2 viral persistence and non-SARS-CoV-2 infections (pre-existing, viral reactivation, or new infections) in facilitating or mediating PASC. However, the heterogeneous nature and timing of co-infections have made it challenging to understand, interpret, and contextualize their contribution to PASC. Here, we summarize the impact of potential viral, bacterial, and fungal infections on SARS-CoV-2 pathogenesis, with a focus on their possible roles in the development of PASC. We also provide a framework to understand the mechanisms of PASC and inform basic, translational, and clinical research initiatives, including RECOVER, a large and ongoing research initiative to understand, treat, and prevent long COVID.}, }
@article {pmid41246243, year = {2025}, author = {Kaaniche, FM and Zouari, F and Jerbi, S and Dahech, I and Abdellatif, A and Taher, YB and Feki, W and Hakim, Z and Briki, S and Dlensi, D and Allala, R}, title = {[Specific features of multisystem inflammatory syndrome in adults related to SARS-CoV-2].}, journal = {The Pan African medical journal}, volume = {52}, number = {}, pages = {29}, pmid = {41246243}, issn = {1937-8688}, mesh = {Humans ; *COVID-19/diagnosis/complications/therapy/physiopathology ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/physiopathology/virology ; Adult ; Prognosis ; Adrenal Cortex Hormones/administration &amp; dosage ; Immunoglobulins/administration &amp; dosage ; }, abstract = {Multisystem inflammatory syndrome in adults (MIS-A) is a rare and severe entity occurring after SARS-CoV-2 infection, and it is often underrecognized in adults. The purpose of this study is to describe the clinical, paraclinical, therapeutic, and prognostic characteristics of MIS-A through a structured review of the literature. A search was conducted in PubMed, Scopus, and Web of Science databases up to May 2024. Articles included were clinical case reports or case series of MIS-A in adults. Eighteen (18) articles were included. MIS-A mainly manifests as persistent fever, multiorgan involvement, marked inflammatory response, and frequently negative SARS-CoV-2 PCR but positive serology. Treatment is based on immunoglobulins, corticosteroids, and, in some cases, anti-IL-6 therapy. Although rare, MIS-A represents a medical emergency to be considered in the aftermath of COVID-19 infection, even in asymptomatic cases. Diagnosis is based on nonspecific clinical and biological criteria, which makes recognition challenging. Early immunomodulatory treatment can improve prognosis.}, }
@article {pmid41245505, year = {2025}, author = {Taylor, HL and Cuadros, P and Gee, M and Menachemi, N}, title = {The unintended health effects of US COVID-19 lockdowns: a systematic review.}, journal = {Health affairs scholar}, volume = {3}, number = {11}, pages = {qxaf208}, pmid = {41245505}, issn = {2976-5390}, abstract = {INTRODUCTION: US lockdowns and school closures implemented during the COVID-19 pandemic were intended to mitigate viral transmission and protect public health. However, the broader health effects of these interventions remain unclear.<br><br>METHODS: We conducted a systematic review of peer-reviewed studies that assessed the impact of US lockdowns and school closures on health-related outcomes excluding COVID-19 transmission and mortality.<br><br>RESULTS: A total of 132 studies met inclusion criteria, yielding 454 unique outcomes. Lockdowns and school closures were associated with detrimental health effects in the majority of outcomes analyzed, including over 90% of mental health, obesity-related, and health-related social need outcomes (child development/education, employment, access to food, and economic/financial stability). Analyses focused on vulnerable populations, such as racial and ethnic minorities, low-income groups, and individuals with disabilities, were significantly more likely to report detrimental outcomes than the general population.<br><br>CONCLUSION: Given how lockdowns and school closures may affect population well-being, policymakers should carefully weigh both the benefits and harms of these interventions, including how they may affect vulnerable populations. We conclude with policy recommendations to mitigate ongoing harms and inform more evidence-based decision-making.}, }
@article {pmid41245378, year = {2025}, author = {Al-Aqqad, N and McCarthy, LJ and Roura, M}, title = {The bidirectional effects of the COVID-19 pandemic on the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries: A systematic review of qualitative studies.}, journal = {Journal of migration and health}, volume = {12}, number = {}, pages = {100369}, pmid = {41245378}, issn = {2666-6235}, abstract = {BACKGROUND: This systematic review aims to synthesize the available qualitative evidence on the bidirectional effects of the COVID-19 pandemic on the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries.<br><br>METHODS: A systematic search of peer-reviewed articles published in English was conducted in August 2025 using five databases: PubMed, Scopus, PsycINFO, Embase, and ASSIA. The Critical Appraisal Skills Program qualitative studies checklist was used to assess the quality of qualitative and mixed-methods studies. The Dahlgren and Whitehead model of the social determinants of health was used as a reference framework for data extraction and analysis. The themes that emerged during the data extraction process were used to create an adapted framework.<br><br>RESULTS: Out of 12,607 studies found, 32 studies were included for review. The COVID-19 pandemic had profound effects on most of the social determinants of health among refugees and internally displaced persons in low and lower-middle income countries. Also, unfavorable health determinants of refugees and internally displaced persons residing in these countries made them more susceptible to COVID-19.<br><br>DISCUSSION: The COVID-19 pandemic had bidirectional effects on refugees' and internally displaced persons' social determinants of health. The pandemic negatively affected their work conditions, economic status, education, and healthcare access. On the other hand, lack of access to clean water, crowded housing, and poor health literacy level affected their compliance with protective measures making them more prone to COVID-19 infection.}, }
@article {pmid41244103, year = {2025}, author = {Yue, Y and Han, X and Chen, Q and Dai, L and Ai, Q and Zhang, Z and Ma, F and Gao, J}, title = {The effect of pulmonary rehabilitation for post-acute sequelae of SARS-CoV-2 infection in patients: a systematic review and meta-analysis.}, journal = {Frontiers in rehabilitation sciences}, volume = {6}, number = {}, pages = {1634351}, pmid = {41244103}, issn = {2673-6861}, abstract = {BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID, are characterized by persistent symptoms such as fatigue, dyspnea, and reduced functional capacity. Pulmonary rehabilitation (PR) is recommended for chronic respiratory conditions, but its effectiveness in PASC, particularly across different delivery modes, remains uncertain.<br><br>OBJECTIVE: To assess the impact of PR, including telerehabilitation and in-person modalities, on physical function, dyspnea, pulmonary function, fatigue, and quality of life in patients with PASC.<br><br>METHODS: We conducted a systematic search of PubMed, Embase, the Cochrane Library, and Web of Science from inception to March 25 for controlled clinical trials assessing the effects of PR in PASC patients. Two independent reviewers performed study selection and data extraction. The risk of bias was assessed using the Cochrane Risk of Bias Tool, and data were analyzed using Review Manager (RevMan) 5.4.1. Effect sizes were reported as mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CI).<br><br>RESULTS: Ten randomized controlled trials involving 673 participants were included. Most studies were judged to have a moderate risk of bias. Compared with usual care, PR significantly improved six-minute walk distance (MD: 76.85 meters; 95% CI: 57.35-96.36; p&#x2009;<&#x2009;0.001), maximal inspiratory pressure (MD: 17.63&#x2005;cmH&#x2082;O; 95% CI: 4.50-30.76; p&#x2009;=&#x2009;0.009), fatigue (SMD: -1.15; 95% CI: -1.83 to -0.48; p&#x2009;<&#x2009;0.001), and quality of life (SMD: 1.73; 95% CI: 0.56-2.91; p&#x2009;=&#x2009;0.004). No statistically significant improvement was found for dyspnea (MD: -0.41; 95% CI: -1.51 to -0.68; p&#x2009;=&#x2009;0.46). Subgroup analyses showed no significant differences between telerehabilitation and in-person PR across all outcomes, including exercise capacity (p&#x2009;=&#x2009;0.84), dyspnea (p&#x2009;=&#x2009;0.86), fatigue (p&#x2009;=&#x2009;0.93), and quality of life (p&#x2009;=&#x2009;0.44).<br><br>CONCLUSIONS: PR improves physical and functional outcomes in patients with PASC. Telerehabilitation offers a clinically equivalent alternative to in-person PR, supporting its broader implementation.}, }
@article {pmid41242507, year = {2025}, author = {Singh, R and Pradhan, AK and Roy, D and Arya, M and Chakravarti, R and Dutta, D and Kundu, A and Bhaduri, S and Singh, P and Ahmed, KT and Bhattacharya, B}, title = {Emerging molecular targets and natural therapeutics for idiopathic pulmonary fibrosis: Insights into mechanisms, risks, and COVID-19 links.}, journal = {Respiratory medicine}, volume = {250}, number = {}, pages = {108519}, doi = {10.1016/j.rmed.2025.108519}, pmid = {41242507}, issn = {1532-3064}, mesh = {Humans ; *Idiopathic Pulmonary Fibrosis/drug therapy/etiology ; *COVID-19/complications/epidemiology ; Risk Factors ; SARS-CoV-2 ; Molecular Targeted Therapy/methods ; }, abstract = {Pulmonary fibrosis, often termed as idiopathic pulmonary fibrosis (IPF), is a leading cause of death for patients with lung damage, acute respiratory distress syndrome, and even Coronavirus disease. This article focuses on key factors, such as transforming growth factor, fibroblast growth factors, Neurogenic locus notch homolog (Notch), and Sonic hedgehog, involved in the progression of IPF. Historically, our understanding of IPF's impacts on the immune system that was limited due to the complexity. Recent reports, however provided valuable insights into defence mechanisms and factors. We highlight various factors of pulmonary fibrosis. Here, we will discuss the impact of diverse risk factors, including anticancer agents such as bleomycin and methotrexate; mineral silica; and metals like arsenic, aluminium and copper, which have been identified as potential triggers of pulmonary fibrosis. Current treatment strategies for IPF are not fully effective, and the mechanism of the disease remains poorly understood. This review will also discuss the role of natural phytocompounds, including steroidal saponin, stilbenoid polyphenol resveratrol, safflomin of Carthamus tinctorius or safflower yellow, along with several genetic modulation approaches in addressing IPF. Finally, we examine the aspects and associations of IPF and SARS-CoV-2 to better understand disease severity, causes, and associated comorbidities.}, }
@article {pmid41242463, year = {2025}, author = {Blavier, J and Esposito, G and Twizere, JC and Percipalle, P}, title = {Targeting viral replication complexes with mRNA-encoded nanobodies: a new frontier for antiviral design.}, journal = {Drug discovery today}, volume = {30}, number = {12}, pages = {104531}, doi = {10.1016/j.drudis.2025.104531}, pmid = {41242463}, issn = {1878-5832}, abstract = {Emerging and re-emerging RNA viruses continue to challenge global health preparedness, underscoring the need for broad-spectrum antivirals that can be rapidly deployed. We propose a family-specific antiviral design strategy that targets conserved replication-transcription complexes (RTCs) using nanobodies delivered as mRNA therapeutics. This approach overcomes the long-standing limitation of intracellular delivery of antibody-based biologics. By expressing antiviral nanobodies directly inside infected cells via lipid-nanoparticle-encapsulated mRNA, it becomes possible to disrupt essential protein-protein interactions within viral RTCs. Using SARS-CoV-2 non-structural protein 9 (NSP9) as a proof-of-concept, we show that stabilizing non-functional NSP9 oligomers can inhibit viral replication. This combined nanobody-mRNA technology provides a versatile platform for rapid antiviral development across virus families.}, }
@article {pmid41242396, year = {2025}, author = {Sharma, R and Walia, A and Lakhanpal, D}, title = {Human metapneumovirus: an underdiagnosed public health threat.}, journal = {Infectious diseases now}, volume = {56}, number = {1}, pages = {105189}, doi = {10.1016/j.idnow.2025.105189}, pmid = {41242396}, issn = {2666-9919}, abstract = {Human metapneumovirus (hMPV), a negative-sense RNA virus in the Pneumoviridae family, has emerged as a major yet under-recognized cause of acute respiratory infections worldwide. Since its identification in 2001, hMPV has shown steady genetic evolution into genotypes A and B, with newer sublineages such as A2.2.1, A2.2.2, and B2 currently detected across continents. A recent global rise in hMPV detections, detailed in reports from China, Europe, and the USA, likely reflects both expanded testing and the re-establishment of seasonal circulation following the COVID-19 pandemic. Co-infections with respiratory viruses, including RSV and influenza, contribute to severe clinical outcomes and hospital burden. Multiplex RT-PCR remains the most sensitive and widely used diagnostic method for detection of hMPV, outperforming conventional PCR approaches, while metagenomic sequencing and CRISPR-based assays are primarily research tools. Diagnostic sensitivity also varies with sample source, and access to advanced technologies remains globally uneven. Despite its growing clinical impact, no approved antiviral is available. Promising candidates, including monoclonal antibodies against the fusion protein, siRNA therapies, and mRNA-based vaccines, are in the early stages of development. This review encompasses recent evidence on hMPV epidemiology, molecular evolution, diagnostic approaches, and therapeutic and vaccine development, underscoring a need for sustained surveillance, equitable diagnostic capacity, and proactive vaccine research more effectively addressing a largely overlooked respiratory pathogen.}, }
@article {pmid41241149, year = {2025}, author = {Park, WH}, title = {The mitochondrial nexus: Dysfunction, inhibition, and therapeutic frontiers in lung disease.}, journal = {Respiratory medicine}, volume = {250}, number = {}, pages = {108506}, doi = {10.1016/j.rmed.2025.108506}, pmid = {41241149}, issn = {1532-3064}, mesh = {Humans ; *Mitochondria/metabolism/physiology ; *Lung Diseases/metabolism/physiopathology/therapy ; COVID-19/metabolism ; Reactive Oxygen Species/metabolism ; SARS-CoV-2 ; Mitophagy/physiology ; Pulmonary Disease, Chronic Obstructive ; Energy Metabolism ; Antioxidants/therapeutic use ; }, abstract = {Mitochondria are increasingly recognized as central arbiters of cellular fate, placing them at the nexus of pulmonary health and disease. Beyond their canonical role in adenosine triphosphate (ATP) synthesis, these organelles are critical hubs for redox signaling, metabolic homeostasis, and programmed cell death. Mitochondrial dysfunction-a multifaceted condition characterized by impaired bioenergetics, excessive reactive oxygen species (ROS) production, aberrant dynamics, and defective quality control via mitophagy-is a unifying pathogenic feature in chronic lung diseases, including chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and pulmonary arterial hypertension (PAH). This dysfunction is also a critical determinant of severity in acute conditions like acute lung injury (ALI) and COVID-19 and is a key mechanistic driver of Long COVID. This review synthesizes the core mechanisms of mitochondrial impairment, delineates their specific contributions to this spectrum of pulmonary pathologies, and discusses the burgeoning field of mitochondria-targeted therapeutics. Strategies ranging from targeted antioxidants and metabolic modulators to novel regenerative approaches like mitochondrial transplantation are highlighted, with an expanded discussion on their limitations, challenges, and clinical implications. By framing mitochondrial integrity as a critical determinant of pulmonary disease, we underscore a pivotal axis for future diagnostic and therapeutic innovation.}, }
@article {pmid41239836, year = {2025}, author = {Liu, M and Zhang, L and Huang, S and Xu, Y and Jin, C}, title = {Application of Super-Resolution Microscopy in Virology Research: Principles, Technological Advances, and Analysis of the Viral Life Cycle.}, journal = {Journal of biophotonics}, volume = {}, number = {}, pages = {e202500461}, doi = {10.1002/jbio.202500461}, pmid = {41239836}, issn = {1864-0648}, support = {2021YFF0700305//National Key Research and Development Program of China/ ; 2024C03218//Zhejiang Provincial Leading Geese Program/ ; }, abstract = {Super-resolution microscopy (SRM) has exerted a pivotal influence on virology by surpassing the diffraction limits of conventional optical microscopy, enabling unprecedented visualization of viral structures and dynamics. Techniques such as stimulated emission depletion, photoactivated localization microscopy, stochastic optical reconstruction microscopy, and structured illumination microscopy facilitate nanoscale imaging of viruses, providing critical insights into the viral life cycle and virus-host interactions. We examine the principles and advancements in SRM techniques and their applications in virology. We discuss the development and selection of fluorescent probes, highlighting specific labeling methods. Key applications of SRM are illustrated through case studies of viruses such as influenza, HIV, and SARS-CoV-2, demonstrating the technology's impact on understanding viral mechanisms. We also explore future developments in SRM, including enhanced spatial and temporal resolution, and integration with technologies such as single-molecule imaging and fluorescence resonance energy transfer, positioning SRM as a pivotal tool for advancing viral research and therapeutic development.}, }
@article {pmid41239485, year = {2025}, author = {Gao, G and Lin, R and Ma, D}, title = {Human metapneumovirus: pathogenesis, epidemiology, diagnostic technologies, and potential intervention strategies.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {376}, pmid = {41239485}, issn = {1743-422X}, support = {ESY-GSP-YXPT-A02//Guangdong High-level Hospital Construction Fund/ ; ESY-GSP-YXPT-A02//Guangdong High-level Hospital Construction Fund/ ; JCYJ20220530155415035//Science and Technology Foundation of Shenzhen City/ ; 2023A1515220134//Guangdong Basic and Applied Basic Research Foundation-Enterprise Joint Fund/ ; }, mesh = {Humans ; *Metapneumovirus/pathogenicity/genetics/immunology ; *Paramyxoviridae Infections/diagnosis/epidemiology/prevention &amp; control/virology/therapy/drug therapy ; *Respiratory Tract Infections/virology/diagnosis/epidemiology/prevention &amp; control ; Antiviral Agents/therapeutic use ; Viral Vaccines/immunology ; Molecular Epidemiology ; }, abstract = {Human metapneumovirus (HMPV) is a notable viral pathogen that is responsible for respiratory tract infections in infants, young children, elderly individuals, and immunocompromised individuals. Particularly in the post-COVID-19 era, HMPV has gradually surpassed other respiratory viruses and continues to pose a threat to human health. While substantial progress has been made in understanding the mechanisms of HMPV infection in the host, as well as in terms of diagnostic and prevention methods, no effective vaccines or specific antiviral drugs against HMPV have yet been approved. In this review, we summarize the structure of HMPV and its pathogenic mechanisms; discuss the molecular epidemiology and diagnostic techniques related to HMPV; and summarize the latest advances in the prevention and treatment of HMPV infections, particularly the development of neutralizing antibodies, vaccines, and antiviral drugs. Finally, we discuss the prospects and challenges that lie ahead for HMPV research and clinical interventions.}, }
@article {pmid41239375, year = {2025}, author = {Twagirumugabe, T and Gashame, DF and Uwamahoro, DL and Riviello, E}, title = {Advanced non-invasive respiratory support in resource-constrained settings: a narrative review.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {492}, pmid = {41239375}, issn = {1466-609X}, mesh = {Humans ; COVID-19/therapy ; *Noninvasive Ventilation/methods/economics ; Developing Countries ; *Respiratory Insufficiency/therapy ; *Health Resources/supply &amp; distribution ; }, abstract = {Advanced non-invasive respiratory support techniques include high flow oxygen, continuous positive airway pressure, and non-invasive ventilation. Given their relative simplicity and lower resource intensity as compared with invasive mechanical ventilation, these mechanisms of respiratory support represent an attractive opportunity for use in patients with acute respiratory failure in resource-constrained settings. High flow oxygen in particular has the potential to provide high levels of respiratory support with relatively low levels of human and other resources to a wide variety of patients with respiratory failure, including those with delirium or obtundation. Even after the COVID-19 pandemic, during which utilization of these techniques increased in high-income countries, low and lower-middle income countries still have little access to advanced non-invasive respiratory support. Evidence from high-income countries and limited evidence from low-income countries suggest that these respiratory support methods may be particularly beneficial in resource-constrained settings; however, the evidence also suggests that the populations chosen and particularly the attention and resources invested in implementation are critical in ensuring the safety and effectiveness of non-invasive support. While non-invasive respiratory support does not require the complex training and monitoring needed for invasive support (e.g. specific risks associated with the endotracheal tube, sequelae of sedation, complex ventilator modes), it nonetheless requires resources in order to be applied effectively. Particular domains that need careful consideration are: clinical systems of care; oxygen consumption and connector compatibilities; human resources and training; location within the hospital; acceptability; cost; and device characteristics. In addition, ongoing research is needed that includes randomized controlled trials with attention to context, so that clinicians in resource-constrained settings can apply relevant evidence for non-invasive respiratory support for patients in their settings.}, }
@article {pmid41238304, year = {2025}, author = {Trabocchi, A}, title = {The peptidomimetic approach for the design of viral protease inhibitors.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {93-128}, doi = {10.1016/bs.enz.2025.06.007}, pmid = {41238304}, issn = {0423-2607}, mesh = {*Peptidomimetics/pharmacology/chemistry ; Humans ; *Drug Design ; *Viral Protease Inhibitors/pharmacology/chemistry/chemical synthesis ; SARS-CoV-2/enzymology/drug effects ; Zika Virus/enzymology/drug effects ; *Antiviral Agents/pharmacology/chemistry ; Viral Nonstructural Proteins/antagonists &amp; inhibitors ; Dengue Virus/enzymology/drug effects ; Coronavirus 3C Proteases/antagonists &amp; inhibitors ; }, abstract = {The transformation of peptides into drug leads is an established approach in medicinal chemistry and drug discovery. Peptidomimetics are designed to mimic the bioactivity of peptides while addressing their limitations, such as poor metabolic stability and low bioavailability, thus resulting in improved receptor affinity and selectivity. Over last decades, a range of synthetic strategies has emerged to improve the pharmacological properties of these molecules through local and global conformational restrictions and introducing secondary structure mimetics. Herein the essential tools and methodologies in peptidomimetic design are reported with highlights to their therapeutic relevance, particularly in antiviral drug development. Peptidomimetics have shown notable success in targeting viral proteases as key enzymes involved in the life cycle of several pathogenic viruses. Case studies involving peptidomimetic inhibitors of HIV protease, HCV NS3/4A protease, SARS-CoV-2 main protease (3CLpro), and the NS2B-NS3 proteases of Zika and Dengue viruses are reported highlighting the efficacy of this approach, emphasizing the potential of peptidomimetic drugs as powerful tools in the treatment of infectious diseases.}, }
@article {pmid41238303, year = {2025}, author = {Bonardi, A}, title = {Computational approaches for designing viral protease inhibitors.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {59-91}, doi = {10.1016/bs.enz.2025.06.005}, pmid = {41238303}, issn = {0423-2607}, mesh = {Humans ; *Drug Design ; *Viral Protease Inhibitors/chemistry/pharmacology ; *Antiviral Agents/pharmacology/chemistry ; SARS-CoV-2/enzymology/drug effects ; *Viral Proteases/chemistry/metabolism ; Drug Discovery ; Machine Learning ; Computational Biology/methods ; }, abstract = {Viral proteases are critical enzymes that play essential roles in the replication of viruses such as Human Immunodeficiency, Hepatitis C, SARS-CoV-2, Zika, Dengue, West Nile, Yellow Fever, Japanese and Saint Louis Encephalitis, Tick-Born Encephalitis, Chikungunya, and others. Designing potent inhibitors against these proteases has been a major therapeutic strategy to control and treat these viral infections. Computational approaches, including structure-based drug design, ligand-based drug design, machine learning and artificial intelligence-based techniques, have significantly accelerated the discovery and optimization of viral protease inhibitors. This chapter provides an in-depth review of the computational methodologies employed in the development of inhibitors for these major viral targets, highlighting case studies for each virus, discussing strategies to overcome resistance, and exploring future directions in antiviral drug discovery.}, }
@article {pmid41238302, year = {2025}, author = {Supuran, CT and Pisano, L}, title = {Challenges for developing selective viral protease inhibitors as antiinfectives.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {319-335}, doi = {10.1016/bs.enz.2025.06.009}, pmid = {41238302}, issn = {0423-2607}, mesh = {Humans ; *Viral Protease Inhibitors/pharmacology/chemistry/therapeutic use ; *Antiviral Agents/pharmacology/chemistry ; SARS-CoV-2/drug effects/enzymology ; Drug Design ; Drug Development ; COVID-19 Drug Treatment ; *Viral Proteases/metabolism ; Animals ; }, abstract = {The biochemical machinery of most viruses comprises proteases which are crucial for their life cycle. In the last decades, proteases from pathogenic viruses started to be considered as potential drug targets, and this led to the development of several classes of effective antivirals used for the management of HIV, HCV and SARS CoV 2 infections. More than 25 clinically used protease inhibitors (PIs) are now available for the management of these three infections, but many other viruses encode for proteases which started to be considered only recently as potential drug targets. They include enterovirises, filoviruses such as Zika, Dengue and West Nile viruses, Chikungunya and other togaviruses, Ebola, Marbug and many other hemorrhagic viruses. The proteases of many such pathogens have been cloned, characterized and in some cases also crystallized in complex with inhibitors, but no compounds progressed yet to clinical trials. There are several relevant challenges in designing PIs as novel antivirals, such as: (i) the drug design strategies of peptidomimetic inhibitors, which are many times complex and expensive; (ii) the difficulties in identifying non-peptidomimetic PIs; (iii) the selectivity for the target versus host proteases of the identified PIs; (iv) their metabolism, absorption and in vivo antiviral activity, and, most importantly, (v) the emergence of drug/multidrug resistance due to the high mutation rates of many viruses. Many of these challenges started to be approached by innovative strategies which will be duscussed in the chapter.}, }
@article {pmid41238299, year = {2025}, author = {Elsawi, AE and Tawfik, HO and Eldehna, WM}, title = {Coronaviruses papain-like proteases and their inhibitors.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {209-249}, doi = {10.1016/bs.enz.2025.06.006}, pmid = {41238299}, issn = {0423-2607}, mesh = {Humans ; *Coronavirus Papain-Like Proteases/antagonists &amp; inhibitors/metabolism/chemistry ; *Antiviral Agents/pharmacology ; Virus Replication/drug effects ; *Protease Inhibitors/pharmacology/chemistry ; Animals ; }, abstract = {The multipurpose enzyme papain-like protease (PLpro) is crucial for both immune evasion and viral multiplication. The replication-transcription complex is formed when PLpro, encoded by nonstructural protein 3 (nsp3), cleaves the viral polyprotein to release nsp1 through nsp4. Furthermore, by eliminating ubiquitin and ISG15 from key immune signaling proteins, such as IRF3, STING, and MDA5, PLpro impairs host antiviral defenses by reducing type I interferon responses. The catalytic triad and several functional domains, including the flexible BL2 loop that regulates access to the viral polyprotein substrate and inhibitor, as well as the SUb1 and SUb2 binding sites for ISG15/Ub recognition, are structural features of PLpro. Due to these features, PLpro is a desirable target for both allosteric and active-site inhibition. Numerous prospective inhibitors have been identified through drug repurposing and natural product screening, supported by structural and computational analyses that highlight key interaction sites. The biological significance, structural intricacy, and therapeutic potential of PLpro as a dual-action antiviral target, which can inhibit viral replication and restore host immune function, are highlighted in this chapter.}, }
@article {pmid41238297, year = {2025}, author = {Supuran, CT and Capasso, C}, title = {Coronaviruses main proteases and their inhibitors.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {183-208}, doi = {10.1016/bs.enz.2025.07.005}, pmid = {41238297}, issn = {0423-2607}, mesh = {Humans ; *SARS-CoV-2/enzymology/drug effects ; *Antiviral Agents/pharmacology/chemistry/therapeutic use ; *Protease Inhibitors/pharmacology/chemistry/therapeutic use ; *COVID-19 Drug Treatment ; *Coronavirus 3C Proteases/antagonists &amp; inhibitors/metabolism/chemistry ; Drug Discovery ; COVID-19/virology ; Peptidomimetics/pharmacology ; }, abstract = {The SARS-CoV-2 main protease (M[pro]) plays a pivotal role in the viral life cycle by cleaving polyproteins pp1a and pp1ab into functional non-structural proteins (NSPs), including components essential for RNA replication, such as nsp7, nsp8, and RNA-dependent RNA polymerase. The high sequence conservation across coronaviruses and absence of closely related human proteases make M[pro] an attractive target for selective antiviral interventions. Recent efforts in drug discovery have led to the development of a wide spectrum of M[pro] inhibitors, including covalent peptidomimetics (e.g., nirmatrelvir) and non-covalent small molecules with enhanced pharmacological profiles, such as ensitrelvir. Structure-based drug design, fragment-based drug discovery (FBDD), high-throughput screening (HTS), and in silico approaches have contributed to identification of novel scaffolds and optimization of binding interactions within the catalytic pocket. Non-covalent inhibitors offer reversible binding mechanisms that reduce off-target effects and are particularly promising for clinical translation. However, challenges such as the limited oral bioavailability of peptidomimetic compounds, metabolic instability, and emerging resistance highlight the need for further optimization. Ongoing research is exploring prodrug strategies, advanced delivery systems, and combinatorial regimens that integrate M[pro] inhibitors with other antivirals to achieve synergistic effects and suppress resistance. This chapter provides a comprehensive overview of the current landscape of M[pro]-targeted therapeutics and emphasizes their potential role in future pandemic preparedness.}, }
@article {pmid41238295, year = {2025}, author = {Rusconi, S and Paoletti, N and Supuran, CT}, title = {HIV protease and its inhibition.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {129-149}, doi = {10.1016/bs.enz.2025.06.001}, pmid = {41238295}, issn = {0423-2607}, mesh = {*HIV Protease Inhibitors/pharmacology/chemistry/therapeutic use ; Humans ; *HIV Protease/metabolism/chemistry ; Drug Resistance, Viral ; *HIV-1/enzymology/drug effects ; HIV Infections/drug therapy/virology ; }, abstract = {The HIV protease (HPR) is a virus-specific aspartic protease responsible for processing the polyproteins of gag and gag-pol during virion maturation and for the proliferation of HIV. The activity of HPR is essential for virus infectivity, thus it is an important target for the development of anti-HIV drugs. HPR is only one major viral protease, since there are other proteases, which are specific to HCV or SARS-CoV-2 and are therapeutic targets as well. HPR inhibitors in combination with other classes of anti-HIV drugs are one of the main components of an effective anti-HIV therapy. Nevertheless, upon several circumstances, HIV can develop a discrete pattern of resistance towards one or several HPR inhibitors through the phenomenon of cross-resistance. The aim of our work is to illustrate various features of HPR: its structure, the various mechanisms which lead to its inhibition, the HPR inhibitors which are used in the clinical arena, and the pathways involved in drug resistance, plus the mechanisms to overcome it.}, }
@article {pmid41238294, year = {2025}, author = {Pisano, L and Supuran, CT}, title = {Viral proteases as targets for antivirals drugs.}, journal = {The Enzymes}, volume = {58}, number = {}, pages = {1-18}, doi = {10.1016/bs.enz.2025.06.002}, pmid = {41238294}, issn = {0423-2607}, mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; *Viral Proteases/metabolism ; *Viral Protease Inhibitors/pharmacology/therapeutic use ; Animals ; SARS-CoV-2/enzymology/drug effects ; Virus Diseases/drug therapy ; *Viral Proteins/antagonists &amp; inhibitors/metabolism ; }, abstract = {The biochemical machinery of all viruses comprises enzymes able to cleave polyproteins formed after the transcription of the viral genetic material, which belong to the protease class. Viral proteases known so far belong to the aspartic, serine and cysteine protease classes, with no viral metalloprotease described to date. The tridimensional structure, biochemical properties and susceptibility to be inhibited by various classes of compounds for many such enzymes have been investigated in detail in the last decades. Many antiviral drugs target viral proteases which produce diseases in mammals, but such enzymes are also present in viruses which attack plants or bacteria, and potential applications for such enzymes or their inhibition started to be considered in recent years. The aspartic protease encoded in the HIV genome, the serine proteases found in various HCV serotypes and more recently the two cystein proteases from coronaviruses, including SARS CoV 2, are targeted by clinically used drugs belonging to the protease inhibitors, which effectively interrupt the life cycle of the virus, alone or in combination therapies with other antivirals and showed a relevant clinical success. Many other less investigated viruses encode for proteases belonging to the three classes mentioned above and they started to be investigated for obtaining novel antivirals for the management of Dengue, Zika, West Nile and other flaviviruses infections but also Chikungunya, Ebola, Marbug and various other filoviruses, for which few therapeutic options are available to date.}, }
@article {pmid41237896, year = {2025}, author = {Kolodziej, LM and Grootegoed, LC and van Buul, LW and Spijker, R and Schinkel, J and de Jong, MD and Leeflang, MMG and Kuil, SD}, title = {The impact of respiratory viruses on older adults in long-term care facilities: a scoping review.}, 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.2025.11.002}, pmid = {41237896}, issn = {1469-0691}, abstract = {BACKGROUND: Evidence on the clinical impact of seasonal respiratory viruses in long-term care facilities (LTCFs) is limited.<br><br>OBJECTIVES: To provide an overview of the evidence available on the clinical impact of seasonal respiratory viruses on older adults in LTCFs worldwide.<br><br>DATA SOURCES: Medline (OVID Medline ALL) and Embase (Embase.com) until 13 May 2025.<br><br>STUDY ELIGIBILITY CRITERIA: Original research articles involving LTCF residents with at least one laboratory-confirmed viral respiratory tract infection (RTI), excluding SARS-CoV-2 and pandemic influenza, reporting any RTI-associated clinical outcome.<br><br>PARTICIPANTS: LTCF residents (mean or median age >60 years).<br><br>METHODS OF DATA SYNTHESIS: An evidence gap map was created to visualise the distribution of evidence across viruses and outcomes. Where possible, outcome proportions (defined as the number of cases with the outcome divided by the total number of cases) were extracted from the included studies. These were summarised and visualised in dot plots with medians and interquartile ranges (IQRs) per virus.<br><br>RESULTS: 117 studies were included. The majority of the studies focused on influenza viruses and conventional outcomes including attack rate, lower respiratory tract infection (LRTI), hospitalisation, and mortality. Evidence was limited for human rhinovirus, parainfluenza viruses, enterovirus, adenovirus, and endemic human coronaviruses, as well as for outcomes such as aggravation of underlying diseases and patient-centred outcomes, including quality of life and functional status. Human metapneumovirus (hMPV) was associated with the highest rate of LRTI (median 0.50; IQR 0.45-0.75) as well as the highest mortality rate (median 0.17; IQR 0.10-0.37) found in this study, although based on small numbers of confirmed.<br><br>CONCLUSIONS: Substantial knowledge gaps remain regarding the impact of seasonal respiratory viruses on older adults in LTCFs. In order to inform decision-making regarding viral RTI management in this population, future studies should prioritise underrepresented viruses including hMPV and incorporate patient-centred outcomes.}, }
@article {pmid41237560, year = {2025}, author = {Anson, K and Patel, S}, title = {Misinformaion and its impact on measles vaccine hesitancy in the pediatric population: A scoping review.}, journal = {Journal of pediatric nursing}, volume = {86}, number = {}, pages = {136-147}, doi = {10.1016/j.pedn.2025.11.008}, pmid = {41237560}, issn = {1532-8449}, abstract = {OBJECTIVE: This scoping review is a synthesis of what is known in the literature about the relationship between misinformation and measles, mumps, and rubella (MMR) vaccine hesitancy.<br><br>METHODS: A scoping review using Arksey and O'Malley's framework was completed. PubMed, Academic Search Complete, CINHAL, and EBSCOHost were searched for literature published from January 2020 to December 2024 in English on MMR vaccine hesitancy and misinformation.<br><br>RESULTS: Initial search resulted in 141 articles. After removing duplicates and articles not meeting inclusion criteria, 23 studies were retained for analysis. Misinformation promulgated in social and religious groups, social media, internet searches, and movies impacted measles vaccine hesitancy. Declining vaccination rates corresponded with circulating social media posts promoting misinformed beliefs towards the MMR vaccine. Interventions targeting vaccine hesitancy have used a variance of communication strategies with limited success. Unfortunately, the COVID-19 pandemic media response decreased institutional trust and increased trust in misinformation, despite evidence to the contrary.<br><br>CONCLUSION: Despite scientific demonstration of immunizations benefits, little work has been attempted to understand how and why vaccine decisions are being made, including the effect of misinformation. Research gaps include the pervasiveness of misinformation, the limited efficacy of communication interventions on changing vaccine intention, and the lack of a cohesive theoretical framework.<br><br>PRACTICAL IMPLICATIONS: Nurses remain at the crux of vaccination decisions with a unique role in educating parents. Future research should focus on understanding parental MMR vaccine decisions guided by a theoretical framework examining the impact unique social interactions of common beliefs have on decision-making.}, }
@article {pmid41237540, year = {2025}, author = {Devsam, B and Bortolussi, K and Tippins, J and Vasiliadis, S and Danchin, M and O'Neill, J and Attwell, K and Kaufman, J}, title = {The experience of seeking &amp; granting special medical exemptions for mandated vaccines: A scoping review.}, journal = {Vaccine}, volume = {68}, number = {}, pages = {127935}, doi = {10.1016/j.vaccine.2025.127935}, pmid = {41237540}, issn = {1873-2518}, mesh = {Humans ; *COVID-19 Vaccines/administration &amp; dosage/adverse effects ; *Vaccination/legislation &amp; jurisprudence ; *COVID-19/prevention &amp; control ; Health Personnel/psychology ; SARS-CoV-2 ; Parents/psychology ; *Vaccines ; Caregivers/psychology ; *Mandatory Programs ; }, abstract = {BACKGROUND: Medical exemptions to mandated vaccines are permitted for contraindications, such as anaphylaxis and immunosuppression. However, clinicians encounter 'special medical exemptions' when the medical reason for requiring an exemption falls outside strict criteria. Processes for seeking, assessing, and granting these exemptions are often unclear and vary across jurisdictions.<br><br>AIM: To map the published literature on the experiences of parents, caregivers, or individuals seeking special medical exemptions for mandated childhood vaccines, occupational vaccines for healthcare workers, and COVID-19 vaccines, as well as the experiences of clinicians assessing and granting such exemptions globally.<br><br>METHODS: A scoping review was conducted using PRISMA-ScR and JBI methodology. Databases searched included Embase, Medline, CINAHL, PsycInfo, PubMed, Web of Science, and Google Scholar. Qualitative, quantitative, review articles, and grey literature were included. Screening and data extraction were completed in Covidence by two independent reviewers. Data were analysed using descriptive and inductive content analysis.<br><br>RESULTS: Eighteen articles met inclusion criteria. Key findings were: (1) special medical exemptions are inconsistently granted; (2) individuals seeking special medical exemptions often support vaccination broadly, but express context-specific health concerns; (3) evidence on how vaccines affect the medical conditions underlying exemption requests were often lacking, leaving key gaps for decision-making not addressed by current criteria; (4) trust in clinicians who prioritised individual health needs over strict policy shaped families' subsequent vaccine decision; and (5) special medical exemptions can have wider implications from an individual or interpersonal level to a broader community and policy level.<br><br>CONCLUSION: Special medical exemptions currently lack definitional clarity and standardised criteria, leading to inconsistent and potentially inequitable exemption decisions. More research is needed to inform evidence-based guidance that balances public health protection with individual clinical complexity. Clearer policy frameworks and clinician support are essential to ensure fair and transparent exemptions processes.}, }
@article {pmid41235245, year = {2025}, author = {Chen-Camaño, R and DeAntonio, R and López-Vergès, S}, title = {T-cell exhaustion in COVID-19: what do we know?.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1678149}, pmid = {41235245}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *T-Lymphocytes/immunology ; T-Cell Exhaustion ; }, abstract = {T-cell exhaustion is a terminal state of immune dysfunction characterized by impaired proliferation and effector functions, diminished cytokine secretion, and sustained expression of inhibitory receptors. In coronavirus disease 2019 (COVID-19), increasing evidence links exhausted T-cell phenotypes with poor clinical outcomes, including severe disease, delayed viral clearance, and persistent symptoms associated with Long COVID. Exhaustion results from prolonged antigenic stimulation and inflammatory signals and is marked by transcriptional reprogramming, metabolic and epigenetic dysregulation, and co-expression of inhibitory receptors such as programmed cell death protein-1 (PD-1), T-cell immunoglobulin and mucin-domain containing-3 (TIM-3), and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4). Notably, exhausted phenotypes in COVID-19 frequently coexist with hyperactivation, raising the unresolved question of whether inhibitory receptor expression reflects transient activation or irreversible dysfunction. Emerging therapeutic strategies to reverse these dysfunctional states include immune checkpoint inhibitors, cytokine modulation, metabolic interventions, and epigenetic therapies, although their clinical translation remains at an early stage. Critical research gaps include the scarcity of longitudinal data, incomplete profiling of T-cell subsets across disease stages during COVID-19 and Long COVID-19, and contradictory evidence of vaccine-induced exhaustion with limited understanding of its consequences. This non-systematic literature review synthesizes current advances in COVID-19 immunopathology and therapeutic strategies, underscoring that understanding T-cell exhaustion is crucial to improving outcomes and shaping next-generation immunotherapies and vaccines.}, }
@article {pmid41235244, year = {2025}, author = {Wang, D and Zhang, F}, title = {CKD-related impairment in humoral and cellular immune response and potential correlation with long COVID-19: a systematic review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1690298}, pmid = {41235244}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/prevention &amp; control ; *Immunity, Humoral ; *Renal Insufficiency, Chronic/immunology/therapy ; *Immunity, Cellular ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology ; Antibodies, Viral/blood/immunology ; Vaccination ; }, abstract = {INTRODUCTION: Patients with chronic kidney disease (CKD) are at high risk of morbidity and mortality from SARS-CoV-2 infection (COVID-19). However, their immune response to vaccination may vary among individuals. The purpose of this review was to identify characteristics of alterations in humoral and cellular immune responses to the vaccination, and to provide insights into their immune dysfunctions for a better care of acute COVID-19 and prevention of long COVID-19.<br><br>METHODS: PubMed, Embase, Scopus, Web of science and Cochrane Central were systematically searched. Eligible publications included clinical studies reporting immune response to COVID-19 vaccination in CKD patients without dialysis or KT, CKD patients undergoing dialysis, as well as CKD patients with KT. Demographics, measurements and results of their humoral and cellular response were evaluated, and the quality of studies were assessed using the Joanna Briggs Institute (JBI) critical appraisal tool and the Newcastle-Ottawa quality assessment scale (NOS).<br><br>RESULTS: A total of 31 eligible studies were identified. A decreased proportion of patients with KT showed anti-S IgG positivity after the 2[nd] (67%) and 3[rd] (56.6%) dose of vaccination. Similarly, a decreased proportion of these patients presented S-specific T-cell response after the 2[nd] (17.7%) and 3[rd] (12.9%) dose. Though lower anti-S IgG titers in patients with CKD or on dialysis, as well as T-cell response in patients on dialysis were reported to be lower after the 2[nd] or 3[rd] dose of vaccination, conflicting results were reported by other studies. Limited studies on correlated change between humoral and cellular immune response revealed a low rate of co-presence of the two in patients with dialysis, though antibody level was correlated with rate of cellular response, while no such correlation was revealed in patients with KT.<br><br>CONCLUSION: The study provides crucial information on features of humoral and cellular immune responses to COVID-19 vaccinations in CKD patients, and suggests possible directions for strategy of management such as antibody monitoring, additional booster dose or immunomodulatory therapies not only for acute COVID-19 but also for long COVID-19.}, }
@article {pmid41234979, year = {2025}, author = {Liu, Y}, title = {What Has SARS-CoV-2 Taught Us About Evolution?.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e94502}, pmid = {41234979}, issn = {2168-8184}, abstract = {Over the past five and a half years, SARS-CoV-2 has demonstrated in real time many concepts and principles of evolutionary biology. Soon after it was disseminated globally, the virus underwent adaptive radiation, resulting in the generation of multiple dominant variants. Later variants drove earlier ones to extinction in a series of selective sweeps. The nature of adaptation was shifting molecular specialization, with the spike protein losing binding affinity toward bat cells to gain affinity toward human cells, losing replicative fitness in lung cells to gain fitness in nasal cells. Evolution of the spike protein was constrained between two beneficial results: enhancing receptor binding and evading neutralizing antibodies. Because there are limited ways of functional improvement, multiple variants converged on the same spike mutations, with higher-impact mutations fixed before lower-impact mutations, giving a new meaning to diminishing-returns epistasis. Later genetic changes became repetitive and cyclical. The Delta variant represented an evolutionary dead end. Evolution of the virus also demonstrated punctuated equilibrium, with saltatory changes producing highly mutated variants, which subsequently experienced gradual structural and functional drifts. While structural proteins experienced strong positive and purifying selections, nonstructural and accessory proteins accumulated neutral and deleterious mutations, most of which remain unfixed. Selection of adaptive missense mutations resulted in deoptimization of codon usage. These phenomena point to Muller's ratchet in action. The higher codon usage score in the initial Omicron variant was probably due to long-term preservation of the virus in an immunocompromised host, where low immune pressure prevented genetic degradation.}, }
@article {pmid41234654, year = {2025}, author = {Kadivarian, S and Rostamian, M and Kooti, S and Dashtbin, S and Hosseinabadi, S and Abiri, R and Alvand, A}, title = {Diagnostic value comparative analysis of the commercial kits for the detection of SARS-CoV-2 in clinical samples: a systematic review and meta-analysis.}, journal = {Iranian journal of microbiology}, volume = {17}, number = {5}, pages = {669-681}, pmid = {41234654}, issn = {2008-3289}, abstract = {BACKGROUND AND OBJECTIVES: Rapid and accurate identification of suspicious SARS-CoV-2 patients is essential in controlling the infection. Numerous commercial kits are developed which target diverse regions of the SARS-CoV-2 virus genome. This systematic review addresses the lack of comprehensive analyses comparing the diagnostic value of commercial kits for SARS-CoV-2 detection. We aimed to compare diagnostic value of commercial SARS-CoV-2 kits in clinical samples using a systematic review and meta-analysis method.<br><br>MATERIALS AND METHODS: A comprehensive search was conducted on main databases of Medline (PubMed), Embase, Web of Science and Scopus from 2019 to October 2021 using the appropriate keywords. Systematic Reviews and Meta-Analysis guideline PRISMA checklist was used to select eligible studies.<br><br>RESULTS: The most frequent introduced kits were from USA (33 cases) and China (27). Among all studies, 11, 9 and 7 papers had assessed FDA -CDC, Sansure and Allplex kits, respectively. The majority of the kits were based on RT-PCR (52 cases) and the most frequent genes target was N protein (63 cases). The overall sensitivity of the kits was 80.5%. The lowest sensitivity was reported for Daan Kit, while the highest sensitivity was seen for many kits. The specificity of the kits ranged from 87.9% to 99.8% and the overall specificity was 97.9%. Both PPV and NPV of the kits ranged from 87.9% to 99.8% for PPV and 82.9% to 99.8% for NPV.<br><br>CONCLUSION: Based on DOR obtained from three different formulas, GeneFinder, InBios, NxTAG, Simplexa and FDA-CDC kit have better detection performance. The GeneFinder Kit appears to be among the more suitable options regarding cost-effectiveness for each reaction.}, }
@article {pmid41233199, year = {2025}, author = {Lertamornkitti, N and Britton, PN}, title = {Measles is misery: A brief update for paediatricians.}, journal = {Paediatric respiratory reviews}, volume = {56}, number = {}, pages = {24-28}, doi = {10.1016/j.prrv.2025.10.003}, pmid = {41233199}, issn = {1526-0550}, mesh = {Humans ; *Measles/prevention &amp; control/epidemiology/diagnosis ; *Measles Vaccine ; COVID-19/epidemiology/prevention &amp; control ; Child ; Vaccination ; SARS-CoV-2 ; Pediatricians ; Vaccination Hesitancy ; }, abstract = {Measles is an important vaccine-preventable disease that has re-emerged in recent years. Since the COVID-19 pandemic, interruptions to routine immunisation programs and declining vaccine coverage have altered the incidence and patterns of respiratory virus infections. Global outbreaks have intensified, and vaccine hesitancy is recognised as major health threat. Revisiting the clinical presentation of measles is crucial for early diagnosis and to reduce transmission of this highly contagious infection. As serious respiratory and neurological complications can follow natural infection and no specific antiviral therapy is available, vaccination remains the most effective strategy for prevention and control.}, }
@article {pmid41232510, year = {2025}, author = {Korber, B and Fischer, W and Theiler, J}, title = {Real-time monitoring of SARS-CoV-2 evolution during the COVID-19 pandemic.}, journal = {Cell host &amp; microbe}, volume = {33}, number = {11}, pages = {1802-1806}, doi = {10.1016/j.chom.2025.10.013}, pmid = {41232510}, issn = {1934-6069}, mesh = {*COVID-19/virology/epidemiology ; *SARS-CoV-2/genetics ; Humans ; *Evolution, Molecular ; Pandemics ; Mutation ; }, abstract = {The global response to COVID-19 during the pandemic resulted in an unprecedented view of viral evolution. Here, we discuss both the capacity of the scientific community to monitor viral evolution on a global scale in real time and the mutational mechanisms and selective forces that shaped the evolution of SARS-CoV-2.}, }
@article {pmid41232270, year = {2025}, author = {Liu, B and Liu, C and Sunggip, C and Pu, G and Deng, D}, title = {Viruses in gastrointestinal cancers: Molecular pathogenesis, oncogenic mechanisms, and translational perspectives.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101415}, doi = {10.1016/j.mam.2025.101415}, pmid = {41232270}, issn = {1872-9452}, abstract = {Viral pathogens are one of the most significant causes of human carcinogenesis, contributing to up to 15-20 % of worldwide cancers. The gastrointestinal (GI) tract is one of the most vulnerable human organ system to virus-mediated tumorigenesis as a result of frequent exposure to viral infections and various immunological processes. The present review aims to describe the dual roles of viral infections in the development of gastrointestinal cancers (GICs), with a focus on Human Immunodeficiency Virus (HIV) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). HIV represents an oncological challenge in the era of effective antiretroviral therapy (ART), where significant immune dysfunction, persistent inflammation, and gut microbiome disruption render infected patients more susceptible to various GICs. On the other hand, SARS-CoV-2 is an emerging viral pathogen whose potential role in oncogenesis remains controversial yet biologically plausible. In this context, SARS-CoV-2 tropism to the gastrointestinal tissues and its capacity to drive cytokine storms, profound dysbiosis, and immune exhaustion raise significant questions regarding its potential to act as a pro-tumorigenic factor. Discussing mechanistic insights from well-known oncogenic viral pathogens, the present review describes the direct and indirect mechanisms by which these two major viruses may affect GI tumorigenesis. Moreover, this review translates these mechanisms into clinical perspectives, underscoring implications for diagnostics, prevention, and therapeutic strategies, while highlighting urgent research priorities for long-term surveillance and biomarker discovery. It highlights the importance of continuous scientific awareness to address the increasing cancer risks presented by emerging and re-emerging viruses through bridging virology and oncology.}, }
@article {pmid41231197, year = {2025}, author = {Bermúdez Endrino, LM and Berral García, A and Gómez Peña, B and Uclés-Torrente, MDM and Aparicio-Martinez, P}, title = {Efficacy of technology interventions in preventing depression among older adults experiencing social isolation: a systematic review and meta-analysis.}, journal = {Aging &amp; mental health}, volume = {}, number = {}, pages = {1-13}, doi = {10.1080/13607863.2025.2585501}, pmid = {41231197}, issn = {1364-6915}, abstract = {OBJECTIVES: The global rise in the aging population, intensified by the COVID-19 pandemic, has increased loneliness, social isolation, and depression among older adults. This review aimed to examine the relationships between these psychological challenges and to assess the effectiveness of Information and Communication Technology (ICT)-based interventions in mitigating them.<br><br>METHOD: A systematic review and meta-analysis were conducted following PRISMA guidelines. Studies published within the last five years were retrieved from PubMed, Web of Science, Scopus, and CINAHL. Methodological quality was assessed using CONSORT and STROBE, and quantitative synthesis was performed with RevMan 5.4.1.<br><br>RESULTS: Thirteen studies, including experimental and observational designs, met the inclusion criteria; 61.5% analysed pandemic effects and 38.5% evaluated ICT interventions. Depression, loneliness, and social isolation were strongly associated, with the pandemic worsening outcomes, while pre-pandemic isolation predicted poorer mental health. ICT interventions significantly reduced depression (78% reduction; 95% CI 0.15-0.33; OR = 0.22) and anxiety (80% reduction; 95% CI 0.10-0.32; OR = 0.20), though their impact on social isolation was limited (95% CI 0.87-1.19; OR = 1.07).<br><br>CONCLUSION: ICT interventions effectively reduce depression and anxiety but have limited effects on social isolation, highlighting the need for long-term evaluation and community-based strategies to improve emotional well-being in older adults.}, }
@article {pmid41228476, year = {2025}, author = {Rizzi, M and Manzoni, P and Germano, C and Quevedo, MF and Sainaghi, PP}, title = {Lactoferrin, a Natural Protein with Multiple Functions in Health and Disease.}, journal = {Nutrients}, volume = {17}, number = {21}, pages = {}, pmid = {41228476}, issn = {2072-6643}, mesh = {*Lactoferrin/therapeutic use/metabolism/physiology/pharmacology ; Humans ; COVID-19 ; Biomarkers/metabolism ; SARS-CoV-2 ; Enterocolitis, Necrotizing/drug therapy ; }, abstract = {Lactoferrin is a multifunctional glycoprotein showing multiple biological properties (antimicrobial, antiviral, antioxidant, antigenotoxic, prebiotic, probiotic) that play an essential role in maintaining host physiological homeostatic condition by exerting immunomodulatory and anti-inflammatory activities. Thanks to these biological properties, lactoferrin has widely been studied as a therapeutic agent in gastroenteric diseases, neonatal sepsis and necrotizing enterocolitis, lung diseases, and COVID-19, showing very heterogeneous results based on the disease considered and the population studied. Since lactoferrin is one of the main components of neutrophils' secondary granules, it has also been investigated as a potential disease-monitoring biomarker, especially for diseases in which inflammation is a key component. This narrative review offers updated and comprehensive insights into the available literature on lactoferrin biology, biological properties, and clinical utility.}, }
@article {pmid41228189, year = {2025}, author = {Sorina, E and Novacescu, D and Barb, AC and Ciolofan, A and Dumitru, CS and Zara, F and Patrascu, R and Enache, A}, title = {From Burnout to Resilience: Addressing Moral Injury in Nursing Through Organizational Innovation in the Post-Pandemic Era.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {21}, pages = {}, pmid = {41228189}, issn = {2227-9032}, abstract = {The COVID-19 pandemic has profoundly amplified burnout and moral injury among nurses, exposing structural vulnerabilities in healthcare systems and accelerating workforce attrition. Beyond the acute crisis, nurses continue to face chronic staff shortages, overwhelming workloads, and unresolved ethical tensions that compromise both well-being and quality of care. Synthesis of recent meta-analyses in this review indicates that nurse burnout during the pandemic ranged between 30% and 50%, illustrating the magnitude of the problem. Particular attention is given to innovative organizational strategies that foster resilience, including workload redistribution, enhanced professional autonomy, supportive leadership, and the integration of digital technologies such as telecare. Comparative perspectives across healthcare systems illustrate how policy reforms, staffing models, and ethical frameworks can mitigate psychological distress and strengthen organizational resilience. By reframing burnout and moral injury not only as individual challenges but as systemic phenomena requiring structural solutions, this review emphasizes the imperative of multilevel interventions. Building resilient nursing workforces through innovation, leadership, and evidence-based policies is essential for sustaining high-quality patient care in the post-pandemic era.}, }
@article {pmid41228128, year = {2025}, author = {Shah, ST and Ali, Z and Waqar, M and Kim, A}, title = {Federated Learning in Public Health: A Systematic Review of Decentralized, Equitable, and Secure Disease Prevention Approaches.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {21}, pages = {}, pmid = {41228128}, issn = {2227-9032}, support = {TP-2025-RS-2024-00437191//MSIT/ ; SBA-QT240015//National Research Foundation (NRF)/ ; }, abstract = {Background and Objectives: Public health needs collaborative, privacy-preserving analytics, but centralized AI is constrained by data sharing and governance. Federated learning (FL) enables training without moving sensitive data. This review assessed how FL is used for disease prevention in population and public health, and mapped benefits, challenges, and policy implications. Methods: Following PRISMA 2020, we searched PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar for peer reviewed English-language studies from January 2020-30 June 2025, applying FL to surveillance, outbreak detection, risk prediction, or policy support. Two reviewers screened and extracted data with third-reviewer arbitration. Quality was appraised with a tool adapted from MMAT and AI reporting frameworks. No meta-analysis was performed. Results: Of 5230 records identified (4720 after deduplication), 200 full texts were assessed and 19 were included. Most used horizontal FL across multiple institutions for communicable diseases, COVID-19, tuberculosis and some chronic conditions. Reported gains included privacy preservation across sites, better generalizability from diverse data, near real-time intelligence, localized risk stratification, and support for resource planning. Common barriers were non-IID data, interoperability gaps, compute and network limits in low-resource settings, unclear legal pathways, and concerns about fairness and transparency. Few studies linked directly to formal public-health policy or low-resource deployments. Conclusions: FL is promising for equitable, secure, and scalable disease-prevention analytics that respect data sovereignty. Priorities include robust methods for heterogeneity, interoperable standards, secure aggregation, routine fairness auditing, clearer legal and regulatory guidance, and capacity building in underrepresented regions.}, }
@article {pmid41228085, year = {2025}, author = {Lai, YH and Chang, MY and Wang, CC}, title = {Applying Meta-Analytic Structural Equation Modeling to Examine the Relationships Among Work Stress, Job Burnout, and Turnover Intention in Taiwanese Nurses.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {21}, pages = {}, pmid = {41228085}, issn = {2227-9032}, abstract = {Background/Objectives: Nursing staff are essential to healthcare delivery, yet Taiwan has experienced a significant rise in nurse turnover in recent years. Retention has thus become a critical concern for healthcare institutions. Identifying the factors influencing nurses' turnover intentions (TIs) and improving workplace conditions may help to reduce attrition. This study investigates the relationships among TI, work stress (WS), and job burnout (JB), examining variations across healthcare settings and comparing the periods before and after the COVID-19 pandemic. Methods: This study systematically reviews 28 studies published between 2011 and 2025, retrieved from Taiwan's Master's and Doctoral Thesis Knowledge Value Added System, Airiti Library, and Google Scholar. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. The data were analyzed using a combined approach of meta-analysis and structural equation modeling. Results: The findings of this study indicate that WS has a statistically significant impact on TI (path coefficient = 0.281, 95% CI: 0.102 to 0.459, p = 0.002). Similarly, JB significantly influences TI (path coefficient = 0.342, 95% CI: 0.163 to 0.520, p < 0.001). WS also has a strong and significant effect on JB (path coefficient = 0.612, 95% CI: 0.485 to 0.739, p < 0.001). These results suggest that WS has a particularly strong effect on JB among nurses working in non-medical center hospitals in Taiwan. Additionally, no significant differences were found in the relationships among TI, WS, and JB before and after the COVID-19 pandemic. Conclusions: Based on the findings of this study, it is recommended that healthcare administrators closely monitor the stress experienced by nursing staff and identify the key factors that lead to WS and JB. Developing targeted policies for different healthcare settings may help to reduce nurses' intentions to leave their jobs.}, }
@article {pmid41228047, year = {2025}, author = {Pizarro-Mena, R and Rotarou, ES and Baracaldo-Campo, HA and Duran-Aguero, S and Parra-Soto, S and Retamal-Walter, F and Wachholz, PA and Maranzano, S and Tirro, V and Aguilar-Navarro, S and Barrientos-Calvo, I and Carpio-Arias, V and Botello, C and López, MF and Mukamal, R and Tieppo, A and Cigarroa, I and Medola, F and Riveros-Basoalto, G}, title = {Implementation of Telehealth Among Older People: A Challenge and Opportunity for Latin America and the Caribbean-A Literature Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {21}, pages = {}, pmid = {41228047}, issn = {2227-9032}, abstract = {Although the COVID-19 pandemic negatively affected the health and quality of life of older people (OP), it provided an opportunity for the implementation of telehealth in the areas of Gerontology and Geriatrics, globally and in the countries of Latin America and the Caribbean, which enabled the continuity of healthcare interventions. Therefore, this literature review aimed to (a) conceptualize telehealth in OP through the lens of Gerontology and Geriatrics; (b) analyze the implementation, facilitators, and barriers of telehealth for OP during the COVID-19 pandemic at both global and Latin American and Caribbean regional levels; (c) identify lessons learned and considerations for improving implementation and reducing barriers to telehealth for OP; and (d) discuss challenges related to the integration of telehealth for OP in the region. The databases consulted were PubMed, Scopus, and Scielo; scientific articles in both English and Spanish were considered, including research conducted globally and in Latin American and Caribbean countries that contributed to the objectives of the literature review; the search was conducted from the year 2020 onwards. In addition, government documents and non-governmental technical guidelines from countries in the region were included, whether they focused specifically on older populations or the general population; the search was not limited to a specific time period. Initially, in our search strategy, 1631 scientific articles and 20 governmental and non-governmental documents were identified for the literature review. After eliminating duplicate and applying the inclusion and exclusion criteria, 84 documents were selected for the literature review (46 analyzed the implementation, barriers, and facilitators of telehealth during the COVID-19 pandemic). This literature review presents a conceptual analysis of the implementation and facilitators of, as well as barriers to, telehealth among OP during the COVID-19 pandemic from the perspective of healthcare providers and OP themselves. The paper synthesizes a number of international and Latin American experiences and proposes several recommendations for the implementation of telehealth for OP in the Latin American and Caribbean region. Despite the ongoing challenges regarding telehealth research and training, this review describes telehealth for OP as an intervention approach that improves the provision of holistic care, favoring OP autonomy, functionality, and overall quality of life. This review also proposes telehealth as a regular intervention approach to clinical practice in Gerontology and Geriatrics in the region. Collaborative endeavors are needed to further regulate and promote public policy on telehealth, telemedicine and telerehabilitation for OP.}, }
@article {pmid41226854, year = {2025}, author = {Zakynthinos, GE and Kokkinos, NK and Tzima, IG and Dimeas, IE and Gialamas, I and Gerostathis, A and Katsarou, O and Tsatsaragkou, A and Kalogeras, K and Oikonomou, E and Siasos, G}, title = {One Enzyme, Many Faces: The Expanding Role of DPP3 in Cardiovascular and Critical Care.}, journal = {Journal of clinical medicine}, volume = {14}, number = {21}, pages = {}, pmid = {41226854}, issn = {2077-0383}, abstract = {Dipeptidyl peptidase 3 (DPP3) is a zinc-dependent aminopeptidase that is found in several places and is thought to be a cytosolic enzyme that helps break down peptides. Recent studies, however, have revealed its extensive therapeutic relevance upon release into circulation, functioning not only as a biomarker for cellular injury but also as an active modulator of cardiovascular homeostasis and critical disease. High levels of circulating DPP3 (cDPP3) have been linked to the causes of cardiogenic shock, septic shock, acute coronary syndromes, heart failure, and serious viral diseases like COVID-19. Its enzymatic breakdown of angiotensin II disrupts vascular tone and myocardial contractility, leading to hemodynamic instability and multi-organ failure. In numerous cohorts, cDPP3 levels reliably correspond with disease severity, acute renal damage, and death, but dynamic trajectories yield superior predictive information relative to single assessments. In addition to risk stratification, translational studies utilizing rodent and porcine models illustrate that antibody-mediated inhibition of cDPP3 with the humanized monoclonal antibody Procizumab reinstates cardiac function, stabilizes renal perfusion, diminishes oxidative stress and inflammation, and enhances survival. First-in-human experiences in patients with refractory septic cardiomyopathy have further emphasized its therapeutic promise. DPP3 is a good example of a biomarker and a mediator in cardiovascular and critical care. Its growing clinical and translational profile makes cDPP3 a strong predictor of bad outcomes and a prospective target for treatment. Ongoing clinical trials using Procizumab will determine if neutralizing cDPP3 can lead to enhanced outcomes in individuals with cardiogenic and septic shock. This review outlines the physiological mechanisms, clinical implications, and emerging therapeutic potential of DPP3 in cardiovascular and critical care. Ongoing trials with Procizumab will clarify whether neutralizing cDPP3 can improve outcomes in patients with cardiogenic and septic shock.}, }
@article {pmid41226731, year = {2025}, author = {Varghese, S and Al-Hassani, I and Al-Aani, U and Rob, NJ and Al-Mannai, S and Jaguri, A and Yousif, RA and Al-Mulla, A and Palayangal, FF and Laws, S and Al-Ali, D and Zakaria, D}, title = {Long-Term Complications of Multisystem Inflammatory Syndrome in Children and Adults Post-COVID-19: A Systematic Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226731}, issn = {1422-0067}, mesh = {Adult ; Child ; Humans ; *COVID-19/complications/complications ; SARS-CoV-2 ; *Systemic Inflammatory Response Syndrome/complications/therapy/etiology ; }, abstract = {The SARS-CoV-2 pandemic has posed global medical challenges due to its ability to affect multiple organ systems. Among the post-COVID-19 complications, multisystem inflammatory syndrome has emerged as a severe condition affecting both children (MIS-C) and adults (MIS-A). This review aims to compile and analyze published data to investigate clinical characteristics, laboratory findings, and outcomes of MIS post-COVID-19. A comprehensive search of various databases was conducted to identify studies reporting MIS-related complications in pediatric and adult populations post-COVID-19 infection. Screening, data extraction, and cross-checking were performed by two independent reviewers. Only 64 studies met our inclusion criteria, and compiled results revealed that cardiac complications were the predominant manifestation followed by gastrointestinal, hematologic, neurological, and mucocutaneous involvement. Laboratory findings consistently demonstrated elevated inflammatory markers including CRP, ferritin, D-dimer, and IL-6. Most patients required hospitalization, and many needed intensive care; treatment typically involved IVIG, corticosteroids, and biologic therapies. While most patients recovered, a subset experienced persistent complications. These findings highlight the importance of early recognition, multidisciplinary management, and structured follow-up for MIS. Future research is warranted to clarify the underlying mechanisms, risk factors, and long-term outcomes associated with MIS in post-COVID-19 patients.}, }
@article {pmid41226415, year = {2025}, author = {Zolotarenko, AD and Poghosyan, HM and Sheptiy, VV and Bruskin, SA}, title = {COVID-19 Hijacking of the Host Epigenome: Mechanisms, Biomarkers and Long-Term Consequences.}, journal = {International journal of molecular sciences}, volume = {26}, number = {21}, pages = {}, pmid = {41226415}, issn = {1422-0067}, support = {123120500032-9//Ministry of Science and Higher Education of the Russian Federation/ ; }, mesh = {Humans ; *COVID-19/genetics/virology/immunology/pathology ; *SARS-CoV-2/physiology ; *Epigenesis, Genetic ; *Epigenome ; Biomarkers/metabolism ; Immunity, Innate ; *Host-Pathogen Interactions/genetics ; MicroRNAs/genetics ; DNA Methylation ; }, abstract = {The epigenetics of COVID-19 is a rapidly expanding field that reveals how the SARS-CoV-2 virus initiates alterations in the host's genome, influencing the susceptibility to infection, the disease severity, and long-term consequences, known as "long COVID." In this review, we describe the mechanisms utilized by the virus to manipulate the host epigenome, suppressing antiviral responses and creating a favorable environment for viral replication. We also highlight virus-induced epigenetic changes across diverse cell populations that contribute to COVID-19 pathogenesis. Notably, the virus reprograms hematopoietic stem and progenitor cells, leading to long-lasting alterations in innate immunity, a phenomenon known as "trained immunity." These epigenetic modifications are maintained in differentiated daughter cells and may explain the persistent inflammation and other symptoms of long COVID. Furthermore, we discuss emerging epigenetic biomarkers of disease severity, including methylation signatures in genes such as AIM2, HLA-C, and PARP9, as well as dysregulated miRNA profiles. Understanding this complex interplay between the virus and the host's epigenetic landscape is crucial for developing new therapeutic approaches that target specific epigenetic modifications to suppress pathological processes and improve clinical outcomes for COVID-19 patients.}, }
@article {pmid41225670, year = {2025}, author = {Wolfe, H and Shepherd, CB and Lee, R and Oliver-Pyatt, W}, title = {Real-world patient outcomes for telehealth-delivered, remote eating disorder treatment: a scoping review.}, journal = {Journal of eating disorders}, volume = {13}, number = {1}, pages = {259}, pmid = {41225670}, issn = {2050-2974}, abstract = {BACKGROUND: Only 30% of individuals with eating disorders receive specialized treatment. While preliminary evidence suggests that telehealth-delivered, remote eating disorder treatment may offer improved accessibility with similar effectiveness to in-person treatment, research on these services remains limited, particularly regarding the communities that are disproportionately affected by barriers to standard care. This scoping review sought to map the existing research on real-world patient outcomes in remote eating disorder treatment, identify knowledge gaps, and prioritize areas for future studies.<br><br>METHODS: This review followed the Joanna Briggs Institute methodology for scoping reviews. It comprises observational evaluations of telehealth-delivered, remote eating disorder treatment conducted in routine clinical settings. An electronic database search was performed in PsycINFO, PubMed, and ProQuest Dissertations &amp; Theses Global in August 2024 and updated in September 2025.<br><br>RESULTS: Following the search and screening process, 27 articles, comprising six case reports and 21 cohort/case series designs, were deemed eligible for inclusion. Remote treatments evaluated differed across level of care, therapeutic modalities, provider types, dosage, and adjunctive technologies used. Just under half of the studies compared outcomes from remote and in-person treatment, while the remainder examined remote treatment alone. Articles were published between 2011 and 2025 and, when excluding case reports, nearly 60% evaluated programs that rapidly transitioned to remote delivery due to COVID-19. While demographic reporting was limited and inconsistent, available information indicated that participants ranged from three to 75 years old and were predominantly White, cisgender women/females diagnosed with anorexia nervosa. Though preliminary, findings tentatively suggest that remote eating disorder treatment can yield improvements across core outcome domains, largely comparable to in-person settings. Less is known about how outcomes may differ across demographic groups.<br><br>CONCLUSIONS: Overall, this body of literature remains small and characterized by limitations and inconsistencies, including differences in the treatment services evaluated as well as disparities in study design, methodology, and reporting. Utilization of remote treatment by historically excluded groups remains low, calling for further reflection around its accessibility for target communities. Additional studies with more rigorous, intentional designs are needed. The field would also benefit from standardization in relation to data collection and reporting to allow for better synthesis of findings.}, }
@article {pmid41225329, year = {2025}, author = {Kabadayı, G and Atay, &#xd6; and Baysal Bakır, D and Yağmur, H and Kaşıkçı Mermer, ET and Okur Acar, S and Öztürk Yılmaz, &#x15e; and Hazan, F and Gözmen, S and Uzuner, N}, title = {Expanding the clinical spectrum of Cernunnos/XLF deficiency: a literature review of a rare cause of severe combined immunodeficiency including a novel case.}, journal = {BMC immunology}, volume = {26}, number = {1}, pages = {89}, pmid = {41225329}, issn = {1471-2172}, mesh = {Humans ; Infant ; *DNA Repair Enzymes/genetics ; *DNA-Binding Proteins/genetics/deficiency ; Genetic Association Studies ; Hematopoietic Stem Cell Transplantation ; Mutation ; *Severe Combined Immunodeficiency/genetics/diagnosis/therapy ; }, abstract = {BACKGROUND: Severe combined immunodeficiency (SCID) is a congenital immunodeficiency characterized by significant numerical or functional defects in T lymphocytes and is often accompanied by B lymphocyte dysfunction. It presents early in life with severe, recurrent opportunistic infections. Early diagnosis and hematopoietic stem cell transplantation (HSCT) are vital for patient survival. Cernunnos/XLF deficiency is an autosomal recessive form of SCID caused by mutations in the NHEJ1 gene, which plays a critical role in repairing DNA double-strand breaks. First described in 2006, this condition remains exceedingly rare, with only about 55 cases reported to date. This study aimed to describe a novel infant with Cernunnos/XLF deficiency and to review previously reported patients carrying the same variant, thereby expanding the clinical spectrum of this rare disease.<br><br>METHODS: With written informed consent, we retrospectively evaluated a pediatric patient with Cernunnos/XLF deficiency followed at our clinic. Demographic, clinical, laboratory, and radiological findings were reviewed. The diagnosis was based on clinical and immunological features and confirmed via clinical exome sequencing. A literature review was conducted to compare the genotype-phenotype correlations of previously reported patients carrying the same NHEJ1 variant.<br><br>RESULTS: We report an infant who was hospitalized at 6.5&#xa0;months of age with a preliminary diagnosis of meningitis and was subsequently diagnosed with Cernunnos/XLF deficiency. The patient exhibited microcephaly, growth retardation, recurrent infections, prolonged SARS-CoV-2 PCR positivity, and localized BCGitis following live Bacillus Calmette-Gu&#xe9;rin (BCG) vaccination. Immunological evaluation revealed T- and B-cell lymphopenia and hypogammaglobulinemia. Genetic testing confirmed a homozygous nonsense mutation in NHEJ1. HSCT from a matched sibling donor was performed.<br><br>CONCLUSION: This study describes a rare case of Cernunnos/XLF deficiency diagnosed in early infancy, underscoring the value of early recognition and the critical role of genetic testing and HSCT. It also expands the clinical spectrum of the disease and provides a comparative perspective with previously reported patients carrying the same mutation. In infants presenting with unexplained infections or complications related to live vaccines, inborn errors of immunity should be considered. Our findings emphasize the importance of timely diagnosis and comprehensive, multidisciplinary follow-up, particularly in patients with additional complications.}, }
@article {pmid41225237, year = {2025}, author = {Bordoloi, S and Singh, SC and Bayry, J}, title = {COVID-19-associated Autoimmune and Inflammatory Diseases: Molecular Mechanisms and the Role of IVIG Therapy.}, journal = {Clinical reviews in allergy &amp; immunology}, volume = {68}, number = {1}, pages = {99}, pmid = {41225237}, issn = {1559-0267}, mesh = {Humans ; *COVID-19/immunology/complications/therapy ; *Immunoglobulins, Intravenous/therapeutic use ; *SARS-CoV-2/immunology ; *Autoimmune Diseases/immunology/therapy/etiology ; COVID-19 Drug Treatment ; *Inflammation/immunology ; }, abstract = {The emergence of SARS-CoV-2 has not only reshaped our understanding of viral pathogenesis but also highlighted its capacity to trigger autoimmune and inflammatory diseases. Accumulating evidence indicates that SARS-CoV-2 infection can lead to a broad spectrum of immune-mediated complications, ranging from well-defined conditions such as Guillain-Barré syndrome, multisystem inflammatory syndrome in children (MIS-C), and systemic lupus erythematosus, to the development of diverse autoantibodies and atypical inflammatory phenotypes. This review synthesizes the current clinical and experimental evidence linking COVID-19 to autoimmune and inflammatory sequelae. We have provided a structured overview on the multifactorial mechanisms underpinning this immune dysregulation, including molecular mimicry, epitope spreading, bystander activation, cytokine storm, host genetic predisposition, and viral genomic variability. Additionally, we discussed the contribution of gut dysbiosis and metabolic reprogramming in shaping aberrant immune responses following infection. Special attention is given to the therapeutic potential of intravenous immunoglobulin (IVIG), which has shown promise in mitigating hyperinflammation and modulating autoimmunity in affected individuals. IVIG can provide therapeutic benefits by diverse mutually nonexclusive mechanisms. By integrating emerging insights across clinical immunology, virology, and host-pathogen interactions, this review aims to advance our understanding of COVID-19-induced immune complications and therapeutic strategies to manage post-COVID autoimmune and inflammatory syndromes.}, }
@article {pmid41224444, year = {2026}, author = {Limbach, KE and Fan, D and Melstrom, LG}, title = {Remote Telemonitoring and Telehealth in Surgical Oncology.}, journal = {Hematology/oncology clinics of North America}, volume = {40}, number = {1}, pages = {79-88}, doi = {10.1016/j.hoc.2025.07.007}, pmid = {41224444}, issn = {1558-1977}, mesh = {Humans ; *Telemedicine ; *Surgical Oncology/methods ; *COVID-19/epidemiology ; *Neoplasms/surgery ; Quality of Life ; SARS-CoV-2 ; Monitoring, Physiologic/methods ; }, abstract = {Remote monitoring and telehealth platforms have been of increasing interest since the beginning of the Corona Virus disease-2019 pandemic, with rising rates of implementation. Surgical oncology patients are a unique population that may derive a particular benefit from the use of such technology, which has been shown to be feasible and acceptable to patients and providers. Previous studies have shown benefits in quality of life and symptom severity as well as a decreased readmission rate in select surgical oncology clinical settings; however, further research is ongoing to more specifically determine how the use of remote telemonitoring will affect clinical outcomes including complications and cost.}, }
@article {pmid41224425, year = {2025}, author = {Rowland, B and Sunkara, P and Hicks, MH and Khanna, AK}, title = {Remote Patient Monitoring to Support Rapid Discharge-Wearables.}, journal = {Advances in anesthesia}, volume = {43}, number = {1}, pages = {127-138}, doi = {10.1016/j.aan.2025.07.010}, pmid = {41224425}, issn = {1878-0415}, mesh = {Humans ; *Patient Discharge ; *COVID-19 ; *Wearable Electronic Devices ; Monitoring, Physiologic/methods ; Telemedicine ; Remote Patient Monitoring ; }, abstract = {The ability to remotely monitor patients after hospital discharge with near real-time feedback with an integrated health network represents a technological advancement that has shown promising results across surgical and medical domains including improvements in hospital length of stay, unplanned readmission, and mortality. COVID-19 and improvements in monitoring technology has catalyzed the increased use and evaluation of remote monitoring. In this article, we provide a landscape of remote monitoring and its role in postdischarge care to date across medical and surgical domains in adult medicine. We also address implementation, research, and ethical considerations for remote monitoring in clinical care.}, }
@article {pmid41224292, year = {2025}, author = {Browne, S and Kelly, MP and Bowers, B and Kuhn, I and Duschinsky, R and Daniels, C and Barclay, S}, title = {General practitioner care of residential aged care facility residents at end of life: a systematic literature review and narrative synthesis.}, journal = {BMJ open}, volume = {15}, number = {11}, pages = {e104243}, pmid = {41224292}, issn = {2044-6055}, mesh = {Humans ; *Terminal Care ; *Homes for the Aged ; *General Practitioners ; *Nursing Homes ; Aged ; *Palliative Care ; }, abstract = {OBJECTIVES: In 2023, 21% of deaths occurred in residential aged care facilities (RACFs), a setting expected to play an increasing role in palliative and end-of-life care (PEoLC). General practitioners (GPs) oversee and deliver PEoLC in residential and nursing homes, yet little is known about their practice. We conducted a systematic review of the published evidence concerning how GPs provide this care: what they do and the quality, challenges and facilitators of that care.<br><br>DESIGN: Systematic review and narrative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.<br><br>DATA SOURCES: Medline, Embase, CINAHL, PsycINFO, Web of Science, Scopus and NHS Evidence and grey literature via Google Scholar were searched through 9 October 2024.<br><br>ELIGIBILITY CRITERIA: We included studies presenting new empirical data from qualitative, quantitative or mixed methods, were published in the English language and conducted in the UK, the European Union, Australia, New Zealand and Canada. We excluded studies with no new empirical data, discussion papers, conference abstracts, opinion pieces, study participants under 18 years old and in care settings other than RACF.<br><br>DATA EXTRACTION AND SYNTHESIS: One independent reviewer used standardised methods to search and screen study titles for inclusion. This reviewer assessed all abstracts of the included papers, and a second independent reviewer screened 60% of the abstracts to validate inclusion. Risk of bias was assessed using Gough's Weight of Evidence assessment. Thematic analysis was used to describe the contents of the included papers; a narrative synthesis approach was taken to report the findings at a more conceptual level.<br><br>RESULTS: The search identified 5936 titles: 35 papers were eligible and included in the synthesis. This is a nascent evidence base, lacking robust research designs and characterised by small sample sizes; the results describe the factors observed to be important in the delivery of care. Care provision is extremely variable; no models of optimal care have been put forward or tested. Challenges to care provision occur at every level of the care system. At macro level, service-level agreements and policies vary: at meso level, team-working, communication technology solutions and equipment availability vary: at micro level, GPs' interests in providing PEoLC vary as does their training. No study addresses residents' and relatives' experiences and expectations of GPs' involvement in PEoLC in RACFs.<br><br>CONCLUSIONS: The limited evidence base highlights that GP care at end of life for RACF residents varies greatly, with enablers and challenges at all levels in the existing care systems. Little research has examined GP PEoLC for RACF residents in its own right; insight is derived from studies that report on this issue as an adjunct to the main focus. With national policies focused on moving more PEoLC into community settings, these knowledge deficits require urgent attention.}, }
@article {pmid41224245, year = {2025}, author = {Kurz, X and Cohet, C and Perez-Gutthann, S and Rao, S and Gardarsdottir, H}, title = {Strengthening Pharmacoepidemiology in a Changing Research Environment: The European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP).}, journal = {Pharmacoepidemiology and drug safety}, volume = {34}, number = {11}, pages = {e70263}, pmid = {41224245}, issn = {1099-1557}, mesh = {*Pharmacoepidemiology/methods/organization &amp; administration/trends ; *Pharmacovigilance ; Humans ; Europe/epidemiology ; COVID-19/epidemiology ; }, abstract = {Key changes in the pharmacoepidemiological research environment had a significant influence on the activities of the European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) over the last decade. These changes included the SARS-CoV-2 pandemic, the increased access to anonymized real-world data (RWD) sources, the integration of real-world evidence (RWE) into regulatory and public health decision-making, and the emergence of new technologies and methods. This paper describes how ENCePP has evolved in this changing environment to strengthen pharmacoepidemiological methods and practice in Europe and globally. It also provides future perspectives for the network. Through a collaborative approach in non-interventional research, ENCePP will collectively continue to promote excellence for RWE generation, supporting the safe and effective use of medicines.}, }
@article {pmid41224205, year = {2025}, author = {Ebrahimi, F and Ebrahimi, R and Beer, M and Schönenberger, CM and Ewald, H and Briel, M and Janiaud, P and Hirt, J and Hemkens, LG}, title = {Colchicine for the secondary prevention of cardiovascular events.}, journal = {The Cochrane database of systematic reviews}, volume = {11}, number = {11}, pages = {CD014808}, pmid = {41224205}, issn = {1469-493X}, mesh = {Aged ; Humans ; Middle Aged ; Bias ; *Cardiovascular Diseases/prevention &amp; control/mortality ; Cause of Death ; *Colchicine/administration &amp; dosage/adverse effects/therapeutic use ; Hospitalization/statistics &amp; numerical data ; Myocardial Infarction/prevention &amp; control/mortality ; Percutaneous Coronary Intervention/statistics &amp; numerical data ; Quality of Life ; Randomized Controlled Trials as Topic ; *Secondary Prevention/methods ; Stroke/prevention &amp; control/mortality ; }, abstract = {RATIONALE: People with cardiovascular disease are at risk of recurrent major adverse cardiovascular events, and chronic low-grade inflammation may be a major underlying factor. Treatment with low-dose colchicine has been proposed for the secondary prevention of cardiovascular events in individuals at high cardiovascular risk. A previous Cochrane review showed considerable uncertainty regarding the benefits and harms of this approach.<br><br>OBJECTIVES: To evaluate the benefits and harms of low-dose colchicine in the prevention of cardiovascular events in adults with a history of stable CVD or following myocardial infarction or stroke.<br><br>SEARCH METHODS: We conducted a comprehensive search of the literature until February 2025 using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the drugs@FDA database, references of key papers, and references of included studies.<br><br>ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) comparing the use of low-dose colchicine for a minimum of six months versus any control intervention in patients of any age with cardiovascular disease (i.e. history of stable cardiovascular disease, previous myocardial infarction or stroke).<br><br>OUTCOMES: Our critical outcomes were all-cause mortality, myocardial infarction, and serious adverse events. Our important outcomes were cardiovascular mortality, stroke, all-cause hospitalisations, coronary revascularisation (percutaneous coronary intervention (PCI)/angioplasty or coronary artery bypass graft (CABG)), quality of life, and gastrointestinal adverse events (i.e. diarrhoea, nausea, abdominal pain, or vomiting).<br><br>RISK OF BIAS: Two authors independently assessed the risk of bias using the Cochrane RoB2 tool.<br><br>SYNTHESIS METHODS: We conducted meta-analyses using the random-effects model. We generated forest plots to facilitate visualisation of the data. We did not perform any subgroup analysis. We used GRADE to assess the certainty of evidence for all critical outcomes and for cardiovascular mortality, stroke, and coronary revascularisation. This was carried out by two review authors working independently.<br><br>INCLUDED STUDIES: We included 12 studies involving 22,983 randomised participants. The follow-up in the studies ranged from 6 to 80 months. Overall, 11,524 participants were assigned to low-dose colchicine treatment and 11,459 were assigned to a control intervention, which constituted either usual care plus placebo or usual care only. The doses of colchicine used were 0.5 mg once or twice daily. At baseline, the mean age of participants ranged from 57 to 74 years. Most participants (79.4%) were male.<br><br>SYNTHESIS OF RESULTS: There is high-certainty evidence that low-dose colchicine treatment reduces the risk of myocardial infarction, with a risk ratio (RR) of 0.74 (95% confidence interval (CI) 0.57 to 0.96; 22,153 participants, 8 studies; I[2] = 51%), yielding an absolute risk reduction of 9 fewer events (95% CI 16 fewer to 2 fewer) per 1000 patients, when the myocardial infarction rate is about 4% (36 events per 1000 patients) in the control group. There is also high-certainty evidence that low-dose colchicine reduces the risk of stroke with a RR of 0.67 (95% CI 0.47 to 0.95; 22,483 participants, 10 studies; I[2] = 40%), yielding an absolute risk reduction of 8 fewer events (95% CI 12 fewer to 1 fewer) per 1000 patients, when the stroke rate is about 2% (22 events per 1000 patients) in the control group. There is high-certainty evidence that the use of low-dose colchicine does not increase the rate of serious adverse events (RR 0.98, 95% CI 0.94 to 1.02; 15,677 participants, 4 studies; I[2] = 0%). However, gastrointestinal adverse events were more common under treatment with colchicine (RR 1.68, 95% CI 1.11 to 2.57; 22,185 participants, 10 studies; I[2] = 91%). For all other outcomes assessed, the evidence is of moderate certainty. Colchicine probably results in little to no difference in all-cause mortality (RR 1.01, 95% CI 0.84 to 1.21; 22,747 participants, 10 studies; I[2] = 1%; moderate-certainty evidence), in cardiovascular mortality (RR 0.94, 95% CI 0.73 to 1.22; 22,271 participants; 8 studies; I[2] = 13%; moderate-certainty evidence), and coronary revascularisation (RR 0.83, 95% CI 0.64 to 1.08; 13,705 participants, 5 studies; I[2] = 40%; moderate-certainty evidence). There is no evidence about the benefits or harms of colchicine on quality-of-life or on the risk of all-cause hospitalisation.<br><br>AUTHORS' CONCLUSIONS: People with cardiovascular disease using low-dose colchicine as secondary prevention for at least six months benefit from reduced rates of myocardial infarction and stroke, without an increase in serious adverse events. Moderate-certainty evidence did not show a benefit from low-dose colchicine for the risk of mortality (i.e. all-cause and cardiovascular mortality) or coronary revascularisation rates. Colchicine use was associated with an increased risk of gastrointestinal adverse events, which were typically described as mild and transient in nature. Additional studies are warranted to investigate the benefits and harms of low-dose colchicine in relevant subgroups and in specific indications, such as long-term use in individuals with stable coronary artery disease versus limited-time use following acute coronary syndrome.<br><br>FUNDING: Review author FE was supported by the Margot und Erich Goldschmidt &amp; Peter Ren&#xe9; Jacobson Foundation. Review author CMS was supported by the Janggen P&#xf6;hn Foundation and the Swiss National Science Foundation (MD-PhD grant Number: 323530_221860).<br><br>REGISTRATION: This review is based on its protocol, which is available via DOI 10.1002/14651858.CD014808, and a previous review, which is available via DOI 10.1002/14651858.CD011047.pub2.}, }
@article {pmid41224139, year = {2025}, author = {Li, X and Oberlander, TF and Lebel, C}, title = {Natural experiments: Disasters and disease outbreaks as models of perinatal hardship and its effects on child brain and behavior.}, journal = {Neuroscience and biobehavioral reviews}, volume = {180}, number = {}, pages = {106475}, doi = {10.1016/j.neubiorev.2025.106475}, pmid = {41224139}, issn = {1873-7528}, abstract = {Human brain development begins in utero and is influenced by the environment. Numerous studies show effects of perinatal maternal psychological distress (e.g., depression) on child brain and behavior. Less attention has been paid to exposure to external real-world stressors (e.g., objective hardship), which are independent of individual characteristics. We systematically reviewed 39 human studies on perinatal maternal stress from natural disasters and disease outbreaks and associations with children's brain structure and function, behavior, and mental health. Studies have mainly focused on the 1998 Quebec Ice Storm or the COVID-19 pandemic, with a handful from other natural disasters. Prenatal maternal objective hardship is related to brain volumes and functional connectivity, though studies have been small and in overlapping samples; no studies to date have examined postnatal maternal objective hardship and brain. Disaster- and disease-related perinatal hardship is related to multiple domains of neurodevelopmental outcomes, including temperament, cognition, and behaviour, with generally negative outcomes (more hardship predicts worse cognition/behaviour). Early gestational exposure is more associated with cognition, though more research is needed to understand windows of vulnerability. The apparent effects of prenatal objective stress on child behavior may occur in part through child brain alterations. Future studies with larger samples are needed, particularly to understand the effects of exposure timing and type, to further investigate sex differences, and to clarify the role of postnatal maternal objective hardship. The COVID-19 pandemic presents a unique opportunity to do this, and several ongoing studies are likely to provide valuable insight in the coming years.}, }
@article {pmid41223978, year = {2026}, author = {Spanoghe, M and Antonacci, T and Schneider, N and Molmans, THJ}, title = {Viewpoint | linking long Covid and AD(H)D through neuroimmune dysfunction: A translational framework proposal for precision medicine.}, journal = {Brain, behavior, and immunity}, volume = {131}, number = {}, pages = {106181}, doi = {10.1016/j.bbi.2025.106181}, pmid = {41223978}, issn = {1090-2139}, }
@article {pmid41223552, year = {2025}, author = {Sharma, D and Sinha, R and Multisanti, CR and Faggio, C}, title = {From personal hygiene products to health threats: Triclosan and its impact on endocrine health.}, journal = {The Science of the total environment}, volume = {1006}, number = {}, pages = {180856}, doi = {10.1016/j.scitotenv.2025.180856}, pmid = {41223552}, issn = {1879-1026}, mesh = {*Triclosan/adverse effects/toxicity ; *Endocrine Disruptors/toxicity/adverse effects ; Humans ; Animals ; *Environmental Pollutants/toxicity ; *Environmental Exposure ; COVID-19 ; *Endocrine System/drug effects ; Cosmetics ; *Anti-Infective Agents, Local/adverse effects ; }, abstract = {Daily exposure to diverse emerging environmental pollutants raises significant concern, particularly regarding endocrine-disrupting chemicals such as triclosan (TCS). Notably, in the post-COVID-19 pandemic, strategies to manage the disease have increased the use of products formulated with antibacterial compounds like TCS. TCS has been used worldwide as a broad-spectrum antibacterial agent over the past four decades. Owing to its antibacterial and antifungal properties, it is an ingredient in an array of commercial products, such as personal care, medical, acrylic, veterinary, and household items. Recent data reveal its frequent presence and widespread exposure in natural environments and human tissues. Studies across multiple species provide compelling evidence of its endocrine-disrupting effects, especially concerning reproductive hormones. Several proposed mechanisms of action include interference with hormone metabolism, disruption of hormone-receptor binding, and inhibition of steroidogenic enzyme activity. This review aims to elucidate the sources, bioaccumulation patterns, and endocrine-disrupting effects of TCS in humans. Further extrapolating and discussing the impact on non-target organisms, including aquatic species and rodents. Thus, it will help in guiding further research and related underlying mechanisms.}, }
@article {pmid41223394, year = {2025}, author = {Zamora, FV and Santos, ACFF and Zamora, AV and Galvao, LKCS and Pimenta, NDS and Salles, JPCEA and Carneiro, VB and Starling, CEF}, title = {Hyperbaric Oxygen Treatment for Long-COVID syndrome: A Systematic Review of Current Evidence on Cognitive Decline.}, journal = {Undersea &amp; hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc}, volume = {52}, number = {3}, pages = {327-335}, pmid = {41223394}, issn = {1066-2936}, mesh = {Humans ; *Hyperbaric Oxygenation/methods ; *Cognitive Dysfunction/therapy/etiology ; *COVID-19/complications ; Executive Function ; Post-Acute COVID-19 Syndrome ; Attention ; Randomized Controlled Trials as Topic ; Fatigue/therapy ; }, abstract = {INTRODUCTION: There is no established specific treatment for long-COVID syndrome (LCS), yet hyperbaric oxygen (HBO2) treatment has been studied as a potential option. Therefore, we conducted a systematic review to evaluate the benefits of HBO2 treatment in LCS patients.<br><br>METHODS: We systematically searched PubMed, Embase, and Cochrane databases until April 2024. Risk of bias and GRADE quality assessment were evaluated. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with ID CRD42024530421.<br><br>RESULTS: Seven studies from seven countries, divided into RCTs and observational studies, included 199 participants. HBO&#x2082; treatment protocols included breathing 100% oxygen at 2.0 ATA until 2.5 ATA; the number of sessions varied from ten to 60 depending on the patient's comorbidities and symptoms. Memory, executive function, attention, fatigue, and pain level improved with HBO2 treatment. The intervention had minimal side effects, and none were serious.<br><br>CONCLUSION: HBO&#x2082; treatment might be a potential option and safe treatment in LCS patients. However, further research should be focused on evaluating its efficacy in a larger number of patients through randomized studies.}, }
@article {pmid41223266, year = {2025}, author = {Camacho-García, M and Serrano-Macías, M and Ortega-Martin, E and Alvarez-Galvez, J}, title = {Drivers of health polarization during the COVID-19 pandemic: A systematic review.}, journal = {Science advances}, volume = {11}, number = {46}, pages = {eady5064}, pmid = {41223266}, issn = {2375-2548}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Public Health ; Pandemics ; SARS-CoV-2 ; Politics ; Socioeconomic Factors ; Social Media ; Communication ; Trust ; }, abstract = {Health polarization has emerged as a critical factor shaping public health attitudes and behaviors, particularly during crises such as the COVID-19 pandemic. This study provides a systematic review of the key determinants driving health polarization, highlighting the complex interplay of political, social, economic, and psychological factors. By synthesizing findings from 90 studies, we identify six primary drivers: political ideology and partisanship, misinformation and disinformation, social media structures and dynamics, trust in health institutions and professionals, risk and public health perceptions, and socioeconomic factors. Our analysis reveals how these determinants reinforce societal divisions, exacerbate health inequalities, and influence adherence to public health measures. Furthermore, we discuss the implications of these findings for designing effective interventions that address the root causes of health polarization. Understanding the mechanisms underlying these divisions is essential for mitigating their negative impact on public health and fostering more cohesive, evidence-based health communication strategies.}, }
@article {pmid41223086, year = {2025}, author = {Udi, Y and Aitchison, JD and Rout, MP and Obado, S}, title = {Breaking Barriers: Respiratory Viral Strategies Targeting the Host's Nuclear Pore Complex and Nuclear Transport Pathways.}, journal = {Molecular biology of the cell}, volume = {}, number = {}, pages = {mbcE25070322}, doi = {10.1091/mbc.E25-07-0322}, pmid = {41223086}, issn = {1939-4586}, abstract = {From stealthy infiltrators to blunt-force saboteurs, many human viruses-perhaps all-disrupt nuclear transport to control host gene expression, suppress immune responses, and redirect cellular resources toward their own replication. Among them, respiratory viruses stand out for their global impact and relentless evolution, from seasonal scourges to pandemic threats. Focusing on adenoviruses, influenza, rhinoviruses, RSV and SARS-CoV-2, we explore a series of molecular case studies that reveal both shared strategies and the diverse molecular innovations these respiratory pathogens use to subvert the nuclear transport machinery. We organize these tactics into six recurring strategies: NPC docking and nuclear entry, inhibition of immune-factor import, hijacking nuclear protein transport and karyopherins, sabotage of host mRNA export, degradation of FG-Nups, and exploitation of mitotic nuclear envelope breakdown. These insights not only illuminate fundamental virus-host conflicts but may also point the way toward new therapeutic vulnerabilities in the viruses' attack strategies.}, }
@article {pmid41222338, year = {2025}, author = {Serrano-Lázaro, A and Portillo-Cortez, K and de la Mora Mojica, MB and Durán-Álvarez, JC}, title = {A Review on ZnO Nanostructures for Optical Biosensors: Morphology, Immobilization Strategies, and Biomedical Applications.}, journal = {Nanomaterials (Basel, Switzerland)}, volume = {15}, number = {21}, pages = {}, pmid = {41222338}, issn = {2079-4991}, abstract = {ZnO nanostructures have attracted attention as transducer materials in optical biosensing platforms due to their wide bandgap, defect-mediated photoluminescence, high surface-to-volume ratio, and tunable morphology. This review examines how the dimensionality of ZnO nanostructures affects biosensor performance, particularly in terms of charge transport, signal transduction, and biomolecule immobilization. The synthesis approaches are discussed, highlighting how they influence crystallinity, defect density, and surface functionalization potential. The impact of immobilization strategies on sensor stability and sensitivity is also assessed. The role of ZnO in various optical detection schemes, including photoluminescence, surface plasmon resonance (SPR), localized (LSPR), fluorescence, and surface-enhanced Raman scattering (SERS), is reviewed, with emphasis on label-free and real-time detection. Representative case studies demonstrate the detection of clinically and environmentally relevant targets, such as glucose, dopamine, cancer biomarkers, and SARS-CoV-2 antigens, with limits of detection in the pico- to femtomolar range. Recent developments in ZnO-based hybrid systems and their integration into fiber-optic and microfluidic platforms are explored as scalable solutions for portable, multiplexed diagnostics. The review concludes by outlining current challenges related to reproducibility, long-term operational stability, and surface modification standardization. This work provides a framework for understanding structure-function relationships in ZnO-based biosensors and highlights future directions for their development in biomedical and environmental monitoring applications.}, }
@article {pmid41221170, year = {2025}, author = {Seo, SH and Song, MK}, title = {Advancements and challenges in next-generation mRNA vaccine manufacturing systems.}, journal = {Clinical and experimental vaccine research}, volume = {14}, number = {4}, pages = {299-307}, pmid = {41221170}, issn = {2287-3651}, abstract = {The coronavirus disease 2019 pandemic has accelerated the global adoption and development of messenger RNA (mRNA) vaccine technology. While traditional manufacturing approaches rely on centralized and batch-based processes that are limited in scalability and accessibility, recent innovations in modular, decentralized, and continuous-flow production systems offer promising alternatives. This review summarizes the evolution of mRNA manufacturing, examines technological advances such as BioNTech's BioNTainer and Quantoom's Ntensify, and critically evaluates persistent barriers including raw material supply, regulatory compliance, sustainability, and cold-chain requirements. The implementation of artificial intelligence, thermostable formulations, and self-amplifying mRNA technologies are discussed as future directions. Collectively, these innovations offer a pathway to equitable, scalable, and rapid vaccine deployment in the context of both pandemics and routine immunization.}, }
@article {pmid41220927, year = {2025}, author = {Cai, J and Chen, C and Wang, J and Zhang, X and Cui, Y and Zhu, Q and Sun, H}, title = {PROTAC: a revolutionary technology propelling small molecule drugs into the next golden age.}, journal = {Frontiers in oncology}, volume = {15}, number = {}, pages = {1676414}, pmid = {41220927}, issn = {2234-943X}, abstract = {Proteolysis Targeting Chimera (PROTAC) is a heterobifunctional molecule comprising three core components: a target protein ligand (typically a small-molecule inhibitor), a linker, and an E3 ubiquitin ligase ligand. By harnessing the specificity of the endogenous ubiquitin-proteasome system (UPS), PROTACs induce ubiquitination and subsequent degradation of target proteins. This technology constitutes an advanced therapeutic strategy for selective protein degradation, thereby expanding the horizons of drug design. Its significant therapeutic potential extends to treating cancers, viral infections (e.g., HIV and SARS-CoV-2), and chronic diseases. Recent clinical studies on compounds such as ARV-471 have yielded encouraging results, validating the efficacy of this approach. Over the past decade, PROTAC technology has garnered widespread attention in biomedicine for its promise in developing novel targeted therapies. This review will elucidate the broad therapeutic prospects and future challenges of PROTACs by detailing their mechanism of action, recent advances, progress in targeted therapy research, and current clinical trial landscape.}, }
@article {pmid41220708, year = {2025}, author = {Zaiser, C and Pahlenkemper, M and Brandt, G and Ballero Reque, C and Sabel, L and Laskowski, NM and Paslakis, G}, title = {Feeding the feelings: gender differences in emotional eating during COVID-19: a systematic review and meta-analysis.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1680872}, pmid = {41220708}, issn = {2296-861X}, abstract = {CONTEXT: The COVID-19 pandemic intensified mental health issues and increased emotional eating (EE), a coping mechanism, where food is consumed in response to emotions rather than hunger. During the pandemic, gender-specific EE patterns were observed, with women reporting elevated EE levels in response to stress, anxiety, and depression due to various social and psychological factors.<br><br>OBJECTIVES: This study primarily focused on examining gender differences in EE during the COVID-19 pandemic. As a secondary outcome, it aimed to explore predictors of EE.<br><br>DATA SOURCES AND EXTRACTION: This systematic review was pre-registered (PROSPERO CRD42023421727) and adhered to PRESS and PRISMA guidelines. Studies published between March 2020 and August 2024 were identified across Scopus, Web of Science, PubMed, and PsycINFO. The quality assessment was performed using the "Critical Appraisal Checklist for Analytical Cross-Sectional Studies." The meta-analysis was conducted following MOOSE guidelines.<br><br>DATA ANALYSIS: Of 14,347 studies identified, 30 met inclusion criteria (only if population &#x2265;18&#x202f;years, without clinical diagnoses, gender-specific analysis regarding EE, observational studies with original data collection during COVID-19 pandemic), with 16 incorporated into the meta-analysis. Gender significantly moderated pandemic-related stress. Higher EE scores in women were linked to isolation and caregiving responsibilities, while men's EE often appeared as reward-seeking. Across diverse measures and regions, women consistently exhibited higher EE scores (Cohen's d&#x202f;=&#x202f;0.39). Young adults and students showed a stronger association with EE, suggesting heightened vulnerability. Key predictors included increased food intake, COVID-19-related stress and lifestyle changes, sleep quality, and physical activity.<br><br>CONCLUSION: The predominance of cross-sectional designs limits the ability to draw causal conclusions, and selection bias in studies, often targeting specific groups, restricts generalizability. Future longitudinal studies are needed to assess causality and explore the inferences to additional factors, such as socioeconomic status and mental health. Gender-sensitive interventions are suggested to address EE risks, particularly in women.<br><br>PROSPERO (CRD42023421727). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023421727.}, }
@article {pmid41220463, year = {2025}, author = {Alakeel, AN and Alskait, BK and Binshafi, GB and AlAmro, HA and Alkharji, SK and Elsherbini, M and Aleid, NA and Alfrayan, RA}, title = {The Impact of Telehealth Adoption on Patient Outcomes: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e94328}, pmid = {41220463}, issn = {2168-8184}, abstract = {Telehealth adoption gained popularity during the coronavirus disease 2019 (COVID-19) pandemic and had substantial and various impacts on patient outcomes depending on the specific environment, healthcare system, and quality of telehealth services supplied. Hence, this systematic review explored those impacts and their sustainability post-pandemic. To conduct this systematic review, a thorough literature search was undertaken in electronic databases such as PubMed, Medline, Web of Science, Google Scholar, databases, Embase, and PsycINFO using relevant keywords. We included articles written in English and published in the last 10 years that reported on the impact of telehealth adoption on various patient outcomes and the impact of sustainability post-pandemic. The findings of this systematic review highlight the remarkable impact of telehealth adoption on patient outcomes and the sustainability of these initiatives post-pandemic. Telehealth has proven to enhance various aspects of healthcare, spanning from prevention to follow-up. Another effect of telehealth adoption is the significant reduction in hospitalizations. Furthermore, telehealth profoundly impacts hospital stays, leading to a decrease in all-cause hospital days per patient by 1.07 (95% confidence interval (CI): 1.76 to 0.39) days and a shorter mean hospital stay for condition-related hospitalizations by 89% (95% CI 1.42 to 0.36), providing evidence of efficient healthcare delivery. There was also a reduction in mortality rates for patients receiving telemedicine interventions. Telehealth is also cost-effective while remaining highly effective. Patient satisfaction is another key outcome of telehealth adoption observed. The convenience and reduced expenses of telehealth have garnered positive feedback from patients, reinforcing the desirability of telehealth as a viable alternative to in-person visits. Despite these numerous benefits, barriers and disparities in telehealth adoption and utilization persist, especially in rural hospitals that face challenges, including a lack of Health Information Exchange (HIE) capacity, limited patient engagement capabilities, and the absence of financial reimbursement. This systematic review underscores the remarkable impact of telehealth adoption on patient outcomes and its sustainability post-pandemic. However, barriers and disparities still exist, requiring attention to ensure equitable access to telehealth services. The evidence supports the continued development and implementation of telehealth initiatives to improve healthcare delivery and patient outcomes post-pandemic.}, }
@article {pmid41220300, year = {2025}, author = {Dagenais, C and Proulx, M and Hot, A and McSween-Cadieux, E and Villemin, R and Gautier, L and de Araujo Oliveira, SR and Cloos, P and Traverson, L and Zinszer, K and Ridde, V}, title = {How to formulate high-quality lessons learned: a rapid review.}, journal = {Global health action}, volume = {18}, number = {1}, pages = {2546691}, pmid = {41220300}, issn = {1654-9880}, support = {F32 DC000190/DC/NIDCD NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics ; }, abstract = {Lessons learned convey information and experiences that were studied when carrying out projects or policies, in order to improve procedures and practices to better cope with future similar problems in other contexts. Although the term lessons learned appears in the titles of thousands of scientific articles, most do not describe how these lessons were produced or the level of rigor involved in their development. As part of a project aimed at deriving lessons from hospitals' resilience during the COVID-19 pandemic in five countries (the HoSPiCOVID project), we sought to systematised the process of producing these lessons. To do so, we conducted a rapid review to identify the best ways of developing quality lessons learned (QLLs). A QLL results from a systematic process of collecting, compiling, and analysing data derived from a research project. The rapid review follows the same key steps as a systematic review, adapted to a more accelerated and pragmatic format. From 1,881 documents initially identified, 18 were retained. Their analysis identified three principles to guide the process of developing QLLs: 1) Creating a supportive climate; 2) Choosing the right leaders or facilitators for the process; and 3) Engaging in a scientific approach. Based on these findings, we developed a guide comprising 11 steps, structured into two main phases: preparatory steps for QLL development, and steps for identifying and formulating QLLs. This guide offers a structured process for teams seeking to enhance the rigor, clarity, and potential transferability of the lessons they formulate.}, }
@article {pmid41220197, year = {2025}, author = {De Wals, P and Quach, C}, title = {Off-Label use of vaccines may save lives and money: lessons from the province of Quebec, Canada.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {1-13}, doi = {10.1080/14760584.2025.2589214}, pmid = {41220197}, issn = {1744-8395}, mesh = {Humans ; Quebec ; *Off-Label Use/economics ; *Vaccines/administration &amp; dosage/economics/adverse effects ; Immunization Programs/economics ; *Vaccination/economics ; COVID-19 Vaccines/administration &amp; dosage ; COVID-19/prevention &amp; control ; }, abstract = {INTRODUCTION: In Canada, vaccines are authorized by Health Canada but publicly funded programs are of provincial/territorial jurisdiction. Off-label (OL) use of vaccines has been frequently implemented in Quebec over the last 30 years.<br><br>AREAS COVERED: The first part of this manuscript describes 11 recommendations from the Quebec Immunization Committee on meningococcal, pneumococcal, hepatitis A and B, HPV, rotavirus, and COVID-19 vaccines that were clearly OL. In the second part, challenges associated with OL use are discussed, including (i) the justifications of OL recommendations, (ii) the level of supporting scientific evidence, (iii) effectiveness and safety considerations, (iv) vaccine confidence and acceptability, (v) liability risks and informed consent.<br><br>EXPERT OPINION: With one exception, OL vaccine use in Quebec was successful. Reducing the number of doses or recommending the use of two different vaccines in a single immunization regimen (one vaccine having a much lower purchase cost than the other) allowed for more cost-effective immunization programs. Another OL's justification was to increase protection, by extending the age limit or interval between doses, or allowing an interchangeability of available vaccines. OL vaccine use should always be considered when properly justified by scientific evidence and vaccinology principles, and carefully evaluated when implemented.}, }
@article {pmid41220194, year = {2025}, author = {Liu, R and Shao, W and Ye, Q}, title = {Resurgence of Mycoplasma pneumoniae Infections in the Post-COVID-19 Era: Epidemiology, Therapeutic Challenges, and Mitigation Strategies.}, journal = {APMIS : acta pathologica, microbiologica, et immunologica Scandinavica}, volume = {133}, number = {11}, pages = {e70092}, doi = {10.1111/apm.70092}, pmid = {41220194}, issn = {1600-0463}, support = {LKLY25H200004//the Joint Fund of Zhejiang Provincial Natural Science Foundation of China/ ; GZY-KJS-ZJ-2025-015//Joint TCM Science &amp; Technology Projects of National Demonstration Zones for Comprehensive TCM Reform/ ; LR24H200001//the Zhejiang Provincial Outstanding Youth Science Foundation/ ; }, mesh = {Humans ; *Pneumonia, Mycoplasma/epidemiology/drug therapy/therapy/prevention &amp; control ; *COVID-19/epidemiology ; Anti-Bacterial Agents/therapeutic use ; *Mycoplasma pneumoniae/drug effects ; SARS-CoV-2 ; Drug Resistance, Bacterial ; }, abstract = {This study aims to review recent literature on the delayed re-emergence of Mycoplasma pneumoniae (MP) and to discuss its epidemiological characteristics, treatment strategies, and future research directions for global MP prevention and control. Through a systematic review of the recent relevant literature, the epidemiological changes in MP and the rate of increase in drug resistance during and after the COVID-19 pandemic were analyzed. Moreover, the main treatment strategies for MP, including traditional antibiotics, immunomodulators, and combination therapy, were comprehensively analyzed. The results demonstrated that nonpharmacological interventions (NPIs) implemented during the COVID-19 pandemic exerted a marked reduction in MP detection rates. However, subsequent to the progressive relaxation of NPI measures, a resurgence of MP infections has been observed across multiple global regions, accompanied by an escalating prevalence of antimicrobial resistance-particularly concerning macrolide antibiotics. The investigation further conducted systematic analyses of current therapeutic regimens for MP infection, providing critical evaluations of their respective clinical advantages and limitations in practical application. This study proposes strategies for MP's delayed recirculation control amidst its changing epidemiology and drug resistance, offering a scientific basis and practical suggestions for global MP prevention.}, }
@article {pmid41219464, year = {2025}, author = {Byrne, D and Gale, C and Canty, N and Meehan, J and Dumitriu, D and Yonts, A and Mulkey, SB and Molloy, EJ}, title = {Neurological and neurodevelopmental effects of Covid and MIS-C on children.}, journal = {Pediatric research}, volume = {}, number = {}, pages = {}, pmid = {41219464}, issn = {1530-0447}, abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been shown to cause a unique disease phenotype in the paediatric population compared to adults, following the emergence of Multisystem Inflammatory Syndrome of Children (MIS-C) and Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). Over the course of the pandemic, neurological symptoms associated with SARS-CoV-2 have been reported in the paediatric population. The neurological and neurodevelopmental sequelae of both acute SARS-CoV-2 infection and MIS-C/PIMS-TS in the paediatric population are not well understood. Little is known about the underlying pathophysiology and the potential neurovirulence of SARS-CoV-2. Further awareness and research are needed on the neurological sequelae and long-term consequences of SARS-CoV-2 on the developing brain. IMPACT: Detailed review of the current knowledge on neurological and neurodevelopmental effects of SARS-CoV-2 and MIS-C on the paediatric population. Emphasise the importance of acknowledging the potential direct effects of SARS-CoV-2 and MIS-C on neurological and neurodevelopmental outcomes. Highlight the need for further research and inclusion of paediatric patients in follow up studies of long-term effects of SARS-CoV-2 and MIS-C focusing on neurodevelopmental and neurological sequelae.}, }
@article {pmid41218870, year = {2025}, author = {He, XY and Li, XH and Tong, ZH}, title = {[Cognitive impairment in long COVID: advances in pathological mechanisms and exercise rehabilitation interventions].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {48}, number = {11}, pages = {1087-1095}, doi = {10.3760/cma.j.cn112147-20250610-00315}, pmid = {41218870}, issn = {1001-0939}, support = {2023YFC0872500//National Key Research and Development Program/ ; Ggyfz202503//Reform and Development Program of Beijing Institute of Respiratory Medicine/ ; }, mesh = {Humans ; *Cognitive Dysfunction/rehabilitation/etiology ; *COVID-19/complications/psychology ; *Exercise Therapy ; *Post-Acute COVID-19 Syndrome ; Quality of Life ; }, abstract = {Since the outbreak of the novel coronavirus (COVID-19) pandemic, long-term effects of the virus, known as long-COVID, has emerged. It is a chronic syndrome following infection. It is estimated that around 20% of COVID-19 survivors worldwide experience cognitive dysfunction. This is characterized by impairments in executive function, attention, memory, and other cognitive domains, and can have a significant impact on quality of life and social functioning. This article systematically reviewed recent studies and summarized the potential pathological mechanisms underlying cognitive dysfunction in long COVID, including neuroinflammation, glial cell dysregulation, involvement of the olfactory pathway and limbic system, autoimmunity and viral reactivation, cerebrovascular and blood-brain barrier damage, as well as abnormalities in neurotrophic factors and synaptic plasticity. Additionally, it explored the effects of exercise rehabilitation and multidimensional comprehensive rehabilitation strategies. The aim was to provide theoretical and scientific foundations for optimizing intervention programs for cognitive dysfunction in long COVID and for formulating clinical guidelines and public health policies.}, }
@article {pmid41218570, year = {2025}, author = {Ledderer, L and Nielsen, KH and Skodborg, L and Fage-Butler, A}, title = {Public trust and mistrust of COVID-19 vaccines: A systematic meta-narrative review.}, journal = {Vaccine}, volume = {69}, number = {}, pages = {127947}, doi = {10.1016/j.vaccine.2025.127947}, pmid = {41218570}, issn = {1873-2518}, abstract = {INTRODUCTION: Trust played a fundamental role in vaccine decision-making and uptake during the COVID-19 pandemic. The purpose of this study is to explore how public trust was conceptualized, operationalized, and implicated in vaccine uptake research on COVID-19 vaccines.<br><br>METHODS: Using a systematic meta-narrative review, we searched literature around trust/distrust, science and COVID-19 vaccines. This involved identifying research areas, aims, methods, and sample sizes for each study while inductively/deductively exploring six narratives of trust - attitudinal, cognitive, affective, contingent, contextual, and communicated - developed in a previous study to synthesize findings across diverse disciplines and methodologies.<br><br>RESULTS: The final sample consisted of 79 peer-reviewed studies on trust in relation to COVID-19 vaccination. Our analysis revealed a degree of methodological uniformity as most were quantitative survey-based investigations conducted in Europe and the United States with trust typically operationalized through Likert-scale measures assessing attitudes toward science, scientists, public health authorities, and the vaccines themselves. Conceptual diversity was also evident as although trust was treated as a key explanatory factor in nearly all studies, its referents varied widely, from institutions and information sources to personal dispositions and social dynamics. Similarly, the implications of trust ranged from vaccination intention and motivation to hesitancy and actual uptake. The meta-narrative framework highlighted that attitudinal and contingent trust dominated the literature, while cognitive and affective dimensions were mainly underexplored. Despite the methodological dominance of quantitative approaches, this standardization offers strengths of comparability and policy relevance, but the limited exploration of emotional, relational, and communicative aspects of trust points to missed opportunities for more nuanced understanding.<br><br>CONCLUSION: The meta-narrative approach provided a valuable tool for synthesizing conceptual pluralism. Our findings suggest that trust in vaccination is not a singular construct, but a constellation of interrelated attitudes and judgments shaped by context, communication, and experience, each with implications for public health.}, }
@article {pmid41218566, year = {2025}, author = {Jimeno, J and Varona, JF and Lopez-Martin, JA and Izquierdo-Useros, N and Molina Molina, E and Guisado-Vasco, P and Sachse, M and Risco, C and Losada, A and Fudio, S and Luepke, E and Nieto, A and Gomez, J and Aviles, P and Cuevas, C and Bouhaddou, M and Sola, I and Krogan, NJ and Enjuanes, L and Fernandez-Sousa, JM and GarcÍa-Sastre, A and White, K}, title = {Pharmacological reprogramming of plitidepsin as a SARS-CoV-2 inhibitor.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101412}, doi = {10.1016/j.mam.2025.101412}, pmid = {41218566}, issn = {1872-9452}, abstract = {Selective pressures in the ocean promote the evolution of potent molecules that may be useful in therapeutic settings. Tunicates provide a rich source of bioactive molecules that have been shown to have anti-neoplastic and anti-microbial activities. Plitidepsin, a natural marine cyclic depsipeptide originally isolated from the tunicate Aplidium albicans, was originally developed as an anti-tumor drug, and has been approved for use in Australia in patients with advanced pretreated myeloma. Early in the SARS-CoV-2 pandemic, plitidepsin was shown to have potent preclinical efficacy against the virus, suggesting that it could be repurposed for the treatment of COVID-19. This review summarizes the clinical development of plitidepsin first as an anti-tumor drug, before providing a recapitulation of current efforts to repurpose the molecule as an antiviral therapy. The pharmacokinetic and pharmacodynamic data on plitidepsin will be analyzed, and the various experimental lines of evidence in support of the molecule's multifactorial mechanism of action will be explored. Finally, the available data on the use of plitidepsin in patients with COVID-19 will be presented, including results from a Phase I proof-of-concept study, real-world data from immunocompromised patients, and a look of results from a Phase III clinical trial that confirms the working hypothesis.}, }
@article {pmid41217408, year = {2025}, author = {Desai, S and Rath, C and Bhandarkar, N and Jape, G and Rao, S}, title = {Virtual Reality Experience to Relieve Stress, Burnout, Fatigue, and Anxiety in Healthcare Professionals: A Systematic Review.}, journal = {Journal of healthcare management / American College of Healthcare Executives}, volume = {70}, number = {6}, pages = {416-434}, pmid = {41217408}, issn = {1096-9012}, mesh = {Humans ; *Burnout, Professional/prevention &amp; control/therapy/psychology ; *Health Personnel/psychology ; *Anxiety/therapy/prevention &amp; control ; *Virtual Reality ; COVID-19/epidemiology ; *Fatigue/prevention &amp; control/therapy ; *Stress, Psychological/therapy/prevention &amp; control ; }, abstract = {GOAL: Healthcare professionals (HCPs) working long shifts are prone to physical, emotional, and psychological stress leading to harmful effects on their mental health, an issue compounded by the COVID-19 pandemic. Novel efforts such as virtual reality (VR)-based immersion have been explored to mitigate this problem in HCPs. However, the studies vary in their clinical settings, scales used for measuring outcomes related to mental health, sample size, and other relevant parameters. We conducted a systematic review (SR) to collate all available evidence on the feasibility and efficacy of VR-based interventions for reducing stress, burnout, fatigue, and anxiety in HCPs.<br><br>METHODS: We searched major databases for comprehensive literature on HCP mental well-being measures in September 2023 and February 2024. Risk of bias was assessed using the Effective Public Health Practice Project (EPHPP) quality assessment tool, and PRISMA guidelines were used for reporting this SR.<br><br>PRINCIPAL FINDINGS: A total of 17 studies out of 1,422 citations were included in the final analysis. The number of study participants ranged from 14 to 219 (1,053 total). Seven studies were randomized controlled trials, and the rest were pre-post intervention studies. Meta-analysis was not feasible because the included studies were heterogeneous in their study settings, methodology, and assessed mental health domain. Based on the EPHPP tool, one study had a strong global rating, two had a moderate rating, and 14 had a weak rating.<br><br>PRACTICAL APPLICATIONS: VR-based interventions during break times appear to be feasible and useful in addressing HCP stress, burnout, fatigue, and anxiety. However, limited high-quality studies warrant caution in interpretation.}, }
@article {pmid41217268, year = {2025}, author = {Arcari, G and Colombini, L and Castelli, M and Novazzi, F and Clementi, N and Santoro, F and Mancini, N}, title = {Global spread of Streptococcus pyogenes A genomics-supported narrative review.}, journal = {FEMS microbiology reviews}, volume = {49}, number = {}, pages = {}, pmid = {41217268}, issn = {1574-6976}, support = {PE00000007//European Union/ ; }, mesh = {*Streptococcus pyogenes/genetics/pathogenicity/classification ; Humans ; *Streptococcal Infections/epidemiology/microbiology/transmission ; *Genome, Bacterial ; Genomics ; Whole Genome Sequencing ; Global Health ; COVID-19/epidemiology ; }, abstract = {Group A Streptococcus (GAS) has recently reemerged as a leading cause of both mild and severe invasive infections worldwide, with recent upsurges in invasive disease among children and adults. Notwithstanding a partial synchronicity with the COVID-19 pandemic, this rapid global dissemination of more virulent GAS lineages has been promptly detected, as well as the molecular shifts underlying the observed changes in clinical patterns. Whole-genome sequencing (WGS)-based genomic epidemiology allowed us to gain relevant insights into this upsurge as it was happening. This review integrates the canonical research publication-based approach with genomic data and metadata and identifies a subset of genomic clusters playing a major role in invasive GAS (iGAS) infections worldwide, which were named as Global Pathogenic Lineages (GPLs). The four GPLs broadly coincide with five sequence types (STs): GPL1 with ST28, GPL2 with ST15 and ST315, GPL3 with ST52, and GPL4 with ST39. While non-GPLs clusters maintain a baseline reservoir of antimicrobial-resistance and virulence genes, GPLs show varying but noteworthy resistance profiles and are frequent causes of iGAS. The integration of WGS into routine diagnostics procedures is a forthcoming improvement, aimed not only at informing tailored therapy and implementing infection control strategies, but also to perform continuous surveillance. Ongoing WGS in clinical microbiology, as a matter of fact, will provide unparalleled insights into lineage emergence, transmission dynamics, and the geographic clustering of virulence and resistance determinants.}, }
@article {pmid41217254, year = {2025}, author = {Lee, DH and Lee, W and Bach, H}, title = {Nanomedicine in the development of vaccines against Herpesviridae: a narrative review.}, journal = {Nanomedicine (London, England)}, volume = {}, number = {}, pages = {1-21}, doi = {10.1080/17435889.2025.2587714}, pmid = {41217254}, issn = {1748-6963}, abstract = {The Herpesviridae family, more commonly known as herpesviruses, includes the Alphaherpesvirinae, Betaherpesvirinae, and Gammaherpesvirinae subfamilies, each with unique clinical presentations. Herpesvirus infections are a major public health concern. Current management approaches for herpesviruses primarily focus on antiviral or symptomatic treatment, with few licensed vaccines. Recent advancements in nanotechnology applied to the COVID-19 pandemic have created new opportunities to develop vaccines using nanomedicine to prevent herpesvirus infections. The authors reviewed 62 papers studying nanomedicine applications for vaccine development for herpesviruses. Nanoparticle-based vaccine delivery strategies may be feasible and practical options for herpesvirus prevention.}, }
@article {pmid41216008, year = {2025}, author = {Abbas, U and Kumar, H and Hussain, N and Ahmed, I and Laghari, RN and Tanveer, M and Hadif, M and Fatima, K and Khalid, MU and Anwar, K and Khan, M}, title = {Immune dysregulation in type 2 diabetes mellitus: Implications for tuberculosis, COVID-19, and HIV/AIDS.}, journal = {Infectious medicine}, volume = {4}, number = {4}, pages = {100211}, pmid = {41216008}, issn = {2772-431X}, abstract = {Diabetes mellitus (DM) is a complex and multifactorial disorder associated with elevated blood sugar levels, poor insulin sensitivity, and inadequate insulin production. It has a major impact on the immune system, making a person more susceptible to and influenced by a variety of infectious illnesses. This narrative review summarizes the relationship between chronic inflammation and high glucose levels in DM, on susceptibility and outcomes in endemic infectious diseases. We focused on impact of DM on disease progression, and treatment response in these infections. Literature was identified through searches of PubMed, Scopus, and Google Scholar, focusing on epidemiologic, clinical, and mechanistic studies. The evidences suggest that immune modulation in DM has profound inverse relations with the outcome of infectious diseases including tuberculosis, COVID-19, and HIV/AIDS. DM increases the risk of developing severe forms of infectious diseases due to downregulation of the immune system which is associated with glycemic control. There is a need to understand the relationship between DM and immunological control for developing methods to reduce these risks and improve outcomes for the affected population.}, }
@article {pmid41214693, year = {2025}, author = {Sad, SA and Iftikhar, L and Chamout, M}, title = {Revisiting HPV vaccination post-COVID: geopolitical, sociocultural, and ethical disparities in global health.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {308}, pmid = {41214693}, issn = {1475-9276}, abstract = {BACKGROUND: HPV vaccines have been revolutionary in preventing HPV-related cervical cancer and reshaping the cervical cancer screening guidelines in the past decades. Yet, challenges persist in achieving universal accessibility and utilization. Since the COVID-19 pandemic, shifts have emerged in HPV vaccine research, implementation strategies, and the determinants shaping uptake and delivery, particularly from a global equity perspective.<br><br>METHODS: This is a scoping review examining English-language, peer-reviewed articles published following the onset of the COVID-19 pandemic until the end of 2024. It focuses on the human papillomavirus (HPV) vaccine and factors influencing its uptake. Articles were retrieved from PubMed and Embase databases and screened for relevance using predefined search terms.<br><br>RESULTS: Out of 2755 articles, 349 were included. We identified that most peer-reviewed articles focus on interventions and implementation strategies more than acknowledging geopolitical affairs, gender specificity, religious and ethical dimensions, medical mistrust, or healthcare discrimination. Most of the articles were cross-sectional in nature and most were funded by the National Cancer Institute. Interestingly, we found no peer-reviewed articles on the intersectionality of Judaism and HPV vaccine uptake, with a limited number on Islamic, Christian, or other religious intersectionality. Articles addressing how low- and middle-income countries could be equipped to develop and manage their own vaccine programs and manufacturing were largely absent; instead, cost-effectiveness research focused primarily on the vaccine&#x2019;s ability to reduce disease burden.<br><br>CONCLUSION: Post-pandemic research on HPV vaccination indicates that levels of hesitancy and uptake have remained relatively stable. However, the literature highlights persistent inconsistencies in how the vaccine is prioritized across communities, healthcare professionals, and health systems. Messaging regarding its importance for cancer prevention remains fragmented, while cost barriers and the absence of the vaccine from many national immunization schedules continue to limit access. Notably, ethical, religious, and cultural considerations receive limited attention in current research, despite the pandemic underscoring the global significance of these factors in shaping health behaviors. These findings suggest a need to re-examine how HPV vaccination is framed and advanced as a public health priority within diverse sociocultural and systemic contexts.}, }
@article {pmid41214450, year = {2025}, author = {Badra, R and Zhang, W and Tam, JSL and Webby, R and Van Der Werf, S and Nikisins, S and Cullinane, A and Gharaibeh, S and Njouom, R and Peiris, M and Kayali, G and Heraud, JM}, title = {A Systematic Review of New, Enhanced Surveillance Systems and Methodologies for Zoonotic Influenza Viruses in Animals and Human-Animal Interface.}, journal = {Influenza and other respiratory viruses}, volume = {19}, number = {11}, pages = {e70178}, pmid = {41214450}, issn = {1750-2659}, support = {203434270/WHO_/World Health Organization/International ; }, mesh = {Animals ; Humans ; *Epidemiological Monitoring ; Global Health ; *Influenza, Human/epidemiology/virology/transmission/prevention &amp; control ; *Orthomyxoviridae/isolation &amp; purification ; *Orthomyxoviridae Infections/epidemiology/prevention &amp; control/veterinary/virology ; Pandemics ; *Viral Zoonoses/epidemiology/prevention &amp; control/transmission/virology ; }, abstract = {In 2009, the World Health Organization (WHO) developed a public health research agenda for influenza to guide researchers and outline directions and priority areas for research on influenza aiming at reducing the burden of seasonal epidemic influenza and the risk and impact of pandemic influenza. The agenda was updated in 2017, but since then, important research has been conducted, and major changes have occurred to the global health landscape impacted mainly by the COVID-19 pandemic. Therefore, there is a need to assess advances in zoonotic influenza surveillance methods reported between 2017 and 2024 in order to highlight key achievements and identify remaining gaps that limit their broader implementation, hence informing an update of the research agenda. We conducted a comprehensive literature review of zoonotic influenza surveillance and monitoring, focusing on novel and enhanced methodologies reported globally between 2017 and 2024. A systematic analysis was performed following PRISMA guidelines on 7490 peer-reviewed manuscripts from 2017 to 2024 retrieved from PubMed, of which 164 records were included in this review. Analysis of the information collected indicated several advances and gaps at different levels of surveillance and unmet public health needs. Most countries do not have active and comprehensive surveillance programs for zoonotic influenza at the human-animal interface, which underestimates the true burden of zoonotic influenza diseases. The review concludes with a set of high-priority research recommendations focused on filling gaps in One Health data integration, validation, and field deployment of novel diagnostic technologies, wider adoption of noninvasive and environmental surveillance approaches, and stronger linkage of methodological innovations to risk assessment and policy action. In light of the recent upsurge in H5N1 activity and cross-species transmission, the WHO has convened multiple R&amp;D Blueprint consultations over the past year to prioritize research and development for H5N1 candidate vaccines, diagnostics, and pandemic preparedness. These ongoing initiatives underscore the critical importance of strengthening surveillance at the human-animal interface.}, }
@article {pmid41214236, year = {2026}, author = {Uraki, R and Korber, B and Diamond, MS and Kawaoka, Y}, title = {SARS-CoV-2 variants: biology, pathogenicity, immunity and control.}, journal = {Nature reviews. Microbiology}, volume = {24}, number = {1}, pages = {8-28}, pmid = {41214236}, issn = {1740-1534}, mesh = {*SARS-CoV-2/pathogenicity/immunology/genetics ; Humans ; *COVID-19/immunology/prevention &amp; control/virology/transmission/epidemiology ; COVID-19 Vaccines/immunology ; Pandemics/prevention &amp; control ; }, abstract = {More than 5 years have passed since the emergence of the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), yet this virus continues to circulate globally, undergoing evolutionary changes. The effective control of SARS-CoV-2 necessitates an understanding of its antigenicity, replicative capacity, pathogenicity and transmissibility, as well as the development of preventive and treatment options. In this Review, we describe the origins and evolution of SARS-CoV-2, and outline variant and subvariant-specific characteristics. We also discuss the challenges faced in implementing prevention and treatment methods, such as the emergence of antigenically distinct variants and the phenomenon of immune imprinting. This Review provides insights into combating the ongoing COVID-19 pandemic and guidance for future research and vaccine development efforts.}, }
@article {pmid41213787, year = {2025}, author = {Adusei-Mensah, F and Olubamwo, O and Olaleye, S and Akter, L and Balogun, OS and Moshoeshoe, RJ and Awoniyi, L and Olawuni, A and Kauhanen, J}, title = {Updating the impact of mRNA COVID-19 vaccine exposure during pregnancy on obstetric and neonatal outcomes.}, journal = {Taiwanese journal of obstetrics &amp; gynecology}, volume = {64}, number = {6}, pages = {957-970}, doi = {10.1016/j.tjog.2025.07.022}, pmid = {41213787}, issn = {1875-6263}, mesh = {Female ; Humans ; Infant, Newborn ; Pregnancy ; Congenital Abnormalities/epidemiology ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage ; Fetal Distress/epidemiology ; *Pregnancy Complications, Infectious/prevention &amp; control ; *Pregnancy Outcome/epidemiology ; Premature Birth/epidemiology ; SARS-CoV-2 ; Vaccination ; }, abstract = {Being a new vaccine platform, continuous monitoring of the mRNA COVID-19 vaccines in pregnant women is of critical importance. This systematic review and meta-analysis evaluate the maternal and neonatal outcomes associated with mRNA COVID-19 vaccination during pregnancy. We conducted a systematic search of PubMed, Embase, Cochrane Library, and clinical trial registries for studies published between December 2020 and July 2024. Studies were included if they assessed obstetric and neonatal outcomes following mRNA COVID-19 vaccination in pregnant women. Data were extracted and analyzed using a random-effects model to calculate pooled odds ratios (ORs) and 95 % confidence intervals (CIs). Fifteen studies met the inclusion criteria, encompassing 42,944 vaccinated and 183,733 unvaccinated pregnant women. mRNA vaccination was associated with a significant reduction in preterm delivery (OR 0.743, 95 % CI 0.607-0.911), fetal distress (OR 0.699, 95 % CI 0.546-0.893), neonatal congenital abnormalities (OR 0.712, 95 % CI 0.570-0.889), and NICU admissions (OR 0.718, 95 % CI 0.617-0.836). However, a slight increase in gestational diabetes risk was observed (OR 1.107, 95 % CI 1.054-1.162). mRNA COVID-19 vaccines are safe during pregnancy and associated with reduced risks of adverse obstetric and neonatal outcomes. An observed marginal increase in gestational diabetes risk underscores the need for continuous monitoring. These findings support the inclusion of pregnant women in vaccination campaigns and inform public health policies and clinical practices to improve maternal and neonatal health outcomes.}, }
@article {pmid41213387, year = {2025}, author = {Rong, H and Ren, J and Wu, Q and Zhu, H and Dong, C and Wang, G}, title = {Repurposing niclosamide for COVID-19: Synergistic strategies of nanotechnology and novel materials to enhance antiviral efficacy.}, journal = {Microbial pathogenesis}, volume = {210}, number = {}, pages = {108169}, doi = {10.1016/j.micpath.2025.108169}, pmid = {41213387}, issn = {1096-1208}, abstract = {The persistent prevalence of COVID-19 and its emerging variants continues to threaten global health security. While most of these viruses have been controlled through medications or vaccines, the increasing number of SARS-CoV-2 variants and the inequitable access to vaccines across nations remain significant challenges for epidemiological management. Niclosamide, an FDA-approved anthelmintic drug, exhibits broad-spectrum antitumor, antibacterial, and antiviral properties, yet suffers from poor bioavailability. Repurposing niclosamide in combination with advanced material technologies may offer a promising therapeutic strategy. To optimize its future clinical applications, we summarize the antiviral mechanisms of niclosamide and emphasize strategies such as nanotechnology and novel material design to enhance its bioavailability and stability. Additionally, we discuss the latest clinical trial outcomes of niclosamide. Looking ahead, with the ongoing advancements in material synthesis, the synergistic integration of nano-hybridization and innovative material systems for niclosamide is poised to become a pivotal tool in epidemiological management and combating viral threats, providing an innovative, accessible, and cost-effective solution for pandemic control.}, }
@article {pmid41213341, year = {2025}, author = {Xavier, D and Silva, W and Correa, F and Porto, I and Soares, L and Melgaço, G and Oliveira, V and Lima, V and Oliveira, M}, title = {Experience of parenting children and adolescents with cystic fibrosis: A systematic review of qualitative studies and meta-synthesis.}, journal = {Respiratory medicine}, volume = {249}, number = {}, pages = {108485}, doi = {10.1016/j.rmed.2025.108485}, pmid = {41213341}, issn = {1532-3064}, mesh = {Humans ; *Cystic Fibrosis/psychology/therapy ; Adolescent ; Child ; Qualitative Research ; *Parenting/psychology ; *Parents/psychology ; *Caregivers/psychology ; Adaptation, Psychological ; COVID-19/epidemiology/psychology ; Palliative Care/psychology ; Social Support ; Female ; Male ; }, abstract = {BACKGROUND: Caring for children with cystic fibrosis (CF) poses significant emotional and practical challenges for parents and caregivers. Understanding their experiences is crucial to improving care.<br><br>METHODS: A systematic review was conducted of qualitative studies on the experiences of parents and caregivers of children and adolescents with CF. Multiple databases were searched. Studies were independently screened and appraised. A meta-synthesis approach was used to integrate the findings.<br><br>RESULTS: Key themes were identified in 27 studies, mainly from English-speaking countries: impact of diagnosis, routine care demands, healthcare relationships, faith, adolescent transition, support systems, uncertain future, palliative care, and COVID-19 challenges. Caregivers face emotional distress, guilt, and burden, along with the limitations of the healthcare system and social stigma. Optimism about treatments coexisted with fear and uncertainty. Adolescent transition brought challenges in terms of autonomy and adherence to treatment. Spirituality was both a coping tool and a source of conflict.<br><br>CONCLUSIONS: Caregiving for children and adolescents with CF is complex and multifaceted. Clear communication, continuous psychosocial support, and respect for both emotional and spiritual needs are vital, especially upon receiving the diagnosis and during adolescence. Open discussions on sensitive topics, such as palliative care, can improve caregiver experiences and outcomes.}, }
@article {pmid41213226, year = {2025}, author = {Nagai, K and Mitani, T and Kawahara, Y and Oguma, H and Gomi, A and Yasumoto, A and Tajima, T and Muramatsu, K and Osaka, H}, title = {A pediatric case of anti-PF4 antibody-induced cerebral venous sinus thrombosis and thrombocytopenia following adenovirus infection: a literature review.}, journal = {Brain &amp; development}, volume = {47}, number = {6}, pages = {104483}, doi = {10.1016/j.braindev.2025.104483}, pmid = {41213226}, issn = {1872-7131}, mesh = {Humans ; Female ; *Platelet Factor 4/immunology ; Child, Preschool ; *Sinus Thrombosis, Intracranial/etiology/immunology/diagnostic imaging ; *Thrombocytopenia/etiology/immunology ; *Adenoviridae Infections/complications/immunology ; Autoantibodies ; }, abstract = {INTRODUCTION: Vaccine-induced immune thrombocytopenia and thrombosis (VITT) is a rare disorder caused by antibodies against platelet factor 4 (PF4) triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines using non-replicable adenoviral vectors. It emerged during the pandemic, with patients typically presenting with thrombosis at uncommon sites, thrombocytopenia, and elevated D-dimer levels. VITT antibodies and heparin-dependent antibodies bind to distinct PF4 epitopes. Recently, VITT-like clinical, laboratory, and anti-PF4 antibody features have also been observed in patients with adenoviral infections. Only four pediatric cases of cerebral venous sinus thrombosis (CVST) have been reported.<br><br>CASE REPORT: The patient was a previously healthy 2-year-old girl with no history of heparin exposure or SARS-CoV-2 vaccination. She presented with fever and was diagnosed with adenovirus infection. The fever resolved by day 4, but by day 6 she became increasingly lethargic and experienced vomiting. On day 12, Laboratory data showed severe thrombocytopenia and elevated D-dimer levels. Computed tomography revealed CVST along with a secondary hemorrhage in the right temporal lobe. She underwent hematoma removal with external/internal decompression and was started on continuous intravenous unfractionated heparin, and she was switched to warfarin. The thrombus decreased, platelet count spontaneously increased. Platelet activation assays using acute-phase serum identified a PF4-dependent platelet-activating antibody.<br><br>CONCLUSION: We report a case of CVST in a 2-year-old girl following adenovirus infection. Unlike heparin-induced thrombocytopenia, where heparin exacerbates the condition, it is effective here by competitively inhibiting anti-PF4 antibody binding. In patients with prior adenovirus infection presenting with CVST and thrombocytopenia, anti-PF4 disorders should be considered.}, }
@article {pmid41212631, year = {2025}, author = {Goodfellow, H and Blandford, A and Bradbury, K and Gomes, M and Hamilton, F and Henley, W and Stevenson, F and Fernandez-Reyes, D and Hurst, J and Heightman, M and Pfeffer, P and Ricketts, W and Singh, R and Hylton, H and Linke, S and Bindman, J and Robson, C and Walker, S and Ismaila, H}, title = {Development and implementation of a digital health intervention in routine care for long COVID patients: a comprehensive synopsis.}, journal = {Health and social care delivery research}, volume = {13}, number = {39}, pages = {1-27}, doi = {10.3310/GJHG0331}, pmid = {41212631}, issn = {2755-0079}, mesh = {Humans ; *COVID-19/rehabilitation ; Male ; Female ; Telemedicine/organization &amp; administration ; Middle Aged ; SARS-CoV-2 ; Adult ; Patient Reported Outcome Measures ; United Kingdom ; Aged ; State Medicine ; Digital Health ; }, abstract = {BACKGROUND: By July 2020, large numbers of post-COVID patients were experiencing symptoms for weeks or months, but traditional National Health Service models of rehabilitation service delivery could not meet demand.<br><br>OBJECTIVES: Design and deploy a digital health intervention to provide digitally delivered, remotely supported rehabilitation to long COVID patients on complicated and evolving pathways.<br><br>METHODS: The multidisciplinary team combined established research methods based on engineering and computer science (considering safety, stability and user requirements) with those based on biomedical and health service research (considering effectiveness and population impact). Qualitative data comprised recordings of meetings between study team members and clinicians and semistructured interviews with clinician and patient users. Quantitative data comprised referral, registration and usage rates; demographic and clinical characteristics of patients; and patient-reported outcome measures.<br><br>RESULTS: We created a modifiable digital health intervention, 'Living With COVID Recovery[TM] developed by Living With Ltd', London, UK, that continues to be used by National Health Service trusts. The digital health intervention included integration into a clinical pathway, a clinician-facing dashboard, two-way messaging and a patient-facing app with information and evidence-based treatments. We aimed to register 1000 users. By study completion on 20 December 2022, there were 9781 patients invited, of whom 7679 (78.5%) had registered, at 33 National Health Service clinics.<br><br>LIMITATIONS: Data came from patients at long COVID clinics, however data were unlikely to be representative of people with long COVID. We could not observe clinics under lockdown and had limited access to patient digital health intervention users or to people not engaging with the digital health intervention. Patient user data were incomplete, with inconsistent patient-reported outcome measure and other questionnaire data completion and no data on initial severity of disease, vaccination status, comorbidities or other individual circumstances.<br><br>CONCLUSIONS: Long COVID can be extremely debilitating, comparable to stage IV lung cancer in relation to fatigue and health-related quality of life. Care and rehabilitation should address the management of fatigue and reflect the impact of social disadvantage on symptom severity. With sufficient resources, a digital health intervention can be developed quickly and effectively using agile methodology and bringing together a genuinely multidisciplinary team, including, importantly, an industry partner. Digital health intervention product design and deployment are both important in getting National Health Service trusts, healthcare professionals and patients to engage with a digital health intervention. Projects should work closely with all user groups. Lockdown and the unmet need of a new patient group encouraged those who might otherwise have been reluctant to try a digital health intervention. Many patients and clinics accepted this digital remote support, which helped patients feel cared for while reducing strain on health services. This may encourage acceptance of other digital health intervention, although medical record integration remains a deterrent to clinics.<br><br>FUTURE WORK: This research focused on the development, deployment and evaluation of a digitally enabled rehabilitation programme for long COVID. Clinical effectiveness will be assessed within the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (UCL, London, UK) study.<br><br>FUNDING: This synopsis presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132243.}, }
@article {pmid41212573, year = {2025}, author = {Alali, M}, title = {Pediatric Hepatitis-Associated Aplastic Anemia.}, journal = {Pediatric annals}, volume = {54}, number = {11}, pages = {e400-e403}, doi = {10.3928/19382359-20250910-02}, pmid = {41212573}, issn = {1938-2359}, mesh = {Humans ; *Anemia, Aplastic/therapy/diagnosis/etiology ; Child ; *Hepatitis/complications ; }, abstract = {Hepatitis-associated aplastic anemia (HAAA) is a rare but life-threatening disorder that requires early recognition and intervention. Pediatricians play a critical role in identifying cases where acute hepatitis transitions to severe bone marrow failure. This review presents the diagnostic and therapeutic complexities associated with HAAA, emphasizing the importance of a multidisciplinary approach. Key topics include the pathophysiology of immune-mediated marrow suppression, diagnostic strategies (eg, immunophenotyping, bone marrow biopsy), and management approaches (eg, immunosuppressive therapy, hematopoietic stem cell transplantation). The review also highlights emerging evidence on viral triggers, such as severe acute respiratory syndrome coronavirus 2, and underscores the need for heightened clinical awareness and standardized treatment strategies.}, }
@article {pmid41212171, year = {2025}, author = {Alkhwaiter, B and Aloud, M and Almezeini, N}, title = {User Experience in mHealth Research: Bibliometric Analysis of Trends and Developments (2007-2023).}, journal = {JMIR mHealth and uHealth}, volume = {13}, number = {}, pages = {e75909}, pmid = {41212171}, issn = {2291-5222}, mesh = {Humans ; *Bibliometrics ; *Telemedicine/trends ; COVID-19/epidemiology ; *Mobile Applications/trends ; }, abstract = {BACKGROUND: The significance of mobile health (mHealth) apps transforms traditional health care delivery and enables individuals to actively manage their health. The success and effectiveness of mHealth apps heavily depend on the user experience and satisfaction. Previous studies have examined mHealth adoption through systematic literature reviews, focusing on mental health, chronic disease management, fitness, and public health responses to crises like the COVID-19 pandemic. However, the state of research, the key trends, themes, and gaps in the user experience and satisfaction with mHealth apps remain unexplored.<br><br>OBJECTIVE: This study aimed to investigate the state of research on user experience in mHealth apps through a bibliometric analysis. Furthermore, the study aims to systematically identify research trends and themes by extending the analysis of the science mapping technique, co-word analysis, and bibliographic coupling.<br><br>METHODS: The bibliographic data corpus was collected from Scopus and Web of Science and systematically analyzed using bibliometric performance analysis and science mapping techniques. The methodology incorporates various data processing and visualization tools, including VOS Viewer, OriginLab, and SiteSpace. Then, a comprehensive review metric, combining the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework and a 4-step approach from data collection to interpretation is used.<br><br>RESULTS: The bibliographic analysis spans 16 years and includes 814 unique publications authored by 4870 researchers from 81 countries and 1948 organizations, published across 351 high-impact journals and prominent conferences. The analysis of research trends identifies 2 key trends: the differentiation in keyword usage for user experience and user satisfaction, and the research methodologies used within the domain. Furthermore, 5 research themes were identified exploring critical aspects of technology use, user engagement, and clinical integration. Although all 5 themes overlap, each theme focuses on distinct elements that help delineate their contributions to the overall understanding of mHealth apps: technological evaluation (Theme 1), design features for engagement (Theme 2), patient usability (Theme 3), long-term engagement factors (Theme 4), and clinical integration (Theme 5).<br><br>CONCLUSIONS: This study offers a fundamental understanding of the bibliographic landscape of research on user experience and satisfaction with mHealth apps. By identifying major research clusters, influential works, and emerging topics, this analysis provides evidence-based guidance for researchers, developers, and health informatics practitioners. Furthermore, based on the research trends findings, future research should prioritize expanding the scope of user experience (UX) evaluation by incorporating diverse user populations, longitudinal studies, and emerging technologies such as artificial intelligence and personalized interventions. Integrating insights from interdisciplinary perspectives such as human-computer interaction, behavioral sciences, and health care informatics, the understanding of user needs and app effectiveness can be enhanced. A more standardized framework for assessing UX in mHealth apps is also recommended to facilitate comparability across studies and improve app design to maximize user engagement and health outcomes.}, }
@article {pmid41212043, year = {2025}, author = {Nadubinszky, G and Székács, B}, title = {[Connection between viral infections, vaccines, and dementia].}, journal = {Orvosi hetilap}, volume = {166}, number = {45}, pages = {1763-1768}, doi = {10.1556/650.2025.33423}, pmid = {41212043}, issn = {1788-6120}, mesh = {Humans ; *Dementia/prevention &amp; control/virology/etiology ; *Virus Diseases/complications/prevention &amp; control ; Aged ; Herpes Zoster Vaccine ; COVID-19 Vaccines ; COVID-19/prevention &amp; control ; Female ; Alzheimer Disease ; }, abstract = {Dementia represents a growing public health challenge in the elderly population worldwide, with its development being influenced by multifactorial mechanisms. In recent years, increasing evidence has supported the notion that certain viral infections – particularly herpesviruses, the human immunodeficiency virus (HIV), and SARS-CoV-2 – may contribute to neurodegenerative processes either directly or indirectly. It has been demonstrated that chronic inflammation, immune system dysregulation, and blood–brain barrier damage induced by viral agents potentially promote the pathogenesis of dementia, especially Alzheimer’s disease. Simultaneously, remarkable new research has emerged highlighting the potential protective effects of vaccination. According to a study conducted by Stanford University and published in 2025, elderly adults vaccinated against herpes zoster (shingles) exhibited a significantly lower incidence of dementia over a 7-year follow-up period. Researchers identified a 20% relative risk reduction, particularly among women. Other studies have supported similar effects for vaccines against influenza, tetanus, and diphtheria. The aim of our publication was to summarize the causative role of viral infections in dementia and to present the inhibitory effects of vaccines, which likely extend beyond specific antiviral infection prevention. Furthermore, we sought to emphasize the clinical and public health significance of these findings, particularly for the elderly population with compromised immune systems. Orv Hetil. 2025; 166(45): 1763–1768.}, }
@article {pmid41211661, year = {2025}, author = {Fan, Y and Zhou, Y and Zhao, J and Zhao, Y}, title = {Advances in Inhaled Nanoparticle Drug Delivery for Pulmonary Disease Management.}, journal = {FASEB journal : official publication of the Federation of American Societies for Experimental Biology}, volume = {39}, number = {21}, pages = {e71191}, pmid = {41211661}, issn = {1530-6860}, support = {R01HL157164//HHS|NIH|National Heart, Lung, and Blood Institute (NHLBI)/ ; R01HL167846//HHS|NIH|National Heart, Lung, and Blood Institute (NHLBI)/ ; R01HL151513//HHS|NIH|National Heart, Lung, and Blood Institute (NHLBI)/ ; R01 HL157164/HL/NHLBI NIH HHS/United States ; R01 HL171220/HL/NHLBI NIH HHS/United States ; R01HL169203//HHS|NIH|National Heart, Lung, and Blood Institute (NHLBI)/ ; R01 HL167846/HL/NHLBI NIH HHS/United States ; R01 HL169203/HL/NHLBI NIH HHS/United States ; R01 HL151513/HL/NHLBI NIH HHS/United States ; R01HL171220//HHS|NIH|National Heart, Lung, and Blood Institute (NHLBI)/ ; }, mesh = {Humans ; Administration, Inhalation ; *Lung Diseases/drug therapy ; *Nanoparticle Drug Delivery System ; Animals ; *Drug Delivery Systems/methods ; SARS-CoV-2 ; *Nanoparticles/administration &amp; dosage ; *COVID-19 Drug Treatment ; COVID-19 ; Lung ; }, abstract = {Pulmonary disorders, notably highlighted by the global impact of COVID-19, continue to pose serious public health concerns with limited treatment options. To address the urgent need for effective lung-targeted therapies, strategies that maximize local therapeutic efficacy while minimizing systemic toxicity are essential to the unique anatomical location of the lungs, inhaled therapy provides a promising strategy for locally targeted drug delivery through intranasal or intratracheal administration. Integrating biomedical nanotechnology and inhaled therapy, inhaled nanoparticle drug delivery systems (INDDs) have emerged as a powerful platform capable of penetrating mucus and pulmonary surfactant barriers, enhancing lung distribution and retention, and precisely delivering small molecules, proteins, and nucleic acids in lung lesions and cells using natural or synthetic carriers. The INDDs provide a universal translational platform for structurally analogous drugs and a wide array of respiratory disorders. This review summarizes recent advances in INDDs, focusing on the critical carrier materials in formulation, performance in in vitro and in vivo, and inhalation dosage forms, highlighting design strategies to overcome lung barriers and improve clinical and preclinical therapeutic efficacy in lung diseases.}, }
@article {pmid41211412, year = {2025}, author = {Hou, J and Duan, W and Wang, Y and Liao, Y and Bu, H and Mu, W and Tang, X and Liu, D}, title = {A systematic review of impacts of COVID-19 on depression and anxiety among general populations around the world.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1659671}, pmid = {41211412}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Anxiety/epidemiology ; *Depression/epidemiology ; *Social Determinants of Health ; *Global Health ; Adult ; Female ; Mental Health ; Health Status Disparities ; Male ; SARS-CoV-2 ; Socioeconomic Factors ; }, abstract = {BACKGROUND: The COVID-19 pandemic has profoundly impacted global mental health, with significant disparities in depression and anxiety observed across populations and countries. Existing literature highlights the role of social determinants of health (SDH) in shaping mental health outcomes, yet systematic reviews synthesizing these impacts across diverse socioeconomic and policy contexts remain limited. This study provides an overview of how COVID-19 is affecting depression and anxiety among general populations, alongside inequalities driven by the SDH.<br><br>METHODS: Six databases (CNKI, Embase, PubMed, Scopus, Cochrane Library, Web of Science) were searched from March 2020 to February 2024. Inclusion criteria encompassed cross-sectional/longitudinal studies assessing depression/anxiety in adults (&#x2265;18&#x202f;years) using validated scales (e.g., PHQ-9, GAD-7). After screening 4,916 records, 59 studies met eligibility criteria. Quality assessment utilized the Joanna Briggs Institute tool, and data extraction covered study characteristics, outcomes, and SDH factors. This review is registered with PROSPERO: CRD420251023201.<br><br>RESULTS: Among 59 studies (39 from low- and middle-income countries [LMICs]; 16 from high-income countries [HICs]), younger individuals, women, and socioeconomically disadvantaged groups exhibited heightened vulnerability to depression and anxiety. High-income countries with stringent lockdowns (e.g., the U.S., France) reported sustained psychological distress, while nations adopting effective early containment strategies saw mental health improvements over time. Population-level determinants, including healthcare infrastructure and policy stringency, significantly influenced outcomes. Low-resource settings faced worsened mental health burdens due to prolonged restrictions and limited medical access. Individual and community-level factors such as unemployment, housing instability, and low social support amplified risks. Temporal trends revealed worsening mental health during extended lockdowns and disparities in recovery trajectories across regions.<br><br>CONCLUSION: The COVID-19 pandemic exacerbated mental health inequalities, disproportionately affecting specific groups and underscoring the interplay of SDH. Tailored interventions addressing socioeconomic vulnerabilities, enhancing social support, and balancing infection control with psychological well-being are critical.<br><br>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251023201, identifier CRD420251023201.}, }
@article {pmid41210968, year = {2025}, author = {Requena, B and Barbas, C and Gonzalez-Riano, C}, title = {Unraveling virus-host interactions: Current advances in viral lipidomics.}, journal = {iScience}, volume = {28}, number = {11}, pages = {113750}, pmid = {41210968}, issn = {2589-0042}, abstract = {Viruses significantly alter host lipid metabolism to facilitate their replication, assembly, and immune evasion. Lipidomics, a mass spectrometry-driven field, enables the comprehensive profiling of virus-induced lipid remodeling and provides crucial insights into host-pathogen interactions. This review provides a comprehensive overview of cutting-edge lipidomic research in viral infections, focusing on studies published from January 2023 onwards. Emphasis is placed on recent advancements in understanding key respiratory viruses (e.g., SARS-CoV-2), bloodborne pathogens (HIV, HCV), and emerging viral threats such as West Nile or the Dengue viruses. We examine the latest analytical platforms, annotation techniques, and biological findings, highlighting how specific alterations in glycerophospholipid, sphingolipid, and sterol pathways reveal novel diagnostic and therapeutic opportunities. While challenges in standardization, isomer annotation, and clinical translation persist, emerging MS technologies and computational strategies promise to overcome these limitations. Integrating lipidomics with systems biology approaches will be crucial for advancing precision virology and developing next-generation antiviral therapies.}, }
@article {pmid41210943, year = {2025}, author = {He, Y and Yuan, Y and Zhou, M and Li, M and Li, L and Li, C and Liang, X and Liu, P and Wang, W and Deng, Z}, title = {Development of siRNA therapeutics to combat microbial infections: a bibliometric analysis.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1697880}, pmid = {41210943}, issn = {2235-2988}, mesh = {*Bibliometrics ; *RNA, Small Interfering/therapeutic use/genetics ; Humans ; COVID-19 ; RNA Interference ; China ; }, abstract = {BACKGROUND: The rise of antimicrobial resistance and the COVID-19 pandemic highlight the limitations of traditional therapies. Small interfering RNA (siRNA) therapeutics, which utilize RNA interference for targeted gene silencing, present a promising approach to combating microbial infections. However, research in this area remains fragmented. This study employs a comprehensive bibliometric analysis to chart research trends and inform future directions.<br><br>METHODS: A total of 8,426 publications from the Web of Science Core Collection (2001-2025) were analyzed using CiteSpace and VOSviewer software to examine annual publication trends, geographic and institutional contributions, author networks, journal impacts, and keyword evolution. Data extraction focused on English-language articles.<br><br>RESULTS: The publication trends for siRNA therapeutics in microbial infections have evolved in three phases: rapid growth, stabilization at a peak, and subsequent cyclical fluctuations. Research contributions spanned 99 countries and regions, with 5,564 institutions and 1,234 journals involved. China (2,849 publications) and the United States (2,820 publications) led in publication volume. While the United States maintained dominance in academic influence and collaboration, China has steadily increased its research output in this area. The Journal of Virology emerged as the leading journal in terms of both productivity and citation impact. Key research areas include delivery systems, target selection, manufacturing technologies, antiviral therapeutics, and combination therapies. The field has shifted from basic mechanistic studies to clinical applications, with future research poised to focus on organ-specific delivery beyond the liver, exploration of diverse administration routes, integration of artificial intelligence-driven strategies, and enhanced global collaboration.<br><br>CONCLUSION: This bibliometric analysis offers a comprehensive overview of siRNA therapeutics for microbial infections, highlighting collaboration networks and academic influence across authors, countries, institutions, and journals. The study provides valuable insights into current research trends and serves as a foundational reference for guiding future collaborative efforts and innovations in this field.}, }
@article {pmid41210584, year = {2025}, author = {Ige, MA and Ren, X and Yang, Y and Zhang, H and Shen, C and Jiang, Y and Li, J and Wan, X}, title = {mRNA therapeutics: Transforming medicine through innovation in design, delivery, and disease treatment.}, journal = {Molecular therapy. Nucleic acids}, volume = {36}, number = {4}, pages = {102721}, pmid = {41210584}, issn = {2162-2531}, abstract = {mRNA therapeutics have revolutionized medicine, offering a versatile platform to address previously untreatable diseases. Recent advancements in biotechnology have enabled the efficient production of functional proteins, antibodies, and peptides via mRNA, providing rapid and adaptable solutions for vaccine development and therapeutic interventions. The success of mRNA vaccines, exemplified during the COVID-19 pandemic, underscores their potential for combating infectious diseases with unparalleled speed and scalability. This review explores the latest developments in mRNA technology, including innovations in design, delivery, and disease treatment; modulation of immune response; and the role of AI. Particular emphasis is placed on optimizing mRNA constructs to maximize therapeutic efficacy, new delivery vehicles for mRNA, and the modulations of immune response evoked by mRNA vaccines. The potential applications of mRNA therapeutics in genetic disorders, infectious diseases, and cancer are highlighted, alongside a discussion of existing challenges such as delivery efficiency and production scalability. By integrating molecular biology, RNA technology, and nanotechnology, mRNA therapeutics hold the promise of transforming precision medicine. These advancements offer hope for patients with complex or intractable conditions, paving the way for a new era in targeted therapies and personalized healthcare.}, }
@article {pmid41209866, year = {2025}, author = {Osifo, SE and Shobode, MA}, title = {Telerehabilitation After Total Knee Arthroplasty: A Narrative Review of Its Effectiveness, Safety, and Access in the Post-COVID Era.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e94102}, pmid = {41209866}, issn = {2168-8184}, abstract = {Osteoarthritis (OA) is a leading cause of disability worldwide, affecting primarily older adults. With rising rates of obesity and population aging, the global burden of OA is expected to grow substantially. Total knee arthroplasty (TKA) remains the definitive treatment for end-stage knee OA. However, the growing demand for postoperative rehabilitation has intensified the strain on the physical therapy (PT) workforce. The COVID-19 pandemic accelerated the adoption of telerehabilitation, but evidence regarding its effectiveness, safety, cost-efficiency, and equity after TKA remains scattered. A narrative review of English-language, full-text articles published between January 2018 and May 2025 was performed. PubMed, MEDLINE, and Google Scholar were searched using terms including "telerehabilitation", "virtual physical therapy", and "total knee arthroplasty". Eligible studies were randomized controlled trials (RCTs), cohort studies, case series (n ≥ 10), or systematic reviews/meta-analyses that compared telerehabilitation with conventional in-person rehabilitation after TKA. Outcomes included functional metrics, e.g., Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Knee Society Score (KSS), pain (visual analog scale, VAS), patient satisfaction, adherence, cost/utilization data, and equity indicators. Eight studies (six RCTs, two meta-analyses; n ≈ 2,070) met the inclusion criteria. Interventions included AI-driven apps, video-based therapy, and wearable sensors. Most studies found telerehabilitation to be non-inferior to conventional PT in improving pain, range of motion (ROM), and function. Meta-analyses showed comparable gains in KOOS, ROM, and VAS scores. Cost-effectiveness was favorable in bundled care models, though technology costs were inconsistently reported. No increased adverse events were observed. Digital literacy and broadband access emerged as equity challenges. Telerehabilitation is a safe, effective adjunct to in-person PT following TKA, with potential to expand access and reduce system strain. Hybrid models may offer the most sustainable path forward.}, }
@article {pmid41209585, year = {2025}, author = {Smail, SW and Ismail, BA and Maghdid, IS and Flaih, AH and Janson, C}, title = {Antioxidant and oxidative enzymes, genetic variants, and cofactors as prognostic biomarkers of COVID-19 severity and mortality: a systematic review.}, journal = {Frontiers in molecular biosciences}, volume = {12}, number = {}, pages = {1700263}, pmid = {41209585}, issn = {2296-889X}, abstract = {Oxidative stress plays a pivotal role in the pathogenesis and progression of coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disrupts redox homeostasis through excessive generation of reactive oxygen and nitrogen species, driving inflammation, endothelial dysfunction, and multi-organ injury. Serum oxidative and antioxidative enzymes, their genetic polymorphisms, and essential micronutrient cofactors have emerged as potential prognostic biomarkers for COVID-19 severity and mortality. Evidence indicates that imbalances in antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase correlate with disease progression, while polymorphisms in GST, superoxide dismutase, CAT, and HO-1 genes may modify susceptibility and outcomes. Biomarkers of oxidative damage, including malondialdehyde, 8-isoprostanes, nitrotyrosine, and protein carbonyls, consistently associate with respiratory failure, intensive care admission, and mortality. Furthermore, micronutrients such as selenium, zinc, copper, manganese, and iron, which act as enzymatic cofactors, influence antioxidant defense capacity and clinical prognosis. Despite promising data, limitations in biomarker standardization and assay specificity remain key challenges for clinical translation. The aim of this systematic review is to integrate enzymatic, genetic, and cofactor-based biomarkers to enhance risk stratification, challenging and to improve prognostic modelling in COVID-19. A better understanding of these biomarkers may facilitate early identification of high-risk patients, guide therapeutic interventions, and ultimately improve clinical outcomes in COVID-19.}, }
@article {pmid41207935, year = {2026}, author = {Farnia, P and Velayati, AA and Ghanavi, J and Farnia, P}, title = {Tuberculosis: An Ongoing Global Threat.}, journal = {Advances in experimental medicine and biology}, volume = {1484}, number = {}, pages = {1-31}, pmid = {41207935}, issn = {0065-2598}, mesh = {Humans ; Global Health ; *COVID-19/epidemiology ; *Tuberculosis/epidemiology/drug therapy/diagnosis ; *Tuberculosis, Multidrug-Resistant/epidemiology/drug therapy ; Antitubercular Agents/therapeutic use ; SARS-CoV-2 ; Mycobacterium tuberculosis/drug effects/pathogenicity ; }, abstract = {Tuberculosis (TB) remains one of the world's most urgent public health challenges, with a substantial global burden that continues to affect millions annually. According to the World Health Organization (WHO) Global Tuberculosis Report 2024, approximately 10.6 million people developed TB in 2023, resulting in 1.6 million deaths. The highest incidence rates persist in low- and middle-income countries, where socioeconomic determinants such as poverty, malnutrition, overcrowded living conditions, and limited access to quality healthcare exacerbate disease transmission and worsen outcomes. The emergence and spread of drug-resistant TB, including multidrug-resistant (MDR-TB), extensively drug-resistant (XDR-TB), and totally drug-resistant (TDR-TB) strains, pose significant challenges to effective treatment and control, contributing to increased mortality and healthcare costs. The coronavirus disease-2019 (COVID-19) pandemic has further disrupted TB services worldwide, causing declines in case detection, delayed diagnoses, and interruptions in treatment, thereby reversing years of progress. Despite the availability of effective vaccines and treatment regimens, gaps in awareness, funding, healthcare infrastructure, and social determinants of health hinder global elimination efforts. Coordinated, multisectoral strategies are essential to address this complex epidemic, improving diagnostic capacity, expanding access to comprehensive treatment, combating stigma, addressing socioeconomic barriers, and investing in research for novel prevention and therapeutic tools. These efforts are critical to achieving the WHO's End TB Strategy targets and ultimately eliminating TB as a public health threat.}, }
@article {pmid41207217, year = {2025}, author = {Wu, Y and Huang, S and Sha, Q and Yu, J}, title = {Emerging and Re-emerging viruses as triggers of human endogenous retrovirus activation: Implications for aging and age-related pathologies.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101422}, doi = {10.1016/j.mam.2025.101422}, pmid = {41207217}, issn = {1872-9452}, abstract = {The human genome contains a substantial legacy of ancient retroviral infections known as Human Endogenous Retroviruses (HERVs), composing 8 % of our DNA. In healthy young individuals, these elements are kept dormant by robust epigenetic mechanisms, primarily DNA methylation and repressive H3K9me3 histone marks. However, this epigenetic silencing deteriorates with age, leading to the reactivation of HERVs, particularly the youngest HERV-K subfamily. This report posits that this HERV awakening is not a passive byproduct of aging but an active, transmissible driver of pathology. The reactivation of HERVs leads to the production of retrovirus-like particles (RVLPs) that can induce senescence in healthy neighboring cells, propagating a contagious aging phenomenon. Furthermore, the accumulation of HERV-derived dsRNA and reverse-transcribed DNA triggers chronic innate immune responses through pathways including cGAS-STING and IFIH1-MAVS, fueling the systemic, low-grade inflammation characteristic of inflammaging, catalytically accelerated by exogenous viral infections. Pathogens such as SARS-CoV-2, Epstein-Barr Virus (EBV), and Herpes Simplex Virus (HSV-1) can directly transactivate HERVs via their own viral proteins, overwhelming the already compromised epigenetic controls in an aging host. This mechanistic link between viral triggers and endogenous retroviral activity is strongly implicated in a range of age-related diseases, including neurodegenerative disorders such as Alzheimer's disease and Amyotrophic Lateral Sclerosis (ALS), where the HERV-K envelope protein is directly neurotoxic. It is also linked to autoimmune diseases like Multiple Sclerosis and various cancers. This report synthesizes these findings and identifies a novel mechanistic link between viral activity, chronic inflammation, and the onset of age-related diseases.}, }
@article {pmid41206776, year = {2025}, author = {Mulet I Piera, X and Del Campo-Montoya, R and Cuadrado-Tejedor, M and Garcia-Osta, A and Garbayo, E and Blanco-Prieto, MJ}, title = {Intranasal delivery of lipid-based nanoparticles for the treatment of neurodegenerative diseases: advances, challenges and future perspectives.}, journal = {Expert opinion on drug delivery}, volume = {}, number = {}, pages = {1-19}, doi = {10.1080/17425247.2025.2587903}, pmid = {41206776}, issn = {1744-7593}, abstract = {INTRODUCTION: Neurodegenerative diseases such as Parkinson's or Alzheimer's disease urgently require new therapeutic approaches. Despite significant efforts, no disease-modifying therapies targeting specific molecular pathways have demonstrated consistent clinical efficacy. This challenge has shifted attention toward drug delivery strategies that improve bioavailability, targeting, and patient accessibility. Intranasal delivery has emerged as a promising, non-invasive approach that bypasses the blood-brain barrier, and improves patient compliance. Lipid-based systems, especially following the success of COVID-19 vaccines, have gained attention as versatile platforms for delivering RNAs. Their ability to encapsulate diverse payloads and tunable composition makes them ideal candidates for targeting neurodegenerative disorders via the intranasal route.<br><br>AREAS COVERED: This review discusses recent advances in intranasal delivery for the treatment of neurodegenerative disorders, emphasizing on lipid-based nanoparticles. It addresses formulation challenges such as stability, targeting efficiency, and compatibility with nasal physiology, and outlines key design parameters affecting brain delivery. Future directions are explored to advance formulation development and clinical translation.<br><br>EXPERT OPINION: Intranasal lipid-based drug delivery represents a promising strategy to bypass the blood-brain barrier in neurogenerative disorder treatment. Although regulatory gaps and the absence of long-term safety evaluation, intranasal administration offers clear advantages for CNS targeting underscoring strong potential for future clinical translation.}, }
@article {pmid41206191, year = {2026}, author = {Lin, EA and Renfree, KJ}, title = {AI-Enabled Remote Patient Monitoring Systems in Hand Surgery.}, journal = {Hand clinics}, volume = {42}, number = {1}, pages = {75-83}, doi = {10.1016/j.hcl.2025.08.009}, pmid = {41206191}, issn = {1558-1969}, mesh = {Humans ; *Artificial Intelligence ; COVID-19/epidemiology ; *Hand/surgery ; Wearable Electronic Devices ; Monitoring, Physiologic/methods ; Pandemics ; Telemedicine ; SARS-CoV-2 ; Machine Learning ; Remote Patient Monitoring ; }, abstract = {Artificial intelligence-enabled remote patient monitoring is transforming hand surgery by using advanced technologies like machine learning and computer vision to track patient recovery in real-time. Wearable devices and sensors collect objective data, enabling early detection of complications and personalized rehabilitation protocols. Accelerated by the COVID-19 pandemic, these technologies can potentially replace in-person visits, offering tailored-treatment options through data-driven insights.}, }
@article {pmid41205670, year = {2025}, author = {Ludwig-Walz, H and Heinisch, S and Siemens, W and Niessner, C and Eberhardt, T and Dannheim, I and Guthold, R and Bujard, M}, title = {Trends in physical fitness among children and adolescents in Europe: A systematic review and meta-analyses during and after the COVID-19 pandemic.}, journal = {Journal of sport and health science}, volume = {}, number = {}, pages = {101101}, doi = {10.1016/j.jshs.2025.101101}, pmid = {41205670}, issn = {2213-2961}, abstract = {BACKGROUND: Physical fitness is a key indicator of current and future health in children and adolescents. Evidence suggests that fitness levels have declined then stagnated in recent decades, but it remains unclear how the coronavirus disease 2019 (COVID-19) pandemic has impacted this trend.<br><br>METHODS: We conducted a systematic review and meta-analyses to assess pandemic-related changes in physical fitness among children and adolescents (0-19 years) in the World Health Organization European Region. Seven databases were searched up to February 28, 2025 for studies reporting validated pre- and during/post-pandemic fitness measurements. Two reviewers independently performed screening, data extraction, risk-of-bias assessment (Risk Of Bias In Non-randomized Studies - of Exposure; ROBINS-E), and certainty grading (Grading of Recommendations, Assessment, Development and Evaluation; GRADE). Random-effects meta-analyses yielded standardized mean differences (SMDs) with 95% confidence intervals (95%CIs). Subgroup analyses examined sex, age, year, and national restriction severity (Oxford Stringency Index).<br><br>RESULTS: Thirty-two studies comprising 270,179 participants and 1,519,386 fitness measurements from 17 European countries were included. Cardiorespiratory fitness declined significantly during the pandemic, especially in 2021, with reductions in endurance (SMD =&#x202f;-0.43; 95%CI: -0.61 to -0.25) and speed (SMD&#x202f;=&#x202f;-0.29; 95%CI: -0.61 to 0.03). While speed returned to baseline by 2023, endurance remained below pre-pandemic levels (SMD =&#x202f;-0.10; 95%CI: -0.12 to -0.08). Girls and adolescents were disproportionately affected. In contrast to cardiorespiratory fitness, muscular fitness remained largely unchanged. Stricter national regulations were associated with greater declines in cardiorespiratory fitness.<br><br>CONCLUSION: COVID-19 pandemic restrictions were associated with a marked decline in cardiorespiratory fitness in European children and adolescents, with levels not recovered by 2023. These findings call for urgent, targeted public health interventions to improve physical fitness and prevent long-term health consequences.}, }
@article {pmid41205477, year = {2026}, author = {Huang, S and Shi, W and Chen, L and Liu, Y and Wei, P and Li, R}, title = {Sarocladium strictum meningoencephalitis with cerebral vasculitis: a case report and literature review.}, journal = {Diagnostic microbiology and infectious disease}, volume = {114}, number = {2}, pages = {117171}, doi = {10.1016/j.diagmicrobio.2025.117171}, pmid = {41205477}, issn = {1879-0070}, mesh = {Humans ; Female ; Adult ; *Vasculitis, Central Nervous System/diagnosis/complications/microbiology/drug therapy ; Antifungal Agents/therapeutic use ; *Meningoencephalitis/microbiology/diagnosis/drug therapy/complications ; Amphotericin B/therapeutic use ; Voriconazole/therapeutic use ; *Meningitis, Fungal/diagnosis/drug therapy/microbiology ; China ; }, abstract = {Sarocladium strictum (S. strictum) meningitis is a rare but rapidly progressive and often fatal central nervous system (CNS) infection, typically presenting with nonspecific symptoms such as headache, fever, and limb weakness, making early diagnosis difficult. We report a 42-year-old woman with a history of sarcoidosis and prior immunosuppressive therapy who developed fever and headache during travel in Inner Mongolia, China. Initially misdiagnosed as an upper respiratory tract infection, her condition worsened within one week. Cerebrospinal fluid analysis showed elevated intracranial pressure, protein, and cell counts. Next-generation sequencing and lymph node biopsy confirmed S. strictum meningitis. With the increasing use of immunosuppressants in the post-COVID-19 era, the incidence of rare fungal CNS infections may rise. Amphotericin B combined with voriconazole appears to be an effective treatment. In cases with cerebral vasculitis, adjunctive anti-vasculitis therapy may be helpful. However, the exact mechanisms remain unclear.}, }
@article {pmid41205407, year = {2025}, author = {McCarthy, K and Silkiss, RZ}, title = {Ocular manifestations of vaccine-preventable diseases: A comprehensive review.}, journal = {Vaccine}, volume = {68}, number = {}, pages = {127900}, doi = {10.1016/j.vaccine.2025.127900}, pmid = {41205407}, issn = {1873-2518}, mesh = {Humans ; *Vaccine-Preventable Diseases/complications/prevention &amp; control ; *Eye Infections, Bacterial/etiology/prevention &amp; control ; *Eye Infections, Viral/etiology/prevention &amp; control ; *Vaccination ; }, abstract = {Vaccine-preventable diseases (VPDs) remain a significant contributor to global ocular morbidity, yet their ophthalmic manifestations are often underrecognized. This review synthesizes current evidence on viral and bacterial VPDs with ocular involvement, highlighting a spectrum of presentations-from conjunctivitis to keratitis, uveitis, and optic neuritis. Such infections may affect a range of ocular tissues through mechanisms including direct viral invasion, immune-mediated inflammation, and secondary complications. While the frequency and severity of ocular involvement vary among pathogens, the potential for permanent vision loss, particularly in unvaccinated or immunocompromised individuals, underscores the clinical and public health importance of early recognition and prevention. Conditions such as congenital rubella syndrome, herpes zoster ophthalmicus, and acute retinal necrosis illustrate the breadth of pathology, while emerging infections like COVID-19 and monkeypox further expand the spectrum. Vaccination remains the most effective strategy for mitigating both systemic and ophthalmic sequelae. Greater awareness of ocular manifestations can facilitate earlier diagnosis, enhance outbreak detection, and reinforce the critical role of immunization in preserving vision.}, }
@article {pmid41202641, year = {2026}, author = {Thomas, C and Gosling, J and Ashton, RE and Owen, R and Faghy, MA}, title = {A scoping literature review of rehabilitation policy recommendations during the COVID-19 pandemic in the WHO European Region.}, journal = {Health policy (Amsterdam, Netherlands)}, volume = {163}, number = {}, pages = {105477}, doi = {10.1016/j.healthpol.2025.105477}, pmid = {41202641}, issn = {1872-6054}, mesh = {*COVID-19/epidemiology/rehabilitation ; Humans ; *Health Policy ; World Health Organization ; Europe/epidemiology ; SARS-CoV-2 ; *Rehabilitation/organization &amp; administration ; Pandemics ; }, abstract = {BACKGROUND: As with other frontline healthcare services, the delivery of rehabilitation services has been greatly affected by the COVID-19 pandemic with many services suspended, despite WHO's mandate that rehabilitation is an essential service.<br><br>OBJECTIVE: This review aimed to provide an overview of policy responses that were taken across the WHO European Region to identify systems and processes that helped to inform and shape decisions pertaining to rehabilitation during the COVID-19 pandemic.<br><br>METHODS: A scoping literature search was conducted according to PRISMA-ScR guidelines and prospectively registered on Prospero (ID: CRD42024550641). Cinahl, Cochrane, PubMed and Scopus databases were searched from inception to February 2024. Eligibility criteria for selecting publications: Published work that includes any policy documents that informed rehabilitation during the COVID-19 pandemic in any of the 53 World Health Organisation European member states. Search results were extracted using the PESTLE heading framework in Microsoft Excel.<br><br>RESULTS: Seven publications comprising seven policy documents from Italy (N=2), England (N=2) and the United Kingdom (N=3) were included in this review. Five key areas were identified in response to COVID-19 and rehabilitation: 1) government direction, 2) funding, 3) education, 4) telerehabilitation, and 5) social distancing and isolation.<br><br>CONCLUSIONS: Our study's findings demonstrate a dearth of published government policy documentation referring to rehabilitation in response to the COVID-19 pandemic. This lack of published documents indicates that rehabilitation is not considered an essential health service during emergency response. Research should investigate the systems and processes of key decision-makers to inform future rehabilitation pandemic preparations.}, }
@article {pmid41202611, year = {2025}, author = {Zhang, Q and Lewis, KB and Phillips, JC and Ma, H and Kiss, A and Goge, S and Rader, T and Stacey, D}, title = {Decisional needs of older adults considering COVID-19 booster vaccinations: A systematic review comparing China with other countries.}, journal = {Vaccine}, volume = {68}, number = {}, pages = {127949}, doi = {10.1016/j.vaccine.2025.127949}, pmid = {41202611}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention &amp; control ; Aged ; *COVID-19 Vaccines/administration &amp; dosage/immunology ; China/epidemiology ; *Immunization, Secondary/psychology ; Middle Aged ; Aged, 80 and over ; *Decision Making ; SARS-CoV-2/immunology ; Vaccination/psychology ; Vaccination Hesitancy/psychology ; }, abstract = {INTRODUCTION: Older adults are at high risk of severe COVID-19 outcomes. Although COVID-19 booster vaccinations reduce disease severity and hospitalizations, many older adults are hesitant about receiving one. Our study aimed to identify the decisional needs of older adults considering COVID-19 booster vaccination.<br><br>METHODS: We conducted a systematic review and used PRISMA reporting guidelines. Eligible studies reported decisional needs of people 60&#xa0;years or older considering COVID-19 booster vaccinations. We searched five databases from December 2019 to October 2024. Two reviewers independently screened studies, extracted data, and assessed study quality. We used the Ottawa Decision Support Framework coding manual for descriptive analysis.<br><br>RESULTS: Of 5156 citations screened, nine studies were eligible. Studies were conducted in six countries (4 in China, 1 each in England, Israel, Malaysia, Saudi Arabia, and the United States) and involved 7684 adults aged 60 to 94&#xa0;years old, with 56.9&#xa0;% having chronic health conditions. In all studies, adults reported inadequate knowledge. Other decisional needs were: delay in acceptance of booster vaccination (3 China, 4 other countries); manifestation of decisional conflict (3 China; 3 other countries); inadequate support and resources from governments, healthcare authorities, healthcare professionals and family members (1 China; 4 others); and personal and health-related characteristics (chronic health condition) influencing their COVID-19 booster vaccination decision (3 China, 1 other).<br><br>DISCUSSION: Many older adults were hesitant about COVID-19 booster vaccinations. Common decisional needs were inadequate knowledge, inadequate support, and being concerns about the effect of vaccines on their chronic health conditions. Decisional needs of older adults considering COVID-19 vaccination could be addressed using decision support tools.}, }
@article {pmid41202175, year = {2025}, author = {White, BK and Talamayan, F and Aynsley, TR and Riziki, RB and Bertrand-Ferrandis, C and Von Harbou, K and Inigo, RL and Moran, T and Samuel, R and Scales, D and Machiri, SV}, title = {Current Approaches To and Implementation of Information Environment Assessments in the Context of Public Health: Rapid Review.}, journal = {JMIR infodemiology}, volume = {5}, number = {}, pages = {e72165}, pmid = {41202175}, issn = {2564-1891}, mesh = {Humans ; *Public Health ; *Information Dissemination/methods ; COVID-19 ; Information Seeking Behavior ; }, abstract = {BACKGROUND: With the advances in digital information sharing channels, democratization of content, and access, as well as social shifts in information exchange, we live in increasingly complex information environments. How people process and manage this is layered with multiple determinants that can impact information seeking, health behaviors, and public health. Understanding the dynamics of the information environment in priority populations and its impact on communities and individuals is critical for those working in public health and health emergencies.<br><br>OBJECTIVE: This study aimed to provide an overview of the approaches to and implementation of information environment assessments as they relate to public health and health emergencies.<br><br>METHODS: We conducted a rapid scoping review of the approaches to, and implementation of information environment assessments. The search followed guidance from the Joanna Briggs Institute on conducting systematic scoping reviews, and our reporting is in line with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews. We included both academic and gray literature in the English language. As this is an emerging field, an additional step involved input from an informal expert group to identify any further tools or approaches. Studies that assessed, described, or discussed approaches to assessing the information environment were included. We excluded papers where the information environment was not the primary focus, or the focus was on individual components only. Two authors (BKW and SVM) independently screened results for inclusion.<br><br>RESULTS: A total of 17 publications were identified through the structured literature and internet searches, with an additional 5 sourced from the informal expert group. The review highlighted a significant variety in the breadth and number of domains covered in an assessment, including information needs, seeking, access, production, engagement, information quality, and reach. Some assessments adopted a comprehensive, systems-oriented approach, examining factors influencing information beyond the individual level to encompass broader systemic dynamics, while others were significantly narrower in scope.<br><br>CONCLUSIONS: The COVID-19 pandemic has intensified interest in understanding how the information environment shapes people's access to, engagement with, and ability to act on health information. Assessing the information environment is a critical step in identifying and understanding barriers and facilitators that impact different populations and identifying opportunities for strengthening systems. However, a universally accepted approach for such assessments in public health and health emergencies is currently lacking. This paper contributes to the literature by synthesizing current knowledge on assessment tools and frameworks, providing a foundation for future research and development in this area.}, }
@article {pmid41201952, year = {2025}, author = {De Rubeis, V and Tonmyr, L and Rahman, S and Pagaduan, J and Drysdale, M and Morissette, K and MacMillan, HL and Aylward, E and Nanziba, F and Powell, S and Corrin, T and Khan, A and Boland, LS}, title = {Changes in child maltreatment occurrence during the COVID-19 pandemic: A systematic review.}, journal = {Child abuse &amp; neglect}, volume = {169}, number = {Pt 1}, pages = {107744}, doi = {10.1016/j.chiabu.2025.107744}, pmid = {41201952}, issn = {1873-7757}, mesh = {Humans ; *COVID-19/epidemiology ; *Child Abuse/statistics &amp; numerical data/trends ; Child ; Adolescent ; SARS-CoV-2 ; Pandemics ; Risk Factors ; }, abstract = {BACKGROUND: Child maltreatment (CM) is an important public health issue. During the COVID-19 pandemic, there was widespread concern that CM risk factors were exacerbated while opportunities to seek support were reduced, potentially impacting occurrences of CM.<br><br>OBJECTIVE: To synthesize evidence evaluating changes in CM outcomes during the COVID-19 pandemic compared to pre-pandemic.<br><br>PARTICIPANTS AND SETTING: Individuals &#x2264;18&#xa0;years old living in member countries of the Organization for Economic Co-operation and Development.<br><br>METHODS: We conducted a systematic review of primary studies identified in multiple databases. Independent reviewers screened titles/abstracts and full texts. Moderate to low risk of bias studies were synthesized using frequency counts to categorize CM outcomes as having increased, decreased, or not changed from pre- to during the pandemic. These were used to develop narrative statements, which underwent assessment for certainty in the evidence.<br><br>RESULTS: We included 71 studies. Most CM outcomes relied on administrative data and showed mixed findings across the categories. Overall, there was likely no change in emotional neglect (moderate certainty), and may have been an increase in neglect (low certainty) and exposure to intimate partner violence (very low certainty). Changes in physical, sexual, and psychological abuse and any CM were very uncertain.<br><br>DISCUSSION: The evidence informing changes in CM from before to during the COVID-19 pandemic is mixed and very uncertain for most outcomes, underpinned by gaps in the CM data collection systems during the pandemic period. Efforts to strengthen CM data and surveillance systems could improve preparedness for future pandemic situations.}, }
@article {pmid41201592, year = {2025}, author = {Kalani, M and Zare, M and Choopanizadeh, M and Kalani, M and Fazeli, P and Panji, M}, title = {Kawasaki Disease: Unraveling Immunopathogenesis, Genetic Factors, and AI Applications in Diagnosis with a Focus on Iran.}, journal = {Pediatric cardiology}, volume = {}, number = {}, pages = {}, pmid = {41201592}, issn = {1432-1971}, abstract = {Kawasaki disease (KD) is an acute multisystem vasculitis that represents the leading cause of acquired pediatric heart disease in children aged 1-5 years in developed nations. The diagnosis of KD remains clinically challenging due to its diverse clinical manifestations and the absence of definitive laboratory tests. Growing evidence suggests that inflammatory processes play a pivotal role in the pathogenesis of KD, implicating a significant involvement of the immune system in disease development. Given the established associations between KD and various biomarkers, ranging from genetic factors to immune system components, this review systematically examines the current knowledge on the immunological and genetic aspects of KD, with a particular focus on the Iranian population. Meanwhile, artificial intelligence (AI) may be revolutionized disease diagnosis, prognosis, and predictive modeling. Its applications have extended to KD, including early detection and classification, as briefly discussed in this review. By synthesizing existing evidence, we aim to identify critical research gaps and enhance understanding of KD's unique characteristics in this demographic context.}, }
@article {pmid41201472, year = {2025}, author = {Pervaiz, A and Soubani, AO}, title = {Virus-associated pulmonary aspergillosis: A rising challenge in respiratory infections.}, journal = {The American journal of the medical sciences}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.amjms.2025.10.021}, pmid = {41201472}, issn = {1538-2990}, abstract = {Invasive Aspergillosis (IA) is a severe fungal infection primarily caused by Aspergillus species, notably Aspergillus fumigatus. However, newly emerging species, some exhibiting antifungal resistance, are becoming increasingly common. IA mainly affects immunocompromised individuals, including those with hematological malignancies and solid organ transplant recipients. In recent years, however, new at-risk populations have been identified, regardless of immune status, particularly those with severe viral infections requiring intensive care unit admission. This condition has gained prominence in intensive care unit settings following the recent H1N1 influenza and COVID-19 pandemics. Virus-associated pulmonary Aspergillosis (VAPA) encompasses two distinct entities: influenza-associated pulmonary Aspergillosis (IAPA) and COVID-19-associated pulmonary Aspergillosis (CAPA). These conditions are typically diagnosed in 10-20% of patients with severe influenza or COVID-19 when appropriate diagnostic methods are employed. Key diagnostic tools include bronchoalveolar lavage for fungal culture, galactomannan testing, and Aspergillus PCR, complemented by bronchoscopy to detect invasive Aspergillus tracheobronchitis visually. Azole antifungals are the first-line treatment, with liposomal amphotericin B serving as an alternative in regions with azole resistance. Despite antifungal interventions, IAPA and CAPA are linked to poor outcomes, with fatality rates often surpassing 50%. This review article discusses the pathophysiological mechanisms, clinical characteristics, diagnosis, and treatment of IAPA and CAPA. Additionally, it highlights key knowledge gaps and suggests potential areas for future research.}, }
@article {pmid41200593, year = {2025}, author = {Idahor, CO and Esomu, EO and Ogbonna, N and Momoh, Z and Ogbeide, OA and Ikhu-Omoregbe, O and Adigwe, A and Erhabor, OM and Osaghae, O and Orons, N}, title = {Infectious Disease Surveillance in the Era of Big Data and AI: Opportunities and Pitfalls.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e93929}, pmid = {41200593}, issn = {2168-8184}, abstract = {The landscape of infectious disease surveillance (IDS) is undergoing a profound shift, driven by the rapid emergence of big data and artificial intelligence (AI). Traditional surveillance systems, while foundational to public health, are increasingly limited by delayed reporting, data silos, and fragmented information flows. In response to these limitations, the integration of AI and big data offers new possibilities for enhancing disease detection, monitoring, and response strategies on both local and global scales. This review explores the potential of AI-enabled tools and big data systems to support early outbreak detection, real-time surveillance, and predictive modeling. These technologies facilitate the synthesis of diverse datasets, including clinical, genomic, geospatial, and environmental information, enabling a more holistic understanding of disease patterns. Additionally, AI contributes to improved diagnostic accuracy and optimized resource allocation, which are critical during public health emergencies. However, the adoption of these technologies has not been without challenges. Concerns about data privacy, equity in access, algorithmic bias, and over-reliance on automated systems present significant ethical and operational hurdles. In low-resource settings, limited digital infrastructure further complicates implementation. The review also highlights real-world applications from recent outbreaks, such as COVID-19, influenza, and Zika, to demonstrate both the promise and the limitations of AI-driven surveillance. To move forward responsibly, public health systems must adopt a balanced approach that integrates AI capabilities with human oversight. Strategic investment, cross-sector collaboration, and the development of clear ethical frameworks are essential to unlocking the full potential of big data and AI in infectious disease surveillance.}, }
@article {pmid41200370, year = {2025}, author = {Tembo, A and Gray, A and Nyamuzihwa, T and Venter, FWD and Maimin, J and Bayat, A and Miot, J and Johnston, D}, title = {Leveraging community pharmacies for HIV services in South Africa: Opportunities and constraints.}, journal = {Southern African journal of HIV medicine}, volume = {26}, number = {1}, pages = {1739}, pmid = {41200370}, issn = {2078-6751}, abstract = {Access to HIV services in South Africa remains challenging, despite their availability in the public healthcare sector. While the legislative framework allows for the provision of these services in community pharmacies, the process is often complex. This article describes various models for the provision of HIV services in community pharmacies in South Africa through a review of existing policies and legislation. It further discusses barriers and opportunities for the expansion of services. The existing legal framework enables prescribing by healthcare professionals other than medical practitioners through authorisations issued under either the Medicines and Related Substances Act of 1965 or the Nursing Act of 2005. Community pharmacies have extended their role beyond dispensing medication, with the emergence of telehealth and potential initiatives such as Pharmacist-Initiated Management of Antiretroviral Therapy (PIMART). Telehealth, accelerated by the COVID-19 pandemic, provides remote consultations and electronic prescriptions. PIMART, on the other hand, can empower pharmacists to initiate and manage antiretroviral therapy (ART) for HIV patients, a role traditionally reserved for clinicians. Extending Nurse-Initiated Management of Antiretroviral Therapy (NIMART) into the private sector could further increase ART rollout. Despite these advancements made in the last two decades, legislative reforms are necessary to fully realise the potential of community pharmacies for providing HIV services.}, }
@article {pmid41200220, year = {2025}, author = {Dhaliwal, S and Fremont, D and Li, W and Myran, D and Solmi, M and Tanuseputro, P and Wilson, J and Sood, MM}, title = {Depression and depressive symptoms in physicians prior to the COVID-19 pandemic: a systematic review and meta-analysis.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1627507}, pmid = {41200220}, issn = {1664-0640}, abstract = {BACKGROUND: Mental health disorders, such as depression, can significantly impact a physician's well-being and the quality of care they provide. We conducted a systematic review and meta-analysis to identify risk factors and to estimate the prevalence of depression and depressive symptoms in physicians prior to the COVID-19 pandemic.<br><br>METHODS: This PRISMA 2020-compliant systematic review and meta-analysis searched EMBASE, APA PsycINFO, and MEDLINE databases for studies published between January 2002 and March 2020 (pre-COVID-19 period). Risk of bias was assessed using a modified Newcastle-Ottawa Scale for cohort and cross-sectional studies. We included studies of physicians where depression/depressive symptoms were measured by either a validated questionnaire or clinical diagnosis. The primary and secondary outcomes measures included assessing the prevalence of depression/depressive symptoms, and whether depression differed by pertinent risk factors (study design, sex, specialty, training stage) in the literature prior to the COVID-19 pandemic.<br><br>RESULTS: Forty-two studies from 14 countries involving 27,284 physicians (7,293 with depression or depressive symptoms) were included. The pooled prevalence estimate was 34.2% (95% CI: 26.4-43.0%), with substantial heterogeneity identified across studies (I[2] = 98%). Most studies were cross-sectional surveys (n=28) and cohort studies (n=14). A total of 13 different assessment methods were used. We found no statistically significant difference in depression between male and female physicians (OR: 0.78, 95% CI: 0.46, 131), and a slightly increased rates in residents compared to staff physicians [pooled estimates of 36% (95% CI: 26-47%) and 29% (95% CI: 13-53%)]. Finally, 25 studies were deemed "High" risk of bias, while the remaining 17 were "Low" risk.<br><br>CONCLUSIONS: In this review examining depression and depressive symptoms among physicians, we report a pooled estimate of 34% prior to the COVID-19 pandemic. Due to the high degree of heterogeneity in study design and limited examination of key risk factors, limited conclusions can be made regarding the true prevalence across the physicians, and how best to target interventions.<br><br>https://www.crd.york.ac.uk/prospero/, identifier CRD42021232814.}, }
@article {pmid41199467, year = {2025}, author = {Gil, YM}, title = {Research Trends in Medical and Dental Education (2015-2024) Based on Author Keywords: Commonalities, Differences, and Opportunities for Collaboration.}, journal = {Journal of dental education}, volume = {}, number = {}, pages = {}, doi = {10.1002/jdd.70099}, pmid = {41199467}, issn = {1930-7837}, support = {//New Faculty Startup Fund from Seoul National University/ ; }, abstract = {OBJECTIVES: Medical and dental education share the common goal of preparing clinically competent and socially responsible health professionals. Despite this shared goal, the two disciplines have evolved as distinct academic fields, with limited empirical comparisons between them. Understanding their commonalities and differences can foster mutual development and cross-disciplinary collaboration. This study aims to compare research priorities in medical and dental education by analyzing author keywords from representative journals in each field.<br><br>METHODS: A bibliometric analysis was conducted using author keywords from two medical education journals (Advances in Health Sciences Education and BMC Medical Education) and two dental education journals (European Journal of Dental Education and Journal of Dental Education) over a 10-year period (2015-2024). Data were retrieved from the Web of Science database, including only original research articles and review articles. Frequency analysis of the top 10 author keywords was performed in 2-year intervals, and bump charts were created to visualize temporal ranking changes. In addition, co-occurrence network maps were constructed using all keywords appearing 10 or more times over the study period. Data processing and visualization were conducted using VOSviewer and Tableau software.<br><br>RESULTS: A total of 9391 articles were analyzed, comprising 6806 articles from medical education journals and 2585 articles from dental education journals. Both fields consistently emphasized "students," "assessment," and "curriculum" as core research topics. However, medical education placed greater emphasis on "postgraduate medical education" and student mental health (e.g., empathy, resilience, and depression), whereas dental education focused more on "educational technology" and clinical skills development (e.g., simulation, virtual reality, and psychomotor skills). The keyword "covid-19" emerged prominently in both fields from 2019 to 2020 onward, reflecting the pandemic's transformative impact on education. "Interprofessional education" appeared as a shared emerging theme, suggesting growing recognition of collaborative practice needs.<br><br>CONCLUSION: This study identifies both foundational commonalities and discipline-specific innovations in medical and dental education research over the past decade. These findings suggest that shared interests and distinctive priorities can lead to meaningful opportunities for collaborative educational development and joint research efforts across health professions education.}, }
@article {pmid41199417, year = {2025}, author = {Pourshaban, M and Hasankhani, H}, title = {What Is 'Missed Nursing Care' During an Emerging Infectious Disease? A Concept Analysis.}, journal = {Nursing open}, volume = {12}, number = {11}, pages = {e70216}, pmid = {41199417}, issn = {2054-1058}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; *Communicable Diseases, Emerging/nursing ; *Nursing Care/standards ; SARS-CoV-2 ; *Concept Formation ; *Quality of Health Care/standards ; Pandemics ; }, abstract = {AIM: Missed nursing care (MNC) is a global and important phenomenon in nursing and is universally used as an indicator of the quality of nursing care. However, no precise definition is available for this concept's dimensions and clinical features during an emerging infectious disease. This study aims to furnish a comprehensive evidence-based definition of MNC in the context of the COVID-19 pandemic.<br><br>DESIGN: A concept analysis paper.<br><br>METHODS: This study was conducted using an integrative approach to the concept analysis of Walker and Avant. In the literature review stage, the databases CINAHL, Web of Science, Scopus and PubMed as well as the Google Scholar search engine were searched from December 2019 to April 2024. Keywords of the study were selected according to the Medical Subject Headings (MeSH) and previous research. Textual analysis of the selected articles was conducted using an inductive and deductive approach. Throughout the study, the authors followed the SRQR checklist.<br><br>RESULTS: The results indicated the concept of 'missed nursing care' during an emerging and infectious disease such as COVID-19 refers to a set of nursing activities and procedures that require interaction and close contact with patients and must be included in the care and treatment plan for patients (supportive, psychological-social care and basic/bedside care). However, these activities have been presented as suboptimal, prioritised and interrupted. These attributes are caused by the complexity of caring for emerging diseases, aggravating lack of human and material resources, communication/teamwork and individual factors.<br><br>CONCLUSION: The concept of MNC during an emerging infectious disease is an altered cognitive process that can be defined as disrupted nursing care (DNC) in the nurse role adjustment, time management and care environment for various reasons. COVID-19 has been the most significant disruptor in healthcare, but it will not be the last.<br><br>This conceptual analysis can help sensitise care managers to the holistic view and adaptation of policies and strategies in crises, develop care models and theories, and help researchers generate specific tools or clinical scales for accreditation in emerging infectious diseases.<br><br>CONSENT: No patient or public contribution.}, }
@article {pmid41199361, year = {2025}, author = {Obeid, C and Oenema, A and Jaalouk, D and Kremers, SPJ and Gubbels, JS}, title = {Determinants of adherence to the Mediterranean diet among adults in Mediterranean countries: a systematic literature review.}, journal = {Public health nutrition}, volume = {28}, number = {1}, pages = {e194}, doi = {10.1017/S1368980025101432}, pmid = {41199361}, issn = {1475-2727}, mesh = {Humans ; *Diet, Mediterranean/statistics &amp; numerical data/psychology ; Adult ; Mediterranean Region ; Female ; Socioeconomic Factors ; Male ; Middle Aged ; *Patient Compliance/statistics &amp; numerical data ; Cross-Sectional Studies ; Aged ; }, abstract = {OBJECTIVE: This study aims to provide an overview of evidence on factors affecting Mediterranean diet (MD) adherence across socio-ecological levels (individual, interpersonal and environmental) in Mediterranean countries, which can be target points for future interventions to promote MD adherence.<br><br>DESIGN: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and registered in the Prospero database (CRD42020189337). Literature was searched in PubMed, Web of Science and PsycINFO.<br><br>SETTING: The MD is one of the healthiest dietary patterns, reducing risk of chronic disease while promoting better health outcomes. However, adherence to the MD remains challenging, even in Mediterranean countries.<br><br>PARTICIPANTS: Healthy adults aged 18 years and older, living in a Mediterranean country.<br><br>RESULTS: A total of thirty-seven cross-sectional studies were included, with 190 to 13 262 participants. Most studies (30/37) were conducted in European Mediterranean countries, primarily Italy (n 14), Spain (n 9) and Greece (n 6). All studies involved community-based samples; two studies included only women. Individual-level determinants were the most frequently examined. Higher socio-economic status, regular breakfast consumption, being unemployed, a job seeker or retired were linked to better MD adherence. Socio-cognitive and interpersonal factors were underexplored. At the environmental level, COVID-19 confinement boosted adherence, whereas the effects of economic crises were inconsistent. Effect sizes were mostly very small to small, and findings are based on low-quality studies.<br><br>CONCLUSIONS: This systematic review highlighted several socio-economic and environmental factors potentially influencing MD adherence. However, more robust research is needed to better understand socio-cognitive and ecological factors.}, }
@article {pmid41199320, year = {2025}, author = {Jung, C and Gillmann, HJ and Stueber, T}, title = {Effectiveness and safety of prolonged prone positioning in adult patients with acute respiratory distress syndrome (ARDS): a systematic review and meta-analysis.}, journal = {Critical care (London, England)}, volume = {29}, number = {1}, pages = {475}, pmid = {41199320}, issn = {1466-609X}, mesh = {Humans ; Prone Position/physiology ; *Respiratory Distress Syndrome/therapy/mortality ; Adult ; COVID-19 ; *Patient Positioning/methods/standards ; Time Factors ; Randomized Controlled Trials as Topic ; }, abstract = {BACKGROUND: Prolonged prone positioning (PPP) for ≥ 24 h may enhance outcomes in moderate to severe acute respiratory distress syndrome (ARDS), but may also increase risks such as pressure injuries and complications. Despite clinical rationale, high-quality evidence for PPP's safety and efficacy remains scarce.<br><br>METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) and observational studies. Trials that compared two distinct treatment groups in adult patients with ARDS were included: prone position&#x2009;<&#x2009;24&#xa0;h (standard) and &#x2265;&#x2009;24&#xa0;h (prolonged). Databases searched included MEDLINE, CENTRAL, ClinicalTrials.gov, ISRCTN, ICTRP and the Cochrane Covid-19 Study Register (last search: 3 July 2025). Risk of bias was assessed using ROB-2 for RCTs, and the ROBINS-I V2 tool for non-randomised intervention studies (NRSI). The primary outcome was mortality. Secondary outcomes included improvement of oxygenation and adverse events. Outcomes (Risk ratios and hazard ratios) were calculated using a random-effect model with 95% confidence intervals (CI). The quality of evidence was evaluated using the GRADE assessment.<br><br>RESULTS: Of 19,986 records, 9 (n&#x2009;=&#x2009;1,045) were included in the qualitative and quantitative analysis. Four studies, including two small RCTs (n&#x2009;=&#x2009;112) and two NRSIs (n&#x2009;=&#x2009;581), had a low to moderate risk of bias. Most studies included patients with COVID-19 ARDS. Meta-analysis showed no significant effect on 90-day mortality (n&#x2009;=&#x2009;641, HR 0.72; 95% CI 0.41-1.25). No heterogeneity was detected among studies (I&#xb2; = 0%), but the confidence interval for I&#xb2; was wide (95% CI: 0-89%), suggesting the possibility that substantial heterogeneity may exist. Similarly, no significant differences were found for secondary outcomes.<br><br>DISCUSSION: Current evidence does not support the use of PPP outside of clinical studies. Pooled data from small trials and NRSIs reveal no significant effect of PPP on mortality, oxygenation, or safety outcomes. The evidence is of low to very low certainty, limited by inconsistency and imprecision. The wide confidence intervals indicate low statistical power, therefore both harm and benefit remain plausible on the basis of the available evidence. Well-powered RCTs are needed to clarify the potential benefits and risks of PPP in ARDS.}, }
@article {pmid41199232, year = {2025}, author = {Conduah, AK and Ofoe, SH}, title = {Intersecting impacts of ageing, migration, and socioeconomic disparities on health equity: a post-pandemic policy review.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {304}, pmid = {41199232}, issn = {1475-9276}, mesh = {Humans ; *Health Equity ; *COVID-19/epidemiology ; *Aging ; Socioeconomic Factors ; SARS-CoV-2 ; *Health Status Disparities ; Pandemics ; Health Policy ; *Emigration and Immigration ; Social Determinants of Health ; Socioeconomic Disparities in Health ; }, abstract = {BACKGROUND: The COVID-19 pandemic exposed and intensified structural inequities at the nexus of ageing, migration, and socioeconomic vulnerability. These overlapping disadvantages resulted in uneven health outcomes and highlighted systemic fragilities in health systems; yet, few policy reviews have integrated these demographic dimensions into a single analytical framework.<br><br>OBJECTIVES: This review critically examines how ageing, migration, and socioeconomic disparities intersect to shape health equity during and after the pandemic. It identifies structural bottlenecks, adaptive responses, and lessons for policy design in low- and middle-income as well as high-income contexts.<br><br>METHODS: A systematic policy review was conducted following PRISMA 2020 guidelines and preregistered on the Open Science Framework. Peer-reviewed studies, institutional reports, and grey literature published between 2020 and 2024 were appraised using differentiated quality criteria. Thematic convergence, guided by the Social Determinants of Health, Human Capital Theory, and Feminist Gerontology, informed narrative synthesis across 49 included sources.<br><br>RESULTS: A total of four intersecting themes emerged: (1) demographic inequality and uneven risk exposure; (2) exclusionary health systems and digital divides; (3) socioeconomic precarity and erosion of human capital; and (4) fragmented policy responses with limited ageing- and migrant-sensitivity. Comparative evidence underscores persistent inequities across regions, with gaps most pronounced in the Global South.<br><br>CONCLUSION: Post-pandemic health equity demands integrated and anticipatory governance. Strengthened geriatric and migrant-inclusive health systems, expanded universal social protection, investment in digital and community infrastructure, and institutionalised intersectional policy design are essential to break cycles of cumulative disadvantage and advance health justice. This review uniquely integrates ageing, migration, and socioeconomic inequities into a unified framework across regions, offering theory-informed policy clusters to guide future governance.<br><br>PROTOCOL REGISTRATION: The review protocol was prospectively registered on the Open Science Framework (OSF) under the DOI: https://doi.org/10.17605/OSF.IO/6YHC4 .}, }
@article {pmid41197969, year = {2025}, author = {Habtie, TE and Adisu, MA and Feleke, SF and Kitaw, TA}, title = {Burden Beyond the Bedside: A Global Synthesis of Depression in Informal Cancer Caregivers: An Umbrella Review.}, journal = {Journal of pain and symptom management}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jpainsymman.2025.10.033}, pmid = {41197969}, issn = {1873-6513}, abstract = {OBJECTIVE: The aim of this umbrella review is to synthesize pooled prevalence of existing evidence on depressive morbidity among informal cancer caregivers.<br><br>METHOD: This umbrella review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the protocol was registered in PROSPERO (CRD420251032522). A comprehensive search of major databases was performed to identify relevant studies. Predefined inclusion and exclusion criteria were applied. The corrected covered area (CCA) was calculated to assess overlap, and the methodological quality of included reviews was evaluated using the AMSTAR 2 tool.<br><br>RESULTS: This umbrella review included four systematic reviews and meta-analyses, comprising a total of 160 primary studies with 40,605 participants worldwide. The pooled global prevalence of depression among informal caregivers of cancer patients was 38% (95% confidence intervals, 95% CI: 28%-48%). However, prevalence estimates varied widely, ranging from 4 to 55%, likely due to differences in the depression assessment tools used across studies.<br><br>CONCLUSION AND RECOMMENDATION: In conclusion, this review reveals a high prevalence of depression among informal caregivers of cancer patients a burden comparable to or exceeding that observed in other chronic illnesses and global crises such as the COVID-19 pandemic. Integrating routine mental health screening using validated tools such as the CES-D or PHQ-9 into oncology care is essential. Structured interventions including counseling, psych-education, and respite care should be embedded within care pathways. Future research should prioritize standardized assessment tools and caregiver-focused strategies to enhance comparability and guide best practices. Policymakers must invest in caregiver mental health to ensure sustainable and compassionate cancer care systems.}, }
@article {pmid41194817, year = {2025}, author = {Dimitrakopoulou, A and Sarantaki, A and Nanou, CI and Georgakopoulou, VE and Taskou, C and Chouli, M and Diamanti, A}, title = {Long COVID-Related Fatigue During Pregnancy: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e93877}, pmid = {41194817}, issn = {2168-8184}, abstract = {Long sequelae of COVID-19 (Long COVID), or post-acute sequelae of SARS-CoV-2 infection, encompasses a wide range of persistent symptoms, with fatigue emerging as one of the most prevalent and disabling. Pregnant individuals may be uniquely susceptible to post-viral fatigue due to immunological and physiological adaptations during gestation. This review consolidates existing data regarding the prevalence, risk factors, and clinical implications of Long COVID-associated fatigue in pregnant individuals. A narrative review was conducted of studies examining fatigue among pregnant individuals with confirmed SARS-CoV-2 infection. Key outcomes included fatigue prevalence, symptom persistence, associated risk or protective factors, and comparisons with non-pregnant populations. Across both the acute and post-acute stages of COVID-19, fatigue emerged as a consistently common symptom. Its prevalence and persistence varied significantly across studies, partly due to heterogeneity in assessment tools and follow-up durations. Severe acute illness, hospitalization, obesity, and smoking during pregnancy were linked to a higher risk of prolonged fatigue, whereas anosmia appeared to act as a potential protective factor. In contrast, comorbidities such as hypertension, diabetes, and lung disease were not significantly linked to fatigue risk. No consistent associations were found with maternal age or alcohol use. Long COVID-related fatigue presents a substantial burden in pregnancy, with implications for maternal health, quality of life, and postpartum recovery. Early recognition, individualized care strategies, and public health interventions targeting modifiable risk factors are essential to support this vulnerable population. Ongoing research is essential to uncover underlying mechanisms and guide evidence-based clinical management.}, }
@article {pmid41194530, year = {2025}, author = {Grandinetti, C and Budwal-Jagait, M and Abid, H and Gebbia, E and Boley, E and Williams, L and Fisher, A and Marcus, L and Muldowney, L and Sellers, J and Wakelin-Smith, J and Ayalew, K}, title = {Evolving Standards: Good Clinical Practice Insights from US FDA, MHRA UK, and Health Canada.}, journal = {Clinical pharmacology and therapeutics}, volume = {}, number = {}, pages = {}, pmid = {41194530}, issn = {1532-6535}, support = {FD999999/ImFDA/Intramural FDA HHS/United States ; }, abstract = {As clinical trial design and conduct continue to evolve with innovative approaches, new technologies, and emerging data sources, regulatory frameworks are undergoing significant updates to align with these advancements. This article explores recent revisions to the International Council for Harmonization (ICH) Guideline for Good Clinical Practice (GCP) E6(R3) and the regulatory perspectives on adopting a risk-proportionate approach to trial design and conduct. Drawing from insights shared at the FDA-MHRA-HC 2024 Joint GCP Symposium, this article highlights the key themes shaping the future of clinical trials, including quality-by-design (QbD), risk proportionality, and cross-regulatory collaboration. Additionally, this article addresses the impact of the COVID-19 pandemic in accelerating trial innovations, such as the use of decentralized trial elements and digital health technologies (DHTs), while also emphasizing the need for regulatory flexibility to accelerate their adoption. Regulatory agencies, such as the US-FDA, MHRA-UK, and Health Canada, have issued guidance to promote clinical trial flexibilities and proportionate, risk-based approaches, ensuring the protection of participant rights, safety, and well-being and overall reliability of trial results. These updates advocate for proportionate approaches to trial oversight, which allow for innovation while safeguarding the trial's critical to quality factors. As regulators continue to refine their practices and enhance collaboration, the integration of QbD and risk proportionality into clinical trials and cross-regulatory collaboration will ultimately drive more efficient, participant-centered trials and improve the global clinical research landscape.}, }
@article {pmid41194187, year = {2025}, author = {Sun, YT and Wu, W and Guo, ZH and Liu, YC and Yao, YT and , }, title = {Burnout among doctors in China: a systematic review and meta-analysis.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3787}, pmid = {41194187}, issn = {1471-2458}, mesh = {Humans ; *Burnout, Professional/epidemiology/psychology ; China/epidemiology ; COVID-19/epidemiology/therapy ; *Physicians/psychology/statistics &amp; numerical data ; Prevalence ; Risk Factors ; }, abstract = {OBJECTIVES: The current study was performed to systemically examine the prevalence of burnout, risk factors among Chinese doctors, and possible treatment strategies.<br><br>METHODS: Two authors independently conducted literature searches in PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Chinese Scientific and Technical Papers and Citation (CSTPC) databases from the year of 1974 (when "burnout" was first defined), to May 27th, 2023, without language restriction. All published studies investigating burnout, and/or its 3 dimensions among practicing doctors in China, were included. Quality assessment followed the Joanna Briggs Institute (JBI) Critical Appraisal Checklists.<br><br>RESULTS: A total of 133 studies comprising 193,866 Chinese doctors were included in the current study. The pooled prevalence of burnout and severe burnout among Chinese doctors were 61% and 12%, respectively. The corona virus disease 19 (COVID-19) pandemic had a significant impact on severe burnout (14%). Emergency physicians had the highest prevalence of burnout (91%), while neurologists experienced the highest prevalence of emotional exhaustion (69%) and depersonalization (59%), whereas the lowest personal accomplishment levels were detected among anesthesiologists (65%). Additionally, 27 risk factors were demonstrated to be associated with burnout among Chinese doctors. Of which, personal psychological status was the greatest predictor of burnout among Chinese doctors (OR 3.88, 95% CI 3.75-4.01).<br><br>CONCLUSIONS: The overall prevalence of burnout is high among Chinese doctors, and it varies across different medical specialties. Personal psychological status was the greatest predictor of burnout among Chinese doctors. Regular psychological counseling, workload alleviation and income increase are recommended coping strategies.}, }
@article {pmid41193785, year = {2025}, author = {Li, X and Xiao, H and Zhou, M and Yang, C and Yang, X and Cheng, T and Yuan, L and Xia, N}, title = {Organoids in respiratory virus research: advances and perspectives.}, journal = {Molecular biomedicine}, volume = {6}, number = {1}, pages = {100}, pmid = {41193785}, issn = {2662-8651}, support = {82002139//National Natural Science Foundation of China/ ; 3502Z202471022//Natural Science Foundation of Xiamen/ ; 20720220006//Fundamental Research Funds for the Central Universities/ ; 20720250004//Fundamental Research Funds for the Central Universities/ ; }, mesh = {*Organoids/virology ; Humans ; Animals ; SARS-CoV-2 ; COVID-19/virology ; }, abstract = {The pandemics of respiratory viruses pose a worldwide public health problem and bio-safety threat. Therefore, the development of high-throughput and accurate infection models is crucial for elucidating viral pathogenesis and accelerating countermeasures to address the evolving respiratory viruses and the unexpected outbreaks of emerging variants. Compared to traditional 2D cultures, organoids exhibit pronounced intercellular interactions, extracellular matrix signaling, and tissue-specific multicellular cooperation, thereby more accurately recapitulating the in vivo microphysiological environment. However, research involving animal models typically requires prolonged experimental timelines, making it challenging to perform high-throughput screening or rapidly develop therapeutic strategies within the valuable timeframe. Since the outbreak of SARS-CoV-2, organoids have significantly advanced basic virology research and demonstrated potential in replicating the pathological and immunological characteristics in human patients. This review provides a comprehensive summary of the theoretical foundations, methodological framework, and complete procedures for identification and validation in organoid construction, along with their applications in the investigation of various respiratory viruses, such as coronaviruses, the influenza virus, respiratory syncytial virus, and others. Overall, the development of organoids, in conjunction with the integration of interdisciplinary technologies, has significantly advanced our fundamental understanding of the immunopathology process of respiratory viral infections, improved research efficiency, and provided precise tools for translational medical research.}, }
@article {pmid41193340, year = {2025}, author = {Fabre, A and Guerry, P and Morand, A}, title = {Hepatitis in the time of pandemics: A comparative bibliometric analysis of early publications on MIS-C, acute hepatitis of unknown aetiology and Mpox.}, journal = {Archives de pediatrie : organe officiel de la Societe francaise de pediatrie}, volume = {32}, number = {8}, pages = {527-531}, doi = {10.1016/j.arcped.2025.09.003}, pmid = {41193340}, issn = {1769-664X}, mesh = {Humans ; *Bibliometrics ; *Systemic Inflammatory Response Syndrome/epidemiology ; *COVID-19/epidemiology/complications ; Acute Disease ; *Hepatitis/epidemiology/etiology ; *Pandemics ; Child ; }, abstract = {BACKGROUND: The emergence of acute hepatitis of unknown etiology in the spring of 2022 was strikingly reminiscent of how multisystem inflammatory syndrome in children (MIS-C) had appeared two years earlier.<br><br>OBJECTIVE: To carry out a bibliometric analysis of the early literature on acute hepatitis of unknown aetiology, and another coincident but non-pediatric disease, Mpox, in comparison with our previous findings on the early coverage of MIS-C.<br><br>METHODS AND SETTINGS: A review of the literature was conducted in the MEDLINE database, on preprint servers, and among Reuters news articles. Articles were included if they had been published in 2022 and were specifically about acute hepatitis of unknown aetiology or Mpox.<br><br>RESULTS: The first newspaper/non-academic journal article on acute hepatitis of unknown aetiology was published in week 14 and the weekly number rapidly peaked in week 16 before decreasing gradually down to zero in week 22. The first peer-reviewed article was published in week 15 and remained between 3 and 7 from weeks 17 to 23. Just under a quarter (23.5 %) of references in these articles were to health agency publications on acute hepatitis of unknown aetiology. Over 7-week periods beginning just before the corresponding health agency alerts, 25 articles were published on MIS-C (21 peer-reviewed and 4 preprints), 20 articles were published on acute hepatitis of unknown aetiology (18 peer-reviewed and 4 preprints), and 74 on Mpox (48 peer-reviewed and 26 preprints). The proportion of preprints was significantly associated with disease type (p = 0.03), as was the proportion of clinical studies, with values of 52 %, 10 %, and 18 %, respectively (p = 0.002). Many more non-academic articles were published on Mpox (N = 180) than on acute hepatitis of unknown aetiology (17) or MIS-C (24).<br><br>CONCLUSION: Although Mpox attracted more overall attention, the medical community responded similarly rapidly to acute hepatitis of unknown aetiology and to MIS-C. The fact that a major source of early information on these diseases was health agency reports suggests that these should be included in bibliographic databases for ease of access.}, }
@article {pmid41192196, year = {2025}, author = {Faghir-Ganji, M and Abdolmohammadi, N and Ansari-Moghaddam, A and Askari, S and Eshrati, B}, title = {COVID-19 vaccination and stroke risk: A systematic review and meta-analysis of ischemic and hemorrhagic events.}, journal = {Journal of infection and public health}, volume = {19}, number = {1}, pages = {103021}, doi = {10.1016/j.jiph.2025.103021}, pmid = {41192196}, issn = {1876-035X}, abstract = {Reports of potential side effects have led to public concerns regarding COVID-19 vaccines. This systematic review and meta-analysis globally investigated the adverse effects, focusing specifically on the risks of stroke, myocarditis, and pneumonia following COVID-19 vaccination. A systematic search was performed across databases (including PubMed, Scopus, and Google Scholar) using MeSH terms such as "adverse events," "COVID-19," and "SARS-CoV-2," spanning from February 2019 to December 2023. From 708 reports identified, 8 studies were ultimately included. For hemorrhagic and ischemic stroke, the pooled risk ratio was 1.13 (95 % CI: 0.87 -1.47), but this result showed high heterogeneity (I[2]=97.7 %). Subgroup analysis confirmed that the study country was a significant contributor to this variability. Overall, the meta-analysis revealed no statistically significant increase in the pooled risk of the investigated adverse outcomes (stroke, myocarditis, or pneumonia). Given the substantial disease prevention benefits, these findings support the recommendation for widespread vaccination across all age groups.}, }
@article {pmid41191793, year = {2025}, author = {Jung, HW and Kim, DY and Lee, I and Kim, O and Lee, S and Lee, S and Chung, US and Kim, JH and Kim, S and Kim, JW and Shin, AL and Lee, JJ}, title = {Key Features of Digital Phenotyping for Monitoring Mental Disorders: Systematic Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e77331}, pmid = {41191793}, issn = {1438-8871}, mesh = {Humans ; Wearable Electronic Devices ; COVID-19/psychology/epidemiology ; Smartphone ; *Mental Disorders/diagnosis ; SARS-CoV-2 ; Phenotype ; Telemedicine ; }, abstract = {BACKGROUND: The COVID-19 pandemic has intensified mental health issues globally, highlighting the urgent need for remote mental health monitoring. Digital phenotyping using smart devices has emerged as a promising approach, but it remains unclear which features are essential for predicting depression and anxiety.<br><br>OBJECTIVE: This study aimed to identify the types of features collected through smart packages-integrated systems combining smartphones with wearable devices such as Actiwatches, smart bands, and smartwatches-and to determine which features should be considered essential for mental health monitoring based on the type of device used.<br><br>METHODS: A systematic review was conducted. Searches were performed across Web of Science, PubMed, and Scopus on February 5, 2025. Inclusion criteria comprised quantitative studies involving adults (&#x2265;19 years) using smart devices to predict depression or anxiety based on passive data collection. Studies focusing solely on smartphones or qualitative designs were excluded. Risk of bias was assessed using the Mixed Methods Appraisal Tool and the Quality Criteria Checklist. Data were synthesized descriptively, and the relative contribution of each feature was further assessed by calculating coverage (proportion of studies using a feature) and importance among used (proportion identifying it as important when used). These metrics were visualized in quadrant-based scatter plots to identify consistently important features across devices.<br><br>RESULTS: From 1382 records, 22 studies across 11 countries were included. The overall synthesis identified a core feature package-accelerometer, steps, heart rate (HR), and sleep. Device-specific analyses revealed further nuances: in Actiwatch studies, accelerometer and activity were consistently important, but sleep features were rarely examined. In smart band studies, HR, steps, sleep, and phone usage were essential, while GPS, electrodermal activity (EDA), and skin temperature showed high importance when used, suggesting opportunities for broader adoption. In smartwatch studies, sleep and HR emerged as core features, whereas steps and accelerometer were widely used but often not identified as important.<br><br>CONCLUSIONS: This systematic review identified a core feature package comprising accelerometer, steps, HR, and sleep that consistently contributes to mood disorder prediction across devices. At the same time, device-specific differences were observed: Actiwatch studies mainly emphasized accelerometer and activity but underused sleep features; smart bands highlighted HR, steps, sleep, and phone usage, with EDA, skin temperature, and GPS showing additional promise; and smartwatches most reliably leveraged sleep and HR, while steps and accelerometer were widely used yet less effective. These findings suggest that while a shared core set of features exists, optimizing digital phenotyping requires tailoring feature selection to the characteristics of each device type. To advance this field, improving data accessibility, particularly in smartwatch ecosystems, and adopting standardized reporting frameworks will be essential to enhance comparability, reproducibility, and future meta-analytic integration.}, }
@article {pmid41189699, year = {2025}, author = {Zethelius, B and Rubin, J and Pihlström, N and Liminga, UW and Back, H and Aronsson, B and Tegnell, A and Marking, U and Ludvigsson, JF and Andersson, S and Ljung, R}, title = {Overview of approved COVID-19 vaccines in the EU, recommendations for use in Sweden and vaccine uptake over time: Report from the Swedish Medical Products Agency and the Public Health Agency of Sweden.}, journal = {Upsala journal of medical sciences}, volume = {69}, number = {}, pages = {}, pmid = {41189699}, issn = {2000-1967}, mesh = {Humans ; Sweden/epidemiology ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage ; *COVID-19/prevention &amp; control/epidemiology ; European Union ; SARS-CoV-2/immunology ; Vaccination ; Public Health ; Drug Approval ; }, abstract = {OBJECTIVE: The aim of this review is to describe the regulatory background of the COVID-19 vaccines, the national recommendations for use issued and vaccine uptake in Sweden. It includes an overview of licensing and relevant safety aspects identified by the European Medicines Agency (EMA) and the national vaccination plan issued by the Public Health Agency (PHA) of Sweden.<br><br>MATERIALS AND METHODS: Information on dates of licensing and safety aspects of importance identified by EMA published on its website, was compiled and presented in a chronological order. National recommendations on COVID-19-vaccination and vaccinations-data on uptake and coverage using the national-vaccine-register are presented.<br><br>RESULTS: COVID-19 vaccines development, assessments using rolling review and licensing of the covid-19 vaccines was done in 2020 during less than a year. Large-scale production was implemented. Monthly safety reviews performed by the EMA identified risk for thrombosis with thrombocytopenia syndrome with adenoviral vaccines and myocarditis for mRNA vaccines which led to restrictions in national recommendations for specified groups.National vaccinations were launched in a phased manner during 2021. Persons of high age, risk groups and nursing home personnel were prioritised during primary vaccinations and for initial boosters. In the Swedish population, 85% recieved at least on vaccine dose from the age of 12. At least two doses were recieved by 81% from age 18 and 95% from age 80.<br><br>CONCLUSION: Recommendations for national use adhered to relevant adverse drug reactions identified. The vaccine coverage was high. Timelines presented should be considered in follow-up studies of COVID-19-vaccines to manage possible selection bias and confounding.}, }
@article {pmid41186421, year = {2025}, author = {Yapa, HM and MacLean, EL-H and Menzies, NA and Dodd, PJ and Dean, A and Mirzayev, F and Schumacher, SG and Nguyen, LN and Zignol, M and Fox, GJ}, title = {Drug-resistant tuberculosis: a priority pathogen for enhanced public health research and practice.}, journal = {Clinical microbiology reviews}, volume = {}, number = {}, pages = {e0006425}, doi = {10.1128/cmr.00064-25}, pmid = {41186421}, issn = {1098-6618}, abstract = {SUMMARYDrug-resistant tuberculosis (DR-TB) causes substantial morbidity and mortality and has hindered progress toward TB elimination. This slowed progress toward the WHO End TB Strategy's targets was exacerbated by lower TB detection during the COVID-19 pandemic. To inform research and development priorities, we conducted a narrative review of global DR-TB epidemiology and strategies for DR-TB prevention, diagnostics, and treatment. Gaps remain in DR-TB diagnosis, TB drug susceptibility testing (DST), and treatment. The review also shows that DR-TB causes significant post-disease disability, particularly chronic lung disease, impacting quality of life. Newer oral regimens for multidrug-resistant TB are shorter and more effective than traditional regimens. New antibiotics under development may help overcome remaining safety and tolerability issues, while novel advanced therapeutics and precision medicine offer hope to those failing treatment. Emerging diagnostics include rapid DST for second-line drugs, but a paradigm shift is needed to ensure novel DSTs become available as new drugs are introduced. Person-centered research is urgently needed to accelerate the response to DR-TB amidst the global threat of antimicrobial resistance, yet global investment in TB prevention and care currently falls short of need. A holistic approach to interventions to improve DR-TB prevention and care is needed, encompassing all health system components and their interactions, including a One Health approach and consideration of the wider determinants of health.}, }
@article {pmid41185699, year = {2025}, author = {Şimşek, S and Altay, S and Salman, FS and Kayı, &#x130;}, title = {Fairness-based techniques to optimize vaccine allocation among migrants during pandemics: a scoping review.}, journal = {PeerJ}, volume = {13}, number = {}, pages = {e20208}, pmid = {41185699}, issn = {2167-8359}, mesh = {Humans ; *Transients and Migrants/statistics &amp; numerical data ; *Pandemics ; *Vaccination/statistics &amp; numerical data ; Health Services Accessibility ; *Vaccination Coverage ; *COVID-19/prevention &amp; control ; Vaccination Hesitancy ; }, abstract = {INTRODUCTION: Migrants face significant barriers to vaccination due to disparities in access and coverage, necessitating fairness-based strategies and inclusive healthcare infrastructure to ensure equitable immunization, especially during pandemics. This study investigates fairness-based vaccination strategies, focusing on migrant vaccination status during pandemics, and migrant specific vaccine distribution models.<br><br>METHODS: The authors employed established scoping review methods to explore the research question: How have fairness-based strategies for vaccine allocation affected vaccination coverage among migrants during pandemics in urban and rural areas? A scoping review was conducted following the PRISMA and expectation, client group, location, impact, professionals, and service (ECLIPSE) guidelines, utilizing the Joanna Briggs Institute's Checklist for Qualitative Research. The review involved a comprehensive database search across PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MedLine. The eligibility criteria for publications included at least one of the following aspects related to migrants: access to vaccines or frequency of vaccine uptake, vaccine hesitancy, vaccine modeling and optimization approaches, or discussions grounded in principles of fairness. Searches were limited to the articles published in English between 2000-2022. Initially, 5,653 articles were identified, which were reduced to 305 after title screening. Following abstract screening, 19 articles meeting the inclusion criteria-focused on vaccination modeling, allocation, fairness optimization, and behaviors or attitudes in migrant populations-were selected for full-text evaluation.<br><br>RESULTS: Vaccination rates among migrants range from 42.7% to 87%, which are lower compared to the host population. Although the willingness to vaccinate is around 70%, significant barriers such as language obstacles, lack of access to healthcare services, and insufficient information remain critical challenges. While 19 of the studies defined fairness through the use of health services, four of them discussed it on community participation, and two employed modeling approaches. Various techniques, including community involvement, digital health messages and national refugee centers, have been employed to allocate vaccines fairly and consistently. The concept of equity has been addressed inconsistently across studies, and there is insufficient data to develop a fair vaccine distribution strategy for migrant populations.<br><br>CONCLUSION: This study highlights the following: (1) the challenges migrants face, including limited access to healthcare, language barriers and poor living conditions, which complicate equitable vaccine allocation; (2) the lack of specific, systematic national vaccine allocation programs targeting migrants; and (3) the need for a targeted, fairness-based approach, along with further research on national policies and vaccine delivery models that prioritize migrants and address their unique vulnerabilities.}, }
@article {pmid41185679, year = {2025}, author = {Rostami Zarinabadi, C and Daliri, S and Rohani-Rasaf, M and Karimi, A and Zare, F}, title = {Post-Traumatic Stress Disorder after Disaster and Mass-Casualty Incidents in Developed and Developing Countries: A Meta-Analysis Study.}, journal = {Iranian journal of psychiatry}, volume = {20}, number = {3}, pages = {383-404}, pmid = {41185679}, issn = {1735-4587}, abstract = {Objective: Disasters impact global health, with Post Traumatic Stress Disorder (PTSD) being a significant early consequence. Countries differ in their response to disasters and health management, affecting PTSD prevalence. This study aims to compare PTSD prevalence in developed and developing countries and investigate its trends post-COVID-19 compared to other mass-casualty incidents. Method : This study was conducted using systematic review and meta-analysis methods regarding the prevalence of PTSD in the world. Accordingly, all the English language articles published from the beginning of 2010 to the end of 2024 were extracted from the Scopus, Web of Science, PubMed, Cochrane Library, and Google Scholar databases and were investigated. Data analysis was done by random effects model, meta-regression, I[2] index, and Egger test using the STATA (ver. 17) software. Results: One hundred and eight studies, with a total sample size of 498,796, were included in the meta-analysis. The prevalence of PTSD in developed countries at various intervals after exposure to disaster was as follows: 26.3% (1-3 months), 44.5% (4-6 months), 11.1% (7-12 months), 24.0% (13-24 months), and 22.0% (25-36 months). In developing countries, the corresponding prevalence rates were 26.0%, 25.2%, 30.4%, 21.4%, and 20.9%, respectively. PTSD prevalence in men was slightly higher in developing countries compared to developed countries, but the difference was minimal. Conclusion: More than one-fifth of disaster-exposed populations develop PTSD, with no significant prevalence difference between developed and developing countries. PTSD prevalence was higher in men from developing countries, but no significant gender differences were found otherwise. Prompt diagnostic and therapeutic interventions are essential globally to mitigate PTSD's impacts.}, }
@article {pmid41185579, year = {2025}, author = {Park, YS and Schroeder, D and Kim, OJ}, title = {Research Ethics Challenges in Pandemic Korea and Their Implications for the Revised 2024 Declaration of Helsinki.}, journal = {Journal of Korean medical science}, volume = {40}, number = {42}, pages = {e281}, pmid = {41185579}, issn = {1598-6357}, support = {101058094//European Commission/ ; }, mesh = {Humans ; Biomedical Research/ethics ; *COVID-19/epidemiology ; *Ethics, Research ; *Helsinki Declaration ; Informed Consent/ethics ; Pandemics ; Republic of Korea/epidemiology ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The pandemic significantly impacted research ethics, vastly magnifying existing challenges. This study examines challenges for research ethics in Korea during coronavirus disease 2019 (COVID-19) and their implications for the 2024 revised Declaration of Helsinki.<br><br>METHODS: As a literature search method, we applied the scoping review protocol using six databases, search keywords related to research ethics and COVID-19, then analyzed key themes against the revised Helsinki Declaration.<br><br>RESULTS: We reviewed the literature on research ethics during the COVID-19 pandemic in the Republic of Korea, identifying ten key themes: 1) participant safety; 2) national governance; 3) community engagement; 4) global cooperation; 5) reliable research; 6) rapid Institutional Review Board reviews; 7) consent adaptation; 8) fair inclusion of vulnerable groups; 9) ethics of human challenge trials; and 10) use of human materials without consent. The revised Helsinki Declaration of 2024 newly introduces: 1) ethical principles in public health emergencies; 2) meaningful community engagement; 3) scientific rigor; and the Declaration reframes 4) addressing vulnerability; and 5) informed consent for biological materials.<br><br>CONCLUSION: By analyzing the relevance and implications of the challenges identified in this literature review in relation to the revisions made to the Declaration of Helsinki in 2024, we demonstrate that the updated Declaration addresses most of the ethical challenges posed by research in pandemic Korea. This paper highlights that the 2024 revision underscores the significance of research ethics during pandemic situations and proposes approaches to enhance the research environment and ecosystem in the 21st century post-pandemic.}, }
@article {pmid41184791, year = {2025}, author = {Heinz, SS and O'Brien, AJ and Walker, C and O'Sullivan, M and Rouse, P and Whitehead, J and Parsons, M and Cunningham, R and Edmonds, M}, title = {Mediating pathways between resilience, mental health and wellbeing: a scoping review of individual, social, and systemic factors.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3758}, pmid = {41184791}, issn = {1471-2458}, support = {24/981//Health Research Council of New Zealand/ ; }, abstract = {BACKGROUND: Resilience strongly predicts health and wellbeing across populations, but mediating pathways may vary between cultural and socioeconomic contexts. This scoping review examines the mediating variables that explain the relationships between resilience, mental health and wellbeing across different socioeconomic contexts.<br><br>METHODS: Following a literature search of four databases (PubMed, PsycInfo, Scopus, and CINAHL), we identified 824 potentially relevant papers. After rigorous screening using predefined inclusion criteria, 24 high-quality studies were included in the final review. Two independent reviewers assessed methodological quality using the Joanna Briggs Institute Critical Appraisal Tools.<br><br>FINDINGS: Three levels of mediating pathways emerged: individual factors (self-esteem, self-efficacy, mindfulness, self-compassion, coping strategies, emotional regulation); social factors (family support, social networks, community resources); and systemic factors (economic security, digital inclusion, burnout, religious coping). Resilience was consistently associated with better wellbeing, but mediating factors varied by context. In impoverished contexts, structural determinants of economic stability, service availability, and social protection schemes were pivotal in how resilience is enacted to shape wellbeing. In advantaged contexts, internal psychological capacities and social support emerged as primary mediators through which resilience shapes wellbeing. Studies in Western contexts focused on individual factors, while studies in Eastern environments highlighted social factors. Studies in Middle Eastern settings emphasised religious coping mechanisms, while Global South research prioritised resource availability. During acute crises (COVID-19) positive reappraisal and stress recovery were critical mediators, whereas chronic adversity contexts emphasised social support networks and coping mechanisms.<br><br>CONCLUSION: Resilience and wellbeing operate through distinct mediation pathways influenced by social, cultural, and environmental factors. Interventions should target context-specific mediators rather than employing generalised strategies. Future research should address knowledge gaps concerning Indigenous populations and employ longitudinal methodologies to establish causality across diverse environments.}, }
@article {pmid41184276, year = {2025}, author = {Kim, S and Shrestha, K and Cho, G}, title = {Towards practical point-of-care quick, ubiquitous, integrated, cost-efficient molecular diagnostic Kit (QUICK) PCR for future pandemic response.}, journal = {Microsystems &amp; nanoengineering}, volume = {11}, number = {1}, pages = {204}, pmid = {41184276}, issn = {2055-7434}, support = {RS-2025-02263957//Korea Health Industry Development Institute (KHIDI)/ ; RS-2025-02263957//Korea Health Industry Development Institute (KHIDI)/ ; RS-2025-02263957//Korea Health Industry Development Institute (KHIDI)/ ; }, abstract = {In response to the ongoing threat of infectious disease outbreaks, such as coronavirus disease (COVID-19) pandemic, numerous technological advancements in nucleic acid amplification testing (NAAT) based point-of-care test (PoCT) have been introduced to enable simple, rapid, and accurate diagnostic tests. However, only a few innovations in NAAT methods have been successfully commercialized. In this review, the significant advancements in diagnostic technologies, focusing on sample preparation methods, rapid thermal cycling technologies, and integrated result readout methods, are summarized with their key limitations that have hindered the practical implementation of polymerase chain reaction (PCR)-based PoCT, called a QUICK-PCR: quick, ubiquitous, integrated, cost-efficient molecular diagnostic kit based on PCR. In addition, the details of the core components to realize QUICK-PCR were prospectively suggested with a comparative overview for the PCR-based molecular diagnosis process, innovations in sample preparation using microfluidic chips, and direct PCR approaches. Especially, advancement in recent thermal cycling techniques that use Joule heating, thermoelectric heating, and plasmonic heating were highlighted while integrated readout methods that utilize fluorescence, colorimetry, and electrochemical techniques were examined. Based on analyzing key barriers in developing PCR-based PoCT, we highlight recent advancements in developing the PCR-based PoCT which can be implemented in the QUICK-PCR. The prospective QUICK-PCR will remove inequality in health care in resource-limited remote areas under the threatens of infectious diseases.}, }
@article {pmid41181159, year = {2025}, author = {Li, J and Zhang, J and Li, SG and Guo, Q and Xu, J and Zhang, L and Zou, Y and Long, T and Yu, R and Zhang, Y}, title = {Rapidly progressive anti-GBM disease secondary to long-standing rheumatoid arthritis: a case report and literature review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1661117}, pmid = {41181159}, issn = {1664-3224}, mesh = {Humans ; *Arthritis, Rheumatoid/complications/immunology ; Male ; Aged ; *Anti-Glomerular Basement Membrane Disease/therapy/etiology/diagnosis ; COVID-19/complications ; Fatal Outcome ; SARS-CoV-2 ; Antibodies, Monoclonal, Humanized/therapeutic use ; Disease Progression ; Plasma Exchange ; Plasmapheresis ; }, abstract = {BACKGROUND: Long-standing rheumatoid arthritis (RA) complicated by anti-glomerular basement membrane (anti-GBM) disease is exceptionally rare.<br><br>CASE: A 71-year-old man with long-standing seropositive RA developed a rapidly progressive glomerulonephritis due to anti-GBM disease, without any known drug triggers. Despite plasmapheresis (therapeutic plasma exchange), corticosteroids, and low-dose cyclophosphamide, he remained dialysis-dependent; RA activity was subsequently controlled with tocilizumab. Complications included Stenotrophomonas maltophilia pneumonia, COVID-19 and cytomegalovirus infection, and he died of pneumonia eight months after diagnosis.<br><br>CONCLUSION: This case highlights the need for early serological testing for anti-GBM disease in RA patients with unexplained hematuria/proteinuria and for immunosuppressive therapy mindful of infection risk. Additionally, our literature review identified only ten reported cases of RA with anti-GBM disease, highlighting the rarity of this condition.}, }
@article {pmid41181142, year = {2025}, author = {Hartnell, L and Agudelo-Romero, P and Montgomery, ST and Ben-Othman, R and Verhasselt, V and Stick, SM and Kollmann, TR}, title = {What goes up must come down: dynamics of type 1 interferon signaling across the lifespan.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1654604}, pmid = {41181142}, issn = {1664-3224}, mesh = {Humans ; *Interferon Type I/immunology/metabolism ; *Signal Transduction/immunology ; Animals ; *Aging/immunology ; Virus Diseases/immunology ; *Longevity/immunology ; Membrane Proteins/metabolism/immunology ; Disease Susceptibility ; }, abstract = {Type 1 interferons (T1IFNs) are typically expressed in low concentrations under homeostatic conditions, but upon pathogenic insult or perturbation of the pathway, these critical immune signaling molecules can become either protectors from or drivers of pathology. While essential for initiating antiviral defense and modulating inflammation, dysregulation of T1IFN signaling can contribute to immunopathology, making it and its associated pathways prime targets for immune evasion and disruption by pathogens. This review focuses on the changes in T1IFN signaling across the lifespan, with particular emphasis on the role of the Stimulator of Interferon Genes (STING) pathway in autoimmune and infectious disease susceptibility, especially in the context of viral infections. Aging is associated with diminished T1IFN responsiveness, partially resulting from chronic stimulation of the STING pathway, which contributes to increased susceptibility and impaired viral clearance. Conversely, neonates and young children also show increased vulnerability to certain viral infections, but whether this is driven by T1IFN differences or another mechanism remains incompletely understood. Despite growing interest in T1IFN-based immunotherapies, pediatric and elderly populations remain underrepresented in clinical trials. Here, we advocate for a deeper molecular and systems understanding of how the interferon response evolves across the human lifespan, to inform age-tailored therapeutic approaches and more inclusive study designs, thereby improving outcomes in both the youngest and oldest patients.}, }
@article {pmid41180709, year = {2025}, author = {Khan, A and Asghar, T and Yumn, L and Ishtiaq, S and Saeed, M and Ansari, RA and Fatima, M and Antar, M and Haider, MZ and Laghari, MA}, title = {Trends in hypertensive heart disease-related mortality among population with Alzheimer's in the United States: a 22-year nationwide analysis.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {11}, pages = {7325-7333}, pmid = {41180709}, issn = {2049-0801}, abstract = {BACKGROUND: Alzheimer's disease (AD) is a progressive neurodegenerative disorder, while hypertensive heart disease (HHD) is a major cardiovascular condition linked to chronic hypertension (HTN). HTN is common among patients with AD, significantly impacting mortality. This study explores trends in HHD-related mortality among patients with AD in the US from 1999 to 2020, utilizing the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database.<br><br>METHODS: Data from the CDC WONDER database were used to extract mortality information for individuals aged &#x2265;65&#xa0;years, with AD and HHD as the underlying or contributing causes of death. Mortality rates were analyzed by age, sex, race/ethnicity, urban-rural classification, and region. Both crude- and age-adjusted mortality rates (AAMRs) were calculated. Joinpoint regression was employed to identify significant trends and changes in mortality over time.<br><br>RESULTS: HHD-associated mortality among patients with AD showed a significant upward trend, with deaths rising from 710 in 1999 to 3263 in 2020. The AAMR increased from 2.08 per 100&#xa0;000 in 1999 to 6.26 per 100&#xa0;000 in 2020, a threefold increase. Female patients had higher mortality rates than males throughout the study period. The highest mortality rates were observed in the age group of 85+ years, with notable regional disparities, particularly in the South and Midwest. The COVID-19 pandemic in 2020 contributed to a marked spike in mortality.<br><br>CONCLUSION: A concerning rise in HHD-related mortality among patients with AD, particularly in the last decade is observed. Significant disparities exist across demographic groups and regions. These findings highlight the need for public health interventions and policies to address the dual burden of AD and HHD.}, }
@article {pmid41180683, year = {2025}, author = {Abbasher Hussien Mohamed Ahmed, K and Kalool Fadlalla Ahmad, T and Ismail Abdu Ismail, M and Elgadi, AT and Hassan Salih Elhaj, E and Mustafa Ahmed, GE and Khan, F and Mohammed, MBH and Manhal, GAA and Daffalla Mussaad Mohammed, A and Ali, MMI and Abdullah Mohammed, MEA and Meshref, M and Hussien, A}, title = {Neurological manifestations of COVID-19 and its vaccines: an updated comprehensive review with an insight into pathophysiology.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {11}, pages = {7346-7355}, pmid = {41180683}, issn = {2049-0801}, abstract = {The COVID-19 pandemic caused by SARS-CoV-2 has had a significant global impact on the respiratory system and multiple organ systems, including the nervous system. Neurological manifestations associated with COVID-19 infection and its vaccines have been increasingly recognized, ranging from problems with smell and taste to more severe conditions such as encephalitis, stroke, and Guillain-Barré syndrome. This narrative review critically evaluates the neurological manifestations of COVID-19 infection and its vaccines, providing insights into potential pathophysiological mechanisms. A comprehensive literature search was conducted, and data were retrieved from various databases. The prevalence, types, and severity of neurological symptoms in COVID-19 patients were discussed. The possible mechanisms of neurological injury in COVID-19 were explored, including direct viral invasion, hypoxic brain injury, immune-mediated damage, and cerebrovascular injury. Furthermore, the review addressed the neurological complications associated with COVID-19 vaccination. While severe vaccine-related adverse effects remain rare, understanding their occurrence is essential for risk assessment and public health interventions. In conclusion, COVID-19 can affect the nervous system in various ways, leading to various neurological symptoms. Further research is necessary to enhance our understanding of these manifestations and develop effective preventive and treatment strategies to manage this global health crisis.}, }
@article {pmid41180339, year = {2025}, author = {Sedrak, P and Dounaevskaia, V and Mancini, GBJ and Zieroth, S and McKelvie, RS and Chiu, W and Bewick, D and Ducharme, A and Mansour, S and Lepage, S and Pearson, GJ and Welsh, RC and Udell, JA and Connelly, KA}, title = {Vaccination in Patients with Cardiovascular Disease: A Case-Based Approach and Contemporary Review.}, journal = {CJC open}, volume = {7}, number = {10}, pages = {1375-1388}, pmid = {41180339}, issn = {2589-790X}, abstract = {Vaccination is a crucial preventative strategy, particularly in individuals with cardiovascular (CV) disease (CVD). People living with CVD are at increased risk of morbidity and mortality from vaccine-preventable infections such as influenza, severe acute respiratory syndrome-corona virus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), varicella zoster virus (VZV), and pneumococcal disease. These infections also have been associated with downstream CV complications, including ischemic events and myocarditis. Randomized controlled trials have demonstrated that influenza vaccination reduces major adverse CV events and all-cause mortality, especially in people with CVD. The same has been observed in registry analyses during the SARS-CoV-2 pandemic. Pooling of data from observational and cohort studies also has shown significant benefit of vaccination against RSV, VZV, and pneumococcal disease in older populations and those with CV comorbidities. Despite recommendations from national public health guidelines and immunization programs, vaccination uptake in patients with CVD remains suboptimal. This low uptake is influenced by lack of vaccine information, access issues, and mistrust in the healthcare system, all summarized in the term "vaccine hesitancy." Vaccination promotion should focus on addressing these gaps in communication and access barriers at the provider, community, and public health levels. Healthcare providers including cardiologists are reminded, through this review, of the importance of emphasizing vaccination recommendations during clinical encounters. Addressing patient misconceptions and providing patient decision aids strongly improves acceptance rates. Continued efforts at the community and public health levels should address barriers to access and advance surveillance methods to target improved clinical outcomes for groups at risk.}, }
@article {pmid41179760, year = {2025}, author = {Yang, F and Huang, X and Huang, W and Jiang, T}, title = {Development and testing of a public health emergency intelligence analysis system based on text analysis and NLP analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1677306}, pmid = {41179760}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology ; *Public Health ; China/epidemiology ; *Natural Language Processing ; Logistic Models ; *Emergencies ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To tackle challenges including delayed information support and inefficient decision-making in public health emergency response, this study develops an intelligence analysis system for public health emergencies based on emergency information management theory from library and information science.<br><br>METHODS: Using 1,026 text data items such as government reports and flow survey records from the COVID-19 epidemic in Shijiazhuang City (1,033 confirmed cases), multimodal analysis methods were integrated, including logistic regression, C5.0 decision tree, TransH-based knowledge graph, and chi-square test. The BIO tagging scheme was adopted with annotations performed by three epidemiology professionals, achieving an inter-annotator agreement (Kappa) of 0.78.<br><br>RESULTS: Key transmission sites were identified by chi-square test (&#x3c7; [2]&#x202f;=&#x202f;87.32, p&#x202f;<&#x202f;0.001). Risk factors such as advanced age (OR&#x202f;=&#x202f;3.15) and village clinic visits (OR&#x202f;=&#x202f;4.72) were identified through logistic regression. A case-place-time network was constructed using the TransH algorithm (accuracy 0.89). The C5.0 decision tree classified high-risk areas (AUC&#x202f;=&#x202f;0.91), and Apriori association rules revealed patterns such as "wedding banquet &#x2192; family gathering" (confidence 0.86). A Python-based system improved intelligence extraction efficiency by 47.8%.<br><br>CONCLUSION: The study successfully establishes an interdisciplinary framework integrating library informatics, epidemiology, and AI. It identifies churches and wedding banquets as key transmission nodes, and village clinics as amplifiers due to delays in identification and reporting. The developed software tool enhances response efficiency, supporting rapid contact tracing and control strategy formulation.}, }
@article {pmid41178423, year = {2025}, author = {Limami, Y and Wahnou, H and Ndayambaje, M and Hba, S and Chgari, O and Ammara, M and El Kebbaj, R and Naya, A and Oudghiri, M and Duval, RE}, title = {SARS-CoV-2: A Liver Brief.}, journal = {WIREs mechanisms of disease}, volume = {17}, number = {6}, pages = {e70005}, doi = {10.1002/wsbm.70005}, pmid = {41178423}, issn = {2692-9368}, mesh = {Humans ; *COVID-19/complications/virology/pathology/immunology ; *SARS-CoV-2/pathogenicity ; *Liver Diseases/virology/pathology ; *Liver/virology/pathology/immunology/metabolism ; Angiotensin-Converting Enzyme 2/metabolism ; Virus Internalization ; }, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has revealed the virus's ability to induce multi-organ damage, including significant liver injury. The molecular mechanisms of liver dysfunction in COVID-19 patients are explored, focusing on direct viral infection, immune-mediated damage, and the gut-liver axis. SARS-CoV-2 enters liver cells through the Angiotensin-Converting Enzyme 2 (ACE2) and Transmembrane Serine Protease 2 (TMPRSS2) receptors, but alternative pathways, such as CD209/Dendritic Cell-Specific Intercellular adhesion molecule-3-Grabbing Non-integrin (DC-SIGN) and AXL receptors, can also contribute to viral entry. Additionally, immune responses, particularly the cytokine storm, exacerbate liver inflammation, leading to hepatocyte damage. Pre-existing liver conditions, such as metabolic-associated fatty liver disease (MAFLD), alcohol-related liver disease (ALD), and liver fibrosis, heighten the risk of severe outcomes in COVID-19 patients. Post-COVID-19 liver complications, including fibrosis progression and persistent liver damage, have been reported, with emerging evidence suggesting chronic inflammation, viral persistence, and autoimmune reactions as potential contributors. Furthermore, Drug-Induced Liver Injury (DILI) from COVID-19 treatments remains a concern, highlighting the need for careful management. Consequently, understanding the interplay between SARS-CoV-2 and the liver is critical for improving patient outcomes and developing targeted therapies to mitigate liver-related complications in both acute and Long COVID-19 phases. This article is categorized under: Infectious Diseases > Molecular and Cellular Physiology.}, }
@article {pmid41177982, year = {2025}, author = {Xu, Q and Zhao, T and Cai, X and Wang, M and Ao, L and Wei, T and Yang, H and Zhang, S and Zhang, X and Jin, S and Wang, X and Feng, X and Zhao, J and Wu, Y and Yang, J and Cui, F}, title = {Global Hesitancy of COVID-19 Vaccine Among Vulnerable Population From 2020 to 2023: A Systematic Review and Meta-Analysis.}, journal = {Reviews in medical virology}, volume = {35}, number = {6}, pages = {e70079}, doi = {10.1002/rmv.70079}, pmid = {41177982}, issn = {1099-1654}, support = {22BGL246//National Social Science Foundation of China/ ; L222028//Haidian Original Innovation/ ; L222029//Haidian Original Innovation/ ; }, mesh = {Humans ; *COVID-19 Vaccines/administration &amp; dosage ; *COVID-19/prevention &amp; control/epidemiology ; *Vaccination Hesitancy/statistics &amp; numerical data/psychology ; *Vulnerable Populations/psychology ; Vaccination/psychology ; SARS-CoV-2/immunology ; Global Health ; Pandemics/prevention &amp; control ; }, abstract = {Vaccination is an effective response to the COVID-19 pandemic, but vaccine hesitancy is a major challenge. This study aims to explore the pooled prevalence and factors of COVID-19 vaccine hesitancy. We searched the studies published from January 2020 to December 2023 in PubMed, Web of Science, and Embase. The studies with complete start time of the study and national information were included in the generalised additive model to explore the factors affecting the COVID-19 vaccine hesitancy rate by calculating OR and 95%CI. A total of 629 studies were included. The pooled global hesitancy rates of COVID-19 vaccine were 34.6% (95% CI: 31.2%-38.1%) in vulnerable population and 33.2% (95% CI: 31.7%-34.8%) in general populations. The regression model showed that the hesitancy rate of COVID-19 vaccine was correlated with the duration of the epidemic, the monthly governmental stringency index, the monthly incidence and mortality of COVID-19, SDI, geographical location, and health status. Local governments should pay special attention to vaccination of vulnerable population and encourage vaccination to cope with the next possible wave of pandemic as incidence declines and restrictions are eased. The international community should timely provide vaccines for low economy countries.}, }
@article {pmid41177826, year = {2025}, author = {Kilic Gunes, E}, title = {Artificial intelligence in hematology: current trends and application areas.}, journal = {Annals of hematology}, volume = {104}, number = {11}, pages = {6033-6043}, pmid = {41177826}, issn = {1432-0584}, mesh = {Humans ; *Artificial Intelligence/trends ; *Hematology/trends/methods ; COVID-19/therapy ; *Hematologic Diseases/therapy/diagnosis ; SARS-CoV-2 ; Hematopoietic Stem Cell Transplantation ; }, abstract = {This study aims to map the current research trends, application areas, and thematic clusters of artificial intelligence (AI) technologies in hematology. A literature search was conducted in the Web of Science on June 1, 2025, covering the years 1980-2025. A total of 376 original research articles were analyzed using bibliometric techniques, including trend keyword and factor analyses, via the bibliometrix package in R Studio. The USA (n = 111), China (79), the United Kingdom (22), and Germany (21) were the most productive countries, with Harvard University as the leading institution. Keywords revealed research concentration in thrombosis, venous thromboembolism, risk assessment, hematopoietic stem cell transplantation, atrial fibrillation, anticoagulants, morphological analysis, blood management, sepsis, and acute myeloid leukemia. Recent years have shown rising interest in transcriptome, prediction modeling, hematopoietic stem cell transplantation, blood management, thrombosis, venous thromboembolism cancer and COVID-19 related complications. Factor analysis grouped the literature into five clusters: AI and core hematologic diseases, clinical quality improvement, risk prediction using health data, intensive care, and cardiovascular applications. AI demonstrates substantial contributions to diagnostic accuracy, prognostication, and personalized care in hematology. The findings highlight AI's growing potential in enhancing clinical decision-making and improving patient outcomes through data-driven and genomics-based innovations.}, }
@article {pmid41176818, year = {2025}, author = {Anang, V and Kumar, P and Pracha, J and Nho, RS and Mora, AL and Rojas, M and Gowdy, K and Yount, JS and Bednash, JS and Horowitz, JC and Soni, S and Mebratu, YA}, title = {SARS-CoV-2 innate immune recognition and implications for respiratory health.}, journal = {Cytokine &amp; growth factor reviews}, volume = {86}, number = {}, pages = {167-180}, pmid = {41176818}, issn = {1879-0305}, support = {R01 AI148180/AI/NIAID NIH HHS/United States ; R01 AI187330/AI/NIAID NIH HHS/United States ; R01 HL168501/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *Immunity, Innate/immunology ; *COVID-19/immunology/virology ; *SARS-CoV-2/immunology ; Receptors, Pattern Recognition/immunology ; Lung/immunology/virology ; Toll-Like Receptors/immunology ; Animals ; Respiratory Distress Syndrome/immunology ; Cytokine Release Syndrome/immunology ; Interferons/immunology ; }, abstract = {The ongoing global health impact of SARS-CoV-2, particularly on lung and respiratory health, underscores the critical need to decipher the intricate interplay between the virus and the host innate immune system. This review provides an analysis of the key pattern recognition receptors (PRRs) involved in SARS-CoV-2 recognition within the lung, including toll-like receptors (TLRs), RIG-I-like receptors (RLRs), NOD-like receptors (NLRs), and C-type lectin receptors (CLRs). We discuss how the engagement of these innate sentinels triggers crucial downstream consequences, ranging from protective antiviral interferon (IFN) responses to detrimental hyperinflammation characteristic of severe COVID-19. Numerous studies have identified sophisticated mechanisms employed by SARS-CoV-2 to evade or suppress early IFN induction, contributing to unchecked viral replication and subsequent immunopathology. We explore how this aberrant innate immune response drives the "cytokine storm", leading to acute respiratory distress syndrome (ARDS) and long-term sequelae. Furthermore, this review critically assesses current and emerging therapeutic strategies aimed at modulating innate immunity, including TLR agonists/antagonists, RIG-I/MDA5 modulators, NLRP3 inflammasome inhibitors, and IFN-based therapies, highlighting their potential and associated challenges. Finally, we identify key research gaps, emphasizing the need for cell-type-specific PRR studies, comprehensive mapping of viral evasion mechanisms, and the development of precision immunotherapies to enhance protective responses and mitigate pathogenic inflammation for future respiratory viral threats.}, }
@article {pmid41176483, year = {2025}, author = {Galiza, EP and Nakebembe, E and Mboizi, R and Okek, E and Le Doare, K}, title = {Maternal vaccination to prevent neonatal infections and combat antimicrobial resistance.}, journal = {Seminars in fetal &amp; neonatal medicine}, volume = {30}, number = {4}, pages = {101680}, doi = {10.1016/j.siny.2025.101680}, pmid = {41176483}, issn = {1878-0946}, mesh = {Humans ; Female ; Infant, Newborn ; Pregnancy ; *Vaccination/methods ; *Infectious Disease Transmission, Vertical/prevention &amp; control ; *Pregnancy Complications, Infectious/prevention &amp; control ; Anti-Bacterial Agents/therapeutic use ; *Infant, Newborn, Diseases/prevention &amp; control ; }, abstract = {Maternal vaccination during pregnancy is emerging as a powerful strategy in protecting newborns from infectious diseases, improving neonatal outcomes, and potentially reducing antimicrobial use and resistance. Maternal immunisation works by eliciting protective antibodies in the mother that are transferred to the fetus transplacentally and through breastmilk postnatally to provide the infant with passive immunity during the first vulnerable months of life. There is sufficient evidence to support the role of maternal vaccination in averting many neonatal infections that would otherwise require medical intervention. By preventing infections in mothers and their newborn, maternal vaccination also holds significant potential for reducing antimicrobial use and antimicrobial resistance. Fewer neonatal infections translate to a reduced need for antimicrobial use in the neonatal period and in postpartum women, therefore lowering the selective pressure for drug-resistant bacteria. Routine maternal vaccines (tetanus, diphtheria, acellular pertussis (Tdap), influenza, COVID-19, respiratory syncytial virus) already confer measurable antibiotic-sparing benefits by preventing infections that typically trigger antimicrobial therapy in mothers and neonates. Pipeline candidates (Group B Streptococcus, Klebsiella pneumoniae, Escherichia coli) could further lower neonatal sepsis burden, reducing broad-spectrum antimicrobial use in neonatal intensive care units to help slow antimicrobial resistance. Integrated with antibiotic stewardship and infection-prevention measures, maternal immunisation offers a practical, scalable practice to limit perinatal antibiotic exposure.}, }
@article {pmid41176395, year = {2025}, author = {Mayer, KH and Beyrer, C and Cohen, MS and El-Sadr, WM and Grinsztejn, B and Head, JM and Keuroghlian, AS and Miller, V and Phanuphak, N and Rees, H and Reid, M and Starrs, A and Warren, M and Bekker, LG}, title = {Challenges and opportunities in developing integrated sexual and reproductive health programmes.}, journal = {Lancet (London, England)}, volume = {406}, number = {10515}, pages = {2168-2190}, doi = {10.1016/S0140-6736(25)01246-2}, pmid = {41176395}, issn = {1474-547X}, mesh = {Humans ; *Reproductive Health Services/organization &amp; administration ; *Reproductive Health ; *Sexual Health ; Female ; *Delivery of Health Care, Integrated/organization &amp; administration ; Male ; }, abstract = {Sexual and reproductive health and rights are fundamental to both human and societal wellbeing and sustainable development, and encompass a broad array of sociocultural and clinical issues that affect all people across the life course. In 2018, the Guttmacher-Lancet Commission described sexual and reproductive health as a state of physical, emotional, mental, and social wellbeing in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction, or infirmity. The Commission advocated for a positive approach to sexuality and reproduction that recognises the role of pleasurable sexual relationships, trust, and communication in promoting self-esteem and overall wellbeing. The Commission also stipulated that people have a right to make decisions governing their bodies and to access services that support that right. In light of recent sociocultural changes, biomedical advances that have impacted sexual and reproductive health and rights, and the key findings of the Guttmacher-Lancet Commission, we bring together themes from this Lancet Series to discuss the new scientific developments and sociopolitical changes that affect the programmatic integration of sexual and reproductive health services. As people who present for one sexual and reproductive health service frequently have other unmet sexual and reproductive health-related needs, there are often benefits to interventions and services that address multiple connected sexual and reproductive health issues during one clinical encounter (eg, family planning visits, including testing for HIV and other sexually transmitted infections), which supports the rationale for an integrated approach. Historically, key components of sexual and reproductive health have been managed separately, partly because of siloed and inadequate funding streams and structural limitations (eg, separate location of service delivery or insufficient staff cross-training). Vertical methods have also evolved from the need for different approaches to reach key populations, who might be reluctant to seek care from primary health care clinics. We build on the findings of the papers in this Series to discuss the rationale for sexual and reproductive health programmatic integration, which has the potential to better engage patients in care by meeting their preferences, simplify the user experience, and save resources when implemented in a thoughtful, culturally tailored manner. However, wide-scale sexual and reproductive health programmatic integration faces multiple challenges, requiring broadly trained health-care providers, a range of clinical and outreach channels, and well-resourced health systems. Programmatic integration might be further constrained by societal norms and regulations (eg, punitive laws, institutional homophobia, legal restrictions on access to safe abortion, and opposition to sexual and reproductive rights). Notably, the Trump Administration's withdrawal of support from various sexual and reproductive health programmes in January, 2025, is a major threat to continued progress. This Series paper provides a call to action based on the key findings from this Series that delineates the steps needed to better integrate programmes to optimise sexual and reproductive health outcomes.}, }
@article {pmid41176336, year = {2025}, author = {Farjami, Z and Moradi, M and Ebrahimi, N and Akbarin, MM}, title = {COVID-19: Understanding the Granulocyte Response and Exploring Their Therapeutic Interventions.}, journal = {Viral immunology}, volume = {38}, number = {9-10}, pages = {303-316}, doi = {10.1177/08828245251391816}, pmid = {41176336}, issn = {1557-8976}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has led to a global health crisis by triggering extensive systemic and immune dysregulation. Granulocytes, including neutrophils, eosinophils, and basophils, are critical components of the innate immune system that play dual roles in protection and pathogenesis during infection. In this review, we examine the multifaceted roles of granulocytes in COVID-19 and their impact on disease severity through excessive inflammation, cytokine storm, and tissue damage. Neutrophil extracellular traps (NETs) and the overactivation of neutrophil subtypes contribute to the development of thrombosis and acute respiratory distress syndrome. In contrast, eosinophils and basophils modulate T helper 2-type and allergic responses that may influence recovery or disease progression. We further summarize the therapeutic strategies targeting granulocyte activation and signaling pathways, including IL-1, IL-6, IL-17, IL-5 receptor, granulocyte-macrophage colony-stimulating factor inhibitors, and antihistamines, emphasizing their clinical outcomes, approval status, and the global regions in which they are studied. Understanding the regulatory mechanisms of granulocyte activation and inhibition provides new insights into COVID-19 immunopathology and opens pathways for targeted immunomodulatory therapy. These findings underscore the importance of balancing protective immune functions with controlled anti-inflammatory interventions to mitigate the severe complications of SARS-CoV-2 infection.}, }
@article {pmid41176228, year = {2025}, author = {Salvaggio, MR and McCloskey, C and Siegrist, E}, title = {Syphilis in the post-Covid-19 pandemic world.}, journal = {The American journal of the medical sciences}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.amjms.2025.10.025}, pmid = {41176228}, issn = {1538-2990}, abstract = {Syphilis, an ancient malady, remains clinically relevant. Recent increases in syphilis cases, especially congenital syphilis, should increase the clinician's index of suspicion when presented with one of the protean clinical syndromes associated with syphilis. Diagnosis and monitoring of response to treatment remain reliant on testing modalities with varying degrees of sensitivity and specificity, requiring clinical discernment. Penicillin remains the recommended treatment in most syphilis cases. New treatment options may be available soon.}, }
@article {pmid41176175, year = {2025}, author = {Sawangjit, R and Sadoyu, S and Manosanthipaibul, S and Teerawattanapong, N and Puttarak, P and Wanaratna, K and Charoensup, R and Hiransai, P and Meetam, T and Chaiyakunapruk, N}, title = {Effectiveness and safety of turmeric for the treatment of COVID-19: An updated systematic review and meta-analysis of randomized controlled trials.}, journal = {Complementary therapies in medicine}, volume = {95}, number = {}, pages = {103295}, doi = {10.1016/j.ctim.2025.103295}, pmid = {41176175}, issn = {1873-6963}, mesh = {Humans ; *Curcuma ; Randomized Controlled Trials as Topic ; *COVID-19/mortality/therapy ; *COVID-19 Drug Treatment ; Curcumin/therapeutic use ; SARS-CoV-2 ; *Plant Extracts/therapeutic use ; }, abstract = {We conducted a comprehensive and updated systematic review and meta-analysis (SR-MA) to determine the effectiveness and safety of turmeric in patients with coronavirus disease 2019 (COVID-19). Multiple databases were searched from inception to July 31, 2024, for randomized controlled trials (RCTs) assessing turmeric in mild to severe COVID-19. This SR-MA uniquely includes recent trials conducted alongside modern antiviral-based regimens and explores effect modifiers by disease severity, comorbidity, formulation, and treatment duration. Twenty-three RCTs with 1407 participants were included, making this the largest synthesis to date. Most studies (17/23, 73.9 %) enrolled hospitalized patients; over half involved mild to moderate cases. The most common intervention was nano-curcumin 160-240 mg/day (39 %), used as an adjunct to standard care. Nine studies were rated high risk of bias (ROB). Meta-analysis showed turmeric significantly reduced all-cause mortality (Relative risk (RR) = 0.39; 95 % confidence interval (95 %CI): 0.23-0.67; I[2] = 0 %; n = 8 RCTs; moderate certainty), suggesting a 61 % reduction in risk of death. It also reduced the need for intubation/mechanical ventilation (RR = 0.35; 95 %CI: 0.17-0.72) and clinical deterioration (RR=0.36; 95 %CI: 0.22-0.59), while improving overall symptom resolution (RR = 1.36; 95 %CI: 1.16-1.59). These results remained robust after excluding high ROB studies. Adverse events, mostly mild gastrointestinal symptoms, were comparable to placebo. In conclusion, turmeric, particularly bioavailability-enhanced nano-curcumin, provides meaningful clinical benefits and favorable safety profile as adjunctive therapy for COVID-19. Further large-scale, high-quality, multicenter RCTs are warranted to confirm its therapeutic potential, particularly in resource-limited settings.}, }
@article {pmid41175829, year = {2026}, author = {Li, N and Rambod, B and Dukers-Muijrers, N and Chevalier, JM and Steijvers, L and Kojan, L and Wijnen, S and Crutzen, R and Jahn, B and Siebert, U and Stellbrink, L and van Daalen, F and Kretzschmar, M and Hiligsmann, M}, title = {General population preferences for health-related protective behaviors during infectious disease emergencies: a systematic review of conjoint-analysis studies.}, journal = {Social science &amp; medicine (1982)}, volume = {388}, number = {}, pages = {118721}, doi = {10.1016/j.socscimed.2025.118721}, pmid = {41175829}, issn = {1873-5347}, mesh = {Humans ; COVID-19/prevention &amp; control ; *Emergencies/psychology ; *Health Behavior ; *Communicable Diseases/psychology ; *Communicable Disease Control/methods ; }, abstract = {OBJECTIVE: To primarily systematically review the evidence from conjoint analysis (CA) studies on general population preferences for health-related protective behavioral measures during infectious disease emergencies, to secondarily assess the role of social networks in shaping decisions and to synthesize quantitative data to inform behaviorally responsive epidemiological models.<br><br>METHODS: PubMed and EMBASE were searched to identify relevant CA studies published up to June 2025. In addition to study characteristics, the scope of protective measures of included studies were examined and categorized according to seven pre-defined groups; the relative importance of attributes in each study was ranked and compared across studies and the heterogeneity of preferences was explored. The ISPOR checklist was used to assess the quality of reporting of included studies.<br><br>RESULTS: Of 2,523 articles identified, 16 studies were included. The quality of included studies was high with an average score of 24.7 out of 30 (range 18.5-28.5). Lockdown and restriction-related measures were most frequently perceived as important. A moderate level, targeted lockdown in a short period was preferred over severe or no restrictions. Face mask wearing and physical distancing were generally highly valued and preferred; for these measures, there was a clear preference for voluntary compliance over mandatory enforcement. Selective public spaces closures were preferred over broader shutdowns. Long-lasting, mandatory, and broadly applied quarantine was generally less preferred, while targeted quarantine was more acceptable. Substantial heterogeneity in preferences across populations was identified; age- and risk-based discrepancies in preferences were reported.<br><br>CONCLUSION: This review demonstrates the complexity of public preferences for protective measures and highlights the importance of aligning public health strategies with individual preferences by taking into account substantial heterogeneity. Incorporating these insights into policy and mathematical modelling frameworks would be helpful to enhance the acceptability and adherence of health-related protective measures in future pandemic preparedness.}, }
@article {pmid41175359, year = {2025}, author = {Thiriveedi, M and Patel, H and Curran, C and Patel, S and Baddam, S and ElBeblawy, R and Reddy, PJ}, title = {Post-COVID-19-Associated Asymptomatic Sarcoidosis with Hypercalcemia and Renal Dysfunction: A Case Report and Literature Review.}, journal = {The American journal of case reports}, volume = {26}, number = {}, pages = {e950045}, pmid = {41175359}, issn = {1941-5923}, mesh = {Humans ; Female ; *COVID-19/complications ; *Hypercalcemia/etiology/diagnosis ; Middle Aged ; *Sarcoidosis/diagnosis/etiology/complications ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/complications ; *Pneumonia, Viral/complications ; Betacoronavirus ; *Renal Insufficiency/etiology ; }, abstract = {BACKGROUND Sarcoidosis is a multisystem granulomatous disease of unknown etiology that often presents with nonspecific symptoms and lacks a definitive diagnostic test. Diagnosis can be particularly challenging in atypical cases without hallmark features such as bilateral hilar lymphadenopathy or cutaneous lesions. The recent literature suggests that post-COVID-19 immune dysregulation may act as a novel trigger for sarcoidosis. CASE REPORT We present the case of a 60-year-old Black woman with hypertension, osteoarthritis, and a recent coronavirus disease 2019 (COVID-19) infection complicated by persistent anosmia. Routine laboratory testing revealed hypercalcemia, renal insufficiency, and anemia. Despite discontinuing over-the-counter supplements, her hypercalcemia persisted, although she remained otherwise asymptomatic. Diagnostic workup showed normal 25-hydroxy vitamin D, suppressed parathyroid hormone (PTH) levels, and elevated 1,25-dihydroxy vitamin D. Imaging revealed nonspecific pulmonary nodules without hilar lymphadenopathy. Biopsy of a supraclavicular lymph node demonstrated non-caseating granulomas, establishing the diagnosis of sarcoidosis. Treatment with oral prednisone led to improvement of biochemical abnormalities and radiographic findings. CONCLUSIONS This case underscores the diagnostic challenges of sarcoidosis in the absence of classic pulmonary features and highlights the importance of recognizing hypercalcemia and elevated 1,25-dihydroxy vitamin D as key diagnostic clues. Notably, to the best of our knowledge, no prior reports have described asymptomatic sarcoidosis in the post-COVID-19 setting, making this case a unique contribution to the emerging literature. However, as this is a single-patient observation, causality cannot be inferred, and larger studies are needed to explore this potential association.}, }
@article {pmid41174728, year = {2025}, author = {Salami, B and Tulli-Shah, M and Ali, I and Zwaigenbaum, J and Tate, SA and Tseng, HH and Ogawa, R and Gahagan, J and Perrier, M and Maduforo, AN}, title = {A scoping review of intersectional health research related to the COVID-19 pandemic in North America: key findings.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3716}, pmid = {41174728}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/epidemiology ; Health Services Accessibility ; *Healthcare Disparities ; North America/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: This scoping review maps the key findings of intersectional research related to the COVID-19 pandemic in North America. Intersectional approaches highlight how overlapping systems of oppression shape health and social outcomes.<br><br>METHODS: A total of 21 studies were included, comprising 10 quantitative, 8 qualitative, and 3 mixed-methods designs. Studies were reviewed to assess the use of intersectional research methods and to identify common findings across the literature.<br><br>RESULTS: Intersectional research methods are increasingly utilized in pandemic-related studies in North America. Thematic analysis revealed five key themes: deepening disparities in health care systems, barriers to accessing social services, changes to working conditions across economic sectors, impacts of lockdown restrictions, and impacts on mental health. This review also found that interruptions to community connections influenced access to resources, shaping life chances for some populations. Importantly, intersectional research related to the pandemic has often decentralized race, which contrasts with broader non-intersectional studies.<br><br>CONCLUSIONS: Findings underscore the need for public health policies informed by intersectional frameworks. Inequities related to class, race, and gender highlight the importance of disaggregated data collection as standard practice. Targeted interventions, such as workplace protections for racialized women in precarious jobs, are critical to addressing compounded vulnerabilities and ensuring equity in pandemic responses.}, }
@article {pmid41174501, year = {2025}, author = {Zhou, S and Gao, S and Fang, Y and Zhang, N and Ma, G}, title = {Efficacy of vitamin C in COVID-19 management: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {1463}, pmid = {41174501}, issn = {1471-2334}, mesh = {Humans ; *Ascorbic Acid/therapeutic use ; *COVID-19/mortality ; *COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; Hospital Mortality ; Intensive Care Units ; Treatment Outcome ; Length of Stay ; Dietary Supplements ; Respiration, Artificial ; }, abstract = {BACKGROUND: COVID-19 has posed a global burden, with vitamin C considered a potential treatment due to its antioxidant, anti-inflammatory, and antimicrobial properties. However, its efficacy remains uncertain. This study aims to evaluate the impact of vitamin C supplementation on COVID-19 patients.<br><br>METHODS: A comprehensive literature search was conducted across PubMed, MEDLINE, Embase, CBMdisc, WanFang Data, and CNKI from October 26, 2012, to October 1, 2023. The primary outcomes were 28-day mortality and in-hospital mortality, and the secondary outcomes were intensive care units (ICU) length of stay, duration of mechanical ventilation, length of vasopressor use, changes in SOFA score, and PaO2/FiO2 ratio. Random-effects models were employed to analyze the study outcomes. The Cochrane Systematic Review Guidelines and the GRADE system were utilized evaluated the risk of bias and the quality of evidence.<br><br>RESULTS: A total of thirteen studies were included with sample of 12,062. Most of these included studies exhibited low to indeterminate bias risk. The quality of evidence ranged from very low to moderate across in included studies. The overall results indicated that non-substantial favorable impacts were observed in short-term mortality (risk ratio [RR]: 0.92, 95% Confidence Interval [CI]: 0.72 to 1.17, P&#x2009;=&#x2009;0.415) and in hospital mortality (RR: 1.05, 95% CI: 0.95 to 1.16, P&#x2009;=&#x2009;0.286), nor other secondary clinical outcomes.<br><br>CONCLUSION: Although the current application of vitamin C in COVID treatment and management, our findings revealed that vitamin C did not significantly improve COVID outcomes. More high-quality and multicenter trials are required to further elucidate the association between vitamin C and COVID-19.<br><br>TRIAL REGISTRATION: Registration of systematic reviews: This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO), under the registration number CRD42024527599.}, }
@article {pmid41173399, year = {2025}, author = {Han, S and Liu, Y and Xing, B and Yang, Y and Liu, Z and Li, Y and Wang, X and Yu, J and Ping, F and Li, W and Xu, L and Qi, T and Zhang, Y and Li, Y and Zhang, H}, title = {Association of glucagon-like peptide-1 receptor agonist use with risk of infections: A systematic review and meta-analysis.}, journal = {The Journal of infection}, volume = {91}, number = {5}, pages = {106645}, doi = {10.1016/j.jinf.2025.106645}, pmid = {41173399}, issn = {1532-2742}, mesh = {Humans ; COVID-19 ; Diabetes Mellitus, Type 2/drug therapy ; *Glucagon-Like Peptide-1 Receptor Agonists ; *Hypoglycemic Agents/therapeutic use ; *Infections/epidemiology ; Randomized Controlled Trials as Topic ; }, abstract = {OBJECTIVE: To assess whether GLP-1 RA treatment influences infection risk in randomized clinical trials (RCTs).<br><br>METHODS: Systematic searches were conducted across PubMed, EMBASE, Cochrane Library, and Web of Science (inception to September 24, 2024), and reference lists of eligible articles. RCTs comparing GLP-1 RA treatment with placebo or non-GLP-1 RA treatments were included. Dual reviewer resolved disagreements by consensus. Two reviewers independently extracted data following PRISMA recommendations and assessed risk of bias via Cochrane tool.<br><br>RESULTS: A total of 136 RCTs (n = 164,322) were included. GLP-1 RA treatment was associated with a significant reduction in serious infections (RR, 0.89; 95% CI, 0.86-0.93; absolute risk difference, -30 per 10,000 persons/year; I&#xb2; = 0%), non-serious (RR, 0.90; 95% CI, 0.85-0.97; I&#xb2; = 77%), and total infections (RR, 0.89; 95% CI, 0.84-0.94; I&#xb2; = 77%). Reductions were observed for serious respiratory (RR, 0.84; 95% CI, 0.79-0.90), skin and subcutaneous (RR, 0.77; 95% CI, 0.68-0.87), musculoskeletal (RR, 0.79; 95% CI, 0.65-0.97), vascular (RR, 0.65; 95% CI, 0.47-0.90), and COVID-19 infections (RR, 0.82; 95% CI, 0.72-0.92), all with I&#xb2; = 0%. Meta-regression showed greater weight loss (&#x3b2; = -0.011; P =.045), hemoglobin A1c reduction (&#x3b2; = -0.229; P =.026), and higher GLP-1 RA doses (RR, 0.87; 95% CI, 0.83-0.92) were associated with lower risk.<br><br>CONCLUSION: GLP-1 RA use was associated with reduced risk of serious infections, particularly in respiratory, skin, musculoskeletal, vascular systems and COVID-19, partially explained by weight loss and improved glycemic control.}, }
@article {pmid41173166, year = {2026}, author = {Mousavinejad, SN and Lachouri, R and Bahadorzadeh, M and Khatami, SH}, title = {Artificial intelligence for arterial blood gas interpretation.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {579}, number = {}, pages = {120691}, doi = {10.1016/j.cca.2025.120691}, pmid = {41173166}, issn = {1873-3492}, mesh = {Humans ; *Blood Gas Analysis/methods ; *Artificial Intelligence ; COVID-19/diagnosis/blood ; Hypertension, Pulmonary/diagnosis/blood ; SARS-CoV-2 ; }, abstract = {Arterial blood gas (ABG) analysis is a fundamental diagnostic tool in clinical medicine, offering critical insights into a patient's respiratory and metabolic status. However, interpreting ABG results can be complex and time-sensitive, necessitating accurate and rapid analysis. With the advancement of artificial intelligence (AI), new avenues have emerged to enhance the interpretation and application of ABG data. This review explores the role of AI in ABG analysis, highlighting how machine learning algorithms and natural language models such as ChatGPT can aid in the systematic interpretation of complex physiological data. We examine the mechanisms through which AI systems analyze ABG parameters, including pH, PaCO2, and HCO3[-], and provide diagnostic recommendations. Specific applications, such as AI-driven models, in the detection of COVID-19 severity and pulmonary hypertension via ABG data are discussed, demonstrating the expanding clinical utility of AI technologies. Additionally, we explore the potential of 3D animated computer models as educational and diagnostic tools for interpreting blood gas data. The integration of AI into ABG interpretation holds promise for improving diagnostic accuracy, clinical decision-making, and patient outcomes, signaling a transformative shift in modern healthcare diagnostics.}, }
@article {pmid41173090, year = {2025}, author = {Rizzo, M and Tubassum, R and Kaplan, CA and Konde, M and Martin, L and Gigase, F and de Witte, L and Bergink, V and Rommel, AS}, title = {Systematic Review and Meta-Analysis: The Associations of Prenatal Exposure to SARS-CoV-2 Infection and COVID-19 Vaccination With Child Neurodevelopment.}, journal = {Journal of the American Academy of Child and Adolescent Psychiatry}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jaac.2025.10.018}, pmid = {41173090}, issn = {1527-5418}, abstract = {OBJECTIVE: We aimed to systematically review and meta-analyze evidence on the associations between prenatal exposure to SARS-CoV-2 infection or COVID-19 vaccination and child neurodevelopmental outcomes.<br><br>METHOD: We searched MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, and Cochrane CENTRAL for original research on neurodevelopmental outcomes in children prenatally exposed to SARS-CoV-2 infection and COVID-19 vaccination published in any language before November 8, 2024. We performed meta-analyses on any outcome reported in &#x2265;3 controlled studies.<br><br>RESULTS: Seventy studies were identified on neurological (n = 7), neuroimaging (n = 12), motor (n = 3), audiological (n = 29) and neurodevelopmental (n = 35) assessments, and neurodevelopmental disorders (n = 2) with median sample sizes of N = 117 (IQR: 44-340) and follow-up &#x2264;36 months. Meta-analyses of neonatal auditory screenings (n = 10), Ages and Stages Questionnaire (ASQ-3) (n = 9), and ASQ Social-Emotional (ASQ-SE) (n = 3) data suggested a higher risk of transient hearing impairment [RR = 2.01, 95% CI, 1.39-2.91] and delays in fine motor [RR = 1.55, 95% CI, 1.14-2.10] and problem-solving [RR = 1.32, 95% CI, 1.01-1.74] skills in children prenatally exposed to SARS-CoV-2 compared to unexposed children.<br><br>CONCLUSION: Prenatal SARS-CoV-2 exposure was associated with early impairments in hearing, fine motor, and problem-solving skills, which appear to resolve with time. No associations were identified with atypical neurological or neuroimaging outcomes. No adverse neurodevelopmental effects were reported in the two studies that examined prenatal COVID-19 vaccination. Study quality was generally moderate, with small sample sizes, inappropriate control groups, and unmeasured confounding. Taken together, the current body of research does not support a causal relationship between prenatal exposure to SARS-CoV-2 infection or COVID-19 vaccination and adverse neurodevelopmental outcomes.}, }
@article {pmid41171518, year = {2025}, author = {Mallouli, SZ and Munblit, D and Iakovleva, E and Winkler, AS and Fornari, A and Helbok, R and Struhal, W and Beretta, S and De Groote, W and Curatoli, C and Lanza, M and Ericka, F and Crivelli, L and Giussani, G and Wasay, M and Chakroun Walha, O and Safi, F and Leonardi, M and Allegri, R and Guekht, A and Triki, CC}, title = {Persistent neurological sequelae in children and adolescents after SARS-CoV-2: a scoping review.}, journal = {Infection}, volume = {}, number = {}, pages = {}, pmid = {41171518}, issn = {1439-0973}, abstract = {OBJECTIVES: For the past five years, COVID-19 has not only been a priority for health planning but also a hotspot for clinical research. Yet, the weight of the worldwide COVID-19 pandemic arises from the critical phase consequences due to the onset of acute disease, associated containment measures, and documented ongoing disabling symptoms. Investigating the global longitudinal effects on children and adolescents will inform future health directives tailored to this population's needs. This review aimed to report the spectrum of persistent neurological sequelae in children and adolescents following SARS-CoV-2 infection.<br><br>METHODS: Hence, we conducted a scoping review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We included the peer-reviewed articles from PubMed, Google Scholar, Web of Science, Cochrane Library, and WHO COVID database to identify relevant literature on long-COVID-19 neurological signs/symptoms among children and adolescents. The search covered the period between September 2020 and September 2024.<br><br>RESULTS: The results of our analysis of 33 studies found long-COVID-19-related neurological signs/symptoms were predominantly: pain and sensory problems (N&#x2009;=&#x2009;74,612/91,543; 81.5%), followed by sleep disturbances (N&#x2009;=&#x2009;14,630/91,543; 15.9%), and cognitive difficulties (N&#x2009;=&#x2009;2274/91,543; 2.4%). The global prevalence of long COVID-19 neurological signs/symptoms was estimated between 0.4% (20/5032; 95% CI&#x2009;=&#x2009;2.1-3%) and 34% (27/79) based on data obtained through online questionnaire; while it varied between 1.8% (4/215) and 83.14% (74/89; 95%CI&#x2009;=&#x2009;&#x2009;&#x2009;-&#x2009;&#x2009;0.12; 0.30) based on patient assessment. Long-COVID-19-related neurological signs/symptoms were more common in the 11-16 age group. Children with immunocompetent profiles were at higher risk of developing long-COVID-19-related neurological signs/symptoms.<br><br>CONCLUSION: Our results demonstrate a considerable burden of COVID-19-related persistent neurological signs/symptoms in children and adolescents, which should be taken into consideration in healthcare decision-making.}, }
@article {pmid41170424, year = {2025}, author = {Horstink, N and Lassing, K and Knoester, M and Vermeulen, LC and Rossen, JWA and Voss, A and Lokate, M}, title = {Host factors associated with respiratory particle emission and virus presence within respiratory particles: a systematic review.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1652124}, pmid = {41170424}, issn = {1664-302X}, abstract = {INTRODUCTION: Understanding host factor-related mechanisms that drive variability in respiratory particle emission and virus presence in exhaled particles is essential to assess transmission risk and potentially identify individuals with elevated infectiousness.<br><br>METHODS: We conducted a systematic review of human observational studies examining associations between host factors and either respiratory particle emission or virus presence in exhaled particles. Searches in PubMed, EMBASE, and Web of Science covered studies up to September 2024. Risk of bias was assessed using STROBE-based criteria. Findings were synthesized narratively, grouped by host factor and outcome type.<br><br>RESULTS: Forty-four studies met inclusion criteria: 34 assessed host factors in relation to particle emission, and 11 examined viral presence in exhaled particles. Fine particle emission (<5&#x202f;&#x3bc;m) was most consistently associated with older age (n&#x202f;=&#x202f;16), physical exercise (n&#x202f;=&#x202f;6), and active infection (n&#x202f;=&#x202f;6). No consistent associations were found for sex (n&#x202f;=&#x202f;21), body mass index (BMI; n&#x202f;=&#x202f;10), or smoking (n&#x202f;=&#x202f;6). Viral presence-mainly influenza and SARS-CoV-2-was more strongly associated with time since symptom onset (n&#x202f;=&#x202f;8) and lower respiratory symptoms (n&#x202f;=&#x202f;3), based largely on genomic detection. Associations with other factors, including upper respiratory symptoms (n&#x202f;=&#x202f;6), swab viral load (n&#x202f;=&#x202f;11), age (n&#x202f;=&#x202f;6), sex (n&#x202f;=&#x202f;6), and BMI (n&#x202f;=&#x202f;2), were inconsistent or absent. Physical exercise was not evaluated in relation to viral presence.<br><br>DISCUSSION: Fine respiratory particles (<5&#x202f;&#x3bc;m) were the predominant size fraction detected and often contained higher concentrations of viral RNA. Age, physical exercise, and active infection were consistently associated with increased emission of these particles. The presence of respiratory viruses in exhaled air was more strongly linked to infection-related factors such as early symptom onset and lower respiratory involvement. These patterns suggest distinct mechanisms contributing to airborne transmission. Interpretation was limited by methodological heterogeneity and predominant reliance on PCR. Still, consistent associations with host factors suggest their potential as indicators for transmission risk. As evidence focused mainly on influenza and SARS-CoV-2, generalizability is limited. Standardized methods and further research are needed to strengthen outbreak preparedness.}, }
@article {pmid41170359, year = {2025}, author = {Qiao, Y and Rong, L and Chen, H and Guo, J and Li, G and Wang, Q and Bi, H and Wei, L and Gao, T}, title = {Gut microbiota, nutrients, and depression.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1581848}, pmid = {41170359}, issn = {2296-861X}, abstract = {In the post-COVID-19 era, depression incidence has risen sharply, and a healthy diet is confirmed to lower this risk. However, two critical gaps remain: it is unclear whether nutrients alleviate depressive symptoms by improving the gut microbiota, and existing evidence has notable limitations. This study aimed to address these by exploring how deficiencies in key nutrients (protein, lipids, sugars, vitamins, and minerals) affect gut microbiota diversity-potentially a driver of early depression-and systematically evaluating clinical/basic research on nutrients' role in gut microbiota-mediated depression intervention. Results showed nutrients enhance gut microbiota abundance and diversity, regulate the gut-brain axis to boost short-chain fatty acid (SCFA) and neurotransmitter synthesis, and reduce inflammation, thereby alleviating depression. Thus, a healthy anti-inflammatory diet (rich in vegetables, fruits, fish) may lower depressive symptom risk. Three key research gaps were identified: 1. Mechanistic evidence relies heavily on animal studies (e.g., mouse neurotransmitter experiments) with insufficient large-scale human randomized controlled trials (RCTs) to confirm causality; 2. Conflicting findings exist [e.g., alpha-linolenic acid (ALA) has no antidepressant effect in some human cohorts]; 3. The dose-response relationship (e.g., fiber needed to elevate SCFAs to antidepressant levels) is unquantified. Future studies should quantify dietary patterns and target gut microbiota metabolism to advance early depression prevention and deepen understanding of diet-microbiota-depression links.}, }
@article {pmid41170164, year = {2025}, author = {Sun, N and Lu, Y and Li, C and Jiang, A and Liu, L and Guo, J}, title = {Genetic Risk of Different Populations in COVID-19 Susceptibility and Severity.}, journal = {Infection and drug resistance}, volume = {18}, number = {}, pages = {5499-5505}, pmid = {41170164}, issn = {1178-6973}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has created challenges by threatening public health and triggering the largest global economic crisis in recent history. While environmental factors and social activities influence the clinical outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and COVID-19 severity, the host genetic background and variants are increasingly recognized as vital players in individual susceptibility to SARS-CoV-2 infection, ranging from asymptomatic infection to lethal COVID-19. A plethora of genome-wide association meta-analyses have been provided and will continue to provide genetic determinants of the heterogeneity of COVID-19 outcomes. Such discoveries undoubtedly deepen our understanding of the biological underpinnings of SARS-CoV-2 infection and COVID-19 disease, paving the way for the development of more efficient SARS-CoV-2 prevention strategies and drug repurposing. Here, we provide a brief overview of studies regarding host susceptibility to COVID-19 and its clinical outcomes, focusing on the identification of genome-wide significant loci from different ancestral populations.}, }
@article {pmid41169390, year = {2025}, author = {Cheng, Y and Zheng, X}, title = {Characteristics and mechanisms of liver injury caused by emerging infectious diseases.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1647517}, pmid = {41169390}, issn = {1664-3224}, mesh = {Humans ; *Communicable Diseases, Emerging/complications/virology/immunology ; *Liver Diseases/virology/etiology ; Animals ; SARS-CoV-2 ; Endoplasmic Reticulum Stress ; *Liver/pathology/virology ; COVID-19/complications ; }, abstract = {Abnormal liver function has become a common phenomenon in emerging infectious diseases caused by viruses, with incidence rates ranging from 2.5% to 98.6% across different pathogens. This review summarized the characteristics of liver injury caused by SARS-CoV-2, MERS-CoV, H7N9, SFTSV, DENV, and EBOV viruses. Viral infection initiates liver injury through direct attack, ischemia, and microthrombosis, triggering an exaggerated immune response often exacerbated by drug toxicity. Core mechanisms involve interconnected mitochondrial dysfunction (causing energy failure, ROS/mt-DNA release), endoplasmic reticulum stress (with dual roles in adaptation and apoptosis), and aberrant inflammation. These pathways form a vicious cycle, culminating in hepatocyte death, metabolic disruption, and severe hepatic damage. An in-depth exploration of the causes and mechanisms of liver injury also provides diversified strategies for treating and preventing these infectious diseases.}, }
@article {pmid41168795, year = {2025}, author = {Gartmann, J and Sturm, C and Bökel, A}, title = {Physiotherapy interventions in post- and long-COVID-19: a scoping review of the literature up to February 2023.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1425}, pmid = {41168795}, issn = {1472-6963}, abstract = {BACKGROUND: Physiotherapy is an accepted and recommended treatment for post- and long-COVID-19 condition. It is assumed that physiotherapists reported a lack of information on physiotherapy interventions and treatment parameters. This scoping review provides an overview of the evidence on physiotherapy interventions published in the scientific literature.<br><br>METHODS: The scoping review includes studies analysing physiotherapy treatment parameters and interventions in post- and long-COVID patients. Studies focusing on telemedicine or exclusively home-based workouts are excluded. A systematic literature search was conducted by two independent researchers in the databases PubMed, EBSCO, SCOPUS, Web of Science, EMBASE, PEDro, Cochrane, and WISO. Following the abstract screening process, data extraction and critical assessment were performed.<br><br>RESULTS: In this scoping review, 6 studies were included, providing information physiotherapy management of post- and long-COVID-19. The research identified respiratory therapy, aerobic training or strength training as key areas of focus.<br><br>CONCLUSION: This scoping review highlights the need for further studies on physiotherapy treatment in post- and long-COVID condition.<br><br>TRIAL REGISTRATION: Open Science Framework (Registry number osf.io/5k3tA).<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13631-7.}, }
@article {pmid41168772, year = {2025}, author = {Palotino-Ferreira, BM and Rocha, SV and Nunes-Silva, A and Souza-Gomes, AF and Rodrigues, F and Coelho, P and Bachi, ALL and de Oliveira, RA and de Barros, MP and Furtado, GE}, title = {The influence of structured physical activity on vaccination response from adults to older individuals: a systematic review on the Immunoinflammatory crosstalk of COVID-19.}, journal = {Immunity &amp; ageing : I &amp; A}, volume = {22}, number = {1}, pages = {44}, pmid = {41168772}, issn = {1742-4933}, abstract = {BACKGROUND: Amidst the ongoing COVID-19 pandemic, understanding factors that influence vaccine efficacy is crucial, particularly in older adults. Regular physical exercise and/or structured physical activity (SPA) has emerged as a potential modulator of immune responses, enhancing vaccine effectiveness. This systematic review aims to consolidate current evidence on the impact of SPA/exercise on both immune and inflammatory responses to COVID-19 vaccination in adults and older individuals.<br><br>METHODS: Most relevant studies were extracted from indexed databases using health subject terms in English, Portuguese, and Spanish. Studies that examined the impact of regular exercise or SPA on inflammatory and/or immunological responses in relation to COVID-19 immunization were selected. In particular, all chosen studies included individuals who received vaccinations either prior to or following the exercise regimen or SPA, and the main goal was to evaluate these effects on immunological and/or inflammatory reactions induced by vaccination.<br><br>RESULTS: Among the 7 studies included (n&#x2009;=&#x2009;1149), the effects of regular exercise or PA on vaccine-induced immune responses while concurrently assessing inflammatory markers were examined. The findings suggest that moderate to high-intensity structured physical activity (50-70% of maximum heart rate for aerobic exercise and 60-80% of 1RM for resistance training), performed 3-5 times per week, was able to enhance immune responses to COVID-19 vaccination, particularly by mitigating chronic low-grade inflammation. Acute exercise can transiently boost immunity, whilst engagement in moderate SPA over a period of six months may contribute to sustained improvements in immune function, especially in older adults. However, these findings should be interpreted with caution due to variability in study design, sample characteristics, and potential confounding factors.<br><br>CONCLUSION: Regular exercise and SPA play a significant role in improving immune/inflammatory responses to COVID-19 vaccination. Older adults, in particular, may benefit from regular SPA and exercise as a strategy to counteract immunosenescence and optimize vaccine efficacy. However, further research is needed to better refine exercise protocols and determine long-term benefits in different populations.}, }
@article {pmid41165505, year = {2025}, author = {Ishola, AA and Ahmed, IA and Mikail, MA}, title = {Molecular Roadmap of COVID-19: From Viral Entry to Therapeutic Targets.}, journal = {Chemistry &amp; biodiversity}, volume = {}, number = {}, pages = {e01534}, doi = {10.1002/cbdv.202501534}, pmid = {41165505}, issn = {1612-1880}, abstract = {Although the global emergency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has subsided, the pandemic is not over, making the development of effective therapeutics crucial to reduce mortality and restore patient health. Identifying host molecular pathways targeted by the virus is essential for drug discovery, whether through repurposing existing drugs or developing new ones. This review examines the molecular mechanisms of SARS-CoV-2 infection, including signaling pathways, therapeutic targets, viral entry and replication strategies, and associated clinical features. It also discusses current global infection and mortality trends, clinical management, and prospects for drug development. Data were sourced from major scientific databases. Given the virus's high mutation rate and ongoing impact, multidisciplinary collaboration is needed. Plant-derived compounds and herbal medicines show promise as potential antiviral interventions against coronavirus disease 2019 (COVID-19). The information and data on COVID-19 were collated from various resources and literature databases such as PubMed, Science Direct, Wiley, Springer, Taylor and Francis, Scopus, Inflibnet, Google, and Google Scholar.}, }
@article {pmid41165282, year = {2025}, author = {Roedl, K and Genbrugge, C}, title = {Managing cardiac arrest in the intensive care unit.}, journal = {Current opinion in critical care}, volume = {31}, number = {6}, pages = {729-734}, doi = {10.1097/MCC.0000000000001319}, pmid = {41165282}, issn = {1531-7072}, mesh = {Humans ; *Heart Arrest/therapy/epidemiology/etiology/mortality ; *Intensive Care Units ; *COVID-19/epidemiology ; *Cardiopulmonary Resuscitation/methods ; SARS-CoV-2 ; *Critical Care/methods ; }, abstract = {PURPOSE OF REVIEW: This review aims to explore the distinct clinical characteristics, epidemiology, treatment approaches, and research needs concerning cardiac arrest in the intensive care unit (ICU-CA), a specific subset of in-hospital cardiac arrest (IHCA). While IHCA remains a major cause of mortality, recent data indicate improved outcomes, with a notable variation in incidence and survival depending on the location, particularly within the ICU setting.<br><br>RECENT FINDINGS: Recent studies underscore that ICU-CA differs significantly from general IHCA in etiology, monitoring, and treatment environment. Although incidence rates vary widely (4-78 per 1000 ICU admissions), recent data suggest a stabilization. Causes of ICU-CA often involve noncardiac factors such as septic shock and respiratory failure. Treatment is typically guided by general advanced life support (ALS) protocols, but ICU-specific resources such as real-time monitoring, invasive pressure measurements, transesophageal echocardiography, and the potential for extracorporeal cardiopulmonary resuscitation offer unique advantages. The COVID-19 pandemic highlighted the vulnerability of ICU patients, with respiratory causes dominating and extremely poor outcomes reported.<br><br>SUMMARY: In summary, ICU-CA represents a distinct clinical entity requiring tailored research. Future directions should prioritize international registries, validation of predictive models using artificial intelligence, and clarification of do-not-resuscitate practices to improve outcomes and resource allocation in this critically ill population.}, }
@article {pmid41165245, year = {2025}, author = {Akhmetzhanov, AR and Cheng, HY and Cheng, G and Dushoff, J}, title = {Consolidating Estimates of the Incubation Period for Omicron Subvariants From the Literature and Their Comparison to the Estimate From Taiwan: A Systematic Review and Meta-Analysis, September 2024.}, journal = {Influenza and other respiratory viruses}, volume = {19}, number = {11}, pages = {e70171}, pmid = {41165245}, issn = {1750-2659}, support = {YK1120 60//Taiwan Centers for Disease Control/ ; 113-2314-B-002-181-MY3//National Science and Technology Council, Taiwan/ ; }, mesh = {Humans ; Taiwan/epidemiology ; *COVID-19/epidemiology/virology/transmission ; *SARS-CoV-2 ; *Infectious Disease Incubation Period ; Pandemics ; Contact Tracing ; }, abstract = {BACKGROUND: The COVID-19 pandemic was characterized by waves driven by distinct viral variants, including the Omicron variant, which emerged in October 2021. To formulate effective public health strategies and understand disease spread, accurate estimates of the incubation periods of these variants are important. Existing estimates often conflict due to biases caused by epidemic dynamics and selective inclusion of cases. Using data from Taiwan, where disease incidence remained low and contact tracing was comprehensive during the first months of the Omicron outbreak, this study aims to accurately estimate the incubation period of the Omicron (BA.1) variant incubation period.<br><br>METHODS: We reviewed the first 100 Omicron BA.1 symptomatic cases reported in Taiwan's contact-tracing records (between December 2021 and January 2022). Of these, 69 had usable information. Data on exposure and symptom onset dates were fitted with the generalized gamma. A systematic search and meta-analysis on incubation periods for Omicron BA.1/2/4/5 subvariants was then conducted to derive pooled mean estimates for the incubation periods of each subvariant.<br><br>RESULTS: The mean incubation period was estimated at 3.5&#x2009;days (95% credible interval: 3.0-4.0&#x2009;days), with no clear differences based on vaccination status or age. This estimate aligned closely with the pooled mean of 3.7&#x2009;days (3.3-4.0&#x2009;days) for Omicron BA.1 and of 3.7&#x2009;days (2.3-5.1&#x2009;days) for all considered Omicron variants BA.1/2 and BA.5.<br><br>CONCLUSIONS: Omicron subvariants have a relatively shorter incubation period compared to previous SARS-CoV-2 variants. A continuous update of incubation period estimates, based on available data, is necessary to develop guidelines that can reduce the socioeconomic costs associated with COVID-19.}, }
@article {pmid41164170, year = {2025}, author = {Raveendran, VV and AlQattan, S and AlMutairy, E}, title = {A review on clinical implications of S100 proteins in lung diseases.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1618772}, pmid = {41164170}, issn = {2296-858X}, abstract = {The S100 family of proteins plays a pivotal role in the pathogenesis of lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, pulmonary arterial hypertension (PAH), pulmonary fibrosis, lung cancers, acute lung injury, acute respiratory distress syndrome, COVID-19, and lung transplantation. This review comprehensively examines the contributions of S100 proteins to the progression of these disorders, focusing on their potential as diagnostic and prognostic biomarkers, as well as therapeutic targets. S100A protein-mediated key molecular mechanisms that influence inflammation, airway remodeling, fibrosis, and tumorigenesis in the lungs are discussed. The importance of their normal function is evident from the observation that simultaneous mutations in S100A3 and S100A13 predispose individuals to early-onset pulmonary fibrosis, underscoring their critical role in lung health. Furthermore, sustained S100 protein elevation is explored in the context of long COVID, shedding light on its role in chronic inflammation. These proteins act as damage-associated molecular patterns (DAMPs), activating immune pathways via receptors like TLR4 and RAGE, thereby driving inflammation and immune cell recruitment. Notably, in lung transplantation, elevated levels of S100A8, S100A9, and S100A12 serve as early biomarkers of graft rejection and complications such as graft-vs.-host disease, which indicates their role in mediating immune responses and transplant outcomes. While promising, the clinical application of S100 proteins faces challenges, including disease-specific variability and the need for robust validation across diverse populations. This narrative review underscores the dual potential of S100 proteins as biomarkers and therapeutic targets in respiratory medicine while emphasizing the importance of overcoming current limitations through targeted research and clinical trials.}, }
@article {pmid41163691, year = {2025}, author = {Basu, T and Upadhyay, AK}, title = {In silico approaches to identify therapeutic drug targets against COVID-19: a detailed review with a case study.}, journal = {In silico pharmacology}, volume = {13}, number = {3}, pages = {162}, pmid = {41163691}, issn = {2193-9616}, abstract = {The COVID-19 pandemic, caused by the SARS-CoV-2 virus, primarily affects the respiratory system, has impacted millions worldwide and resulted in significant morbidity and mortality. The development of effective therapies for treatment is crucial to reduce the burden of the disease, as the current treatments are mainly supportive. Therefore, identifying therapeutic drug targets for COVID-19 is of utmost importance. Overall, identifying and validating drug targets for COVID-19 is an active area of research. Advances in understanding the molecular mechanisms underlying SARS-CoV-2 infection and the host response to the virus will continue to inform the development of effective therapies for COVID-19. Computational biology has played a crucial role in developing therapeutics for COVID-19, such as drug discovery, vaccine development, understanding viral evolution, predicting drug resistance, and repurposing existing drugs. In this review, we will discuss the details of the different drug targets and their mode of action. Computational biology has been an essential tool in the fight against COVID-19, helping researchers develop new treatments and vaccines and understand the behaviour and evolution of the virus. We demonstrate a case study on the in-silico identification of natural compounds as potential IL-6 inhibitors, highlighting their relevance in managing COVID-19-associated cytokine storms.}, }
@article {pmid41163572, year = {2025}, author = {Liao, C and Zhao, X and Wang, Q}, title = {Design and Development of Small-Molecule Drugs Targeting Enzymes Utilizing Two-Metal-Ion Catalytic Mechanisms.}, journal = {Medicinal research reviews}, volume = {}, number = {}, pages = {}, doi = {10.1002/med.70023}, pmid = {41163572}, issn = {1098-1128}, abstract = {The active sites of numerous metalloproteins feature two metal ion cofactors-either identical or distinct-that are positioned in close proximity, typically around 3.8 Å apart. This two-metal-ion catalytic mechanism (TCM) endows these enzymes with a remarkable catalytic efficiency. Enzymes employing TCM play vital biological roles in both humans and pathogenic organisms, with some identified as validated therapeutic targets. Various rational drug design approaches, including nucleoside analogs, prodrugs, metal-binding group design, bioisosteres, pharmacophore modeling, scaffold hopping, tautomerism, and structure-based drug design, have been successfully applied to several enzymes with TCMs, thus yielding the development and approval of many small-molecule drugs for the treatment of several diseases, including certain catastrophic illnesses, such as hepatitis C infection, coronavirus disease 2019, and acquired immune deficiency syndrome. Additionally, drug repurposing has proven to be a critical strategy in the development of therapeutics targeting TCM enzymes. This article reviews the significant achievements in design and development of small-molecule drugs targeting several enzymes with TCMs, including RNA-dependent RNA polymerase, HIV-1 integrase, influenza virus cap-dependent endonuclease, and phosphodiesterase, hoping to offer valuable insights and guidance to facilitate future drug discovery efforts focused on these enzymes and related molecular targets.}, }
@article {pmid41163324, year = {2025}, author = {Cardoso, MR and Sánchez, ODR and Greenwald, M and Surita, FG and Goodman, A}, title = {Intersectionality and Intimate Partner Violence: Risk Factors and Vulnerabilities During the COVID-19 Pandemic and Other Humanitarian Emergencies.}, journal = {Trauma, violence &amp; abuse}, volume = {}, number = {}, pages = {15248380251367411}, doi = {10.1177/15248380251367411}, pmid = {41163324}, issn = {1552-8324}, abstract = {Intimate partner violence (IPV) presents significant global health, human rights, and protection challenges, particularly during emergencies. The Coronavirus Disease 2019 (COVID-19) pandemic exacerbated preexisting social inequalities, including those related to gender, race/ethnicity, and class, and led to an increase in IPV due to lockdown measures and economic stressors. This study aims to examine risk factors contributing to increased IPV among women and girls during COVID-19 mitigation strategies, explore the intersectional vulnerabilities of Black women in this setting, and compare IPV prevalence during the pandemic with other crises such as natural disasters and conflict settings. The review synthesized existing research to answer two primary questions. A comprehensive search was conducted across 11 databases. Eligible studies were peer-reviewed, published in English, Portuguese, or Spanish, and included women aged 15 years or older. Data extraction and quality assessments were performed by independent reviewers using the Joanna Briggs Institute critical appraisal tools. The findings revealed that IPV rates increased during the COVID-19 pandemic due to risk factors such as economic stress, social isolation, and lack of access to healthcare. Vulnerabilities were particularly pronounced for women and girls from marginalized groups, including Black women, who experienced compounded effects of race, class, and gender. The analysis also found similar patterns of increased IPV during other emergencies, including natural disasters and humanitarian crises. Key barriers to protection from IPV included limited access to resources, social and community support, and discrimination at a societal level. The findings underscore the need for targeted interventions that address the specific needs of women experiencing IPV during crises, with a particular focus on marginalized groups. Recommendations include strengthening support systems, improving access to healthcare and protection networks, promoting anti-racist and equity-focused policies, and enhancing data collection methodologies. Addressing the intersectional nature of vulnerabilities is crucial to developing effective, culturally appropriate solutions to protect women and girls during crises.}, }
@article {pmid41163310, year = {2025}, author = {Mundt, C and Yusufoğlu, B and Kudenko, D and Mertoğlu, K and Esatbeyoglu, T}, title = {AI-Driven Personalized Nutrition: Integrating Omics, Ethics, and Digital Health.}, journal = {Molecular nutrition &amp; food research}, volume = {}, number = {}, pages = {e70293}, doi = {10.1002/mnfr.70293}, pmid = {41163310}, issn = {1613-4133}, abstract = {Personalized nutrition (PN) aims to prevent and manage chronic diseases by providing individualized dietary guidance based on genetic, metabolic, and lifestyle data. Artificial intelligence (AI) has become a key enabler in PN by analyzing large-scale, multiomics datasets in obesity, diabetes, cardiovascular, and gastrointestinal disorders, where digital twins and health knowledge graphs support personalized interventions. Current findings demonstrate that AI models can guide microbiome-based dietary interventions, and support obesity management, thereby extending the scope of conventional nutritional strategies as supported by deepened bibliometric analyses. This study highlights the global increase in AI-based PN studies, accelerated by digital health demands and the COVID-19 pandemic, and the expansion of traditional nutrition strategies through machine learning approaches with the integration of microbiome-based models and omics. However, challenges such as algorithmic bias, limited generalizability, and data privacy remain. To overcome these issues, diverse datasets, explainable AI approaches, and standardized multicenter validation protocols are proposed. These steps are critical for transforming AI-supported PN from a conceptual potential into a fair, reliable, and clinically applicable structure. The growing consensus in the literature highlights that AI can support individual and societal health goals by transforming nutrition science through predictive, adaptive, and ethically based approaches.}, }
@article {pmid41163220, year = {2025}, author = {Kelsen, SG and Maurer, M and Waters, M and Dash, A and Fong, A and Mohan, D and Theess, W and Yang, X and Alvaro, G and Brightling, CE}, title = {Safety and tolerability of astegolimab, an anti-ST2 monoclonal antibody: a narrative review.}, journal = {Respiratory research}, volume = {26}, number = {1}, pages = {302}, pmid = {41163220}, issn = {1465-993X}, mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/drug therapy/immunology ; *Antibodies, Monoclonal, Humanized/adverse effects/therapeutic use ; *Interleukin-1 Receptor-Like 1 Protein/antagonists &amp; inhibitors/immunology/metabolism ; COVID-19/immunology ; *COVID-19 Drug Treatment ; Asthma/drug therapy/immunology ; }, abstract = {Chronic inflammation is an underlying feature of respiratory diseases such as chronic obstructive pulmonary disease (COPD). Novel therapies that target the inflammatory mechanisms driving acute exacerbations of COPD are required. The ST2 receptor, which binds the alarmin interleukin (IL)-33 to initiate an inflammatory response, is a potential target. Astegolimab, a fully human immunoglobulin G2 monoclonal antibody, which binds with high affinity to ST2 to prevent binding of IL-33, is a potential therapy for COPD. However, targeting inflammatory pathways that form part of the immune system may have unintended consequences, such as implications for the response to infection and cardiovascular function. Therefore, an understanding of astegolimab's safety profile in clinical use is essential. This narrative review summarizes clinical safety data from published clinical trials of astegolimab with a focus on adverse events of interest, including infections and cardiac events. Astegolimab was shown to be well tolerated in > 580 patients with asthma, atopic dermatitis, COPD, and severe COVID-19 pneumonia who took part in Phase II trials. The frequency of adverse events (AEs) and serious AEs was similar between the astegolimab and placebo arms in each trial (AEs: 41-81% vs. 58-77%; serious AEs: 3-29% vs. 0-41%, respectively). The number of deaths was similar between treatment arms and there were no astegolimab-related deaths. Astegolimab did not increase the risk of infection or major adverse cardiac events. Ongoing Phase IIb and Phase III trials of astegolimab in patients with COPD who have a history of frequent acute exacerbation(s) of COPD will provide a future opportunity to confirm the safety profile of astegolimab.}, }
@article {pmid41163029, year = {2025}, author = {Zheng, S and Lowe, DM}, title = {Current infectious disease management challenges in inborn errors of immunity.}, journal = {Annals of clinical microbiology and antimicrobials}, volume = {24}, number = {1}, pages = {60}, pmid = {41163029}, issn = {1476-0711}, mesh = {Humans ; Disease Management ; Virus Diseases ; *Communicable Diseases/therapy/diagnosis ; }, abstract = {Inborn errors of immunity (IEIs) are a frequently underdiagnosed group of disorders, with infectious complications posing significant clinical challenges. Recognizing atypical presentations of common infections and the presence of rare opportunistic pathogens can be critical in suspecting an underlying IEI. Among the infectious complications, chronic viral infections are particularly difficult to manage due to limited evidence-based guidelines. Intra-host viral evolution in these patients can lead to treatment resistance and the emergence of novel viral strains, raising concerns about their potential role as reservoirs for mutant viruses. Novel pathogens such as Aichivirus have been identified as significant causes of infection in individuals with IEIs. Furthermore, infections such as talaromycosis, tuberculosis, BCG-related disease, leishmaniasis, and melioidosis may be underrecognized in certain groups of patients with IEIs, largely due to differences in geographic exposure and environmental risk factors. The effects of emerging infections, such as mpox and Middle East respiratory syndrome coronavirus, on individuals with IEIs remain largely unknown. Management strategies for infections in this population include vaccinations, immunoglobulin replacement, and antimicrobial prophylaxis. However, newer higher valency conjugate pneumococcal vaccines may limit the utility of traditional pneumococcal polysaccharide vaccines in assessing immune function. While immunoglobulin replacement is cost-effective, it can interfere with serological diagnostics. Additionally, antimicrobial resistance is a growing issue, emphasizing the need for improved empiric antibiotic strategies and research into optimal treatment durations. This review highlights the key challenges faced by infectious disease clinicians in the care of patients with IEIs.}, }
@article {pmid41161981, year = {2025}, author = {Vishnu, P and Aboulafia, DM}, title = {Hemostatic Disorders Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection, COVID-19 Vaccination, and Long-COVID Syndrome: Current Evidence and Controversies in Clinical Practice.}, journal = {Clinics in laboratory medicine}, volume = {45}, number = {4}, pages = {643-655}, doi = {10.1016/j.cll.2025.07.008}, pmid = {41161981}, issn = {1557-9832}, mesh = {Humans ; *COVID-19/complications/prevention &amp; control ; *COVID-19 Vaccines/adverse effects ; *Hemostatic Disorders/etiology ; SARS-CoV-2 ; *Vaccination/adverse effects ; }, abstract = {The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented profound global health challenges. Beyond acute illness, a substantial proportion of individuals experience persistent symptoms including fatigue, brain fog, and post-exertional malaise, collectively known as Long-COVID. Among the complications associated with SARS-CoV-2 infection and vaccination, hemostatic disorders ranging from mild platelet dysfunction to severe thromboembolic events, and rare but serious coagulation-related adverse effects, such as vaccine-induced immune thrombotic thrombocytopenia, have emerged as a significant concern. Herein we provide an overview of current information and controversies surrounding hemostatic complications in SARS-CoV-2 infection and COVID-19 vaccination.}, }
@article {pmid41161963, year = {2025}, author = {Barnes, K and Faasse, K and Geers, AL}, title = {The COVID-19 pandemic: a special case of placebo and nocebo effects.}, journal = {Handbook of clinical neurology}, volume = {213}, number = {}, pages = {247-262}, doi = {10.1016/B978-0-443-29884-4.00014-5}, pmid = {41161963}, issn = {0072-9752}, mesh = {Humans ; COVID-19/psychology ; *Placebo Effect ; *Nocebo Effect ; *Pandemics ; SARS-CoV-2 ; *Pneumonia, Viral/psychology/epidemiology ; *Coronavirus Infections/psychology/epidemiology ; *Betacoronavirus ; }, abstract = {In late 2019, reports of pneumonia from an unknown cause marked the beginning of an unprecedented health crisis with far-reaching societal consequences. The ensuing global pandemic placed immense strain on healthcare systems, disrupted economies, and altered the way that we work, communicate, and interact. Importantly, as the SARS-Cov-2 (COVID-19) virus spread, so did a range of psychological stressors, including fear, anxiety, and uncertainty. This chapter examines the trajectory of placebo- and nocebo-relevant factors during the early, mid, and late stages of the pandemic, highlighting their impact on health outcomes and human behavior. Understanding the interplay between psychological and physical health during the pandemic is crucial for minimizing maladaptive health outcomes in the future. We therefore review current strategies for mitigating the nocebo effect and leveraging the placebo effect that may be employed to enhance health and well-being and attenuate pandemic-related harms.}, }
@article {pmid41161894, year = {2025}, author = {Dutta, S and Ganguly, A and Ghosh Roy, S}, title = {The interplay between gamma delta (γδ) T cells and cellular stress pathways in the pathogenesis of emerging human viral zoonoses.}, journal = {International review of cell and molecular biology}, volume = {398}, number = {}, pages = {99-149}, doi = {10.1016/bs.ircmb.2025.08.011}, pmid = {41161894}, issn = {1937-6448}, mesh = {Humans ; Animals ; *Receptors, Antigen, T-Cell, gamma-delta/metabolism/immunology ; *Viral Zoonoses/immunology/virology ; SARS-CoV-2/immunology ; *Stress, Physiological/immunology ; Unfolded Protein Response/immunology ; *Intraepithelial Lymphocytes/immunology ; COVID-19/immunology ; }, abstract = {This chapter examines the intricate relationship between gamma-delta (γδ) T cells and cellular stress pathways in the context of emerging infectious diseases. γδ T cells, a distinct subset of lymphocytes, are integral to the innate immune response, as they can recognize a diverse array of antigens independently of Major Histocompatibility Complex (MHC) restriction. They function as initial sentinels, secreting cytokines, and cytotoxic molecules to directly eradicate infected cells and regulate the immune system. This chapter examines the activation mechanisms of γδ T cells in response to viral infectious agents such as Influenza A virus, SARS-CoV-2, West Nile Virus (WNV), Dengue virus, and Human immunodeficiency virus (HIV) emphasizing their role in pathogen control and disease progression. The document examines cellular stress pathways, specifically the unfolded protein response (UPR) and integrated stress response (ISR), which are frequently activated by pathogens. These pathways initiate protective mechanisms; however, their dysregulation may lead to pathological conditions. The chapter examines the mechanisms by which certain pathogens utilize host stress responses to enhance replication and evade immune detection. The impact of stress on γδ T cell functionality and immune responses is examined. The document examines the potential of γδ T cell-based therapies for diverse infections, highlighting the necessity for additional research to enhance delivery methods and reduce the risk of autoimmune disorders. Comprehending these interactions is essential for formulating innovative approaches to prevent and treat emerging infectious diseases.}, }
@article {pmid41161041, year = {2025}, author = {Gromer, DJ and Kalash, S and Tanios, R and Rouphael, N}, title = {The relationship between the immunogenicity and reactogenicity of vaccines: A narrative review.}, journal = {Vaccine}, volume = {68}, number = {}, pages = {127892}, doi = {10.1016/j.vaccine.2025.127892}, pmid = {41161041}, issn = {1873-2518}, mesh = {Humans ; *Immunogenicity, Vaccine/immunology ; *COVID-19 Vaccines/immunology/adverse effects ; *COVID-19/prevention &amp; control/immunology ; SARS-CoV-2/immunology ; Adaptive Immunity ; Immunity, Innate ; Immunity, Humoral ; Immunity, Cellular ; Female ; Vaccination ; }, abstract = {The relationship between vaccine reactogenicity and immunogenicity remains an underexplored but increasingly critical area of vaccinology. This narrative review synthesizes evidence examining this relationship across a diverse array of vaccine platforms and pathogens. The available data suggest a modest but consistent positive association between systemic reactogenicity and humoral immunogenicity, particularly for mRNA-based SARS-CoV-2 vaccines. Associations with innate and adaptive cellular immunity are less well studied. Local reactions are less consistently predictive of immune response than systemic ones. Reactogenicity appears more pronounced in younger adults, females, and those with certain HLA alleles-factors also associated with stronger immune responses. Whether the priming or booster dose of a vaccine series drives greater reactogenicity and immunogenicity appears to depend upon whether the vaccine is live-attenuated or not. However, substantial heterogeneity exists in study design, population, outcome measurement, and statistical analysis. This review emphasizes the need for harmonized tools to quantify vaccine reactogenicity and for study designs that account for pre-vaccination immune status to distinguish true associations from confounding factors and better clarify the relationship between post-vaccine symptoms and immunologic outcomes. Understanding the mechanistic links between innate immune activation, tolerability, and adaptive immune responses could inform vaccine development, clinical trial endpoints, and public communication strategies. As vaccine technologies evolve and tolerability becomes a differentiating factor, further research is needed to unravel the biological basis of vaccine-associated symptoms and their role in predicting protection.}, }
@article {pmid41160925, year = {2026}, author = {Garry, RF}, title = {SARS-CoV-2 Spike displays multiple adaptive changes in addition to the furin cleavage site.}, journal = {Virology}, volume = {614}, number = {}, pages = {110720}, doi = {10.1016/j.virol.2025.110720}, pmid = {41160925}, issn = {1096-0341}, mesh = {*Spike Glycoprotein, Coronavirus/genetics/metabolism/chemistry ; *Furin/metabolism ; *SARS-CoV-2/genetics/metabolism/physiology ; Animals ; Chiroptera/virology ; Humans ; *COVID-19/virology/transmission ; Evolution, Molecular ; }, abstract = {Evolution of SARS-CoV-2 from bat sarbecoviruses involved multiple changes in Spike in addition to insertion of the furin cleavage site (FCS). Analysis of the closely related Spike of BANAL-20-52 reveals key adaptations in the SARS-CoV-2 Spike beyond the FCS that occurred prior to the spillover of SARS-CoV-2's immediate progenitor to humans. Bat sarbecoviruses have enteric tropism and spread mostly by the gastrointestinal route. Their Spike proteins predominantly assume the locked form, which is able to resist the low pH of the bat gastrointestinal tract. Initial changes during the SARS-CoV-2 evolutionary pathway included substitutions that expanded the host range of the sarbecovirus progenitor and allowed circulation in nonbat mammals. Adaptation of the SARS-CoV-2 progenitors also involved remodeling of the amino-terminal domain. Respiratory adaptation occurred during circulation in nonbat animals and resulted in greater propensity for Spike to assume open forms that are less compact and more metastable than the locked or closed forms. Substitutions at monomer interfaces in the Spike trimer facilitate the open shift. Like FCS insertion, these substitutions make Spike more susceptible to low pH degradation and could not have occurred in bats. After SARS-CoV-2 spilled over to humans Spikes of the dominant lineage acquired an aspartic acid to glycine substitution at position 614 that further decreases interaction between monomers and promotes opening of the Spike trimer. A multi-stage evolutionary trajectory is also evident during cross-species transmissions of bat sarbecoviruses to pangolins and the first known spillovers of SARS-CoV via the wildlife trade.}, }
@article {pmid41160817, year = {2025}, author = {Scott, J and Abers, MS and Marwah, HK and McCann, NC and Meyerowitz, EA and Richterman, A and Fleming, DF and Holmes, EJ and Moat, LE and Redepenning, SG and Smith, EA and Stoddart, CJ and Sundaram, ME and Ulrich, AK and Alba, C and Anderson, CJ and Arpey, MK and Borre, E and Ladines-Lim, J and Mehr, AJ and Rich, K and Watts, C and Basta, NE and Jarolimova, J and Walensky, RP and Dugdale, CM}, title = {Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025-2026.}, journal = {The New England journal of medicine}, volume = {393}, number = {22}, pages = {2221-2242}, doi = {10.1056/NEJMsa2514268}, pmid = {41160817}, issn = {1533-4406}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *COVID-19 Vaccines/administration &amp; dosage/adverse effects/immunology ; Hospitalization/statistics &amp; numerical data ; *Influenza Vaccines/administration &amp; dosage/adverse effects/immunology ; *Influenza, Human/epidemiology/prevention &amp; control ; *Respiratory Syncytial Virus Infections/epidemiology/prevention &amp; control ; *Respiratory Syncytial Virus Vaccines/administration &amp; dosage/adverse effects/immunology ; United States/epidemiology ; *Vaccine Efficacy/statistics &amp; numerical data ; Myocarditis/epidemiology/immunology ; Guillain-Barre Syndrome/epidemiology/immunology ; }, abstract = {BACKGROUND: Changes in the vaccine advisory process in the United States have disrupted immunization guidance, which reinforces the need for independent evidence review to inform decisions regarding immunization for respiratory viruses during the 2025-2026 season.<br><br>METHODS: We conducted a systematic review of U.S.-licensed immunizations against coronavirus disease 2019 (Covid-19), respiratory syncytial virus (RSV), and influenza. We searched databases on PubMed/MEDLINE, Embase, and Web of Science for updates of the most recent review by the Advisory Committee on Immunization Practices (ACIP) Evidence-to-Recommendations for each disease, which was performed during the 2023-2024 period. Outcomes included vaccine efficacy and effectiveness against hospitalization, other clinical end points, and safety.<br><br>RESULTS: Of 17,263 identified references, 511 studies met the inclusion criteria. Covid-19 mRNA vaccines against the XBB.1.5 subvariant had pooled vaccine effectiveness against hospitalization of 46% (95% confidence interval [CI], 34 to 55; from cohort studies) and 50% (95% CI, 43 to 57; from case-control studies) among adults and 37% (95% CI, 29 to 44) among immunocompromised adults. In a case-control study, vaccines against the KP.2 subvariant showed an effectiveness of 68% (95% CI, 42 to 82). Maternal RSV vaccination (for infant protection), nirsevimab for infants, and RSV vaccines in adults who were 60 years of age or older showed vaccine effectiveness of 68% or more against hospitalization. Influenza vaccination had a pooled vaccine effectiveness of 48% (95% CI, 39 to 55) in adults between the ages of 18 and 64 years and 67% (95% CI, 58 to 75) in children against hospitalization. Safety profiles were consistent with previous evaluations. The diagnosis of myocarditis associated with Covid-19 vaccines occurred at rates of 1.3 to 3.1 per 100,000 doses in male adolescents, with lower risk associated with longer dosing intervals. The RSVpreF vaccine was associated with 18.2 excess cases of Guillain-Barr&#xe9; syndrome per million doses in older adults; a significant association with preterm birth was not observed when the vaccine was administered at 32 to 36 weeks' gestation.<br><br>CONCLUSIONS: Ongoing peer-reviewed evidence supports the safety and effectiveness of immunizations against Covid-19, RSV, and influenza during the 2025-2026 season. (Funded by the Center for Infectious Disease Research and Policy and the Alumbra Innovations Foundation.).}, }
@article {pmid41160264, year = {2025}, author = {Nor Isamuddin, NH and AbuBakar, S and Chin, KL and Zainal, N}, title = {Heterologous immunity and antibody-dependent enhancement in respiratory virus infections.}, journal = {Molecular biology reports}, volume = {53}, number = {1}, pages = {27}, pmid = {41160264}, issn = {1573-4978}, mesh = {Humans ; *Immunity, Heterologous/immunology ; SARS-CoV-2/immunology ; *Antibody-Dependent Enhancement/immunology ; COVID-19/immunology/virology ; *Respiratory Tract Infections/immunology/virology ; Antibodies, Viral/immunology ; Cross Reactions/immunology ; Animals ; }, abstract = {Respiratory viruses such as influenza viruses and coronaviruses pose persistent and evolving threats to global public health, driven by diverse mechanisms of immune evasion, cross-species transmission, and pandemic potential. Understanding the interplay between heterologous immunity and antibody-dependent enhancement (ADE) is crucial in delineating both protective and pathogenic immune responses following infection or vaccination. This review synthesizes current advances in the molecular and cellular mechanisms underlying virus-agnostic innate defenses, adaptive receptor diversification via V(D)J recombination, and the structural and functional bases of T and B cell cross-reactivity. The dualistic nature of antibody responses is examined in the context of Fc receptor- and complement-mediated ADE, emphasizing the implications for immune protection versus immunopathology. The impact of pre-existing cross-reactive immunity, primed by prior exposures to antigenically distinct viruses or vaccines, is discussed with evidence from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and other seasonal respiratory outbreaks. Finally, the review evaluates recent progress and ongoing challenges in universal vaccine development, proposing that the rational harnessing of broad-spectrum and cross-reactive immune mechanisms will be essential for enhancing pandemic preparedness and mitigating the risks associated with immune enhancement phenomena.}, }
@article {pmid41160032, year = {2025}, author = {Kawai, K and Muhere, CF and Lemos, EV and Francis, JM}, title = {Viral Infections and Risk of Cardiovascular Disease: Systematic Review and Meta-Analysis.}, journal = {Journal of the American Heart Association}, volume = {14}, number = {21}, pages = {e042670}, pmid = {41160032}, issn = {2047-9980}, mesh = {Humans ; *Cardiovascular Diseases/epidemiology ; Risk Assessment ; Risk Factors ; *Virus Diseases/epidemiology ; }, abstract = {BACKGROUND: We conducted a systematic review and meta-analysis of studies examining the association of viral infections with the risk of cardiovascular disease, including coronary heart disease (CHD) and stroke.<br><br>METHODS: MEDLINE, Embase, Web of Science, African-Wide Information, and the Cochrane Library database were searched from inception to July 2024.<br><br>RESULTS: We included 155 studies. HIV infection was consistently associated with an elevated risk of CHD (pooled adjusted risk ratio [RR], 1.60 [95% CI, 1.38-1.85]) and stroke (RR, 1.45 [95% CI, 1.26-1.67]). SARS-CoV-2 infection was associated with an increased risk of CHD (RR, 1.74 [95% CI, 1.44-2.11]) and stroke (RR, 1.69 [95% CI, 1.23-2.31]). In self-controlled case series studies, laboratory-confirmed influenza infection was associated with an elevated risk of acute myocardial infarction (pooled incidence rate ratio, 4.01 [95% CI, 2.66-6.05]) and stroke during the first 1&#x2009;month (incidence rate ratio, 5.01 [95% CI, 3.41-7.37]). In cohort studies, hepatitis C virus infection was associated with a higher risk of CHD (RR, 1.27 [95% CI, 1.13-1.42]) and stroke (RR, 1.23 [95% CI, 1.04-1.46]). Herpes zoster was also associated with an elevated risk of CHD (RR, 1.12 [95% CI, 1.08-1.15]) and stroke (RR, 1.18 [95% CI, 1.09-1.27]). There is insufficient evidence to determine the effect of cytomegalovirus on cardiovascular disease. Although on a limited basis, hepatitis A virus, herpes simplex virus type 1, respiratory syncytial virus, human papillomavirus, dengue, and chikungunya have been linked to an increased risk of cardiovascular disease.<br><br>CONCLUSIONS: Influenza, SARS-CoV-2, HIV, hepatitis C virus, and herpes zoster were associated with an increased risk of major cardiovascular events. Vaccines may play an important role in preventing the risk of cardiovascular disease.}, }
@article {pmid41159228, year = {2025}, author = {Maldonado-Barrueco, A and Quiles-Melero, I and García-Rodríguez, J}, title = {Current diagnostic approach to fungal infection in the critically ill patient.}, journal = {Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia}, volume = {38 Suppl 1}, number = {Suppl 1}, pages = {32-37}, pmid = {41159228}, issn = {1988-9518}, mesh = {Humans ; Critical Illness ; COVID-19/epidemiology ; *Invasive Fungal Infections/diagnosis/microbiology ; *Mycoses/diagnosis/microbiology ; Antifungal Agents/therapeutic use ; Biomarkers ; SARS-CoV-2 ; Galactose/analogs &amp; derivatives ; Mannans ; }, abstract = {Invasive fungal infections are a major cause of morbidity and mortality in critically ill patients, with an increasing global incidence and species diversity, especially after the SARS-CoV-2 pandemic. Diagnosis relies on a combination of classical methods (microscopy, culture) and non-classical tools including biomarkers (1,3-β-D-glucan, galactomannan, mannan) and molecular assays. Fungal infections (candidiasis, aspergillosis, pneumocystosis, and mucormycosis) requires tailored diagnostic strategies based on host risk factors, epidemiology and specimen type. Combining diagnostic tests improves sensitivity and negative predictive value, guiding timely antifungal treatment. An integrated, pathogen-specific approach is essential to improve outcomes in the critical ill patient.}, }
@article {pmid41158965, year = {2025}, author = {Tie, X and Li, J and Wu, H and Weng, R and Zhang, Y and Li, J and Chen, K}, title = {Advances in the structure-based design of protein vaccines for respiratory infectious diseases.}, journal = {Computational and structural biotechnology journal}, volume = {29}, number = {}, pages = {259-270}, pmid = {41158965}, issn = {2001-0370}, abstract = {Respiratory infectious diseases are among the leading causes of morbidity and mortality worldwide, particularly affecting children, older adults, and immunocompromised individuals. Traditional vaccine development approaches face limitations in addressing the rapid mutation and immune evasion mechanisms of respiratory pathogens. In recent years, structure-based protein vaccine design has emerged as a critical direction in vaccine research. This strategy utilizes the three-dimensional structural information of key pathogenic antigens, combined with reverse vaccinology, computational biology, and protein engineering to optimize antigen design and enhance immunogenicity. This review summarizes recent progress in structure-based protein vaccine development for major respiratory pathogens, including influenza viruses, respiratory syncytial virus (RSV), and coronaviruses such as SARS-CoV-2. We highlight innovative vaccine platforms, including antigen optimization strategies, nanoparticle-based vaccines, and novel adjuvant development. Additionally, we discuss the major challenges in vaccine development-such as antigenic variability, immune durability, and large-scale manufacturing-and propose future directions for research and application.}, }
@article {pmid41158581, year = {2025}, author = {Akingbola, A and Adegbesan, A and Tundealao, S and Benson, AE and Makinde, AO and Shekoni, M and Animashaun, K and Fakiyesi, T}, title = {Post-pandemic era: global trends, benefits, and barriers in integrating artificial intelligence into public health education.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1648970}, pmid = {41158581}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Public Health/education ; *Artificial Intelligence ; Africa/epidemiology ; *Pandemics ; Global Health ; SARS-CoV-2 ; *Health Education/methods ; }, abstract = {The COVID-19 pandemic posed an unprecedented challenge to public health systems globally, with African countries exhibiting a wide range of outcomes in terms of preparedness, response, and resilience. This review explores the public health strategies deployed across the African continent during the pandemic, highlighting key successes, identifying critical failures, and synthesizing lessons to inform future health emergency preparedness. Drawing on existing literature, policy documents, and epidemiological data, the study examines the roles of leadership, community engagement, health communication, diagnostic capacity, and vaccine deployment. While several African countries successfully leveraged past epidemic experience, decentralized health systems, and innovative communication strategies, others struggled with misinformation, weak surveillance, and limited critical care infrastructure. The review also discusses the role of international collaboration, local innovation, and donor dependence in shaping response outcomes. Lessons from Africa's handling of COVID-19 underline the importance of strengthening public health infrastructure, investing in health workforce development, improving health information systems, and ensuring equitable access to vaccines and therapeutics. This paper contributes to the growing discourse on pandemic preparedness and highlights Africa's potential not only as a site of vulnerability but also of resilience and innovation in global public health.}, }
@article {pmid41158347, year = {2025}, author = {Xie, K and Zhang, P and Li, Y and Xia, L}, title = {The post-COVID-19 pulmonary sequelae: manifestations, mechanisms and treatment strategies.}, journal = {Journal of thoracic disease}, volume = {17}, number = {9}, pages = {7414-7429}, pmid = {41158347}, issn = {2072-1439}, abstract = {Recent studies have increasingly demonstrated that coronavirus disease 2019 (COVID-19) patients may develop long-term sequelae of varying severity, collectively referred to as long COVID or post-COVID-19 condition. Pulmonary sequelae are particularly common, which significantly impair patients' quality of life. The mechanisms underlying post-COVID-19 pulmonary sequelae are complex and multifactorial, and their management is still at an exploratory stage. This review explores the manifestations, underlying mechanisms, and potential treatment approaches for post-COVID-19 pulmonary sequelae. Fatigue, dyspnea, myalgia, and sleep disturbances are the most commonly reported symptoms following COVID-19 infection, while anxiety and depression are also prevalent. Respiratory symptoms include dyspnoea, persistent cough, hypoxia, and reduced exercise capacity. Impaired lung diffusion capacity is the most frequently observed pulmonary function abnormality, and residual abnormalities on chest computed tomography (CT) commonly include ground-glass opacities (GGO) and fibrotic-like changes. Air trapping is also an important CT finding and has been reported to associated with impaired lung diffusion function. The potential mechanisms may include pulmonary fibrosis, chronic inflammation, immune dysregulation, coagulation abnormalities and thrombosis, and persistent viral infection. Current treatment strategies encompass vaccination, pulmonary rehabilitation, and pharmacological interventions such as antifibrotic, anti-inflammatory, and anticoagulant therapies. A comprehensive understanding of the recovery trajectory and the mechanisms underlying post-COVID-19 pulmonary sequelae is crucial for improving patient outcomes.}, }
@article {pmid41158128, year = {2025}, author = {Prakash, S and Choudhury, P and Bisht, S}, title = {Diabetic cardiomyopathy and COVID-19: intersecting pathways and amplified cardiovascular risk.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1683159}, pmid = {41158128}, issn = {1663-9812}, abstract = {Diabetic cardiomyopathy (DCM) is a diabetes-induced heart condition characterized by ventricular dysfunction without other cardiac diseases. Chronic hyperglycemia, insulin resistance, and metabolic disturbances drive myocardial damage through renin-angiotensin-aldosterone system (RAAS) activation, oxidative stress, mitochondrial dysfunction, advanced glycation end product (AGE) accumulation, and persistent inflammation. The COVID-19 pandemic, caused by SARS-CoV-2, has intensified cardiovascular risk in diabetic patients. The virus uses ACE2 receptors, abundant in the heart and other organs, enabling multi-organ injury. COVID-19 may worsen glucose control or induce new-onset diabetes via pancreatic injury, insulin resistance, and stress hyperglycemia. Pre-existing diabetes increases the risk of severe COVID-19, cytokine storms, endothelial dysfunction, and thrombosis. In combination, both conditions promote RAAS imbalance, exaggerated inflammation, and hypercoagulability, amplifying myocardial injury, fibrosis, and heart failure risk. This review highlights the intricate bidirectional relationship between DCM and COVID-19, emphasizing shared pathogenic mechanisms such as RAAS dysregulation, endothelial damage, cytokine overproduction, and coagulopathy. Understanding these overlapping pathways is crucial for developing effective preventive and therapeutic strategies to mitigate adverse outcomes in this vulnerable population.}, }
@article {pmid41157624, year = {2025}, author = {Mateescu, DM and Ilie, AC and Cotet, I and Guse, C and Muresan, CO and Pah, AM and Badalica-Petrescu, M and Iurciuc, S and Craciun, ML and Avram, A and Enache, A}, title = {Global Burden of Bloodstream Infections in COVID-19: Prevalence, Antimicrobial Resistance, and Mortality Risk.}, journal = {Viruses}, volume = {17}, number = {10}, pages = {}, pmid = {41157624}, issn = {1999-4915}, support = {Institutional funding, no specific grant number//Victor Babes University of Medicine and Pharmacy Timisoara, Romania/ ; }, mesh = {Humans ; *COVID-19/complications/mortality/epidemiology ; Prevalence ; Risk Factors ; SARS-CoV-2 ; *Bacteremia/epidemiology/mortality/drug therapy ; Drug Resistance, Bacterial ; Anti-Bacterial Agents/therapeutic use/pharmacology ; *Sepsis/mortality/epidemiology ; }, abstract = {BACKGROUND: Bloodstream infections (BSIs) complicate COVID-19 inpatients, increasing morbidity, mortality, and healthcare burden. This systematic review and meta-analysis evaluated prevalence, antimicrobial resistance (AMR), risk factors, and outcomes of BSIs in RT-PCR-confirmed COVID-19 cases.<br><br>METHODS: We searched PubMed, Google Scholar, ScienceDirect, and MDPI journals (January 2020-August 2025) following PRISMA 2020 guidelines. Twenty-two observational studies (~123,500 patients, ~602,000 blood cultures) were included: 10 prospective and 12 retrospective. Random-effects models estimated pooled prevalence, odds ratios (ORs), and mean differences, with subgroup analyses (ICU, non-ICU, pediatric) and meta-regression.<br><br>RESULTS: Pooled BSI prevalence was 8.2% (95% CI: 5.7-11.0; I[2] = 50%). Subgroup prevalence was higher in ICU (12.5%) than non-ICU (5.2%) populations. Pediatric cohorts (n = 3) showed a prevalence of 10.8%. Gram-negative pathogens predominated (61%), particularly Klebsiella pneumoniae (26%) and Acinetobacter baumannii (21%). AMR rates were 36% for MRSA and 31% for ESBL-producing Enterobacterales. Risk factors included mechanical ventilation (OR: 2.6), immunosuppression (OR: 2.3), and corticosteroid use (OR: 2.4). BSIs were associated with increased mortality (OR: 2.6), prolonged hospitalization (+6.8 days), and higher ICU admission (OR: 3.1).<br><br>CONCLUSIONS: BSIs, largely driven by multidrug-resistant pathogens, substantially worsen COVID-19 outcomes. Variability in diagnostic criteria (CDC vs. ECDC) and reliance on retrospective designs are limitations, though moderate heterogeneity (I[2] = 50%) enhances generalizability across diverse populations. Strengthened infection prevention and antimicrobial stewardship are urgently required.}, }
@article {pmid41157587, year = {2025}, author = {Heath, AM and Li, D}, title = {Symptomatology of Long COVID Associated with Inherited and Acquired Thrombophilic Conditions: A Systematic Review.}, journal = {Viruses}, volume = {17}, number = {10}, pages = {}, pmid = {41157587}, issn = {1999-4915}, mesh = {Humans ; *COVID-19/complications ; *Thrombophilia/complications ; SARS-CoV-2 ; }, abstract = {Thrombophilic conditions, conditions where blood has a tendency to form thrombi due to abnormal coagulatory processes, can affect the trajectory of diseases such as Post-Acute Sequelae of SARS-CoV-2 Infection, better known as Long COVID (LC), by worsening symptoms and complicating outlooks. As a comorbidity in pro-coagulatory diseases such as COVID-19 and LC, patients with thrombophilic conditions may experience worse symptoms than their peers, due to this elevated level of hypercoagulation. A 15-week literature review through the public PubMed database was conducted to investigate the severity, mechanisms, and symptom profiles of thrombophilic patients with LC. Papers were only included if samples included participants with pre-existing tendencies for hypercoagulable states, and confirmation of SARS-CoV-2 infection via a Polymerase Chain Reaction test. Each paper included in this review was analyzed by topic and assessed for eligibility against the Joanna Briggs Institute's Critical Appraisal tool. Each paper was also assessed for biases. Results from the 6 papers included in this review showed that LC could be predicted following COVID-19 illness by a hypercoagulable blood profile, indicating that LC may be linked to chronic hypercoagulation and inflammation post-infection. Additionally, symptoms linked to microthrombi formation, such as hair loss, arrhythmia, and dizziness, were exhibited more frequently in patients with thrombophilia and/or thrombophilic conditions, indicating that those with thrombophilic conditions may exhibit unique LC symptom profiles compared to healthy controls. This paper's research is preliminary and thus is limited in the strength of its findings; However, further research into LC and its interactions with co-morbidities like thrombophilic conditions would aid in the development of better treatment plans for patients, such as the usage of anticoagulants or screening for hypercoagulable blood profiles post-COVID-19 to assess patient risk.}, }
@article {pmid41157582, year = {2025}, author = {Prakash, S and Karan, S and Lekbach, Y and Tifrea, DF and Figueroa, CJ and Ulmer, JB and Young, JF and Glenn, G and Gil, D and Jones, TM and Redfield, RR and BenMohamed, L}, title = {Insights into Persistent SARS-CoV-2 Reservoirs in Chronic Long COVID.}, journal = {Viruses}, volume = {17}, number = {10}, pages = {}, pmid = {41157582}, issn = {1999-4915}, support = {R01 AI158060/AI/NIAID NIH HHS/United States ; AI158060//National Institute of Allergy and Infectious Diseases/ ; }, mesh = {Humans ; *COVID-19/virology/immunology/complications ; *SARS-CoV-2/physiology/genetics ; Animals ; Chronic Disease ; Post-Acute COVID-19 Syndrome ; RNA, Viral ; Disease Reservoirs/virology ; *Persistent Infection/virology ; }, abstract = {Long COVID (LC), also known as post-acute sequelae of COVID-19 infection (PASC), is a heterogeneous and debilitating chronic disease that currently affects 10 to 20 million people in the U.S. and over 420 million people globally. With no approved treatments, the long-term global health and economic impact of chronic LC remains high and growing. LC affects children, adolescents, and healthy adults and is characterized by over 200 diverse symptoms that persist for months to years after the acute COVID-19 infection is resolved. These symptoms target twelve major organ systems, causing dyspnea, vascular damage, cognitive impairments ("brain fog"), physical and mental fatigue, anxiety, and depression. This heterogeneity of LC symptoms, along with the lack of specific biomarkers and diagnostic tests, presents a significant challenge to the development of LC treatments. While several biological abnormalities have emerged as potential drivers of LC, a causative factor in a large subset of patients with LC, involves reservoirs of virus and/or viral RNA (vRNA) that persist months to years in multiple organs driving chronic inflammation, respiratory, muscular, cognitive, and cardiovascular damages, and provide continuous viral antigenic stimuli that overstimulate and exhaust CD4[+] and CD8[+] T cells. In this review, we (i) shed light on persisting virus and vRNA reservoirs detected, either directly (from biopsy, blood, stool, and autopsy samples) or indirectly through virus-specific B and T cell responses, in patients with LC and their association with the chronic symptomatology of LC; (ii) explore potential mechanisms of inflammation, immune evasion, and immune overstimulation in LC; (iii) review animal models of virus reservoirs in LC; (iv) discuss potential T cell immunotherapeutic strategies to reduce or eliminate persistent virus reservoirs, which would mitigate chronic inflammation and alleviate symptom severity in patients with LC.}, }
@article {pmid41157147, year = {2025}, author = {Jach, ME and Sajnaga, E and Bumbul, M and Serefko, A and Borowicz, KK and Golczyk, H and Kieliszek, M and Wiater, A}, title = {The Role of Probiotics and Their Postbiotic Metabolites in Post-COVID-19 Syndrome.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {20}, pages = {}, pmid = {41157147}, issn = {1420-3049}, mesh = {*Probiotics/therapeutic use/pharmacology ; Humans ; *COVID-19/complications ; Gastrointestinal Microbiome/drug effects ; SARS-CoV-2 ; Dysbiosis ; Fatty Acids, Volatile/metabolism ; }, abstract = {Post-COVID-19 syndrome, also known as long-COVID, is characterized by a wide spectrum of persistent symptoms involving multiple body organs and systems, including fatigue, gastrointestinal disorders, and neurocognitive dysfunction. Emerging evidence suggests that gut microbiota dysbiosis and disruption of the gut-brain axis play a central role in the pathophysiology of this condition. Probiotics and their metabolites (postbiotics) have gained increasing attention as potential therapeutic agents given their immunomodulatory, anti-inflammatory, and antiviral properties. In this review, we discuss the current understanding of the antiviral mechanisms of probiotics, including reinforcement of intestinal epithelial barrier function, direct virus inhibition, receptor competition, and immune system modulation. Special emphasis is placed on short-chain fatty acids (SCFAs), lactic acid, hydrogen peroxide, and bacteriocins as key factors that contribute to these effects. SCFAs appear to be essential postbiotic compounds during post-COVID recovery. We also highlight recent clinical trials involving specific probiotic species, such as Lactiplantibacillus plantarum, Lacticaseibacillus rhamnosus, and Bifidobacterium longum, and their potential role in alleviating long-term COVID symptoms. Although the current results are promising, further research is needed to clarify the most effective strains, dosages, and mechanisms of action in post-COVID therapeutic strategies.}, }
@article {pmid41156656, year = {2025}, author = {Delpino, MV and Quarleri, J}, title = {Mitochondrial Dysfunction in Aging, HIV, and Long COVID: Mechanisms and Therapeutic Opportunities.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {10}, pages = {}, pmid = {41156656}, issn = {2076-0817}, mesh = {Humans ; *Aging/metabolism ; *HIV Infections/metabolism/therapy/pathology ; *Mitochondria/metabolism/pathology ; *COVID-19/metabolism/therapy/pathology ; DNA, Mitochondrial/genetics ; *Mitochondrial Diseases/therapy ; Oxidative Stress ; SARS-CoV-2 ; Mitophagy ; }, abstract = {We hypothesize that a unified mitochondrial perspective on aging, HIV, and long COVID reveals shared pathogenic mechanisms and specific therapeutic vulnerabilities that are overlooked when these conditions are treated independently. Mitochondrial dysfunction is increasingly recognized as a common factor driving aging, HIV, and long COVID. Shared mechanisms-including oxidative stress, impaired mitophagy and dynamics, mtDNA damage, and metabolic reprogramming-contribute to ongoing energy failure and chronic inflammation. Recent advancements highlight new therapeutic strategies such as mitochondrial transfer, transplantation, and genome-level correction of mtDNA variants, with early preclinical and clinical studies providing proof-of-concept. This review summarizes current evidence on mitochondrial changes across aging and post-viral syndromes, examines emerging organelle-based therapies, and discusses key challenges related to safety, durability, and translation.}, }
@article {pmid41156587, year = {2025}, author = {Mboowa, G}, title = {Reimagining Tuberculosis Control in the Era of Genomics: The Case for Global Investment in Mycobacterium tuberculosis Genomic Surveillance.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {10}, pages = {}, pmid = {41156587}, issn = {2076-0817}, support = {U2R TW012116/TW/FIC NIH HHS/United States ; }, mesh = {Humans ; *Mycobacterium tuberculosis/genetics/drug effects ; *Genomics/methods ; *Tuberculosis/prevention &amp; control/epidemiology/microbiology ; COVID-19/epidemiology ; Genome, Bacterial ; Global Health ; Whole Genome Sequencing ; *Tuberculosis, Multidrug-Resistant/epidemiology/prevention &amp; control/microbiology ; }, abstract = {Drug-resistant Mycobacterium tuberculosis remains a significant global public health threat. While whole-genome sequencing (WGS) holds immense promise for understanding transmission dynamics and drug resistance mechanisms, its integration into routine surveillance remains limited. Additionally, insights from WGS are increasingly contributing to vaccine discovery by identifying novel antigenic targets and understanding pathogen evolution. The COVID-19 pandemic catalyzed an unprecedented expansion of genomic capacity in many low- and middle-income countries (LMICs), with public health institutions acquiring next-generation sequencing (NGS) platforms and developing local expertise in real-time pathogen surveillance. This hard-won capacity now represents a transformative opportunity to accelerate TB control enabling rapid detection of drug-resistant strains and high-resolution mapping of transmission networks that are critical for timely, targeted interventions. Furthermore, the integration of machine learning with genomic and clinical data offers a powerful avenue to improve the prediction of drug resistance and to tailor patient-specific TB management strategies. This article examines the practical challenges, emerging opportunities, and policy considerations necessary to embed genomic epidemiology within national TB control programs, particularly in high-burden, resource-constrained settings.}, }
@article {pmid41156582, year = {2025}, author = {Li, J and Lu, H and Hu, G and Pang, S and Xie, Y and Zhu, G and Ding, X}, title = {How Does Porcine Epidemic Diarrhea Virus Escape Host Innate Immunity?.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {10}, pages = {}, pmid = {41156582}, issn = {2076-0817}, support = {HN2024113//Henan Postdoctoral Research Foundation/ ; 22nya08//Science and Technology Plan Project of Taizhou/ ; }, mesh = {Animals ; *Immunity, Innate ; *Porcine epidemic diarrhea virus/immunology/pathogenicity ; Swine ; *Swine Diseases/immunology/virology ; *Immune Evasion ; *Coronavirus Infections/immunology/veterinary/virology ; *Host-Pathogen Interactions/immunology ; Autophagy ; Signal Transduction ; }, abstract = {Porcine epidemic diarrhea virus (PEDV), the causative agent of porcine epidemic diarrhea (PED), induces vomiting, watery diarrhea, and severe dehydration in pigs. It exhibits particularly high lethality in neonatal piglets, posing a significant threat to the global swine industry and inflicting substantial economic losses. The host innate immune system serves as the primary defense against viral invasion; however, PEDV employs multiple strategies to evade this response. This review systematically summarizes the multiple molecular mechanisms by which PEDV evaded the host's innate immunity, including interfering with host intracellular signaling pathways by virally encoded proteins, antagonizing the host's antiviral factors and related immune genes to suppress the innate immune responses, and regulating the autophagy process of the host cells, thereby achieving the escape of the host's innate immunity. A comprehensive understanding of how PEDV subverts innate immunity is crucial for developing effective control strategies and therapeutics. This review aims to provide novel insights and potential targets for combating PED.}, }
@article {pmid41156144, year = {2025}, author = {Lefter, CL and Poddi, S and Rungatscher, A}, title = {Endocarditis: Rising Incidence in the Post-COVID-19 Pandemic Era: A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {20}, pages = {}, pmid = {41156144}, issn = {2077-0383}, abstract = {Infective Endocarditis (IE) incidence has increased in recent years, driven by emerging risk factors affecting both elderly and young adults. Also, the role of Non-Bacterial Thrombotic Endocarditis (NBTE) is gaining importance as it is a subtle, probably underdiagnosed entity. Moreover, the COVID-19 pandemic has influenced the epidemiology of endocarditis, raising questions about their relationship, diagnosis, and management. Diagnosis of IE is sometimes challenging, and classic criteria are now being rediscussed. The aim of our study is to provide a narrative review about how and why IE incidence is rising, the role of NBTE, the impact of the COVID-19 pandemic on endocarditis patterns, and the current diagnostic challenges we face in the post-pandemic era.}, }
@article {pmid41156098, year = {2025}, author = {Qiu, D and Cao, W and Zhang, Y and Hao, H and Wei, X and Yao, L and Wang, S and Gao, Z and Xie, Y and Li, M}, title = {COVID-19 Infection, Drugs, and Liver Injury.}, journal = {Journal of clinical medicine}, volume = {14}, number = {20}, pages = {}, pmid = {41156098}, issn = {2077-0383}, support = {2022YFC2603500//The National Key Research and Development Program/ ; 2022YFC2603505//The National Key Research and Development Program/ ; 2022-1-2172//The capital health research and development of special public health project/ ; discipline leader-03-26//Beijing Municipal Health Commission high-level public health technical personnel construction project/ ; discipline backbone-02-28//Beijing Municipal Health Commission high-level public health technical personnel construction project/ ; ZLRK202301//Beijing Hospitals Authority Clinical medicine Development of special funding support/ ; DFL20241803//Beijing Hospitals Authority "peak" talent training program/ ; 2023YFC2306901//The National Key Research and Development Program/ ; 2023YFC2308105//The National Key Research and Development Program/ ; }, abstract = {Novel coronavirus (SARS-CoV-2) is highly infectious and pathogenic. Novel coronavirus infection can not only cause respiratory diseases but also lead to multiple organ damage through direct or indirect mechanisms, in which the liver is one of the most frequently affected organs. It has been reported that 15-65% of coronavirus disease 2019 (COVID-19) patients experience liver dysfunction, mainly manifested as mild to moderate elevation of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Severe patients may progress to liver failure, develop hepatic encephalopathy, or have poor coagulation function. The mechanisms underlying this type of liver injury are complex. Pathways-including direct viral infection (via ACE2 receptors), immune-mediated responses (e.g., cytokine storm), ischemic/hypoxic liver damage, thrombosis, oxidative stress, neutrophil extracellular trap formation (NETosis), and the gut-liver axis-remain largely speculative and lack robust clinical causal evidence. In contrast, drug-induced liver injury (DILI) has been established as a well-defined causative factor using the Roussel Uclaf Causality Assessment Method (RUCAM). Treatment should simultaneously consider antiviral therapy and liver protection therapy. This article systematically reviewed the mechanism, clinical diagnosis, treatment, and management strategies of COVID-19-related liver injury and discussed the limitations of current research and the future directions, hoping to provide help for the diagnosis and treatment of such patients.}, }
@article {pmid41155962, year = {2025}, author = {Szebeni, J}, title = {Unique Features and Collateral Immune Effects of mRNA-LNP COVID-19 Vaccines: Plausible Mechanisms of Adverse Events and Complications.}, journal = {Pharmaceutics}, volume = {17}, number = {10}, pages = {}, pmid = {41155962}, issn = {1999-4923}, abstract = {A reassessment of the risk-benefit balance of the two lipid nanoparticle (LNP)-based vaccines, Pfizer's Comirnaty and Moderna's Spikevax, is currently underway. While the FDA has approved updated products, their administration is recommended only for individuals aged 65 years or older and for those aged 6 months or older who have at least one underlying medical condition associated with an increased risk of severe COVID-19. Among other factors, this change in guidelines reflect an expanded spectrum and increased incidence of adverse events (AEs) and complications relative to other vaccines. Although severe AEs are relatively rare (occurring in <0.5%) in vaccinated individuals, the sheer scale of global vaccination has resulted in millions of vaccine injuries, rendering post-vaccination syndrome (PVS) both clinically significant and scientifically intriguing. Nevertheless, the cellular and molecular mechanisms of these AEs are poorly understood. To better understand the phenomenon and to identify research needs, this review aims to highlight some theoretically plausible connections between the manifestations of PVS and some unique structural properties of mRNA-LNPs. The latter include (i) ribosomal synthesis of the antigenic spike protein (SP) without natural control over mRNA translation, diversifying antigen processing and presentation; (ii) stabilization of the mRNA by multiple chemical modification, abnormally increasing translation efficiency and frameshift mutation risk; (iii) encoding for SP, a protein with multiple toxic effects; (iv) promotion of innate immune activation and mRNA transfection in off-target tissues by the LNP, leading to systemic inflammation with autoimmune phenomena; (v) short post-reconstitution stability of vaccine nanoparticles contributing to whole-body distribution and mRNA transfection; (vi) immune reactivity and immunogenicity of PEG on the LNP surface increasing the risk of complement activation with LNP disintegration and anaphylaxis; (vii) GC enrichment and double proline modifications stabilize SP mRNA and prefusion SP, respectively; and (viii) contaminations with plasmid DNA and other organic and inorganic elements entailing toxicity with cancer risk. The collateral immune anomalies considered are innate immune activation, T-cell- and antibody-mediated cytotoxicities, dissemination of pseudo virus-like hybrid exosomes, somatic hypermutation, insertion mutagenesis, frameshift mutation, and reverse transcription. Lessons from mRNA-LNP vaccine-associated AEs may guide strategies for the prediction, prevention, and treatment of AEs, while informing the design of safer next-generation mRNA vaccines and therapeutics.}, }
@article {pmid41155751, year = {2025}, author = {Bhatia, L and Al Rekabi, S and Janovskienė, A and Stonkutė, I and Razukevičius, D and Stučinskaitė-Maračinskienė, J}, title = {Systematic Review of Post-Viral Delayed Inflammation Associated with Hyaluronic Acid Dermal Fillers.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {10}, pages = {}, pmid = {41155751}, issn = {1648-9144}, support = {//Lithuanian University of Health Sciences funding will be granted after acceptation of manuscript/ ; }, mesh = {Humans ; *Dermal Fillers/adverse effects/therapeutic use ; *Hyaluronic Acid/adverse effects/therapeutic use ; *Inflammation/etiology ; *Virus Diseases/complications ; Female ; Adult ; }, abstract = {Background: Hyaluronic acid (HA) dermal fillers are among the most widely used injectable materials in esthetic medicine. They are generally safe, but delayed inflammatory reactions (DIRs) have been observed, particularly after viral infections or vaccinations. Such events have raised questions about the role of immune activation in filler-related complications. Objective: This review examined the available literature on DIRs to HA fillers that occurred in the context of viral illness or immunization, with attention to how these reactions present and how they are managed. Methods: A systematic search was carried out in PubMed, ScienceDirect, ClinicalKey, and Google Scholar between October and November 2024. Only human case reports and case series were included. The protocol was registered in PROSPERO (CRD420251030918), and study quality was assessed using the Newcastle-Ottawa Scale. Results: Six publications met inclusion criteria: four case series and two case reports, describing 25 women between 22 and 65 years of age. Patients developed swelling, erythema, angioedema, or, in severe cases, marked facial edema after HA filler injections, with symptom onset ranging from several hours to several weeks following viral exposure. Corticosteroids and hyaluronidase were the most common treatments, though milder cases sometimes resolved without intervention. Study quality varied, with some reports providing limited detail on patient characteristics and follow-up. Conclusions: DIRs associated with viral infections or vaccinations remain uncommon but clinically relevant complications of HA filler use. Limited case-based evidence indicates potential effectiveness of corticosteroids and hyaluronidase, though management practices remain inconsistent. Larger prospective studies are needed to clarify underlying mechanisms and to establish standardized guidelines for treatment.}, }
@article {pmid41155695, year = {2025}, author = {Periferakis, AT and Adalis, GM and Periferakis, A and Troumpata, L and Periferakis, K and Dragosloveanu, CDM and Caruntu, A and Savulescu-Fiedler, I and Dragosloveanu, S and Scheau, AE and Badarau, IA and Scheau, C and Caruntu, C}, title = {The Multifaceted Antimicrobial Profile of Piperine in Infectious Disease Management: Current Perspectives and Potential.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {10}, pages = {}, pmid = {41155695}, issn = {1424-8247}, support = {Publish not Perish institutional programme//The "Carol Davila" University of Medicine and Pharmacy Bucharest, Romania/ ; }, abstract = {Piperine is an alkaloid found in plants of the genus Piper, and particularly in P. nigrum. This compound has been under extensive research lately for its antimicrobial, antiviral, and also anti-inflammatory, anti-oxidant, anticancer, and positive metabolic properties. Regarding its antibacterial applications, current data show that piperine is effective against Bacillus sphaericus, Bacterioides fragilis, Escherichia coli, Mycobacterium tuberculosis, Staphylococcus aureus, Streptococcus mutans, Pseudomonas aeruginosa, and Vibrio cholerae; its antifungal potency is exerted against Candida albicans and members of the Aspergillus family; antiviral activity has been documented against MERS-CoV, SARS-CoV2, EBOV, DENV, HCV, ZKV, and HPIV; and antiparasitic activity against Leishmania spp., Plasmodium spp., Trichomonas vaginalis, and Trypanosoma spp. While such applications are promising, more research is required to elucidate the mechanisms of action and to discover new ways of administration.}, }
@article {pmid41155649, year = {2025}, author = {Zouganeli, C and Toubanaki, DK and Karaoulani, O and Vrioni, G and Karagouni, E and Efstathiou, A}, title = {Impact of the COVID-19 Pandemic on Drug-Resistant Tuberculosis in Europe: A Meta-Analysis of Epidemiological Trends.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {10}, pages = {}, pmid = {41155649}, issn = {1424-8247}, abstract = {Background/Objectives: The COVID-19 pandemic has significantly intensified global concerns surrounding antimicrobial resistance (AMR), particularly in relation to tuberculosis (TB). In the European Union (EU), the reallocation of healthcare resources towards managing COVID-19 led to a de-prioritization of TB surveillance and control. This shift contributed to delays in TB diagnosis and treatment, creating conditions favorable for the emergence and spread of drug-resistant TB strains. This meta-analysis aims to assess epidemiological trends of drug-resistant TB across EU countries before, during, and after the pandemic and quantify the impact of COVID-19 on Mycobacterium tuberculosis resistance patterns. Methods: Data were obtained from the European Centre for Disease Prevention and Control (ECDC) covering 2015 to 2022. Following the TB incidence, the multidrug-resistant TB (MDR-TB) and rifampicin-resistant/MDR-TB (RR/MDR-TB) cases, as well as treatment success rates over 12- and 24-month periods, were analyzed. The analysis included 31 EU countries across three-time frames: pre-pandemic (2015-2019), pandemic onset (2020), and post-pandemic transition (2020-2022). Results: The pandemic was associated with a decrease in reported TB cases but a simultaneous increase in the proportion of MDR and RR/MDR cases. Treatment success rates showed a modest rise for 24-month regimens, while outcomes declined for 12-month therapies. Conclusions: These findings underscore the pandemic's disruptive impact on TB control and highlight the need for renewed investment in diagnostic capacity, treatment access, and antimicrobial stewardship, in order to reduce antimicrobial resistance occurrence. Continued monitoring beyond 2022 is essential to fully understand long-term effects and inform future public health strategies.}, }
@article {pmid41155576, year = {2025}, author = {Siewiorek, K and Jasiński, M and Izdebski, B and Przybylski, M and Kobylecka, M and Mączewska, J and Jamroziak, K and Drozd-Sokołowska, J}, title = {Challenges in the Treatment of HIV-Related Lymphomas Complicated by COVID-19: Case Study and Review of the Literature.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {10}, pages = {}, pmid = {41155576}, issn = {1424-8247}, abstract = {Lymphomas remain a significant cause of morbidity and mortality among patients living with HIV. Although the introduction of antiretroviral therapy has led to a reduction in the incidence of AIDS-related lymphomas (ARL) and an overall improvement in prognosis, these malignancies continue to pose a considerable clinical challenge. Beyond the inherent complexity of lymphoma treatment itself, the management of comorbidities, particularly infections, represents a therapeutic obstacle. Here, we review the published evidence on ARL complicated by COVID-19. Despite the fact that nearly 800 million confirmed cases of SARS-CoV-2 infection have been reported so far, only five cases of ARL and COVID-19 have been published, among whom most patients experienced a mild course of SARS-CoV-2 infection, with only one case progressing to severe COVID-19 that required oxygen therapy and prolonged hospitalization. Additionally, we present another case of a 49-year-old male patient with newly diagnosed ARL, Epstein-Barr virus (EBV)-positive, diffuse large B-cell lymphoma, not otherwise specified, complicated by prolonged SARS-CoV-2 infection. Although initially asymptomatic, the patient subsequently experienced transient respiratory failure. Despite administration of molnupiravir, both SARS-CoV-2 antigen and RT-qPCR tests remained positive for a minimum of 113 days. The prolonged SARS-CoV-2 infection, in conjunction with other opportunistic infections, impeded the delivery of adequate chemotherapy dose intensity and contributed to disease progression and ultimately the patient's death. This case and review of the literature underscores the diversity of the clinical course of SARS-CoV-2 infection in patients with ARL and highlights the associated challenges in delivering optimal anti-lymphoma therapy in those patients.}, }
@article {pmid41155541, year = {2025}, author = {Perez, DM}, title = {α1A-Adrenergic Receptor as a Target for Neurocognition: Cautionary Tale from Nicergoline and Quinazoline Non-Selective Blockers.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {10}, pages = {}, pmid = {41155541}, issn = {1424-8247}, support = {R01 AG066627/AG/NIA NIH HHS/United States ; RO1AG066627/GF/NIH HHS/United States ; }, abstract = {Decades ago, previous studies that used non-selective ergot derivatives suggested that blockage of the α1A-adrenergic receptor mildly increased cognition through increased blood flow to the brain due to vasodilation and, thus, could be used as a treatment for dementia. However, further studies indicated that nicergoline was non-specific and hit many different targets. Today, a similar scenario is developing with the use of non-selective α1-AR antagonists of the quinazoline class, referred to as "osins", as potential treatments for COVID-19/SARS, post-traumatic stress disorder, cancer, and neurodegenerative disorders, such as Parkinson's, Alzheimer's, and amyotrophic lateral sclerosis. While there is extensive evidence of neuroprotection from many clinical trials, the mechanism of action of quinazolines is often not α1-AR-mediated but keyed to its glycolysis-enhancing effects through activation of the enzyme phosphoglycerate kinase 1 (PGK1). These studies have incorrectly labeled the α1A-adrenergic receptor as an "old target" to treat Alzheimer's and other neurocognitive diseases, hampering drug development. This review will summarize these and other studies to indicate that activation, not blockage, of norepinephrine's actions, through α1A-AR, mediates cognitive, memory, and neuroprotective functions that may reverse the progression of neurocognitive diseases.}, }
@article {pmid41155520, year = {2025}, author = {Ribić, R}, title = {Mannose Derivatives as Anti-Infective Agents.}, journal = {International journal of molecular sciences}, volume = {26}, number = {20}, pages = {}, pmid = {41155520}, issn = {1422-0067}, support = {UNIN-BIOMED-25-1-2//University North/ ; }, mesh = {Humans ; *Anti-Infective Agents/pharmacology/chemistry ; *Mannose/pharmacology/chemistry/analogs &amp; derivatives ; Animals ; Antiviral Agents/pharmacology/chemistry ; Glycoconjugates/chemistry/pharmacology ; Biofilms/drug effects ; }, abstract = {Mannose is a natural monosaccharide that plays a central role in host-pathogen interactions and has emerged as a versatile scaffold for designing anti-infective agents. This review summarizes recent advances in mannose-based glycoconjugates with antibacterial, antiviral, antifungal, and antiparasitic activity. In bacteria, FimH antagonists prevent Escherichia coli adhesion, while mannose-functionalized materials disrupt Pseudomonas and Burkholderia biofilms or enhance delivery of anti-tubercular drugs. In virology, mannose-containing dendrimers, glycopolymers, and nanoparticles inhibit HIV, SARS-CoV-2, Ebola, HPV, and HSV by targeting viral glycoproteins or blocking lectin-mediated transmission. Mannose-decorated vaccines and nanocarriers also show promise against fungal pathogens and parasites. Continued optimization of presented structures could lead to the promising candidates for clinically applicable therapies.}, }
@article {pmid41155411, year = {2025}, author = {Caliman-Sturdza, OA and Hamamah, S and Iatcu, OC and Lobiuc, A and Bosancu, A and Covasa, M}, title = {Microbiome and Long COVID-19: Current Evidence and Insights.}, journal = {International journal of molecular sciences}, volume = {26}, number = {20}, pages = {}, pmid = {41155411}, issn = {1422-0067}, support = {760073/23.05.2023, code 285/30.11.2022, within Pillar III, Component C9, Investment 8.//Romania's National Recovery and Resilience Plan/ ; 760073/23.05.2023, code 285/30.11.2022, within Pillar III, Component C9, Investment 8.//Romania's National Recovery and Resilience Plan/ ; }, mesh = {Humans ; *COVID-19/microbiology/complications ; *Gastrointestinal Microbiome ; SARS-CoV-2 ; Dysbiosis/microbiology ; Post-Acute COVID-19 Syndrome ; Probiotics/therapeutic use ; *Microbiota ; }, abstract = {Long COVID, also referred to as post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent multi-systemic symptoms such as fatigue, cognitive impairment, and respiratory dysfunction. Accumulating evidence indicates that gut and oral microbiota play an important role in its pathogenesis. Patients with long COVID consistently exhibit reduced microbial diversity, depletion of beneficial short-chain fatty acid (SCFA)-producing species such as Faecalibacterium prausnitzii and Bifidobacterium spp. and enrichment of proinflammatory taxa including Ruminococcus gnavus, Bacteroides vulgatus, and Veillonella. These alterations may disrupt intestinal barrier integrity, sustain low-grade systemic inflammation, and influence host immune and neuroendocrine pathways through the gut-brain and gut-lung axes. Distinct microbial signatures have also been associated with symptom clusters, including neuropsychiatric, respiratory, and gastrointestinal manifestations. Proposed mechanisms linking dysbiosis to long COVID include impaired SCFA metabolism, tryptophan depletion, microbial translocation, and interactions with host immune and inflammatory responses, including autoantibody formation and viral antigen persistence. Preliminary interventional studies using probiotics, synbiotics, and fecal microbiota transplantation suggest that microbiome-targeted therapies may alleviate symptoms, although evidence remains limited and heterogeneous. This review synthesizes current literature on the role of gut and oral microbiota in long COVID, highlights emerging microbial biomarkers, and discusses therapeutic implications. While causality remains to be firmly established, restoring microbial balance represents a promising avenue for diagnosis, prevention, and management of long COVID.}, }
@article {pmid41155179, year = {2025}, author = {Refrigeri, M and Tola, A and Mogavero, R and Pietracupa, MM and Gionta, G and Scatena, R}, title = {Mechanisms of Mitochondrial Impairment by SARS-CoV-2 Proteins: A Nexus of Pathogenesis with Significant Biochemical and Clinical Implications.}, journal = {International journal of molecular sciences}, volume = {26}, number = {20}, pages = {}, pmid = {41155179}, issn = {1422-0067}, mesh = {Humans ; *Mitochondria/metabolism/virology/pathology ; *COVID-19/metabolism/virology/pathology ; *SARS-CoV-2/metabolism/pathogenicity ; Reactive Oxygen Species/metabolism ; Host-Pathogen Interactions ; Immunity, Innate ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) closely interacts with host cellular mechanisms, with mitochondria playing a crucial role in this process. As essential organelles that control cellular energy production, apoptosis, reactive oxygen species (ROS) metabolism, and innate immune responses, mitochondria are vital to the development of COVID-19. However, the exact molecular interactions between mitochondria and SARS-CoV-2 remain under active investigation. Gaining a comprehensive understanding of mitochondrial involvement in SARS-CoV-2 infection is therefore essential for uncovering complex disease mechanisms, identifying prognostic biomarkers, and developing effective treatments. Ultimately, exploring these virus-host interactions may provide new insights into the fundamental and complex aspects of mitochondrial physiology and pathophysiology.}, }
@article {pmid41154994, year = {2025}, author = {Crespo, NC and Shifflett, S and Kosta, K and Fornasier, JM and Dionicio, P and Hyde, ET and Godino, JG and Ramers, CB and Elder, JP and McDaniels-Davidson, C}, title = {Evidence of Face Masks and Masking Policies for the Prevention of SARS-CoV-2 Transmission and COVID-19 in Real-World Settings: A Systematic Literature Review.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {10}, pages = {}, pmid = {41154994}, issn = {1660-4601}, support = {S21 MD010690/MD/NIMHD NIH HHS/United States ; N/A//The Conrad Prebys Foundation/ ; }, mesh = {*Masks ; *COVID-19/prevention &amp; control/transmission/epidemiology ; Humans ; SARS-CoV-2 ; }, abstract = {Objectives: Prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease COVID-19 is a public health priority. The efficacy of non-pharmaceutical interventions such as wearing face masks to prevent SARS-CoV-2 infection has been well established in controlled settings. However, evidence for the effectiveness of face masks in preventing SARS-CoV-2 transmission within real-world settings is limited and mixed. The present systematic review evaluated the effectiveness of face mask policies and mask wearing to prevent SARS-CoV-2 transmission and COVID-19 in real-world settings. Methods: Following PRISMA guidelines, scientific databases, and gray literature, were searched through June 2023. Inclusion criteria were as follows: (1) studies/reports written in or translated to English; (2) prospectively assessed incidence of SARS-CoV-2 or COVID-19; (3) assessed the behavior and/or policy of mask-wearing; and (4) conducted in community/public settings (i.e., not laboratory). Studies were excluded if they did not parse out data specific to the effect of mask wearing (behavior and/or policy) and subsequent SARS-CoV-2 transmission or COVID-19 disease or if they relied solely on statistical models to estimate the effects of mask wearing on transmission. A total of 2616 studies were initially identified, and 470 met inclusion and exclusion criteria for full-text review. The vote counting method was used to evaluate effectiveness, and risk of bias was assessed using JBI critical appraisal tools. Results: A total of 79 unique studies met the final inclusion criteria, and their data were abstracted and evaluated. Study settings included community/neighborhood settings (n = 34, 43%), healthcare settings (n = 30, 38%), and school/universities (n = 15, 19%). A majority of studies (n = 61, 77%) provided evidence to support the effectiveness of wearing face masks and/or face mask policies to reduce the transmission of SARS-CoV-2 and/or prevention of COVID-19. Effectiveness of mask wearing did not vary substantially by study design (67-100%), type of mask (77-100%), or setting (80-91%), while 85% of masking policies specifically reported a benefit. Conclusions: This systematic literature review supports public health recommendations and policies that encourage the public to wear face masks to reduce the risk of SARS-CoV-2 infection and COVID-19 in multiple real-world settings. Effective communication strategies are needed to encourage and support the use of face masks by the general public, particularly during peak infection cycles.}, }
@article {pmid41154978, year = {2025}, author = {Shek, DTL}, title = {Mental Health of Young People in the Post-Pandemic Era: Perspective Based on Positive Psychology and Resilience.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {10}, pages = {}, pmid = {41154978}, issn = {1660-4601}, support = {ZZUE and W02W//Hong Kong Polytechnic University (ZZUE and W02W)/ ; ZH4Q//Matching Fund of the Research Grants Council (ZH4Q)/ ; }, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Mental Health ; Adolescent ; *Resilience, Psychological ; *Psychology, Positive ; Young Adult ; Pandemics ; SARS-CoV-2 ; }, abstract = {With the gradual decline in COVID-19 cases, there is a need to re-visit the mental health of adolescents and emerging adults in the post-pandemic period. Several observations can be highlighted from the scientific literature. First, while some studies suggest that mental health of young people has worsened in the post-pandemic period, there are inconsistent and conflicting findings. Second, there are more studies on psychological morbidity than on positive psychological attributes. Third, compared with the West, there are relatively fewer Chinese studies. Fourth, compared with adolescents, there are relatively fewer studies on emerging adults. Based on these observations of the existing literature, I have detailed several reflections on the mental health of young people, including enhancing positive psychological attributes in young people through positive youth development (PYD) programs, building up the individual resilience of young people, strengthening family resilience, adopting multidisciplinary, interdisciplinary and transdisciplinary approaches in understanding the mental health of young people, building more well-articulated theoretical models, charting future research directions, and developing intervention strategies in the post-pandemic period.}, }
@article {pmid41154696, year = {2025}, author = {Cañedo-Figueroa, DM and Calderón-Sandate, DN and Hernández-Castillo, J and Huerta-Garza, MJ and Hernández-Rodríguez, X and Velázquez-Cervantes, MA and Barrera-Aveleida, GB and Trujillo-Paez, JV and Lira-Hernández, FI and Marquez-Reyna, BA and León-Juárez, M and García-Herrera, AC and Osuna-Ramos, JF and De Jesús-González, LA}, title = {Natural Compounds with Antiviral Activity Against Clinically Relevant RNA Viruses: Advances of the Last Decade.}, journal = {Biomolecules}, volume = {15}, number = {10}, pages = {}, pmid = {41154696}, issn = {2218-273X}, support = {CBF-2025-I-1331//SECIHTI/ ; R-2024-785-073//Fundaci&#xf3;n IMSS/ ; }, mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *Biological Products/pharmacology/chemistry/therapeutic use ; *RNA Viruses/drug effects ; SARS-CoV-2/drug effects ; Animals ; }, abstract = {RNA viruses remain a significant public health concern due to their rapid evolution, genetic variability, and capacity to trigger recurrent epidemics and pandemics. Over the last decade, natural products have gained attention as a valuable source of antiviral candidates, offering structural diversity, accessibility, and favorable safety profiles. This review highlights key replication mechanisms of RNA viruses and their associated therapeutic targets, including RNA-dependent RNA polymerase, viral proteases, and structural proteins mediating entry and maturation. We summarize recent advances in the identification of bioactive compounds such as flavonoids, alkaloids, terpenes, lectins, and polysaccharides that exhibit inhibitory activity against clinically relevant pathogens, including the Influenza A virus (IAV), human immunodeficiency viruses (HIV), dengue virus (DENV), Zika virus (ZIKV), and Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Special emphasis is placed on the integration of in silico screening, in vitro validation, and nanotechnology-based delivery systems that address challenges of stability, bioavailability, and specificity. Furthermore, the growing role of artificial intelligence, drug repurposing strategies, and curated antiviral databases is discussed as a means to accelerate therapeutic discovery. Despite persistent limitations in clinical translation and standardization, natural products represent a promising and sustainable platform for the development of next-generation antivirals against RNA viruses.}, }
@article {pmid41154502, year = {2025}, author = {Owegie, OC and Kennedy, QP and Davizon-Castillo, P and Yang, M}, title = {Thiol Isomerases: Enzymatic Mechanisms, Models of Oxidation, and Antagonism by Galloylated Polyphenols.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {14}, number = {10}, pages = {}, pmid = {41154502}, issn = {2076-3921}, support = {R00 HL164888/HL/NHLBI NIH HHS/United States ; R00 HL177831/HL/NHLBI NIH HHS/United States ; 5R00HL164888-04/NH/NIH HHS/United States ; 1R00HL177831-01/NH/NIH HHS/United States ; }, abstract = {Thiol isomerases are a family of enzymes that participate in oxidative protein folding. They contain highly reactive vicinal thiols in a CXXC motif within their catalytic domains to mediate thiol-disulfide switching as part of their reductase, oxidase, and isomerase activity. In addition, they participate in chaperone function by binding to partially folded or misfolded proteins and preventing aggregation, thereby facilitating correct protein folding. The CXXC motif is conducive to oxidative influence based on the sulfur nucleophilicity. Redox modification of the CXXC motif may influence the enzymatic function. In this review we briefly discuss the family of thiol isomerases as it relates to thrombotic disorders. We then discuss the chemical mechanisms of making and breaking disulfides by the enzymes. Enzymatic and chemical models of oxidizing the CXXC motif are proposed. Lastly, we highlight evidence that natural galloylated polyphenols can inhibit both the coronavirus main protease Mpro and thiol isomerases, supporting a therapeutic strategy for COVID-19-associated coagulopathy and thrombosis by targeting the CXXC motif with these anti-oxidative compounds.}, }
@article {pmid41154301, year = {2025}, author = {Cianciulli, A and Santoro, E and Manente, R and Pacifico, A and Quagliarella, S and Bruno, N and Schettino, V and Boccia, G}, title = {Artificial Intelligence and Digital Technologies Against Health Misinformation: A Scoping Review of Public Health Responses.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {20}, pages = {}, pmid = {41154301}, issn = {2227-9032}, abstract = {Background/Objectives: The COVID-19 pandemic highlighted how infodemics-an excessive amount of both accurate and misleading information-undermine health responses. Artificial intelligence (AI) and digital tools have been increasingly applied to monitor, detect, and counter health misinformation online. This scoping review aims to systematically map digital and AI-based interventions, describing their applications, outcomes, ethical and equity implications, and policy frameworks. Methods: This review followed the Joanna Briggs Institute methodology and was reported according to PRISMA-ScR. The protocol was preregistered on the Open Science Framework . Searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, and CINAHL (January 2017-March 2025). Two reviewers independently screened titles/abstracts and full texts; disagreements were resolved by a third reviewer. Data extraction included study characteristics, populations, technologies, outcomes, thematic areas, and domains. Quantitative synthesis used descriptive statistics with 95% confidence intervals. Results: A total of 63 studies were included, most published between 2020 and 2024. The majority originated from the Americas (41.3%), followed by Europe (15.9%), the Western Pacific (9.5%), and other regions; 22.2% had a global scope. The most frequent thematic areas were monitoring/surveillance (54.0%) and health communication (42.9%), followed by education/training, AI/ML model development, and digital engagement tools. The domains most often addressed were applications (63.5%), responsiveness, policies/strategies, ethical concerns, and equity/accessibility. Conclusions: AI and digital tools provide significant contributions in detecting misinformation, strengthening surveillance, and promoting health literacy. However, evidence remains heterogeneous, with geographic imbalances, reliance on proxy outcomes, and limited focus on vulnerable groups. Scaling these interventions requires transparent governance, multilingual datasets, ethical safeguards, and integration into public health infrastructures.}, }
@article {pmid41153733, year = {2025}, author = {Izhari, MA and Alghamdi, F and Alodeani, EA and Salem, AA and Almontasheri, AHA and Dardari, DMM and Hadadi, MAA and Gosady, ARA and Alghamdi, WA and Alzahrani, BA and Alzahrani, BMA}, title = {Evolutionary Insight into Fatal Human Coronaviruses (hCoVs) with a Focus on Circulating SARS-CoV-2 Variants Under Monitoring (VUMs).}, journal = {Biomedicines}, volume = {13}, number = {10}, pages = {}, pmid = {41153733}, issn = {2227-9059}, abstract = {The breach of an interspecies barrier by RNA viruses has facilitated the emergence of lethal hCoVs, particularly SARS-CoV-2, resulting in significant socioeconomic setbacks and public health risks globally in recent years. Moreover, the high evolutionary plasticity of hCoVs has led to the continuous emergence of diverse variants, complicating clinical management and public health responses. Studying the evolutionary trajectory of hCoVs, which provides a molecular roadmap for understanding viruses' adaptation, tissue tropism, spread, virulence, and immune evasion, is crucial for addressing the challenges of zoonotic spillover of viruses. Tracing the evolutionary trajectory of lethal hCoVs provides essential genomic insights required for risk stratification, variant/sub-variant classification, preparedness for outbreaks and pandemics, and the identification of critical viral elements for vaccine and therapeutic development. Therefore, this review examines the evolutionary landscape of the three known lethal hCoVs, presenting a focused narrative on SARS-CoV-2 variants under monitoring (VUMs) as of May 2025. Using advanced bioinformatics approaches and data visualization, the review highlights key spike protein substitutions, particularly within the receptor-binding domain (RBD), which drive transmissibility, immune escape, and potential resistance to therapeutics. The article highlights the importance of real-time genomic surveillance and intervention strategies in mitigating emerging variant/sub-variant risks within the ongoing COVID-19 landscape.}, }
@article {pmid41153116, year = {2025}, author = {Yu, L and Chen, Z and Huang, X and Tao, X and Lv, Y}, title = {The Relationship Between Physical Activity and Mobile Phone Addiction in College Students: A Systematic Review and Meta-Analysis.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {10}, pages = {}, pmid = {41153116}, issn = {2076-328X}, support = {24YJC890065//Humanities and Social Science Fund of Ministry of Education of China/ ; }, abstract = {This study aimed to elucidate the relationship between physical activity (PA) and mobile phone addiction (MPA) in college students. Five databases (PubMed, Scopus, Embase, Web of Science, and Cochrane) were searched up to 20 January 2025. A random-effects meta-analysis was conducted to calculate combined Pearson correlation coefficients (r) with 95% confidence intervals. A total of 29 studies were included in the analysis. A significant negative correlation was found between PA and MPA (r = -0.349; p < 0.001). Subgroup analyses revealed a larger effect size in alleviating MPA after the COVID-19 pandemic (r = -0.340; p = 0.008). Additionally, PA demonstrated a large effect size in improving sleep quality (r = -0.365; p < 0.001) and reducing depression and anxiety (r = -0.356; p = 0.024). The effect of PA on self-control was moderate (r = -0.267; p < 0.001), as was its effect on procrastination (r = -0.330; p = 0.016). In contrast, the effect of PA on academic burnout was small (r = -0.141; p < 0.001). In conclusion, increasing PA may reduce MPA by alleviating depression and anxiety and enhancing self-control. PA's benefits for MPA extend to improving sleep quality and reducing academic burnout and procrastination.}, }
@article {pmid41153104, year = {2025}, author = {Meng, J and Suárez, L and Yip, CCE and Marsh, NV}, title = {White-Collar Workers in the Post-Pandemic Era: A Review of Risk and Protective Factors for Mental Well-Being.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {10}, pages = {}, pmid = {41153104}, issn = {2076-328X}, abstract = {This narrative literature review aims to explore the risk and protective factors influencing the mental well-being of white-collar workers in the post-pandemic era. It investigates how factors vary across different phases, including pre-pandemic traditional work models, work-from-home or hybrid models during the pandemic, and the recovery phase of returning to the office in the post-pandemic era. This review highlights the diverse nature of related factors, examining constructs including stress, depression, burnout, thriving, work engagement, workaholism, motivation, workplace civility, and resilience. The Job Demands-Resources model, a recognized theoretical tool for analyzing and understanding the interactions between psychological constructs and their effects on employee well-being and turnover intention, is proposed as a useful framework to consider the relationships between the factors. By synthesizing existing research findings, this review contributes to our understanding of the complex interplay between work-related factors and employee well-being in the evolving landscape of the post-pandemic world. Understanding these dynamics is crucial for developing effective strategies to support white-collar workers' mental well-being and productivity in the post-pandemic era.}, }
@article {pmid41152952, year = {2025}, author = {Iezadi, S and Kolivand, P and Namdar, P and Saberian, P and Gholipour, K and Azari, S}, title = {Racial and ethnic disparities in COVID-19 vaccination: a systematic review and meta-analysis.}, journal = {Archives of public health = Archives belges de sante publique}, volume = {83}, number = {1}, pages = {261}, pmid = {41152952}, issn = {0778-7367}, support = {IR.RCREC.1403.056//Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran/ ; }, abstract = {BACKGROUND: This study aimed to systematically review and synthesize the evidence on the relationship between race/ethnicity and COVID-19 vaccine uptake in the general population.<br><br>METHODS: A comprehensive search of relevant electronic databases was conducted in May 2024 and updated in December 2024. Original research studies comparing COVID-19 vaccine uptake or vaccination rates in racial and ethnic minority populations with those of non-Hispanic White populations were eligible for inclusion. A descriptive synthesis of findings was presented in both narrative and tabular formats. Bayesian random-effects meta-analysis was performed to estimate pooled adjusted relative risk ratios (RRs) and their 95% credible intervals (CrIs) for COVID-19 vaccine uptake across racial and ethnic groups. Posterior distributions were also examined to explore patterns of disparities.<br><br>RESULTS: A total of 30 studies (21 cross-sectional and 9 cohort) were included in the systematic review, of which 10 studies were eligible for meta-analysis. Most studies were conducted in the United States and the United Kingdom. The majority of the studies reported that racial and ethnic minority groups, including Black, Hispanic, and Other/Mixed racial groups, had lower COVID-19 vaccination rates compared to White populations. Meta-analysis results showed that Black individuals were 13% less likely to be vaccinated (RR: 0.87, 95% CrI: 0.81-0.93), and those of Mixed race were 7% less likely (RR: 0.93, 95% CrI: 0.90-0.97), compared to White individuals. For single-dose uptake, Black individuals were 16% less likely to be vaccinated than White individuals (RR: 0.84, 95% CrI: 0.76-0.92), representing the lowest pooled RR among all groups. Posterior distributions confirmed consistent disparities in vaccine uptake for Black and Mixed race populations across dose categories.<br><br>CONCLUSION: Most of the studies reported that racial and ethnic minority groups had lower rates of COVID-19 vaccination compared to White populations. Bayesian effect estimates reinforced these disparities for Black and Mixed race minority groups. While no significant differences were found for Asian, Hispanic, and Other race groups, wide credible intervals in some subgroups suggest the need for further research to explore potential contextual and regional variations not captured in the studies.}, }
@article {pmid41152945, year = {2025}, author = {Ojukwu, E and Pashaei, A and Maia, JC and Omobhude, OF and Tawfik, A and Nguyen, Y}, title = {Evaluating the impact of COVID-19 on the HIV care continuum across global income levels: a mixed-methods systematic review.}, journal = {AIDS research and therapy}, volume = {22}, number = {1}, pages = {115}, pmid = {41152945}, issn = {1742-6405}, mesh = {Humans ; *COVID-19/epidemiology ; *HIV Infections/drug therapy/diagnosis/prevention &amp; control/epidemiology/therapy ; *Continuity of Patient Care ; Income ; Global Health ; SARS-CoV-2 ; Anti-HIV Agents/therapeutic use ; Delivery of Health Care ; Health Services Accessibility ; }, abstract = {BACKGROUND: The COVID-19 pandemic caused significant disruptions to global healthcare systems, including essential services along the HIV care continuum (HCC). While several studies have examined these impacts in specific countries or populations, limited evidence exists on cross-country differences in service disruptions, barriers, and facilitators stratified by national income levels.<br><br>METHODS: We conducted a mixed-methods systematic review following the Joanna Briggs Institute methodology and PRISMA 2020 guidelines. We searched CINAHL, MEDLINE, Embase, and CAB Direct for quantitative and qualitative studies published between March 2020 and January 2024. Eligible studies assessed the pandemic's impact on one or more stages of the HIV care continuum, including prevention, testing, linkage to care, treatment engagement, antiretroviral therapy (ART) adherence, and viral suppression. Data were extracted, appraised, and synthesized using a convergent integrated approach across low-, middle-, and high-income countries as defined by the World Bank.<br><br>RESULTS: A total of 200 studies were included. The most frequently disrupted services were HIV testing, prevention (including pre-exposure prophylaxis [PrEP] use), and medical appointments, particularly in high- and middle-income countries. ART adherence and viral suppression showed greater resilience across all settings. Structural barriers, such as lockdowns, healthcare repurposing, and transportation limitations, were widespread, while digital exclusion, stigma, and socioeconomic inequities disproportionately affected marginalized populations. Key facilitators included telemedicine, multi-month dispensing of ART and PrEP, community-based service delivery, and national-level adaptations. The extent of disruption and success of mitigation strategies varied by income level, reflecting differences in health system preparedness and flexibility.<br><br>CONCLUSIONS: The COVID-19 pandemic disrupted HIV care globally, with variation across income levels and care continuum stages. Health system resilience, equity in access, and pre-existing adaptive infrastructure significantly shaped outcomes. Findings highlight the need to institutionalize flexible, decentralized, and equity-informed service models to strengthen routine HIV care and pandemic preparedness.}, }
@article {pmid41152193, year = {2025}, author = {Sonmez, G and Gunduz, G and Esenboga, S and Cagdas, D}, title = {Lessons From COVID-19 on Inborn Errors of Immunity: A Five-Year Narrative Review.}, journal = {Scandinavian journal of immunology}, volume = {102}, number = {5}, pages = {e70064}, doi = {10.1111/sji.70064}, pmid = {41152193}, issn = {1365-3083}, mesh = {Humans ; *COVID-19/immunology/therapy ; *SARS-CoV-2/immunology/physiology ; Angiotensin-Converting Enzyme 2/immunology ; Immune Evasion ; Cytokine Release Syndrome/immunology ; }, abstract = {COVID-19 research now provides a coherent picture of the virus's immunological impacts, highlighting immune-evasion mechanisms, the particular vulnerabilities of patients with inborn errors of immunity (IEI), and evolving therapeutics for severe disease. SARS-CoV-2 exploits ACE2 for cell entry and can utilise CD147 to infect immune cells, undermining antiviral defences; recent work details cytokine storm biology, NLRP3 inflammasome activation, and suppression of type I interferon responses. IEI patients are disproportionately affected, often with severe, prolonged courses and persistent PCR positivity. Therapeutic approaches such as convalescent plasma, anti-cytokine agents interferon alpha-2b, and plasma exchange show variable effectiveness, while vaccine performance is challenged by ongoing viral evolution. Together, these insights underscore the need for tailored treatment strategies for IEI populations, vigilant monitoring for immune-escape variants, and continuous adaptation of therapeutic and preventive measures. The aim of this review is to synthesise these findings, evaluate their implications for clinical management, and highlight future directions for research and patient care.}, }
@article {pmid41151241, year = {2025}, author = {Raijmakers, RPH and Lund Berven, L and Keijmel, SP and Rodrigo, C and Wyller, VBB and Katz, BZ and Buchwald, D and Evans, RA and Gérardin, P and Knoop, H and Prins, M and Stavem, K and Stiansen-Sonerud, T and Taylor, R and Valencia Arroyo, BM and Wensaas, KA and Selvakumar, JP and van den Wijngaard, C and Lloyd, AR and Sandler, CX}, title = {Immunological associations in post-infective fatigue syndromes including Long COVID-a systematic review and meta-analysis.}, journal = {EBioMedicine}, volume = {121}, number = {}, pages = {105970}, pmid = {41151241}, issn = {2352-3964}, support = {R01 AI105781/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/immunology ; SARS-CoV-2 ; Biomarkers ; *Fatigue/immunology/etiology ; }, abstract = {BACKGROUND: The pathophysiology of post-infective fatigue syndromes (PIFS), including Long COVID, is unknown. This systematic review and meta-analysis aimed to investigate if PIFS is associated with persistent immune activation.<br><br>METHODS: PubMed, EMBASE, and Web of Science were searched for terms related to infection, fatigue, persistent symptoms, and immunological markers.<br><br>POPULATION: adults and adolescents; Exposure: documented acute infection; Comparator: those who developed PIFS vs. recovered controls from the same exposure; and Outcomes: immunological biomarkers. Studies which documented acute infection, applied diagnostic criteria for PIFS, and assayed circulating immunologic markers were eligible.<br><br>FINDINGS: From 14,985 studies screened, 30 articles were included (n = 5102 participants; 833 PIFS/PIFS-like cases, n = 4269 recovered control participants) with many studies excluded by inadequate quality in eligibility criteria. The meta-analysis (11 studies; n = 413 PIFS cases, analysed with random-effects models) showed PIFS cases had increased: white cell counts at 3-6 months (Cohen's d: 0.41, 95% CI 0.09-0.74); and circulating levels of RANTES and TNF&#x3b1; at 6-12 months (Cohen's d: 0.45 [95% CI 0.16-0.73] and 0.30 [95% CI 0.04-0.57], respectively) compared to controls recovered from the same exposure.<br><br>INTERPRETATION: These findings provide cautious support for persistent immune activation in PIFS, but warrant further replication. Future studies should include better documentation of acute infection and PIFS case characterisation.<br><br>FUNDING: ARL is supported by a National Health and Medical Research Council Practitioner Fellowship (Grant 1041897). CXS is supported by a Cancer Institute New South Wales Early Career Fellowship (2021/ECF1310). BZK is supported by the National Institute of Allergy and Infectious Diseases (AI 105781). RAE is supported by the National Institute for Health and Care.}, }
@article {pmid41150959, year = {2025}, author = {Barrientos-Gutiérrez, T and Hernández-Rivas, L and López-Martínez, I and Gabastou, JM and Alomía-Zegarra, JL and Hernández-Ávila, JE and Palacio-Mejía, LS and Zaragoza, C and Cortés-Alcalá, R and Lanz-Mendoza, H and Garza-Ramos, U and López-Santiago, YF and Peralta-Benítez, A and Espinosa-Badillo, T and Alpuche-Aranda, CM}, title = {[Not Available].}, journal = {Salud publica de Mexico}, volume = {67}, number = {4, jul-ago}, pages = {369-380}, doi = {10.21149/16607}, pmid = {41150959}, issn = {1606-7916}, mesh = {Humans ; *Pandemics/prevention &amp; control ; *Epidemiological Monitoring ; *Information Systems/organization &amp; administration ; COVID-19/epidemiology ; }, abstract = {Los sistemas de vigilancia epidemiológica y monitoreo, incluyendo la función de los laboratorios, son esenciales para detectar tempranamente una enfermedad emergente con potencial pandémico y responder adecuadamente ante una crisis sanitaria de interés nacional o internacional potencial o declarada. Por lo tanto, la fortaleza de la estructura y operación de estos sistemas requieren que funcionen con alto desempeño y calidad de manera rutinaria durante estabilidad sanitaria, nutriendo con información en tiempo y forma al sistema de salud para garantizar la orientación adecuada de los programas de prevención y control y, de esta manera, la detección oportuna y atención adecuada de una pandemia. Los planes de preparación y respuesta ante crisis de salud pública, como es el caso de enfermedades emergentes con potencial pandémico o ante pandemias declaradas, requieren sistemas de vigilancia, monitoreo e información con la suficiente flexibilidad para adaptarse y expandirse de acuerdo con las necesidades. Entre otros, se requiere vincular los modelos de vigilancia establecidos con nuevos modelos que permitan la caracterización y aportar detalles de la situación de emergencia de manera dinámica, ya que la información es necesaria para realizar el análisis de riesgo inicial y continuo que debe orientar las acciones de respuesta y recuperación. En este manuscrito se presenta la revisión, análisis y actualización de un ejercicio previo realizado en 2022, donde se delinearon las estrategias y acciones requeridas, así como los hitos esperables derivados de cada una de ellas.}, }
@article {pmid41150446, year = {2025}, author = {Wassilak, SGF and Mohamed, A and Bigouette, JP}, title = {Impediments to Progress Toward Polio Eradication During 2014-2024: Effectively Addressing the Current Challenges.}, journal = {Vaccines}, volume = {13}, number = {10}, pages = {}, pmid = {41150446}, issn = {2076-393X}, abstract = {When the Global Polio Eradication Initiative (GPEI) began in 1988, the year 2000 target was clearly ambitious. Nonetheless, among 20 countries with endemic wild poliovirus transmission in 2000, only Afghanistan, Nigeria and Pakistan remained endemic in 2014; successful global eradication was anticipated within years. Transmission was interrupted in Nigeria after implementing innovative activities; unfortunately, transmission in Afghanistan and Pakistan has continued into 2025. An additional challenge has been controlling outbreaks and interrupting persistent transmission of circulating vaccine-derived poliovirus type 2 detected after global withdrawal of the use of Sabin strain type 2 oral poliovirus vaccine. The impediments to progress since 2014 are detailed and the challenges that the GPEI must successfully mitigate are reviewed herein. Primary challenges since the acute phase of the COVID-19 pandemic include the loss of a sense of urgency and political will/national ownership in stopping poliovirus transmission, lower childhood routine immunization coverage and the decreased quality of outbreak response campaigns. These facets need to be strengthened. Ongoing security challenges require continued vigilance in affected areas of wild poliovirus-endemic countries as well as in countries with persistent transmission of vaccine-derived poliovirus. Eradication can be achieved if the multiple challenges mentioned are urgently and more effectively mitigated. Decreased funding for the GPEI in 2025 represents the primary, acute challenge that, if not urgently addressed, may allow for the reversal of all progress to date.}, }
@article {pmid41150445, year = {2025}, author = {Mansilla, C and Kamlongera, A and Dadari, I}, title = {Gender Barriers to Immunization: A Synthesis of UNICEF's Analyses to Advance Equity and Coverage.}, journal = {Vaccines}, volume = {13}, number = {10}, pages = {}, pmid = {41150445}, issn = {2076-393X}, support = {Not applicable//UNICEF/ ; }, abstract = {BACKGROUND/OBJECTIVES: Despite global efforts to improve childhood immunization rates, gender-related barriers continue to hinder equitable access to vaccines worldwide. This study synthesizes gender barrier analyses conducted in various countries to better understand these challenges. This evidence synthesis aims to (1) identify the main gender-related barriers affecting immunization focusing on zero-dose targets, HPV, and COVID-19 vaccination campaigns; and (2) summarize key recommendations and lessons that have emerged from countries to overcome those gender barriers.<br><br>METHODS: A documentary analysis was used by reviewing data from gender barrier analyses that were conducted by multiple governments with UNICEF support. The study classified barriers using the socio-ecological model (SEM), encompassing systemic, health service, community, household, and individual-level gender barriers. Descriptive statistics and inductive thematic coding were used to analyze data.<br><br>RESULTS: This synthesis includes 24 documents representing gender barrier analyses across 29 countries. Findings highlight multiple barriers, including systemic discrimination against women in public and healthcare spaces, limited political will to address gender disparities, and limited (sex)-disaggregated and gender data. At the community and household levels, social norms restrict women's autonomy in seeking immunization services, while household duties (culturally assigned to women) also restrict their access to immunization services. Adolescents face additional challenges, particularly regarding HPV vaccination, due to misconceptions and stigma from families and peers.<br><br>CONCLUSIONS: Addressing gender-related barriers requires a multi-level approach, integrating gender-responsive policies, and comprehensively addressing gender barriers that are hindering the progress of vaccination efforts. UNICEF's commitment to gender-responsive immunization strategies is critical for achieving the Immunization Agenda 2030 and ensuring equitable vaccine access for all.}, }
@article {pmid41150393, year = {2025}, author = {Al Ghafri, T and Al Balushi, L and Al Balushi, Z and Al Kiyumi, L and Bait Ishaq, A and Al Harthi, J}, title = {The Experience of an Accelerated COVID-19 Immunization Campaign in Oman: A Review Within the WHO Health System Building Blocks Framework.}, journal = {Vaccines}, volume = {13}, number = {10}, pages = {}, pmid = {41150393}, issn = {2076-393X}, abstract = {Oman launched its COVID-19 vaccination campaign in December 2020, navigating significant public health challenges with resilience and adaptability. The country faced global vaccine shortages, community hesitancy to receive the vaccine, and diverse sociocultural and infrastructural obstacles. Despite these issues, Oman scaled up its COVID-19 vaccination efforts, administering over 7 million doses, covering approximately 71% of the population by mid-2022. The campaign, which operated through more than 44 vaccination centers nationwide, exemplified rapid vaccine implementation, strategic prioritization, and a coordinated pandemic response. This study examined the field experience of Oman's accelerated COVID-19 mass vaccination campaign through the World Health Organization's Health System Building Blocks framework. The key domains addressed included (1) multi-sectoral collaboration underpinned by strong governance structures; (2) the role of primary healthcare facilities as essential first responders during health crises, and safe handling of vaccination procedures; (3) transparency and active community engagement, particularly through local leaders and social media, to address vaccine hesitancy; (4) the integration of digital health information systems to ensure unified and efficient data management; (5) building a resilient healthcare workforce by enhancing vaccination capacity and mental health support; and (6) the importance of financial alternatives. Additionally, the critical role of global and regional partnerships in vaccine production and distribution was highlighted. Drawing on Oman's experience, this descriptive review offers context-specific lessons for enhancing health system preparedness and guiding effective responses to public health emergencies.}, }
@article {pmid41150384, year = {2025}, author = {Hazan, A and Lee, HY and Tiong, V and AbuBakar, S}, title = {Bacillus subtilis Spores as a Vaccine Delivery Platform: A Tool for Resilient Health Defense in Low- and Middle-Income Countries.}, journal = {Vaccines}, volume = {13}, number = {10}, pages = {}, pmid = {41150384}, issn = {2076-393X}, support = {GA002-2021//Ministry of Science, Technology and Innovation/ ; }, abstract = {The COVID-19 pandemic exposed the urgent need for innovative tools to strengthen pandemic preparedness and health defense, especially in low- and middle-income countries (LMICs). While vaccination has been the cornerstone of the defense strategy against many infectious agents, there is a critical gap in vaccine equity, ensuring it is accessible to all, especially among the most vulnerable populations. The conventional vaccine delivery platforms, through parenteral administration, face notable limitations, including reliance on trained personnel, sterile conditions, and cold chain logistics. The parenteral vaccines often fail to induce robust mucosal immunity, which is critical for preventing infections at mucosal surfaces, the primary entry point for many pathogens. Bacillus subtilis, a Gram-positive, spore-forming bacterium, has emerged as a promising platform for mucosal vaccine delivery owing to its Generally Recognized as Safe (GRAS) status. Its robust spores are highly resilient to harsh environmental conditions, which may eliminate the need for cold chain storage and further facilitate distribution in LMICs. This review explores the potential of B. subtilis as a next-generation vaccine delivery platform, focusing on its unique characteristics, mechanisms of action, and applications in addressing global health challenges. This review also examines existing research demonstrating the safety, immunogenicity, and efficacy of B. subtilis spore-based vaccines while identifying limitations and future directions for optimization as a scalable and adaptable solution for resilient health defense, particularly in LMICs.}, }
@article {pmid41149852, year = {2025}, author = {Nasiri, A and Alshammari, M and Alqahtani, R and Alshaer, O and Alsolamy, E and Alghethber, H and Alkharras, R}, title = {Next-Generation Anticoagulants: Precision Strategies for Patient-Centered Thromboprophylaxis.}, journal = {Journal of personalized medicine}, volume = {15}, number = {10}, pages = {}, pmid = {41149852}, issn = {2075-4426}, abstract = {Thrombosis remains a leading preventable cause of global morbidity and mortality, with conditions like venous thromboembolism and atrial fibrillation affecting millions worldwide. Traditional anticoagulants (heparins, vitamin K antagonists) require careful monitoring due to narrow therapeutic windows. Direct oral anticoagulants (DOACs) greatly improved convenience and reduced certain hemorrhagic complications (notably intracranial hemorrhage) compared to warfarin, but bleeding, drug-drug interactions, and unmet needs in special populations persist. This review highlights emerging strategies to decouple antithrombotic efficacy from bleeding risk. Novel agents targeting factor XI or XII (small molecules, antibodies, antisense oligonucleotides) have shown in early trials robust thromboembolism prevention with low bleeding. Advances in pharmacogenomics, biomarker-guided dosing, artificial intelligence risk prediction, and digital monitoring promise to personalize therapy. We discuss optimized approaches for high-risk subgroups (cancer-associated thrombosis, extremes of body weight, renal/hepatic dysfunction, pregnancy, perioperative care, and COVID-19) with citations to current evidence. Finally, we outline critical systems-level considerations, including drug accessibility, cost-effectiveness, and educational strategies, that are necessary to realize precision anticoagulation. Our synthesis is grounded in recent peer-reviewed literature and emphasizes innovations likely to improve safety and efficacy of thromboprophylaxis.}, }
@article {pmid41149312, year = {2025}, author = {Zhou, Z and Cho, IH and Kadam, US}, title = {CRISPR-Cas-Based Diagnostics in Biomedicine: Principles, Applications, and Future Trajectories.}, journal = {Biosensors}, volume = {15}, number = {10}, pages = {}, pmid = {41149312}, issn = {2079-6374}, mesh = {*CRISPR-Cas Systems ; Humans ; *Biosensing Techniques ; }, abstract = {CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats)-Cas (CRISPR-associated) systems, originally identified as prokaryotic adaptive immune mechanisms, have rapidly evolved into powerful tools for molecular diagnostics. Leveraging their precise nucleic acid targeting capabilities, CRISPR diagnostics offer rapid, sensitive, and specific detection solutions for a wide array of targets. This review delves into the fundamental principles of various Cas proteins (e.g., Cas9, Cas12a, Cas13a) and their distinct mechanisms of action (cis- and trans-cleavage). It highlights the diverse applications spanning infectious disease surveillance, cancer biomarker detection, and genetic disorder screening, emphasizing key advantages such as speed, high sensitivity, specificity, portability, and cost-effectiveness, particularly for point-of-care (POC) testing in resource-limited settings. The report also addresses current challenges, including sensitivity limitations without pre-amplification, specificity issues, and complex sample preparation, while exploring promising future trajectories like the integration of artificial intelligence (AI) and the development of universal diagnostic platforms to enhance clinical translation.}, }
@article {pmid41149067, year = {2025}, author = {Mara, G and Nini, G and Frent, SM and Lascu, A and Mot, MD and Boru, C and Cotoraci, C}, title = {Thrombophilic Changes and Hematological Complications in Asthmatic Patients with COVID-19: A Systematic Review.}, journal = {Diseases (Basel, Switzerland)}, volume = {13}, number = {10}, pages = {}, pmid = {41149067}, issn = {2079-9721}, abstract = {Background/Objectives: The interplay between asthma and COVID-19 raises critical clinical questions, particularly regarding the risk of hematological complications in patients affected by both conditions. While COVID-19 is known to cause coagulopathy and thromboembolic events, it remains unclear whether asthma independently influences these risks. This systematic review aimed to synthesize existing evidence on hematological abnormalities-including D-dimer elevation, thrombocytopenia, and venous thromboembolism (VTE)-in asthmatic patients with confirmed SARS-CoV-2 infection. Methods: A systematic search was conducted in PubMed and Web of Science databases for studies published between January 2020 and May 2025. Inclusion criteria were studies reporting hematologic outcomes in asthmatic patients with COVID-19. After duplicate removal, 139 unique articles were screened, with 40 studies meeting inclusion criteria. These included observational cohorts, retrospective analyses, and clinical investigations. Data were synthesized in a systematic review with qualitative synthesis due to heterogeneity in design and reporting. Results: The review identified variable patterns of D-dimer elevation and thrombotic events among asthmatic COVID-19 patients. Some studies reported a higher incidence of ICU admission, elevated inflammatory and coagulation markers, and increased thromboembolic risk in asthmatic individuals-particularly those with poor disease control or non-allergic phenotypes. However, findings were inconsistent and often limited by the absence of asthma stratification, standardized outcome measures, and prospective designs. Conclusions: Current evidence does not support a definitive link between asthma and increased thrombotic risk in COVID-19. Further research with prospective, phenotype-stratified methodologies and harmonized hematologic endpoints is needed to clarify whether asthma modifies the hematologic trajectory of SARS-CoV-2 infection.}, }
@article {pmid41148380, year = {2025}, author = {Pal, S and Dutta Gupta, S and Guha, PS and Saha, N}, title = {Microplastics as emerging stressors in plants: biochemical and metabolic responses.}, journal = {Environmental geochemistry and health}, volume = {47}, number = {12}, pages = {530}, pmid = {41148380}, issn = {1573-2983}, mesh = {*Microplastics/toxicity/metabolism ; *Plants/metabolism/drug effects ; *Soil Pollutants/toxicity/metabolism ; COVID-19 ; }, abstract = {Plastics have become an integral part of modern life, driving global production to a new level and contributing to widespread environmental pollution due to inadequate recycling and waste management systems. The COVID-19 pandemic exacerbated this crisis by increasing the use of single-use plastics, countering earlier attempts to reduce plastic use. A critical concern with plastic pollution is its progressive degradation into microplastics (MPs) and nanoplastics (NPs), which can disperse through air, water, and soil and reach every part of ecosystems. The application of sewage sludge, the breakdown of plastic mulch, and wastewater irrigation have made agricultural soils into important MP sinks, with grave consequences for soil health and food safety. MPs and NPs in particular present significant concerns because of their tiny size, high mobility, and capacity to interact with pollutants in the soil, enter plant tissues, and interfere with metabolic, physiological, and biochemical processes. Recent studies have highlighted their uptake in diverse crops, demonstrating oxidative stress, impaired growth, and significant metabolic reprogramming. This review critically examines the pathways of microplastic uptake and transport in plants, resulting in physiological and biochemical alterations, and the underlying metabolic responses. Microplastics are found to interfere with soil microbes and nutrient cycling, as well as plant metabolism. It is essential to comprehend these changes using multi-omics techniques in order to create resilient crops and successful mitigation plans. By identifying current knowledge gaps, it outlines future research directions to deepen our understanding of plant-microplastic interactions and their broader consequences for agriculture and ecosystem sustainability.}, }
@article {pmid41147682, year = {2025}, author = {Yuan, L and Wang, B and Huang, YW}, title = {Regulation of Apoptosis and PANoptosis by Coronavirus: An Overview.}, journal = {Journal of medical virology}, volume = {97}, number = {11}, pages = {e70672}, doi = {10.1002/jmv.70672}, pmid = {41147682}, issn = {1096-9071}, support = {//This study was supported by the Guangdong Basic and Applied Basic Research Foundation (2022A1515110346) and (2023A1515012221), the Laboratory of Lingnan Modern Agriculture Project (NG2022001), and the specific university discipline construction project (2023B10564003)./ ; }, mesh = {Humans ; *Apoptosis ; Animals ; SARS-CoV-2/pathogenicity ; Virus Replication ; COVID-19/virology ; Signal Transduction ; *Coronavirus/pathogenicity/physiology ; }, abstract = {Coronaviruses are a class of RNA viruses that cause disease in animals and humans. Zoonotic coronaviruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2, can cross species barriers and cause high mortality rates in humans. Coronavirus infection can cause different forms of cell death, among which apoptosis is the earliest and most systematic cell death. PANoptosis is a newly discovered inflammatory programmed cell death regulated by the supramolecular complex known as the PANoptosome. The cell death not only eliminates virus-infected cells but also further promotes innate and adaptive immune processes. Recent studies have shown that the important signaling pathways of apoptosis and PANoptosis induced by coronavirus infection are closely cross-linked, which plays a key role in regulating the replication and pathogenicity of coronavirus. In this review, we first revisit the molecular biology and the replication cycle of coronaviruses, summarize the definitions and characteristics of apoptosis and PANoptosis, and then focus on the current mechanisms of coronavirus-induced apoptosis and PANoptosis, as well as the regulatory mechanisms of these pathways for coronaviruses. We are exploring the detailed molecular mechanism between multiple programmed cell death pathways to provide new ideas for the pathogenic mechanism and drug development of coronavirus.}, }
@article {pmid41147546, year = {2025}, author = {Tatz, GS and Ochodo, EA and Fox, T and Owino, EJ and Nyagol, B and Rupali, P and McCaul, M and Kredo, T and Cohen, K}, title = {Molnupiravir for treating COVID-19.}, journal = {The Cochrane database of systematic reviews}, volume = {10}, number = {10}, pages = {CD015381}, pmid = {41147546}, issn = {1469-493X}, mesh = {Humans ; Randomized Controlled Trials as Topic ; *Cytidine/analogs &amp; derivatives/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/adverse effects ; *Hydroxylamines/therapeutic use/adverse effects/administration &amp; dosage ; COVID-19/mortality ; SARS-CoV-2 ; Hospitalization/statistics &amp; numerical data ; Morpholines ; }, abstract = {RATIONALE: Five years from the start of the COVID-19 pandemic, morbidity and mortality have subsided. Vaccines have contributed to reducing the risk of infection and severe disease. However, new COVID-19 variants continue to emerge, and the role of oral antivirals such as molnupiravir in preventing progression of disease or hospitalisation must be assessed.<br><br>OBJECTIVES: To assess the effects of molnupiravir in people with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mild to moderate symptoms.<br><br>SEARCH METHODS: We identified all relevant randomised controlled trials (RCTs) by searching the Cochrane COVID-19 Study Register, Science Citation Index Expanded, the World Health Organization (WHO) Global Literature on Coronavirus Disease database, and the COVID Network Meta-Analysis database with no language restrictions up to 26 April 2024.<br><br>ELIGIBILITY CRITERIA: We considered full-text articles, preprints, abstracts, trial registry records, and reports of ongoing trials. Cluster-RCTs were eligible for inclusion, but cross-over trials were ineligible. Participants had confirmed SARS-CoV-2 infection with or without risk factors for severe disease. The intervention was molnupiravir 800 mg taken orally every 12 hours for five days, and control was no treatment, placebo, or standard of care, as defined by the study authors. We excluded studies comparing molnupiravir with treatment strategies that included molnupiravir.<br><br>OUTCOMES: Our critical outcomes were all-cause mortality and hospitalisation. Our important outcomes were change in clinical status, viral clearance, quality of life, adverse events, and serious adverse events.<br><br>RISK OF BIAS: Two review authors independently assessed the risk of bias in each included study using the Cochrane risk of bias tool (RoB 2). Disagreements were resolved through discussion.<br><br>SYNTHESIS METHODS: We conducted a meta-analysis where two or more studies with reasonably similar clinical and methodological characteristics reported the same outcome. We used data from intention-to-treat analysis where available. We analysed all outcomes at the participant level using the generic inverse variance method, applying a random-effects model. We used the GRADE approach to assess the certainty of evidence.<br><br>INCLUDED STUDIES: This review included 11 studies (31,272 participants). Eight studies recruited outpatients and three recruited inpatients. We did not meta-analyse inpatient studies, as characteristics varied widely. All outpatient studies included participants with mild to moderate COVID-19, with a mean age ranging from 35 years to 57 years and variable prevalences of comorbidities and COVID-19 vaccination. We excluded suboptimal molnupiravir dosing arms in four outpatient studies and one inpatient study.<br><br>SYNTHESIS OF RESULTS: Outpatients Molnupiravir compared to placebo or usual care probably results in little to no difference in all-cause mortality at 28 to 30 days (risk ratio (RR) 0.17, 95% confidence interval (CI) 0.04 to 0.65; 7 RCTs, 29,238 participants; moderate-certainty evidence). The absolute reduction in mortality is nine fewer deaths per 10,000 people treated (95% CI 10 fewer to four fewer per 10,000), which we consider clinically insignificant. Molnupiravir may result in little to no difference in hospitalisation (RR 0.70, 95% CI 0.43 to 1.12; 6 RCTs, 29,228 participants; low-certainty evidence), symptom resolution by day 14 (RR 1.20, 95% CI 0.84 to 1.71; 3 RCTs, 22,400 participants; low-certainty evidence), and symptom resolution by day 28 (RR 1.06, 95% CI 0.89 to 1.26; 3 RCTs, 24,728 participants; low-certainty evidence). Four studies reported viral clearance by day 5, which was higher in people receiving molnupiravir compared with those receiving placebo or usual care (RR 3.40, 95% CI 2.15 to 5.36; 3067 participants). The effect size decreased by day 10 (RR 1.58, 95% CI 1.07 to 2.34; 2 RCTs, 2438 participants) and indicated little to no difference between molnupiravir and control by day 14 to 15 (RR 1.05, 95% CI 0.98 to 1.13; 4 RCTs, 3062 participants). The results at day 28 to 30 again showed higher virus clearance in the molnupiravir arm (RR 1.11, 95% CI 1.03 to 1.19; 3 RCTs, 397 participants), although there were few participants in this analysis. Molnupiravir probably results in little to no difference in adverse events (RR 1.00, 95% CI 0.87 to 1.15; 7 RCTs, 4304 participants; moderate-certainty evidence). Molnupiravir results in little to no difference in serious adverse events (RR 0.86, 95% CI 0.62 to 1.21; 8 RCTs, 30,009 participants; high-certainty evidence). Inpatients The effect of molnupiravir in inpatients is unclear; substantial heterogeneity precluded meta-analysis. Risk of bias and certainty of the evidence We assigned high risk of bias judgements to one of seven RCTs for all-cause mortality, one of six RCTs for hospitalisation, two of three RCTs for symptom resolution at 14 days and 28 days, three of seven RCTs for adverse events, and three of eight RCTs for serious adverse events. We downgraded the certainty of the evidence for serious indirectness as well as risk of bias, as the populations across trials differed by vaccination status. There was no serious imprecision identified for any outcome. Publication bias is likely high in this review, as we identified 16 unpublished trials. Six were listed as complete, but only one had available data.<br><br>AUTHORS' CONCLUSIONS: In outpatients with mild to moderate COVID-19, molnupiravir 800 mg taken orally every 12 hours for five days probably results in little to no difference in all-cause mortality and may result in little to no difference in rates of hospitalisation and symptom resolution. There is evidence of increased viral clearance by day 5, but the clinical relevance of this finding is unclear. There is probably little to no difference in adverse events, and there is little to no difference in serious adverse events, with molnupiravir versus placebo or standard care. Inpatient data are lacking, and there is no evidence of benefit of molnupiravir in this population. Further research involving inpatients may change this.<br><br>FUNDING: The editorial base of the Cochrane Infectious Diseases Group is funded by UK aid from the UK Government for the benefit of low- and middle-income countries (project number 300342-104). The views expressed herein do not necessarily reflect the UK Government's official policies.<br><br>REGISTRATION: Protocol available at https://doi.org/10.1002/14651858.CD015381.}, }
@article {pmid41146789, year = {2025}, author = {Dudek, A and Bursy, M and Szkudlarek, W and Linkiewicz, J and Fabiszewski, Z and Starosta, P}, title = {Chronic Cardiovascular Disorders Associated With COVID-19: A Literature Review.}, journal = {Cureus}, volume = {17}, number = {9}, pages = {e93271}, pmid = {41146789}, issn = {2168-8184}, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the COVID-19 pandemic, is now widely recognized for causing several long-term effects known as post-COVID-19 syndrome (PCS) or long COVID (LC). This presents a growing challenge for healthcare systems worldwide. This narrative review summarizes original peer-reviewed studies indexed in PubMed and published between January 2020 and August 2025. It focuses on adult populations unless stated otherwise. We included studies that provided primary clinical or imaging data on chronic cardiovascular outcomes after confirmed SARS-CoV-2 infection. We excluded case reports, pediatric-only cohorts, and non-peer-reviewed sources. Among the various cardiovascular issues related to LC, we focused on heart fibrosis (HF), postural orthostatic tachycardia syndrome (POTS), new-onset hypertension (HT), and coagulopathy. These conditions consistently show up in the reports and are significant in terms of illness, potential long-term disability, and public health impact. Although these issues are distinct in their underlying causes, they share common mechanisms. These include ongoing inflammation of the endothelium, disruption of the renin-angiotensin-aldosterone system (RAAS), immune-related tissue damage, and an ongoing state that promotes blood clots. These processes can lead to measurable myocardial fibrosis that cardiac magnetic resonance imaging can detect, autonomic dysfunction often seen as POTS, a greater risk of developing hypertension shortly after infection, and a long-term rise in thromboembolic events due to increased clotting and resistant microclots. Current management is mostly focused on relief of symptoms and involves a team approach. It uses repurposed medications and tailored physical rehabilitation since no specific cure is available yet. Promising but still experimental methods, such as endothelial-protective agents like sulodexide and targeting inflammatory pathways, need thorough testing. There are significant gaps in our understanding of the long-term risk of hypertension, the natural progression of fibrosis, and the best treatment for POTS. This highlights urgent needs for future research. Beyond caring for individual patients, these ongoing cardiovascular problems raise important public health concerns. They include higher healthcare use, long-term disability, and economic costs. This situation requires increased clinical attention and proactive cardiovascular monitoring for those recovering from COVID-19.}, }
@article {pmid41145456, year = {2025}, author = {Sujith, S and Gatzke, N}, title = {An overview of clinical presentation and management of long COVID.}, journal = {The Nurse practitioner}, volume = {50}, number = {11}, pages = {38-42}, doi = {10.1097/01.NPR.0000000000000374}, pmid = {41145456}, issn = {1538-8662}, mesh = {Humans ; *COVID-19/nursing/complications/therapy ; Risk Factors ; Nurse Practitioners ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic has been the 21st century's most significant public health emergency. In addition to the acute symptoms of COVID-19, many individuals are facing long-term health issues related to the infection. The terms "long COVID," "postacute sequelae of SARS-CoV-2 infection," "postacute COVID syndrome," and "long-haul COVID-19" refer to long-term consequences of SARS-CoV-2 infection. Symptoms may persist for weeks or months, reducing quality of life. Health practitioners must stay updated and take proactive measures to manage long COVID effectively. This manuscript provides an overview of risk factors, diagnostic tools, and management strategies, which serve as a resource for understanding and managing long COVID.}, }
@article {pmid41145330, year = {2025}, author = {Gleeson-Hammerton, T and Pearce, J and Eckert, M and Esterman, A and Peters, MDJ}, title = {Paramedic assessment and referral of patients with suspected or confirmed COVID-19 in the out-of-hospital environment: a scoping review.}, journal = {Australasian emergency care}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.auec.2025.10.002}, pmid = {41145330}, issn = {2588-994X}, abstract = {OBJECTIVE: To collate assessment tools, diagnostic/screening methods, referral pathways, and clinical practice guidelines (CPGs) available to paramedics managing suspected or confirmed COVID-19 patients in the out-of-hospital (OOH) setting, and to examine the evidence cited in these resources.<br><br>INTRODUCTION: COVID-19 presents with varied severity and has caused over seven million deaths since 2020. Ambulance Health Services (AHSs) have faced sustained demand and implemented new measures for patient care, often without evidence-based guidance. This review explores how paramedics assess, diagnose, and refer these patients, and what evidence supports these practices.<br><br>INCLUSION CRITERIA: Sources from January 2020 to October 2024 were included, with grey literature from six countries eligible until April 2025. Participants were patients of any age assessed or referred by paramedics in OOH settings.<br><br>METHODS: Following JBI methodology and PRISMA-ScR, literature was sourced from databases and ambulance organisations. Data were extracted using Covidence and customised tools, then synthesised narratively and in tables.<br><br>RESULTS: Sixty-seven sources from 20 countries were included. Six screening tools, 29 assessment tools, and 13 referral pathways were identified. Few AHS resources cited evidence.<br><br>CONCLUSIONS: Paramedic practice is significantly heterogenous and most CPGs lack supporting evidence. This review can aide further evidence-mapping and validation of clinical tools and patient pathways.}, }
@article {pmid41145167, year = {2025}, author = {Woolf, SH}, title = {The Youth Mental Health Crisis in the United States: Epidemiology, Contributors, and Potential Solutions.}, journal = {Pediatrics}, volume = {156}, number = {5}, pages = {}, doi = {10.1542/peds.2025-070849}, pmid = {41145167}, issn = {1098-4275}, mesh = {Humans ; Adolescent ; United States/epidemiology ; Child ; Substance-Related Disorders/epidemiology ; Young Adult ; COVID-19/epidemiology ; *Mental Disorders/epidemiology/therapy ; Male ; Female ; Risk Factors ; Suicidal Ideation ; *Mental Health ; Suicide/statistics &amp; numerical data ; Child, Preschool ; Mood Disorders/epidemiology ; Suicide, Attempted/statistics &amp; numerical data ; Infant ; }, abstract = {The mental health of US children and adolescents is in crisis. This narrative review takes a fresh look at current epidemiologic data-with a focus on mood disorders, suicidality, and substance use among youth aged 1 to 19 years-and reviews demographic and geographic risk factors, potential contributors to the crisis, and interventions available to communities, clinicians, and policymakers. The data are worrying. In 2023, almost 40% of high school students were reporting persistent sadness or hopelessness, 18% had experienced major depression, and 10% had attempted suicide. The suicide rate at ages 10 to 19 years increased by 85.3% between 2007 and 2017. Deaths from drug overdoses at ages 15 to 19 years surged during the COVID-19 pandemic, largely because of fentanyl.Mood disorders, substance use, and suicidal behaviors are more common among lesbian, gay, bisexual, transgender, queer (LGBTQ+; especially transgender) youth; rural and American Indian/Alaska Native youth; and those who have experienced poverty, disabilities, or involvement with foster care or juvenile justice systems. Female youth exhibit greater morbidity rates from mood disorders, suicidal ideation, and substance use, but male youth are more likely to die of suicide and drug overdose. Potential contributors to the crisis include decreased social connections; school-related stress; access to lethal agents (eg, firearms), smartphones, and social media; cyberbullying; racism and homophobia; and inadequate access to behavioral health care. Primary, secondary, and tertiary preventive interventions may offer solutions, but the supporting evidence is uneven. Although the crisis calls for greater investment in research, training, and support for youth, the federal government is currently defunding research and eliminating programs.}, }
@article {pmid41145060, year = {2026}, author = {Monteiro Belo Dos Santos, S and Van Tricht, C and Lammertyn, J and Spasic, D}, title = {Zoonotic disease detection at the point-of-care: the best of RPA and CRISPR-Cas.}, journal = {Biosensors &amp; bioelectronics}, volume = {293}, number = {}, pages = {118139}, doi = {10.1016/j.bios.2025.118139}, pmid = {41145060}, issn = {1873-4235}, mesh = {Humans ; *CRISPR-Cas Systems ; *Nucleic Acid Amplification Techniques/methods/instrumentation ; *Biosensing Techniques/methods/instrumentation ; SARS-CoV-2/isolation &amp; purification/genetics ; *COVID-19/diagnosis/virology ; Animals ; *Point-of-Care Systems ; *Zoonoses/diagnosis/virology ; Recombinases ; Molecular Diagnostic Techniques/methods ; Point-of-Care Testing ; Pandemics ; }, abstract = {Biosensors are increasingly crucial in detecting biomarkers for emerging zoonotic diseases at the point-of-care (POC). This imminence was recently highlighted by the deficient response during the SARS-CoV-2 pandemic. While polymerase chain reaction (PCR) is the common nucleic acid (NA) testing method for zoonotic diseases in laboratory settings, it is impractical for the POC settings due to the equipment-related cost, lack of portability and user-friendliness. Recent advances in NA amplification introduced isothermal methods, such as recombinase polymerase amplification (RPA), which is known for its low temperature (37-42 °C), short incubation time (5-20 min) and suitability for integration in miniaturized, portable, low-cost, highly sensitive diagnostic platforms. However, RPA susceptibility to false positive results steered to its combination with CRISPR-Cas12/13, leading to the rise of SHERLOCK and DETECTR. This review first explores RPA-CRISPR-Cas bioassay development as either two- or one-step. This is followed by a discussion on the integration of canonical RPA, or its combination with CRISPR-Cas, into different diagnostic platforms towards NA amplification at the POC (e.g., mobile laboratories, centrifugal, or pump-free platforms). Finally, the advantages, limitations, and outlook for POC-based diagnostics of zoonotic diseases with RPA(-CRISPR-Cas) are discussed, highlighting the need for innovative technologies to address global health challenges. While promising, many of these approaches still require further research to achieve streamlined, single-step reactions and seamless integration into diagnostic platforms. Moreover, despite two decades of RPA(-CRISPR-Cas) development, technology readiness is limited, still missing validated platforms, integrated sample preparation, and AI-powered results analysis enabling real time epidemiological monitoring.}, }
@article {pmid41144923, year = {2025}, author = {Raju, L and Tiz, DB and Iles, A and Košmrlj, J and Jansen-van Vuuren, RD}, title = {Deuteration of Six-Membered N-Heteroarenes: Chemistry and Applications.}, journal = {Chemistry (Weinheim an der Bergstrasse, Germany)}, volume = {31}, number = {67}, pages = {e02659}, pmid = {41144923}, issn = {1521-3765}, support = {101211395//HORIZON EUROPE Marie Sklodowska-Curie Actions/ ; J7-50041//Javna&#xa0;Agencija za&#xa0;Raziskovalno Dejavnost RS/ ; }, abstract = {Six-membered N-heteroarenes ("6NHetAr") play pivotal roles in the pharmaceutical, agrochemical, and materials science industries. In recent times, deuterium (D)-labelled 6NHetAr have demonstrated enhanced performance over their unlabelled counterparts. For example, VV116 and VX-984, approved therapeutics for the treatment of COVID-19 and cancer, and deuterated functional materials for use as ligands in catalysts and organometallic light-emitters. As interest in this field continues to grow, there is a corresponding need to develop more efficient, scalable, and sustainable approaches to deuterate 6NHetAr. In this work, we comprehensively review approaches developed for the incorporation of D into 6NHetAr, their fused counterparts, and complex compounds containing 6NHetAr. We also provide an overview of established and emerging applications for these materials.}, }
@article {pmid41144325, year = {2025}, author = {Dutta, A and Mooventhan, A and Nivethitha, L and Dharani, E}, title = {Efficacy of Yoga Nidra in Managing Sleep Disorders: A Systematic Review of Randomized Controlled Trials.}, journal = {Journal of integrative and complementary medicine}, volume = {}, number = {}, pages = {}, doi = {10.1177/27683605251390728}, pmid = {41144325}, issn = {2768-3613}, abstract = {Background: Sleep disorders are increasingly prevalent and significantly impact physical and mental health. Yoga Nidra, a guided meditative practice, has been proposed as a non-pharmacological intervention to enhance sleep quality. This systematic review evaluates the efficacy of Yoga Nidra in managing sleep disorders across diverse populations. Methods: A systematic search of PubMed, Cochrane Library, PsycINFO, and Scopus databases was conducted to identify randomized controlled trials (RCTs) evaluating Yoga Nidra for sleep-related outcomes, published up to March 31, 2025. The primary objective was to assess the efficacy of Yoga Nidra on sleep quality and related psychological outcomes. Risk of bias (RoB) was assessed using the Cochrane RoB tool (in seven domains). Results: Six RCTs (n = 244) were included, involving participants with chronic insomnia, hypertension, acute insomnia, COVID-19 health care workers, and sportspersons. Most studies reported significant improvements in key sleep parameters such as sleep onset latency, total sleep time, and sleep efficiency among participants practicing Yoga Nidra. Improvements were observed compared to various control interventions, including cognitive behavioral therapy for insomnia, progressive muscle relaxation, and music-based relaxation. However, heterogeneity was noted in intervention protocols, outcome measures, and duration. Most studies had moderate to high RoB, primarily due to lack of blinding and incomplete outcome reporting. Moreover, there was a lack of accurate reporting of adverse events and safety data across the studies. Conclusion: Yoga Nidra appears to show promise as a therapeutic intervention for improving sleep and related mental health outcomes. Nevertheless, high-quality, methodologically robust RCTs are needed to confirm its efficacy and support its integration into evidence-based clinical practice.}, }
@article {pmid41143640, year = {2025}, author = {Shchelokova, EE and Kogan, EA and Avraamova, ST and Demura, TA and Zharkov, NV and Kovyazina, NV and Mordovina, AI and Zelenchenkova, PI and Meerovich, GA and Reshetov, IV}, title = {[Features of lung cancer carcinogenesis involving cancer stem cells in COVID-19. Effects of photodynamic therapy in the treatment of cancer and COVID-19].}, journal = {Arkhiv patologii}, volume = {87}, number = {5}, pages = {65-73}, doi = {10.17116/patol20258705165}, pmid = {41143640}, issn = {0004-1955}, mesh = {Humans ; *Photochemotherapy/methods ; *COVID-19/virology/pathology/complications ; *Lung Neoplasms/pathology/drug therapy/virology/metabolism ; *Neoplastic Stem Cells/pathology/virology/drug effects/metabolism ; SARS-CoV-2/pathogenicity ; *Carcinogenesis/pathology/drug effects ; }, abstract = {Lung cancer occupies a leading position among malignant neoplasms throughout the world, and the issue of carcinogenesis of this disease today still remains relevant. This review examines in detail the issue of the participation of cancer stem cells in the development of lung cancer, the concept of the stem cell niche, and options for their detection using molecular and immunohistochemical studies. A separate section examines the impact of the new coronavirus infection COVID-19 on CSC and lung cancer carcinogenesis in general, as well as the successful results of the use of photodynamic therapy in the treatment of both diseases.}, }
@article {pmid41142721, year = {2025}, author = {Kerobe, W and Msellem, AS and Sabuni, PA and Mkassy, FI and Chilipweli, PM and Kapesa, A and Kidenya, BR and Ayieko, P and Bintabara, D and Konje, ET}, title = {Impact of temperature and humidity on SARS-CoV-2 transmissibility: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1570002}, pmid = {41142721}, issn = {2296-2565}, mesh = {Humans ; *Humidity ; *COVID-19/transmission/epidemiology ; *Temperature ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The SARS-CoV-2 pandemic remains crucial for understanding the epidemiology of future respiratory infections. Gaining insights into the climatic factors influencing the transmissibility of SARS-CoV-2 is an important public health issue in the control and prevention of the disease. Hence, this study aimed to assess the association between SARS-CoV-2 transmissibility and both humidity and temperature.<br><br>METHODS: Articles published between December 2019 and August 2024 were identified from PubMed, Africa Journal Online, Science Direct, and Hinari databases following PRISMA guidelines. The focus was on studies that reported transmissibility based on basic reproductive number, specifically correlation coefficients between basic reproductive number and temperature, or humidity, or corresponding regression coefficients, and their standard errors. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias. Random effect models were applied. The meta-analysis was done in R version 4.3.0.<br><br>RESULTS: 9 studies qualified, but 5 were excluded for missing coefficients, leaving 4 for meta-analysis. The study analysis revealed a significant negative correlation between temperature and SARS-CoV-2 transmissibility (r&#x202f;=&#x202f;-0.509, 95% CI: -0.680 to -0.338, p&#x202f;<&#x202f;0.001). Similarly, a significant but weaker negative correlation was found between humidity and SARS-CoV-2 transmissibility (r&#x202f;=&#x202f;-0.426, 95% CI: -0.548 to -0.303, p&#x202f;<&#x202f;0.001). A unit increase in humidity measured in percentage was associated with a decrease in transmissibility by 0.006 (95% CI: -0.007 to -0.004, p&#x202f;<&#x202f;0.001), while a unit increase in temperature in Celsius (&#xb0;C) was associated with a reduction of transmissibility by 0.008 (95% CI: -0.030 to -0.030, p&#x202f;<&#x202f;0.001).<br><br>CONCLUSION: Temperature and humidity were negatively associated with SARS-CoV-2 transmissibility; thus, disease transmissibility decreased as temperature or humidity increased. Climatic factors are important considerations for effective disease surveillance and preparedness strategies.<br><br>https://www.crd.york.ac.uk/PROSPERO, CRD42025637440.}, }
@article {pmid41142406, year = {2025}, author = {Thambiraj, G and Bazoukis, G and Ghabousian, A and Zhou, J and Bollepalli, SC and Isselbacher, EM and Donahue, V and Singh, JP and Armoundas, AA}, title = {Use of artificial intelligence in predicting in-hospital cardiac and respiratory arrest in an acute care environment-implications for clinical practice.}, journal = {Frontiers in medical technology}, volume = {7}, number = {}, pages = {1681059}, pmid = {41142406}, issn = {2673-3129}, abstract = {BACKGROUND: Artificial intelligence (AI)-based models can augment clinical decision-making, including prediction, diagnosis, and treatment, in all aspects of medicine.<br><br>RESEARCH QUESTIONS: The current systematic review aims to provide a summary of existing data about the role of machine learning (ML) techniques in predicting in-hospital cardiac arrest, life-threatening ventricular arrhythmias, and respiratory arrest.<br><br>METHODS: The study was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) framework. PubMed, Embase, and Web of Science without any restriction were searched to extract relevant manuscripts until October 20, 2023. Additionally, the reference list of all potential studies was searched to identify further relevant articles. Original publications were regarded as eligible if they only recruited adult patients (&#x2265;18 years of age), employed AI/ML algorithms for predicting cardiac arrest, life-threatening ventricular arrhythmias, and respiratory arrest in the setting of critical care, used data gathered from wards with critically ill patients (ICUs, cardiac ICUs, and emergency departments), and were published in English. The following information was extracted: first author, journal, ward, sample size, performance and features of ML and conventional models, and outcomes.<br><br>RESULTS: ML algorithms have been used for cardiac arrest prediction using easily obtained variables as inputs. ML algorithms showed promising results (AUC 0.73-0.96) in predicting cardiac arrest in different settings, including critically ill ICU patients, patients in the emergency department and patients with sepsis, they demonstrated variable performance (AUC 0.54-0.94) in predicting respiratory arrest in COVID-19 patients, as well as other clinical settings.<br><br>CONCLUSION: ML algorithms have shown promising results in predicting in-hospital cardiac and respiratory arrest using readily available clinical data. These algorithms may enhance early identification of high risk patients and support timely interventions, thereby reducing mortality and morbidity rates. However, the prospective validation of these algorithms and their integration into clinical workflows need further exploration.}, }
@article {pmid41142061, year = {2025}, author = {Negari, IP and Khoerunnisa, AN and Tarwadi,  and Sari, AN and Chuang, TH}, title = {Delivery and adjuvant: liposomes for SARS-CoV-2 vaccines.}, journal = {Biotechnologia}, volume = {106}, number = {3}, pages = {339-360}, pmid = {41142061}, issn = {2353-9461}, abstract = {The global COVID-19 pandemic has highlighted the critical role of vaccines in controlling infectious diseases, with liposome-based formulations emerging as a pivotal advancement in vaccine technology. Liposomes are spherical vesicles composed of lipid bilayers that serve as drug delivery systems and versatile adjuvants, enhancing vaccine efficacy through improved antigen stability, targeted delivery, and immunogenicity. This review explores the potential of liposomes as adjuvants in both mRNA and protein subunit SARS-CoV-2 vaccines, detailing their composition and dual impact on innate and adaptive immune responses. Notably, liposome-based mRNA vaccines, such as those developed by Pfizer and Moderna, have demonstrated high efficacy by utilizing lipid nanoparticles to encapsulate mRNA and stimulate antigen-presenting cells, thereby inducing robust immune responses. Despite their advantages, challenges remain, including the optimization of lipid compositions and the mitigation of adverse immune effects. This review also examines the broad applications of liposomes in nanomedicine - from cancer therapy to antifungal treatments - and their potential for future vaccine development. By bridging the gap between engineering and immunology, the study of liposomes underscores their transformative potential in addressing current and emerging global health challenges.}, }
@article {pmid41141841, year = {2025}, author = {Belayneh, AG and Andargie, GA and Seid, K and Lakew, G and Yirsaw, AN and Tefera, M and Bogale, EK and Anagaw, TF and Fenta, ET and Endeshaw, D and Adal, O and Tareke, AA and Kebede, N and Jemberu, L and Getachew, E}, title = {Treatment outcome and associated factors of acute heart failure in East Africa, an Ethiopian perspective: A systematic review and meta-analysis.}, journal = {American heart journal plus : cardiology research and practice}, volume = {59}, number = {}, pages = {100637}, pmid = {41141841}, issn = {2666-6022}, abstract = {BACKGROUND: Acute heart failure is a major global health issue, contributing to significant morbidity, mortality, and healthcare costs in Sub-Saharan Africa, including Ethiopia. Despite its burden, comprehensive data on acute heart failure in East Africa remains scarce.<br><br>OBJECTIVE: This systematic review and meta-analysis aimed to synthesize existing evidence on the treatment outcome of acute heart failure and associated factors in East Africa with a focus on Ethiopia.<br><br>METHODS: Relevant studies were searched in major databases, including PubMed/Medline, Hinari, Science Direct, EMBASE, Scopus, AJOL, Cochrane Library, and local sources from July 5-25, 2024. Both published and unpublished studies in English were included without restrictions on publication date, following PRISMA-2020 protocols. Data quality was assessed using the Newcastle-Ottawa Scale, and meta-analysis was conducted using Stata version 18.<br><br>RESULTS: A total of 9 articles involving 1107 participants were included. The pooled mortality of acute heart failure was 16.36&#xa0;% (95&#xa0;% CI: 12.39, 20.33) with heterogeneity (I[2)] value of 85.86&#xa0;%. Increased blood urea nitrogen (BUN), smoking, and hypotension were the factors significantly associated with the pooled mortality rate of acute heart failure.<br><br>CONCLUSION: This review reveals a high mortality of acute heart failure among hospitalized patients in Ethiopia. Factors such as increased blood urea nitrogen (BUN), smoking, and hypotension contribute to death due to acute heart failure. Therefore, it is necessary to reduce the burden of acute heart failure and improve patient survival in Ethiopia by addressing the identified predictors of poor outcomes and integrating global best practices into local healthcare systems.}, }
@article {pmid41141460, year = {2025}, author = {Irfan, B and Khleif, A and Badarneh, J and Abutaqa, J and Allam, A and Kweis, S and Tarab, B and Abu Shammala, A and Nasser, E and Shweiki, S and Wajahath, M and Padela, A}, title = {Considering Islamic Frameworks to Infectious Disease Prevention.}, journal = {Open forum infectious diseases}, volume = {12}, number = {10}, pages = {ofaf011}, pmid = {41141460}, issn = {2328-8957}, abstract = {Infectious diseases remain a significant global health challenge, particularly in Muslim-majority countries, where socioeconomic disparities, urbanization, and conflict exacerbate the spread of illnesses such as dengue, cholera, malaria, and coronavirus disease 2019. This review explores the potential of Islamic concepts such as taharah (cleanliness), la darar wa la dirar (prevention of harm), and maṣlaḥa (communal benefit) as frameworks for infectious disease prevention. These values may align with public health goals, offering religiously resonant approaches to health promotion while addressing the ethical complexities of integrating religious beliefs with biomedical imperatives. This review examines how community health workers and religious leaders can collaborate to deliver health education, promote vaccination, and manage disease outbreaks, particularly in underserved regions where trust in certain institutions is limited. Challenges arise in ensuring inclusivity, avoiding stigmatization, and balancing the utility of religion in optimal medical end goals. The ethical implications of using religious messaging in public health campaigns are critically analyzed, emphasizing the need for careful framing to avoid coercion while addressing public benefit. By synthesizing existing literature and case studies, this review highlights how Islamic frameworks may be used to support effective, ethical, and sustainable infectious disease prevention for various stakeholders, offering valuable insights for public health strategies.}, }
@article {pmid41141324, year = {2025}, author = {Ahmad Hilmi, SB and Chellappan, DK and Kunnath, AP}, title = {Non-Malignant Granulocyte and Monocyte Disorders: An Update.}, journal = {British journal of biomedical science}, volume = {82}, number = {}, pages = {15072}, pmid = {41141324}, issn = {2474-0896}, mesh = {Humans ; *Neutropenia/genetics/therapy ; *COVID-19/immunology ; *Granulocytes/pathology ; *Monocytes/pathology/immunology ; SARS-CoV-2 ; }, abstract = {Non-malignant disorders of granulocytes and monocytes include a range of conditions characterized by either quantitative issues (such as cytopenias or cytophilias) or qualitative defects in innate immune cells. These disorders encompass neutropenias, monocytopenias, eosinophilic syndromes, and defects in granulocyte maturation. They can result from genetic mutations (including ELANE, HAX1, GATA2, and CSF3R), autoimmune dysregulation, or idiopathic mechanisms. The clinical manifestations of these disorders vary and can include recurrent infections, inflammatory complications, and organ damage. These issues arise from disrupted granulopoiesis, abnormal apoptosis, or dysfunctional chemotaxis. Recent innovations underscore how molecular diagnostics inform both mutation detection and risk stratification in congenital neutropenias. Take ELANE-associated severe congenital neutropenia: such variants not only establish the disorder but also highlight the subsequent hazard of myelodysplastic progression. In contrast, GATA2 deficiency generates isolated monocytopenia, correlating with a broadened window for opportunistic pathogens. Frontline practice now advocates for prompt, integrative assessment using next-generation sequencing alongside quantitative flow cytometry, thereby parsing mild benign states from early clonal hematopoiesis. Management hurdles persist, especially in patients with refractory neutropenia and the calibrated use of immunosuppression in autoimmune etiologies. The COVID-19 pandemic incidentally reiterated the extent of infectious susceptibility within this cohort, prompting the refinement of absolute, personalized prophylactic strategies. This review synthesizes the molecular mechanisms, genetic basis, and therapeutic innovations in non-malignant granulocyte/monocyte disorders, offering a roadmap for personalized management. By bridging mechanistic insights with clinical practice, it addresses unmet needs in diagnostics, risk prediction, and novel biologics, ultimately improving outcomes for these underrecognized yet impactful conditions.}, }
@article {pmid41140791, year = {2025}, author = {Zhang, R and Liu, L and Wang, G}, title = {Medical Policy Reform in the Digital Age: Responding to Health Crises Shaped by Internet Public Opinion.}, journal = {Risk management and healthcare policy}, volume = {18}, number = {}, pages = {3387-3396}, pmid = {41140791}, issn = {1179-1594}, abstract = {The evolution of digital media over recent decades has fundamentally reshaped how health crises are communicated and managed, significantly influencing medical policy reforms. The increasing prominence of social media platforms has created new opportunities and challenges in health crisis management. This review examines how online discourse surrounding health crises, including both accurate information and misinformation, has shaped public health policy by influencing public trust and complicating policy implementation. Through an analysis of case studies and crisis communication literature, this review identifies the key factors driving policy changes in response to digital public opinion. The role of misinformation, viral content, and digital activism in driving or hindering health policy reforms is discussed, with a focus on how governments and health agencies have adapted their communication strategies to maintain public trust and ensure effective policy implementation. Notable examples include South Korea's digital health initiatives during the COVID-19 pandemic and the United States responses to vaccine eligibility confusion, which illustrate the dynamic relationship between digital mobilisation and policy shifts. The review advocates for the integration of digital engagement strategies into health policy development, emphasising transparency, real-time feedback, and active stakeholder participation. Best practices in digital crisis management, such as social media monitoring, data-informed decision-making, and transparent communication, are highlighted. As digital media continues to shape public opinion, agile, transparent, and responsive communication has become critical. Policymakers must now consider digital engagement not only as a tool for crisis management but as an essential component of the policymaking process.}, }
@article {pmid41140367, year = {2025}, author = {Alfonso Arvez, MJ and Tan, GSQ and Leung, MTY and Ademi, Z and Bell, JS}, title = {SGLT2 Inhibitors and the Risk of Infections in Type 2 Diabetes: Systematic Review and Meta-Analyses of Real-World Evidence.}, journal = {Journal of diabetes research}, volume = {2025}, number = {}, pages = {5888495}, pmid = {41140367}, issn = {2314-6753}, mesh = {Humans ; *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use ; *Diabetes Mellitus, Type 2/drug therapy/complications ; *COVID-19/mortality/epidemiology ; *Infections/epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: People with diabetes are at increased risk of infections. Emerging evidence suggests sodium-glucose cotransporter 2 (SGLT2) inhibitors have pleiotropic effects that may protect against certain infections. We systematically reviewed real-world evidence on the association between SGLT2 inhibitors and infections among adults with Type 2 diabetes.<br><br>METHODS: We searched Medline, Embase, Scopus, and Google Scholar from January 1, 2012 to March 18, 2024 for observational studies conducted in adults with Type 2 diabetes published in English. The exposure was SGLT2 inhibitors, and comparators were nonusers or users of other glucose-lowering medications. Studies reporting outcome estimates for specific non-genitourinary infections were included. The study was prospectively registered with PROSPERO (CRD42023492265).<br><br>RESULTS: From 6827 records, 28 studies were included in qualitative synthesis and 14 in meta-analyses. There was no association with COVID-19-related mortality in seven studies (OR 0.91; 95% CI: 0.57-1.46) or COVID-19-related hospitalisation in three studies (OR 0.90; 95% CI: 0.67-1.20). A reduced risk of pneumonia was observed in three studies (HR: 0.61; 95% CI: 0.57-0.66), a reduced risk of pneumonia-related mortality in two studies (HR: 0.49; 95% CI: 0.35-0.67), and a reduced risk of sepsis in three studies (HR: 0.45; 95% CI: 0.30-0.68).<br><br>CONCLUSION: Real-world evidence suggests SGLT2 inhibitors are associated with lower risk of pneumonia, pneumonia-related mortality and sepsis. Given the high burden of infection in this population, these associations deserve further research.}, }
@article {pmid41140224, year = {2025}, author = {Moreal, C and Angelini, J and Venturini, S and Deana, C and Flammini, S and Lugano, M and Lucangelo, U and Montanari, L and Pellis, T and Roman-Pognuz, E and Schioppa, O and Zerbato, V and Bassi, F and Giuliano, S and Tascini, C}, title = {Management of Invasive Fungal Infection: Clinical Strategies in Critical Care from a Multidisciplinary Consensus.}, journal = {The new microbiologica}, volume = {48}, number = {3}, pages = {211-214}, pmid = {41140224}, issn = {1121-7138}, mesh = {Humans ; *Invasive Fungal Infections/drug therapy/diagnosis/microbiology ; *Antifungal Agents/therapeutic use ; *Critical Care/methods ; Consensus ; }, abstract = {Fungal infections pose a growing threat in hospital settings, particularly among critically ill or immunocompromised patients. A multidisciplinary consensus among fifteen clinical experts from Northern Italy examined the increasing challenge of invasive fungal infections, especially in patients with high-risk complications and in critical settings. The report emphasizes early diagnostic integration through clinical assessment, biomarker evaluation, and the essential role of therapeutic drug monitoring in optimizing outcomes. This consensus aims to consolidate clinical strategies for timely diagnosis, personalized pharmacologic intervention, and antifungal stewardship. Azoles are identified as first-line treatment options. Isavuconazole emerged as a preferred therapeutic agent due to its favorable pharmacokinetic profile, safety in renal impairment, and lack of QT interval prolongation. This consensus supports integrated strategies combining early recognition, rapid diagnostics, individualized pharmacology, and antifungal stewardship to improve outcomes, particularly in critical care settings.}, }
@article {pmid41140040, year = {2025}, author = {Madjitey, P and Hunt, M and Andermann, A}, title = {Exploring the Ethical Tensions Experienced by Health Care Workers during Infectious Disease Outbreaks in Low- and Middle-income Countries: A Critical Interpretive Review of the Literature.}, journal = {Disaster medicine and public health preparedness}, volume = {19}, number = {}, pages = {e304}, doi = {10.1017/dmp.2025.10229}, pmid = {41140040}, issn = {1938-744X}, mesh = {Humans ; *Health Personnel/psychology/ethics/statistics &amp; numerical data ; Developing Countries/statistics &amp; numerical data ; *Disease Outbreaks/statistics &amp; numerical data ; Qualitative Research ; COVID-19/epidemiology/psychology ; }, abstract = {OBJECTIVE: This review aimed to map the main ethical tensions experienced by health workers in low- and middle-income countries during infectious disease outbreaks.<br><br>METHODS: We conducted a critical interpretive review of qualitative research studies. After searching 3 databases, 4445 articles were exported to Rayyan, deduplicated, and screened for eligibility. Of the 98 articles retained for full review, 25 met the inclusion criteria. Data were extracted to an Excel spreadsheet and key ethical tensions were identified using a descriptive content and thematic analysis approach.<br><br>RESULTS: Twenty-three of the studies focused on the COVID-19 pandemic, and two addressed Ebola epidemics. Three major ethical tensions were experienced by health workers, which involved conflicts between their professional duty to patients, colleagues, and communities, as against their concerns for personal safety, the well-being of their families, and facing stigma and discrimination. Secondary tensions arose when health workers seeking to manage these primary ethical tensions experienced further uncertainty about whether to disclose information about their professional roles with family members or community.<br><br>CONCLUSIONS: Ethical tensions are unavoidable during contagions, and may be amplified due to structural features. Authorities must take steps to support health workers as they navigate ethical tensions during localized epidemics or global pandemics.}, }
@article {pmid41140011, year = {2025}, author = {Chandrasekaran, K and Chitathoor, S and Deshpande, A and Santhanakrishnan, S and Jayaraman, S and Sankari, L}, title = {Oral Cavity Involvement in Mucormycosis: A Systematic Review.}, journal = {Ear, nose, &amp; throat journal}, volume = {}, number = {}, pages = {1455613251387879}, doi = {10.1177/01455613251387879}, pmid = {41140011}, issn = {1942-7522}, abstract = {BACKGROUND: Mucormycosis is a rare but life-threatening fungal infection. While rhinocerebral forms are well-documented, oral cavity involvement remains underreported and misdiagnosed, despite its potential for rapid progression and serious complications.<br><br>AIM: This systematic review aimed to evaluate and synthesize available evidence on the clinical presentation, anatomical patterns, diagnostic methods, outcomes, and management strategies associated with oral cavity involvement in mucormycosis.<br><br>METHODOLOGY: Literature search was conducted across PubMed, Scopus, Embase, Web of Science, and Google Scholar up to 2025. Eligible human studies were included. Data were extracted and narratively synthesized. Quality assessment was conducted using the Newcastle-Ottawa Scale, and risk of bias was evaluated with the ROBINS-I tool with 7 included studies.<br><br>RESULTS: Seven studies comprising 451 cases were analyzed. Most patients were middle-aged males with diabetes and a recent post-COVID-19 status. Common clinical features included palatal ulcers, eschar, tooth mobility, and necrotic lesions. Diagnosis relied on potassium hydroxide mount, histopathology, and imaging. Amphotericin B was the mainstay of antifungal therapy, often combined with surgical debridement or maxillectomy. Mortality varied widely across studies, with better outcomes linked to early diagnosis and combined treatment.<br><br>CONCLUSION: Oral Mucormycosis is a critical yet often underrecognized condition. Timely identification in high-risk patients is essential to prevent progression.}, }
@article {pmid41138066, year = {2025}, author = {Hamilton, FL and Imran, S and Mahmood, A and Dobbin, J and Bradbury, K and Poduval, S and Scuffell, J and Thomas, F and Stevenson, F}, title = {Design and deployment of digital health interventions to reduce the risk of the digital divide and to inform development of the living with COVID recovery: a systematic scoping review.}, journal = {Health and social care delivery research}, volume = {13}, number = {39}, pages = {1-18}, doi = {10.3310/GJHG1331}, pmid = {41138066}, issn = {2755-0079}, mesh = {Humans ; *COVID-19/rehabilitation ; *Telemedicine/organization &amp; administration ; *Digital Divide ; SARS-CoV-2 ; Digital Health ; }, abstract = {BACKGROUND: Digital health interventions can support health-related knowledge transfer, for example through websites or mobile applications, and may reduce health inequalities by making health care available, where access is difficult, and by translating content to overcome language barriers. However, digital health intervention can also increase health inequalities due to the digital divide. To reach digitally excluded populations, design and delivery mechanisms need to specifically address this issue. This review was conducted during the evolving COVID-19 pandemic and informed the rapid design, deployment and evaluation of a post-COVID-19 rehabilitation digital health intervention: 'Living with COVID Recovery' (LWCR). LWCR needed to be engaging and usable for patients and to avoid exacerbating health inequalities. LWCR was introduced as a service into 33 NHS clinics, was used by 7679 patients, and evaluation ran from August 2020 to December 2022.<br><br>OBJECTIVE: To identify evidence-based digital health intervention design and deployment features conducive to mitigating the digital divide.<br><br>METHODS: Cochrane Library, Epistemonikos, National Institute for Health and Care Excellence Evidence, PROSPERO, PubMed (with MEDLINE and Europe PMC) and Turning Research into Practice; OpenGrey and Google Scholar were searched for primary research studies published in English from 1 October 2011 to 1 October 2021. Adults who were likely to be affected by the digital divide, including older age, minority ethnic groups, lower income/education level and in any healthcare setting.<br><br>INTERVENTIONS: Any digital health intervention with features of design and/or deployment intended to enable access and engagement by the population of focus.<br><br>COMPARATORS: Any or none.<br><br>OUTCOME MEASURES: Any related to participants' access and/or use of digital health intervention and/or change in digital skills and confidence.<br><br>ANALYSIS: Data from studies that met the inclusion criteria were extracted, narratively synthesised and thematically analysed.<br><br>RESULTS: Twenty-two papers met the inclusion criteria. Digital health interventions evaluated included telehealth, text message interventions, virtual assistants, self-management programmes and decision aids. Co-development with end-users, user testing through iterative design cycles, digital health interventions that also helped improve digital skills and digital health literacy, tailoring for low literacy through animations, pictures, videos and writing for low reading ages; virtual assistants to collect information from patients and guide the use of a digital health intervention.<br><br>DEPLOYMENT THEMES INCLUDED: Free devices and data, or signposting to sources of cheap/free devices and Wi-Fi, text message interventions, providing 'human support', providing tailored digital skills education as part of the intervention and enabling peer/family support.<br><br>LIMITATIONS: Our search extended to late 2021, and there has been a massive increase in the literature following the pandemic. However, as our review was undertaken to inform the LWCR digital health intervention design and deployment, we have reported the results that informed this work. The studies included in the review were heterogeneous, so generalisability may be limited. Few randomised controlled trials assessed the digital health intervention's impact on digital health skills by using validated measures.<br><br>CONCLUSIONS: Using the design and deployment findings described above when developing digital health interventions may help overcome the digital divide. Beyond informing the LWCR digital health intervention development, the review findings have wider implications for the equitable design, delivery and evaluation of digital health interventions.<br><br>FUNDING: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR132243.}, }
@article {pmid41137964, year = {2025}, author = {Reis, J and Öztürk, &#x15e; and Buguet, A and Kauffenstein, G and Tulek, Z}, title = {Stroke, infections, and New Mechanisms: a Narrative Review.}, journal = {Current neurology and neuroscience reports}, volume = {25}, number = {1}, pages = {74}, pmid = {41137964}, issn = {1534-6293}, mesh = {Humans ; *Stroke/etiology/epidemiology ; *COVID-19/epidemiology/complications ; Risk Factors ; *Infections/complications/epidemiology ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Infections as a risk factor for stroke remain an underrecognized issue within the medical community although this link was identified for more than 60 years. Preceding infections acting as triggers or even causal factors for ischemic and hemorrhagic stroke were assessed notably for tropical infections.<br><br>RECENT FINDINGS: Since the COVID 19 pandemic, the interest for all kind of infectious agents (bacteria, viruses, fungi, parasitosis) is becoming an emerging concern worldwide. Surprisingly, this risk is addressed only in classification of causes concerning young adults and children. In addition, the seasonality of meteorological conditions (temperature, humidity, rain patterns) probably obscured the underlying causes such as epidemic infections and air pollution peaks (which can act in synergy, notably for respiratory infections). Greater recognition of infection-related stroke risk is essential, especially given the potential for increased incidence driven by global warming, the availability of biomarkers for risk assessment, and the opportunities improving preventive and therapeutic strategies.}, }
@article {pmid41136586, year = {2025}, author = {Vera-Torres, A and Cortes-Mejia, NA and de la Hoz-Valle, JA and Bejarano-Ramírez, DF}, title = {Challenges of high-quality clinical research in Colombia: an example of a clinical trial amidst the COVID-19 pandemic.}, journal = {Journal of public health policy}, volume = {46}, number = {4}, pages = {916-924}, pmid = {41136586}, issn = {1745-655X}, mesh = {Humans ; Colombia/epidemiology ; COVID-19/epidemiology ; *Biomedical Research/standards/organization &amp; administration ; SARS-CoV-2 ; *Randomized Controlled Trials as Topic ; Pandemics ; *COVID-19 Drug Treatment ; Health Policy ; }, abstract = {The COVID-19 pandemic has revealed significant disparities in health research across regions, particularly in Latin America. This viewpoint explores the challenges encountered during a randomized clinical trial in Colombia designed to evaluate the effectiveness of intravenous Alprostadil for treating moderate-to-severe COVID-19. The trial, aimed to address the urgent need for effective treatments, ultimately became undermined by bureaucratic barriers. This experience of regulatory delays and prolonged setbacks highlighted broader systemic issues in health research across Latin America, such as tangled regulatory frameworks, insufficient skilled staff, and limited research infrastructure. These obstacles, combined with financial constraints, prevent timely research, impairing Latin America's ability to address health crises independently. To improve health research policies in the region, lessons from countries like Brazil, Argentina, and Chile, where regulatory processes have been streamlined, suggest that reforms promoting efficient approval systems, policy alignment, and enhanced collaboration are vital for strengthening health research capacity in Latin America.}, }
@article {pmid41136410, year = {2025}, author = {Sherman, AC and Gray, GE and Cao, B and To, KKW and Rouphael, N and Henao-Restrepo, AM and Gordon, AC and Baden, LR}, title = {Acute SARS-CoV-2 infection.}, journal = {Nature reviews. Disease primers}, volume = {11}, number = {1}, pages = {75}, pmid = {41136410}, issn = {2056-676X}, mesh = {Humans ; *COVID-19/epidemiology/physiopathology/therapy ; SARS-CoV-2/pathogenicity ; Antiviral Agents/therapeutic use ; COVID-19 Vaccines ; COVID-19 Drug Treatment ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory pathogen that emerged in December 2019 and caused a global pandemic by March 2020, with >7 million deaths due to coronavirus disease 2019 (COVID-19) globally as of September 2025. The clinical syndrome of COVID-19 ranges from asymptomatic infection to severe disease with pneumonia and death. SARS-CoV-2 variant type, inoculum, previous exposure and host factors influence the clinical trajectory. Identification of key structural proteins of SARS-CoV-2 and insights into the pathophysiology of the immune response to infection led to the development of effective preventive (vaccines and monoclonal antibodies) and therapeutic (antivirals and immunomodulatory agents) agents. Antiviral agents, such as remdesivir and nirmatrelvir-ritonavir, inhibit viral replication and immunomodulatory agents, such as tocilizumab and baricitinib, act to reduce a dysregulated immune response to SARS-CoV-2. The pandemic had economic and socio-cultural consequences that affected the quality of life and overall life expectancy of individuals. As the emergency phase of the pandemic concludes, robust monitoring and surveillance systems must be sustained and research to improve vaccines and therapeutics must continue to maintain control of SARS-CoV-2 in the population and be prepared for emerging pathogens with pandemic potential.}, }
@article {pmid41135434, year = {2025}, author = {Briggs, EE and Chau, IJ and Nguyen, SA and Pelic, JC and Harvey, EA and Meyer, TA}, title = {Acute mastoiditis in children during the Covid era: A systematic review and meta-analysis.}, journal = {International journal of pediatric otorhinolaryngology}, volume = {198}, number = {}, pages = {112613}, doi = {10.1016/j.ijporl.2025.112613}, pmid = {41135434}, issn = {1872-8464}, mesh = {Child ; Humans ; Acute Disease ; Anti-Bacterial Agents/therapeutic use ; *COVID-19/epidemiology ; *Mastoiditis/epidemiology/therapy/complications/diagnosis ; Pandemics ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: Explore the impact of the COVID-19 pandemic on pediatric acute mastoiditis (AM).<br><br>DATA SOURCES: CINAHL, Cochrane Library, PubMed, Scopus.<br><br>METHODS: Literature was searched from 2014 to 2025 for articles reporting AM in children. Specific outcomes included clinical presentation, bacterial epidemiology, complications, and management. Primary outcome measures included continuous measures (mean), proportions (%), mean difference (&#x394;), and relative risk (RR) with 95&#xa0;% confidence intervals (CI).<br><br>RESULTS: There were seven included studies (N&#xa0;=&#xa0;1001 children) with 632 patients in the pre-COVID cohort and 369 in the COVID-era cohort. There was a significant difference in the proportion of intracranial complications with a 20&#xa0;% greater risk of having an intracranial complication after the COVID pandemic than before (RR: 1.2 [95&#xa0;% CI: 0.6-2.3], p&#xa0;=&#xa0;0.0097). There was also a significant decrease in the proportion of cases treated conservatively with antibiotics after the pandemic (mean difference 10.8&#xa0;% [95&#xa0;% CI: 2.9&#xa0;%-18.0&#xa0;%], p&#xa0;<&#xa0;0.01). Bacterial epidemiology also experienced a significant shift in composition following the pandemic.<br><br>CONCLUSION: The COVID-19 pandemic has led to a rise in intracranial complications in pediatric AM, with fewer cases being treated solely with antibiotics. Additionally, the pandemic has altered the bacterial epidemiological patterns of AM, highlighting opportunities for further investigation into the characteristics of AM during and after this period to inform and improve future management strategies.}, }
@article {pmid41134222, year = {2025}, author = {Mugwagwa, T and Marcano Belisario, J and Hartley, L and Phan, NTN}, title = {Nirmatrelvir/ritonavir treatment for COVID-19: an economic value systematic literature review.}, journal = {Journal of medical economics}, volume = {28}, number = {1}, pages = {1933-1954}, doi = {10.1080/13696998.2025.2579407}, pmid = {41134222}, issn = {1941-837X}, mesh = {Humans ; *Ritonavir/economics/therapeutic use ; *COVID-19 Drug Treatment ; Cost-Benefit Analysis ; *Antiviral Agents/economics/therapeutic use ; COVID-19 ; Drug Combinations ; SARS-CoV-2 ; }, abstract = {AIMS: Nirmatrelvir/ritonavir (NMV/r) is an antiviral drug used to treat mild-to-moderate coronavirus disease 2019 (COVID-19) in patients at high risk of progression to severe COVID-19. We conducted an economic systematic literature review to assess key parameters, structures, and outcomes of existing models and analyses of the economic value of NMV/r treatment.<br><br>METHODS: A systematic search of Embase, MEDLINE, and MEDLINE In-Process, as well as bibliographies of systematic reviews and conference and health technology assessment websites, identified relevant articles published between 2022 and 2024. A quality assessment was conducted for each economic evaluation using the Drummond checklist.<br><br>RESULTS: Of the 22 included economic evaluations, most were cost-utility analyses (n&#x2009;=&#x2009;10) and cost-effectiveness analyses (n&#x2009;=&#x2009;9). Most used a short-term decision tree with a long-term Markov model (n&#x2009;=&#x2009;5), with time horizons between 28&#x2009;days to a lifetime, and were from a healthcare system perspective (n&#x2009;=&#x2009;7). Most conducted scenario analyses (n&#x2009;=&#x2009;15) and/or sensitivity analyses (n&#x2009;=&#x2009;18), and many based treatment effectiveness estimates on the Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients (EPIC-HR) randomized controlled trial (n&#x2009;=&#x2009;7). Overall, NMV/r showed economic value across different willingness-to-pay thresholds when compared with standard of care or best supportive care, and all economic evaluations were high or moderate quality.<br><br>LIMITATIONS: Most included economic evaluations were from high-income countries and all were written in English and may not be generalizable to low-income countries or healthcare systems.<br><br>CONCLUSION: While economic evaluations were heterogeneous in terms of modeling approach, population, treatments, and context, these findings indicate that NMV/r has economic value for patients with mild-to-moderate COVID-19 with a high risk of progression to severe disease. Significant changes to the burden of COVID-19 due to the evolution of COVID-19 variants and new vaccination strategies, may warrant updates models.}, }
@article {pmid41134172, year = {2025}, author = {Alshareefi, AH and Zaid, MH and Hamdi, HA and Zaylaee, SY and Muthaffar, IY and Salim, AM and Aqeely, EA and Alaqi, SM and Madkhali, HA and Hedari, GF and Hadadi, RA and Shajeri, SM and Harjah, MA}, title = {A Systematic Review of COVID-19 Vaccination Side Effects, Acceptance, and Attitudes Among Healthcare Workers in Saudi Arabia.}, journal = {British journal of hospital medicine (London, England : 2005)}, volume = {86}, number = {10}, pages = {1-18}, doi = {10.12968/hmed.2024.0837}, pmid = {41134172}, issn = {1750-8460}, mesh = {Humans ; Saudi Arabia/epidemiology ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention &amp; control/epidemiology ; *Health Personnel/psychology/statistics &amp; numerical data ; *Vaccination Hesitancy/statistics &amp; numerical data/psychology ; *Vaccination/adverse effects/psychology ; *Attitude of Health Personnel ; SARS-CoV-2 ; *Patient Acceptance of Health Care ; }, abstract = {Aims/Background The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health and the economy. Vaccination is crucial for controlling its spread, and healthcare workers (HCWs) in Saudi Arabia prioritize vaccination. This systematic review aimed to: (1) evaluate the reported side effects of COVID-19 vaccines among HCWs in Saudi, (2) assess vaccine acceptance rates and their temporal changes, and (3) identify the factors influencing vaccine uptake and hesitancy. Methods We conducted a systematic review following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The protocol included: (1) systematic searching of five major databases (MEDLINE, Embase, PubMed, Scopus, and Web of Science) up to 25 November 2024; (2) independent screening and selection by three reviewers using predefined inclusion criteria; (3) quality assessment using the Joanna Briggs Institute (JBI) critical appraisal tool; and (4) standardized data extraction and synthesis focusing on vaccine side effects, acceptance rates, and influencing factors among healthcare workers in Saudi Arabia. Results Of the 220 citations, 30 met the inclusion criteria. Studies have revealed predominantly mild to moderate side effects, with severity patterns varying by professional role and demographic factors. Vaccine acceptance showed significant improvement over time, which was attributed to public health campaigns, peer influence, and improved accessibility. Higher acceptance was correlated with professional experience and education levels, while hesitancy stemmed from safety concerns and efficacy doubts. Conclusion Understanding these patterns supports the development of targeted interventions, suggesting a need for evidence-based communication and peer-led education programs. Healthcare institutions should focus on transparent safety communication and address specific misconceptions to enhance vaccine confidence among HCWs.}, }
@article {pmid41133205, year = {2025}, author = {Báscolo, E and Houghton, N and Bennett, S}, title = {Political economy of primary health care resilience in Latin America and the Caribbean: insights from the WB/PAHO Commission recommendations.}, journal = {Lancet regional health. Americas}, volume = {50}, number = {}, pages = {101241}, pmid = {41133205}, issn = {2667-193X}, abstract = {The World Bank-PAHO Lancet Regional Health Americas Commission, launched in January 2024, aims to transform primary health care (PHC) in Latin America and the Caribbean (LAC) to enhance resilience against public health emergencies. The Commission's 2025 report offer recommendations to strengthen integrated care, community empowerment, resilient financing, and intersectoral collaboration. Implementing these recommendations requires understanding political and economic factors. Political economy analysis provides insights into how stakeholder interests, institutions, ideologies, and political dynamics affect health policy implementation. Key factors include the influence of interest groups, the role of institutions, the conceptualization of PHC, and political ideologies. Historical legacies and institutional path dependence often hinder reform, but crises like the COVID-19 pandemic highlight the importance of robust, equitable health systems. Addressing political polarization and strengthening social participation will be crucial for building resilient PHC systems that respond to future health crises. Policymakers and advocates must consider these factors to implement the Commission's recommendations effectively.}, }
@article {pmid41132774, year = {2025}, author = {Tarasenko, A and Josy, G and Minnis, H and Hall, J and Danese, A and Lau, JYF and Cortese, S and Stringaris, A and Redlich, C and Ougrin, D}, title = {Mental health of children and young people in the WHO Europe region.}, journal = {The Lancet regional health. Europe}, volume = {57}, number = {}, pages = {101459}, pmid = {41132774}, issn = {2666-7762}, abstract = {Most mental health disorders start before adulthood. They are highly prevalent, disabling and often treatable. This Series paper discusses the current problems that contribute to the growing child, adolescent and youth mental health crisis in Europe. These include the impact of the COVID-19 pandemic, escalating military conflicts, the climate crisis, and unregulated digital environments. Mental health problems in youths are further compounded by a changing landscape of how children and young people engage with the world, healthcare and other services. We outline a comprehensive list of recommendations to address mental health problems through the integration of creative prevention and treatment approaches with the help of community-based services and support systems, as well as robust research and implementation strategies to ensure cost-effective, evidence-based care.}, }
@article {pmid41132488, year = {2025}, author = {Xue, J and Wang, X and Wang, H and Qiao, B and Gao, P and Ren, B and Yan, S}, title = {Unraveled role of TLR7-mediated interferon signaling activation in COVID-19.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1658249}, pmid = {41132488}, issn = {2235-2988}, mesh = {Humans ; *COVID-19/immunology ; *Toll-Like Receptor 7/immunology/metabolism ; *Signal Transduction/immunology ; *SARS-CoV-2/immunology ; *Interferons/immunology/metabolism ; Immunity, Innate ; Adaptive Immunity ; Animals ; Autoantibodies/immunology ; }, abstract = {Emerging evidence underscores the critical role of Toll-like receptor 7 (TLR7)-mediated interferon (IFN) signaling in host defense against viral infections including SARS-CoV-2, through the modulation of both innate and adaptive immunity. However, the specific mechanisms by which TLR7 activation shapes SARS-CoV-2-specific immune responses, particularly via IRF-IFN pathways, remain incompletely elucidated. This review synthesizes current findings on how intrinsic TLR7-driven IFN signaling influences viral clearance, modulates adaptive immunity, and contributes to autoantibody production in COVID-19. A deeper understanding of these processes is essential for developing targeted therapeutic interventions and improved vaccines aimed at mitigating severe COVID-19 and preventing post-acute sequelae of SARS-CoV-2 infection (PASC).}, }
@article {pmid41132374, year = {2025}, author = {Zhang, L and Jin, S and Ma, D and Liu, Z and Ye, J and Liu, Q}, title = {The global trends and clinical progress in influenza co-infection: a visualization and bibliometric analysis (2005-2025).}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1658752}, pmid = {41132374}, issn = {1664-302X}, abstract = {OBJECTIVES: Influenza co-infection, characterized by concurrent or sequential infection with influenza and other pathogens, lacks comprehensive quantitative analysis. This study evaluates the status, key hotspots, and clinical advancements in influenza co-infection research from 2005 to 2025 to guide future investigations.<br><br>METHODS: We analyzed articles from 2005 to 2025 sourced from the Web of Science database using R, VOSviewer, and CiteSpace. Concurrently, we extracted clinical trials from PubMed within the same timeframe to assess advancements in the field.<br><br>RESULTS: The study analyzed 3,058 articles, noting a consistent rise in publications on influenza co-infection from 2005 to 2025, with a significant spike between 2020 and 2021. The United States led in publication numbers, followed by China, Germany, the United Kingdom, and France. Among these, the United Kingdom exhibited the highest international collaboration. Key collaborative centers included the Centers for Disease Control and Prevention, Emory University, and St. Jude Children's Research Hospital. "PLOS ONE" and "BMC Infectious Diseases" published the most articles, while "Journal of Virology" and "Journal of Infectious Diseases" were the most cited. Keywords such as "infection", "virus", "COVID-19", "children", and "respiratory syncytial virus" highlighted research hotspots and emerging trends in influenza co-infection. The study of pathogenic mechanisms and immune interactions in influenza-bacterial co-infection remains crucial. The COVID-19 pandemic has intensified research on the epidemiological shifts and clinical impacts of co-infection. Emphasis has also been placed on the significance of pediatric populations in influenza and respiratory viral co-infections. Clinical trials have mainly targeted preventive strategies for high-risk groups and the effects of influenza vaccination on the respiratory microbiome.<br><br>CONCLUSION: This study comprehensively analyzes the current research landscape and identifies key hotspots in influenza co-infection. The findings offer crucial guidance for future studies in this field.}, }
@article {pmid41132120, year = {2025}, author = {Elson, WH and Forbes, A and Jamie, G and Wimalaratna, R and Morbey, R and Hobbs, FDR and de Lusignan, S and Bernal, JL}, title = {A Systematic Review of the Markers of Severity in Acute Respiratory Infections to Inform Primary Care Surveillance.}, journal = {Influenza and other respiratory viruses}, volume = {19}, number = {10}, pages = {e70172}, pmid = {41132120}, issn = {1750-2659}, support = {//UKHSA/ ; }, mesh = {Humans ; *Primary Health Care ; *Respiratory Tract Infections/epidemiology/diagnosis/pathology ; Severity of Illness Index ; Biomarkers/analysis ; COVID-19/epidemiology ; Acute Disease ; Public Health Surveillance ; Influenza, Human/epidemiology ; }, abstract = {BACKGROUND: Primary care computerised medical records (CMR) are used to report the incidence of acute respiratory infections (ARI) for public health surveillance. These systems could increase their utility by also reporting population-level severity of ARI; however, this is rarely done.<br><br>OBJECTIVES: To identify candidate markers of ARI severity suitable for use in primary care CMR-based surveillance.<br><br>METHODS: We undertook a systematic review of bibliographic databases and grey literature. Eligible studies reported characteristics for >&#x2009;500 patients with ARI, severe ARI, influenza-like illness or suspected COVID-19. Studies had to report at least one potential marker of severity. A panel of clinical primary care informaticians reviewed candidate severity markers and assessed each for severity, specificity, relevance to primary care and whether it was likely to be recorded in a CMR.<br><br>RESULTS: We included 126 studies from 84 countries. Seventy-seven candidate severity markers were identified across 11 groups. These included four outcome groups (complications, hospital events, intensive care events and death) and seven predictor groups (symptoms, signs, scores, investigations, treatments, absenteeism and treatment-seeking behaviour). Thirty markers were considered most suitable for primary care CMR-based ARI surveillance: 7 outcomes (such as hospital admission, attendance and death) and 23 predictors (such as shortness of breath, oxygen levels, work absence and antibiotics). Predictors were generally considered more timely, as they are likely recorded during the consultation.<br><br>CONCLUSIONS: This review provides a list of severity markers that could support the development of population-level severity indicators for ARI surveillance in primary care. This could improve real-time situational awareness during respiratory outbreaks.}, }
@article {pmid41131594, year = {2025}, author = {Trojnacki, A and Nguinkal, JA and May, J and Rainer, K and Duscher, GG and Winkelmayer, L and Ungureanu, A and Jaho, E and Vlachostergiou, A and Suciu, G and Stalidi, C and Marcu, L and Annus, H and Kamdron, K and Aasamäe, A and Groschup, M and Dietze, K and Knauf, S and Keller, M and Mellou, K and Politi, L and Neubauer, G and Ignjatović, D and Melo, AM and Peham, JR and Affara, M and Gehre, F}, title = {Assessing rapid response mobile laboratory (RRML) capacities in Europe and Africa to improve One Health disease surveillance activities and pandemic preparedness across two continents.}, journal = {One health outlook}, volume = {7}, number = {1}, pages = {53}, pmid = {41131594}, issn = {2524-4655}, abstract = {BACKGROUND: Europe and Africa are increasingly affected by (re-)emerging risk group 3 and 4, zoonotic viral disease epidemics, which not only require diagnostic BSL-3/4 laboratory capacity but also a One Health-based control strategy for efficient outbreak containment. In many European and African countries such laboratory capacity is often not readily available, and rapid response mobile laboratories (RRMLs) can play important, complementary roles in outbreak responses and pandemic preparedness activities on national, regional and international level.<br><br>MAIN BODY: The aim of the present review was to assess whether existing European and African RRML infrastructure is prepared for future One Health outbreak responses and to identify potential diagnostic gaps. Based on a literature review (2007-2021), we identified 291 mobile laboratories (Europe: 192, Africa: 99) and assessed them in respect to purpose (e.g. military, civilian), design (suitcase, modular, vehicle mounted), biosafety level, laboratory equipment, diagnostic portfolio, sample types analyzed (human, animal) and quality assurance measures. Following peaks in 2014 (Ebola/West Africa) and 2020 (COVID-19), mobile laboratory numbers have steadily increased. Whilst laboratories were originally designed to diagnose viral haemorrhagic fevers, there has been an increased focus on SARS-CoV-2 since 2020. Recently, there was a shift of African countries to develop an independent mobile laboratory capacity, rather than relying on external support for outbreak responses.<br><br>CONCLUSION: We identified key shortcomings of existing laboratories, as the majority only process samples of human origin (not compliant with One Health principles), only 5% have sufficient capacity to diagnose emerging risk group 3/4 (arbo)viruses, 1-10% have accredited quality assurance systems in place, and mobile laboratories are not interconnected to allow concerted national and international responses. Our results reveal the gaps that should be addressed to make future responses to zoonotic, high-consequence pathogens more effective.}, }
@article {pmid41131532, year = {2025}, author = {Ogieuhi, IJ and Ajekiigbe, VO and Agbo, CE and Anthony, CS and Christopher, AA and Onyehalu, JC and Agu, MC and Mbaji, SM and Akingbola, A and Ahmed, B and Ogieuhi, O and Akinmeji, O}, title = {COVID-19 infection and cancer regression: a review of current evidence, potential mechanisms, and clinical perspectives on a Paradoxical phenomenon.}, journal = {Infectious agents and cancer}, volume = {20}, number = {1}, pages = {74}, pmid = {41131532}, issn = {1750-9378}, abstract = {Since its emergence, the coronavirus (SARS-CoV-2) outbreak has been a pandemic responsible for about 7 million deaths worldwide. Numerous studies have been conducted to determine the virus's multiorgan system involvement, particularly its relation to cancer biology. Spontaneous regression of cancer has been observed in some patients with the coronavirus, which may be attributed to the virus's ability to trigger specific immune responses that can be oncolytic and help reduce and eliminate oncogenic cells. This study aims to explore the paradoxical effects of COVID-19 in inducing cancer regression. The paradoxical effect of SARS-CoV-2 infection has been attributed to the possibility of a heightened immune activation possibly triggered by the virus, and some of these include increased levels of cytokines such as interferon and tumor necrosis factor-alpha (TNF-α), as well as the activation of T cells and natural killer (NK) cells. COVID-19-induced cancer regression presents new perspectives on the relationship between viral infections and the immune system's antitumor capabilities. This would help foster future research investigating specific immune pathways activated during SARS-CoV-2 and discover how these can be therapeutically harnessed to aid cancer regression.}, }
@article {pmid41129928, year = {2025}, author = {Atlas, D}, title = {Targeting neurodegeneration and inflammation with thioredoxin-mimetic peptides.}, journal = {Redox biology}, volume = {87}, number = {}, pages = {103899}, pmid = {41129928}, issn = {2213-2317}, mesh = {Humans ; *Neurodegenerative Diseases/drug therapy/metabolism/pathology ; *Thioredoxins/chemistry/metabolism/therapeutic use ; Animals ; *Inflammation/drug therapy/metabolism/pathology ; *Peptides/chemistry/therapeutic use/pharmacology ; Oxidation-Reduction ; Oxidative Stress/drug effects ; }, abstract = {Neurodegenerative and degenerative disorders are in part, driven by imbalances in cellular inflammatory and oxidation-reduction (redox) states. This vulnerability triggers the activation of highly selective and tightly regulated cellular defense networks against oxidative stress (OS), primarily involving the glutathione (GSH) and the thioredoxin (Trx) enzymatic complexes. These systems operate through reversible oxidation/reduction reactions involving the thiol groups of cysteine (Cys) residues, maintaining redox homeostasis and protecting cells from oxidative damage. To reinforce this defense under pathological conditions, a family of thioredoxin-mimetic (TXM) tri- and tetra-peptides was developed, based on the redox-active sequence motif of thioredoxin. These low-molecular-weight amino peptides each bearing two thiol groups, serve as a versatile platform of diverse redox-active molecules. Structurally optimized with blocked N- and C-termini, the TXM peptides exhibit enhanced cell permeability and are capable of crossing the blood-brain-barrier (BBB), thereby enabling therapeutic protection in both systemic degenerative and neurodegenerative disorders. Upon cellular entry, TXM peptides may undergo hydrolysis, potentially generating a cluster of 10-15 Cys-containing fragments including Cys, a precursor of GSH, which could further enhance and prolong their redox activity. This review summarizes key findings on the functional activity of various TXM-peptides, as demonstrated in both in vitro and in vivo models. Particular emphasis is given to TXM-CB3, which has shown protective effects across a wide range of animal models, including those of asthma, mild traumatic brain injury, obesity, viral infection, epilepsy, wound healing, myocardial infarction, aging, and inflammatory bowel-disease. These findings highlight the therapeutic potential of TXM-peptides in protecting cellular function under diverse pathological conditions.}, }
@article {pmid41129757, year = {2025}, author = {Ameratunga, R and Leung, EY and Woon, ST and Lea, E and Chan, L and Mehrtens, JA and Longhurst, HJ and Steele, R and Lehnert, K}, title = {COVID-19 is a living example of Darwinian natural selection, and SARS-CoV-2 evolution is occurring under (and in) our noses.}, journal = {The New Zealand medical journal}, volume = {138}, number = {162}, pages = {65-75}, doi = {10.26635/6965.7039}, pmid = {41129757}, issn = {1175-8716}, mesh = {Humans ; COVID-19 ; *SARS-CoV-2/genetics ; *Selection, Genetic ; Pandemics ; Evolution, Molecular ; *Betacoronavirus/genetics ; *Pneumonia, Viral/virology/epidemiology ; Biological Evolution ; }, abstract = {This review explores COVID-19 (coronavirus disease of 2019) from the perspective of Darwinian natural selection and consequent evolution of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). COVID-19 has caused unprecedented societal and economic turmoil. The human host population has responded with widespread vaccination, therapeutic monoclonal antibodies, convalescent plasma and antiviral drugs. SARS-CoV-2 has demonstrated remarkable resilience and has been able to quickly adapt to its rapidly changing habitat. SARS-CoV-2 has generated new antibody and vaccine evasive mutations in its genome, while simultaneously optimising its infectivity by improving its affinity to the ACE2 receptor and host proteases. Molecular analysis of SARS-CoV-2 has demonstrated natural selection of advantageous mutations in both individual patients with chronic COVID-19 infection and at a host population level, leading to extinction of less fit strains. COVID-19 is living proof of Darwinian evolution, which is occurring in observable time rather than over millions of years. Viewing COVID-19 from an evolutionary perspective will help mitigate the current and future pandemics. The aim of this article is to illustrate these concepts, using examples from the human host peer-reviewed literature.}, }
@article {pmid41129423, year = {2025}, author = {Yılmaz, M and Gökçe, A and Öztürk, O}, title = {What Is the Real Impact of Smoking on Diseases Alleged to Benefit from It?.}, journal = {European addiction research}, volume = {}, number = {}, pages = {1-8}, doi = {10.1159/000549064}, pmid = {41129423}, issn = {1421-9891}, abstract = {BACKGROUND: Cigarette smoking is a major preventable cause of morbidity and mortality worldwide. Despite its well-known harms, epidemiological studies have reported potential protective associations between smoking and certain diseases, necessitating a critical appraisal of these claims.<br><br>SUMMARY: This review evaluates evidence on smoking's impact across eight conditions: endometrial carcinoma, rheumatoid arthritis, ulcerative colitis, Parkinson's disease, uterine leiomyoma, pre-eclampsia, COVID-19, and psychological stress. While observational data suggest inverse associations in some cases, such effects are often modest, mechanistically unclear, and confounded by biases. The review underscores the scarcity of randomized clinical trials and highlights the complexity of disentangling nicotine's biological actions from the broader toxic effects of tobacco smoke.<br><br>KEY MESSAGES: The potential "protective" effects of smoking do not outweigh its well-established detrimental health consequences. Smoking cessation remains paramount, and further rigorous clinical research is needed to clarify these paradoxical findings and to explore the therapeutic potential of nicotine independent of tobacco use.}, }
@article {pmid41129047, year = {2025}, author = {Mohiuddin, M and Asghar, T and Hameed, H and Din, AM and Siddique, A and Younas, S and Mohi Ud Din, M and Ara, R}, title = {The psychobiotic revolution: comprehending the optimistic role of gut microbiota on gut-brain axis during neurological and Gastrointestinal (GI) disorders.}, journal = {World journal of microbiology &amp; biotechnology}, volume = {41}, number = {10}, pages = {401}, pmid = {41129047}, issn = {1573-0972}, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; *Probiotics/therapeutic use ; *Gastrointestinal Diseases/microbiology/therapy ; *Brain ; *Nervous System Diseases/microbiology/therapy ; *Brain-Gut Axis ; Hypothalamo-Hypophyseal System ; COVID-19 ; Animals ; }, abstract = {The microbiota-gut-brain axis is a complex central nexus, intricately communicating with human health, affecting neurophysiological and cognitive processes. In this review article, the therapeutic potential of psychobiotics is comprehensively examined as a relatively new category of probiotics that have been shown to have beneficial effects on mental health, particularly in the context of the increasing prevalence of neurological and gastrointestinal pathologies in developing economies particularly Pakistan. This current discussion examines the pathways through which psychobiotics are postulated to influence their beneficial effect such as their role in biosynthesis of neuroactive substances, the regulation of the hypothalamic-pituitary-adrenal (HPA) axis, and inflammatory response. Some specific strains of bacteria including Lactobacillus plantarum PS128, Lactobacillus helveticus NS8, Bifidobacterium longum 1714, Lactobacillus rhamnosus (JB-1), and Bifidobacterium infantis (35624) play an important role in overcoming anxiety and mood disorders. The neuroactive chemicals (gamma-aminobutyric acid (GABA), dopamine, norepinephrine, acetylcholine, and serotonin) are extracted from gut microbes and have the ability to alter the brain activity. Other metabolites and intermediate substances, such as Brain-Derived Neurotrophic Factor (BDNF) and short-chain fatty acids (SCFAs), maintain the integrity of the intestinal barrier and control the immune system and inflammatory response. The psychobiotic food pyramid aims to protect gut and mental health while psychobiotic supplements are been known to alleviate chronic stress and anxiety. They are used to treat different types of mental conditions, such as neurodegenerative, neurodevelopmental, psychiatric, and GI disorders as well. Mental health disorders (with depression having the highest percentage) are increasing in various countries including Pakistan every day, with women being affected more than men. The review incorporates existing evidence based on both preclinical and clinical studies and clarifies the nexus of critical importance between the disorder of gut microbiota and the pathogenesis of mental health disorders that were aggravated in the course of the COVID-19 pandemic. Additional research is imperative in determining the long-term effectiveness and safety of psychobiotic interventions, particularly against a diverse population and different socioeconomic environments. This study therefore, contributes to highlighting the tremendous potential of psychobiotics as a cost-effective and innovative approach to supplementing traditional mental healthcare modalities.}, }
@article {pmid41127824, year = {2025}, author = {Chen, HB and Xu, AM and Qiu, HB and Chao, J and Zhao, S}, title = {Single-Cell Sequencing Redefines Immune Heterogeneity and Communication Networks in ARDS: Toward Precision Therapeutics.}, journal = {International journal of genomics}, volume = {2025}, number = {}, pages = {9902676}, pmid = {41127824}, issn = {2314-4378}, abstract = {Acute respiratory distress syndrome (ARDS) is a critical condition characterized by diffuse alveolar damage and intense inflammatory responses. During the COVID-19 pandemic, its incidence and mortality have remained persistently high. Conventional approaches have struggled to uncover the complex cellular heterogeneity and dynamic inflammatory networks underlying ARDS. The advent of single-cell sequencing technologies has revolutionized our ability to dissect the molecular mechanisms of ARDS. This review systematically summarizes recent advances in the application of single-cell sequencing in studying pulmonary inflammation in ARDS, with a focus on its strengths in elucidating immune cell heterogeneity, reconstructing intercellular communication networks, and identifying potential therapeutic targets. Furthermore, we discuss current technical limitations and translational challenges, aiming to provide a theoretical foundation and future direction for translating mechanistic insights into precision medicine for ARDS.}, }
@article {pmid41127349, year = {2025}, author = {Shabbir, R and Shabbir, Z and Parente, PEL and Azad, A}, title = {Vaccine hesitancy and bone health: Musculoskeletal sequelae of vaccine-preventable diseases.}, journal = {Osteoporosis and sarcopenia}, volume = {11}, number = {3}, pages = {83-91}, pmid = {41127349}, issn = {2405-5263}, abstract = {Vaccine hesitancy threatens global health by diminishing herd immunity and permitting the return of vaccine-preventable diseases (VPDs) including poliomyelitis, measles and coronavirus disease 2019 (COVID-19). These infections carry short-term and long-term musculoskeletal consequences, such as paralysis, limb deformities, septic or reactive arthritis, osteomyelitis and chronic pain, that place an ever increasing burden on orthopaedic services. This narrative review synthesizes clinical and epidemiological evidence linking sub-optimal immunization to orthopaedic morbidity caused by major VPDs. Outbreak data show that low vaccination coverage precipitates spikes in invasive bacterial disease after varicella, post-polio deformities, tetanus-related fractures, rubella-associated arthritis and COVID-19-related avascular necrosis (AVN). This impact is amplified in rapidly ageing regions such as Asia, where the population ≥ 60 years will nearly double by 2050, significantly increasing the prevalence of sarcopenia and osteoporosis that exacerbate VPD complications. Although orthopaedic surgeons are not primary vaccinators, they routinely manage these downstream effects and hold a trusted position in society from which they are able to strongly advocate for immunization. Integrating brief vaccine counselling, perioperative vaccination checks, and public health initiatives into orthopaedic practice can improve uptake and reduce preventable disability. Strengthening immunization programs and countering hesitancy are essentially critical not only for infection control but also for safeguarding a rapidly declining global musculoskeletal health. A coordinated strategy involving public-health authorities, primary-care providers, and specialists, including orthopaedic surgeons, is essential to mitigate vaccine hesitancy and its orthopaedic sequelae.}, }
@article {pmid41127248, year = {2025}, author = {Ebrahimi, B and Kargar Jahromi, H and Shafiei Jahromi, N and Molayem, M}, title = {A Systematic Review of Ocular Complications Following Different Types of Covid-19 Vaccines.}, journal = {Journal of immunology research}, volume = {2025}, number = {}, pages = {8766021}, pmid = {41127248}, issn = {2314-7156}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology ; *COVID-19 Vaccines/adverse effects ; *Eye Diseases/etiology ; Risk Factors ; *SARS-CoV-2/immunology ; *Uveitis/etiology/epidemiology ; Vaccination/adverse effects ; }, abstract = {INTRODUCTION: More than 6 million deaths from the novel coronavirus, the Coronavirus disease 2019 (COVID-19) infection, have prompted the development of several prophylactic vaccines of COVID-19. This systematic review summarizes the ocular complications of various COVID-19 vaccinations, diseases diagnosed, treatment, and risk factors.<br><br>METHODS: The search was done in PubMed, Web of Science (WOS), and Google Scholar databases. Manifestations were classified depending on the type of vaccines and the interval between vaccination and the onset of symptoms. Other data such as patients' age, gender, underlying diseases, and follow-up data were also extracted.<br><br>RESULTS: Initially, 10,242 articles were identified and 76 articles were eligible that among them 107 cases were reported. Ocular complications were diagnosed more often in Pfizer-BioNTech COVID-19 vaccine and Oxford-AstraZeneca COVID-19 vaccine (AstraZeneca) recipients than in others.<br><br>CONCLUSION: This systematic review highlights a wide range of ocular complications reported after COVID-19 vaccination, the most common of which is uveitis. While most cases were mild and self-limiting, some involved reactivation of preexisting inflammatory diseases. These findings emphasize the importance of postvaccination ocular surveillance. This is particularly important in individuals with a history of ocular inflammation and suggests a potential immunological mechanism that requires further investigation.}, }
@article {pmid41126833, year = {2025}, author = {Maggi, E and Landolina, N and Mariotti, FR and Munari, E and Tumino, N and Vacca, P and Azzarone, B and Moretta, L}, title = {The innate immune response in SARS-CoV2 infection: focus on toll-like receptor 4 in severe disease outcomes.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1658396}, pmid = {41126833}, issn = {1664-3224}, mesh = {Humans ; *Immunity, Innate ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Toll-Like Receptor 4/immunology/metabolism ; Animals ; Signal Transduction ; Killer Cells, Natural/immunology ; }, abstract = {Innate immunity is the first line of defense against infections, including the detection and response to SARS-CoV-2. Cells of the innate system are usually activated within hours after pathogen exposure and do not generate conventional immunological memory. In this review, the current knowledge of the innate immune cells and of pattern-recognition receptors in sensing and responding to SARS-CoV-2 to mount a protective response has been shortly reviewed. Subsequently, the evasion strategies of the virus, as the inhibition of IFN-I/III production and autophagic response, counteracting the innate cell activity (including NK cells), have been briefly outlined. In the course of the infection, these strategies are also capable of rendering dysfunctional most innate cells, thus deeply interfering with the onset and maintenance of adaptive immunity. Possible mechanism(s) for the maintenance of dysfunctional innate immune response are also discussed. In this context, the importance of a rapid and robust activation of innate immunity through toll-like receptor (TLR) 4 as a key paradigm central to host defense against COVID-19 pathogenesis is also illustrated. We also discuss how the viral excess plus inflammatory signals upregulating TLR4 on innate cells may initiate a vicious loop which maintains and improves hyperinflammation, leading to the most critical outcomes. Targeting the TLR4 or its signaling pathway may be a promising therapeutic strategy, offering the dual benefits of viral suppression and decreasing inflammation.}, }
@article {pmid41125407, year = {2025}, author = {Wang, J and Yuan, B and Fang, Y and Zhao, C and Liu, J and Xiong, K}, title = {Post-tuberculosis morbidities and their associated mortality: moving from challenges to solutions.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {178}, pages = {}, pmid = {41125407}, issn = {1600-0617}, mesh = {Humans ; Risk Factors ; *Tuberculosis/mortality ; Antitubercular Agents/therapeutic use/adverse effects ; Morbidity ; *Tuberculosis, Pulmonary/mortality ; Prevalence ; }, abstract = {The case fatality of tuberculosis (TB) has progressively decreased since the use of antibiotics in anti-TB treatment, leaving 155 million TB survivors alive in 2020. Of the 122 million disability-adjusted life years (DALYs) due to TB in 2019, 58 million DALYs were attributed to the post-TB phase. TB causes massive lung structure damage, declined lung function and excessive inflammation, which persist even after microbiological cure and predispose to multiple lung diseases (e.g. COPD, chronic pulmonary aspergillosis, bronchiectasis and COVID-19). TB survivors also face a higher risk of cancers and cardiovascular diseases. These post-TB morbidities together with worse psychological and socioeconomic status lead to poor quality of life and a three- to four-fold higher mortality rate than the general population. Understanding the epidemiology of post-TB morbidities can help to set intervention and research priorities to lower public health burdens associated with post-TB morbidities. In this narrative review, we summarise what we know and do not know about the prevalence, risk factors and management of post-TB morbidities and their associated mortality. We identify the major post-TB morbidities based on current evidence. Delayed or incomplete TB treatment, residual lung structure damage and prolonged inflammation after TB treatment are important risk factors. Developing host-directed therapies to reduce lung structure damage, smoking cessation, implementing pulmonary rehabilitation to improve lung function and adopting well-tailored preventive strategies and screening protocols may improve the management of these post-TB morbidities and mortality and warrant future research.}, }
@article {pmid41124269, year = {2025}, author = {Forgham, H and Chang, Y and Wang, Y and Zhu, J and Liu, L and Biggs, H and Kakinen, A and Jiang, Y and You, X and Thurecht, KJ and Ma, S and Ju, LA and Tao, W and Davis, TP and Wong, JY and Qiao, R}, title = {The evolution of nanomedicine: The rise of next-generation nanomaterials in cancer nanomedicine.}, journal = {Science advances}, volume = {11}, number = {43}, pages = {eadx1576}, pmid = {41124269}, issn = {2375-2548}, mesh = {Humans ; *Nanomedicine/methods/trends ; *Neoplasms/therapy/drug therapy ; COVID-19/prevention &amp; control ; Nanoparticles/chemistry ; *Nanostructures/chemistry/therapeutic use ; SARS-CoV-2 ; Drug Delivery Systems ; Animals ; }, abstract = {The nanomedicine field continues to gain momentum, with several groundbreaking clinical trials underway. However, despite the promise of advanced antifouling nanoparticles incorporating poly(ethylene glycol)-a key component in the development of COVID-19 vaccines-the clinical translation of nanomedicine remains limited. This is primarily due to the relatively low delivery efficacy, with passive targeting relying on the enhanced permeability and retention effect, and active targeting leading to only modest improvements in target tissue accumulation. Improving the targeting, biocompatibility, and functionality of nanoparticles has the potential to create more effective, personalized, and minimally invasive therapies. This review aims to highlight the rise of a previously unidentified order of immune-minded nanomaterials and explores how mechanobiological principles and biomechanical nanotools are revolutionizing our understanding of nano-bio interactions in relation to disease. By considering mechanical properties such as stiffness, surface topology, and behavior under physiological flow conditions, researchers can better engineer nanoparticles for improved therapeutic outcomes.}, }
@article {pmid41123220, year = {2025}, author = {Moore, TJ and Socal, MP and Anderson, G}, title = {Developing New Drugs for the COVID-19 Emergency: Anatomy of the U.S. Response.}, journal = {Pharmacotherapy}, volume = {45}, number = {11}, pages = {780-790}, pmid = {41123220}, issn = {1875-9114}, mesh = {Humans ; United States ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/economics ; *Drug Development/organization &amp; administration/methods ; Drug Approval ; *Drugs, Investigational/therapeutic use ; United States Food and Drug Administration ; COVID-19 ; SARS-CoV-2/drug effects ; }, abstract = {CONTEXT: To meet the need for effective treatments during the COVID-19 Public Health Emergency, the U.S. government sought to accelerate the discovery and development of new antiviral treatments-a process that normally took 4-12 years. The government changed many features of the established system, selecting the investigational drugs, sponsoring or conducting the clinical testing, and purchasing and managing the distribution of the successful products.<br><br>METHODS: We focused on novel therapeutic agents for COVID-19 that were funded, clinically tested, and/or received Emergency Use Authorization during the Public Health Emergency from January 2020 to May 2023. The primary sources were the public records of the National Institutes of Health, the U.S. Food and Drug Administration, and the Biomedical Advanced Research and Development Authority. Excluded were vaccines, devices, diagnostic tests, and new indications for approved drugs.<br><br>RESULTS: In less than 24&#x2009;months, the emergency program developed, tested, approved, and distributed eight new therapeutic products, including six monoclonal antibodies and two new oral antivirals. In addition, 11 other investigational agents were funded or tested under the emergency program but did not receive Emergency Use Authorization. More than 30 million courses of treatment were distributed at a cost of $29 billion or $881 per patient. By the end of the emergency, viral mutations and rapidly growing population immunity rendered the new products ineffective in almost all patients.<br><br>CONCLUSIONS: The emergency program was dramatically effective in finding and testing new drug treatments using a variety of clinically relevant endpoints and serving varied patient populations. Planning for future pandemics should include a global network of clinical testing centers that were key to a rapid response. Research is needed to discover more durable antiviral treatments, especially in settings where mutation and population immunity are subject to rapid change.}, }
@article {pmid41121642, year = {2025}, author = {Hortsch, M and Girão-Carmona, VCC and Leite, ACRM and Nikas, IP and Gatumu, MK and Koney, NK and Arko-Boham, B and Yohannan, DG and Oommen, AM and Li, Y and Yang, J and Trollope, AF and Meyer, AJ and Van Nuland, SE}, title = {A global overview of anatomical science education and its present and future role in biomedical curricula.}, journal = {Anatomical sciences education}, volume = {}, number = {}, pages = {}, doi = {10.1002/ase.70137}, pmid = {41121642}, issn = {1935-9780}, abstract = {The four main anatomical sciences, gross anatomy, histology, neuroanatomy, and embryology, are fundamental subjects for most health professionals and biomedical students. Usually taught as part of preclinical basic science training, the anatomical sciences provide a structural understanding of human or animal bodies at both macroscopic and microscopic levels. This overview characterizes how the anatomical sciences are currently taught around the globe, highlighting similarities, differences, and recent curricular transformations that were partially in response to the COVID-19 pandemic. Globally, educators of the anatomical sciences navigate similar pressures, including expectations of curricular integration and reduced time for anatomical teaching. Student-centered teaching approaches and e-learning technologies have been adopted across many regions, transforming how educators engage their learners. However, not all educators are provided with technological resources to facilitate such educational advancements, particularly in regions where economic inequality and poor infrastructure hinder access to the internet. Though ethical standards guiding the procurement of human bodies have evolved over time, the sources of human bodies that academic institutions use for anatomy education vary widely. Specific regional issues complicate many aspects of anatomical science education, challenging educators to adopt novel teaching approaches. Despite some differences, every global region appears to be moving in a similar direction. However, where academic institutions fall on that trajectory differs for specific regions/countries. How these educational and technological changes influence anatomy education should be carefully considered for the strengths and weaknesses they provide and the opportunities and threats they bring.}, }
@article {pmid41120028, year = {2026}, author = {Song, Y and Zhang, S and Wang, R and Zhang, Y and Zhang, Y and Lin, H and Wang, F}, title = {Ginseng as promising natural medicine against infectious diseases: Therapeutic targets and potential mechanisms.}, journal = {Journal of ethnopharmacology}, volume = {356}, number = {}, pages = {120764}, doi = {10.1016/j.jep.2025.120764}, pmid = {41120028}, issn = {1872-7573}, mesh = {Humans ; *Panax/chemistry ; Animals ; *Ginsenosides/pharmacology/therapeutic use/isolation &amp; purification ; *Communicable Diseases/drug therapy ; *Anti-Infective Agents/pharmacology/therapeutic use/isolation &amp; purification ; Phytotherapy ; }, abstract = {C.A. Meyer (ginseng) has been esteemed for centuries in traditional Chinese, Korean, and indigenous medicine as a vital tonic and therapeutic agent for enhancing resilience and treating infectious diseases. Historically, used for respiratory or skin infections, gastrointestinal disorders, etc. These applications align with modern evidence supporting its broad-spectrum anti-infective activity. Ginsenosides, the principal bioactive constituents, have been shown to exert targeted effects against diverse infectious pathogens. This review integrates ethnomedical insights with contemporary pharmacology, highlighting ginseng's translational potential in combating antimicrobial resistance and emerging infectious diseases.<br><br>AIM OF THE STUDY: This review aims to elucidate the therapeutic targets and molecular mechanisms of ginsenosides' anti-infective activities and critically evaluates their translational potential in addressing emerging infectious diseases and antimicrobial resistance.<br><br>MATERIALS AND METHODS: A comprehensive literature search was conducted across PubMed, Web of Science, ScienceDirect, SpringerLink, Elsevier, and the Chinese National Knowledge Infrastructure (CNKI) using keywords such as "ginsenosides", "anti-infective", "antiviral", "antibacterial", and "immunomodulation". Relevant studies published in English and Chinese were systematically screened, extracted, and analyzed to elucidate the mechanisms and clinical potential of ginsenosides in combating infectious diseases.<br><br>RESULTS: Ginsenosides exhibit anti-infective effects through three major mechanisms: (i) direct inhibition of viral entry and replication; (ii) immunomodulatory activity via activation of macrophages, T cells, and dendritic cells; and (iii) suppression of pro-inflammatory pathways, particularly NF-&#x3ba;B and MAPK signaling. They also demonstrate synergistic effects with conventional therapies against key pathogens such as influenza virus and SARS-CoV-2. Additional benefits include modulation of the gut microbiota and enhancement of host immune responses, underscoring their multifaceted therapeutic profile.<br><br>CONCLUSION: Ginsenosides represent promising natural anti-infective agents with broad-spectrum activity. This review highlights their mechanistic basis and clinical potential, supporting their development as novel therapeutics in the fight against infectious diseases, including the urgent threat of antimicrobial resistance.}, }
@article {pmid41117273, year = {2025}, author = {Oba, S and Hosoya, T and Iwai, H and Yasuda, S}, title = {Long COVID: mechanisms of disease, multisystem sequelae, and prospects for treatment.}, journal = {Immunological medicine}, volume = {}, number = {}, pages = {1-24}, doi = {10.1080/25785826.2025.2570902}, pmid = {41117273}, issn = {2578-5826}, abstract = {Long COVID has emerged as a significant global health issue, affecting individuals across a wide spectrum of initial disease severity. While its definition and prevalence vary across studies, persistent symptoms such as fatigue, cognitive dysfunction, respiratory difficulties, and cardiovascular complications have been widely reported. Multiple pathophysiological mechanisms have been proposed, including incomplete viral clearance, reactivation of latent viruses, immune dysregulation, autoimmunity, endothelial dysfunction, microbiome alterations, and mitochondrial impairment. These interconnected processes are thought to contribute to chronic inflammation and multi-organ disease. To date, there are no established therapies for Long COVID, and management primarily focuses on symptomatic relief and rehabilitation. Vaccination has been shown to reduce the incidence of Long COVID, and emerging strategies, including antiviral agents, immune-modulating therapies, microbiome restoration, and mitochondria-targeted interventions, are under investigation. This review summarizes the current understanding of the epidemiology, pathophysiology, organ-specific manifestations, and potential therapeutic approaches for Long COVID, aiming to provide insights into future research directions and clinical management strategies.}, }
@article {pmid41117125, year = {2025}, author = {Sanchez, ZM and Y Valente, J and da Silva Dos Santos, MH and Oliveira E Souza, R}, title = {Substance Use During the COVID-19 Pandemic in the Americas: A Scoping Review.}, journal = {Substance use &amp; addiction journal}, volume = {}, number = {}, pages = {29767342251370454}, doi = {10.1177/29767342251370454}, pmid = {41117125}, issn = {2976-7350}, abstract = {BACKGROUND: During the COVID-19 pandemic, substance use in the Americas was influenced by various factors, including social isolation, increased stress, and disruption of healthcare services. While the impacts varied across populations, the health crisis exacerbated challenges related to substance use, particularly in more vulnerable groups. This article aims to describe the pandemic's impact on substance use and substance use disorders in the Americas region.<br><br>METHODS: We conducted a scoping review across 4 databases (Pubmed, Scielo, Lilacs, and Google Scholar) using a search paradigm based on the combination of several keywords related to substance use during the COVID-19 pandemic in the Americas.<br><br>RESULTS: Most studies were conducted at the beginning of the pandemic and carried out in the United States and Canada. A higher proportion of the general population decreased or showed no changes in cannabis consumption. On the other hand, for those who reported pre-pandemic substance use, consumption has increased as a strategy to cope with COVID-related stress, exacerbating preexisting problems. Patients with substance use disorders reduced their visits to treatment services and in-person medication visits declined significantly. In an attempt to reverse the distancing of patients from the services, there was an increase in take-home medication and telehealth services. Rates for opioid-related deaths and other substance overdose-related deaths increased during the pandemic, especially among racial/ethnic minorities.<br><br>CONCLUSION: The study concludes that the pandemic-intensified substance use among vulnerable populations, particularly individuals with pre-existing mental health conditions or a history of substance use disorders, while having a low impact on the general population. This divergence has contributed to widening health disparities.}, }
@article {pmid41116823, year = {2025}, author = {Ebrahim, MA and Makundi, SE and Mushi, NN and Ibrahim, PM and Osman, RS and Fidaali, Z and Nkya, DA}, title = {Multisystem inflammatory syndrome in children associated with COVID-19: a case report and literature review.}, journal = {The Pan African medical journal}, volume = {51}, number = {}, pages = {96}, pmid = {41116823}, issn = {1937-8688}, mesh = {Humans ; *COVID-19/diagnosis/complications/therapy/physiopathology ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/virology/physiopathology ; Immunoglobulins, Intravenous/administration &amp; dosage ; Female ; Child ; Methylprednisolone/administration &amp; dosage ; Myocarditis/virology/etiology ; Gastroenteritis/virology/diagnosis ; }, abstract = {Given the rarity of multisystem inflammatory syndrome related to COVID-19 (MIS-C). This case report highlights the high index of suspicion to diagnose MIS-C in a child who presented with symptoms suggestive of acute gastroenteritis. While admitted in the hospital, she deteriorated with worsening of symptoms, clinical decline, deranged laboratory markers, and significant radiological findings, even though on antibiotics. She had acute myocarditis with myocardial dysfunction on echocardiography and raised cardiac enzymes. Intravenous human immunoglobulin (IVIG) was given, but there was additional need for inotrope (norepinephrine) and methylprednisolone albeit the preliminary echocardiogram was normal. Early recognition of MIS-C with rapid escalation of care post IVIG administration is needed to prevent morbidity and mortality.}, }
@article {pmid41116774, year = {2025}, author = {Wright, A and McGrowder, D and Bryan, S}, title = {Nitric Oxide in the Treatment of COVID-19: Nasal Sprays, Inhalants and Nanoparticles.}, journal = {Biochemistry research international}, volume = {2025}, number = {}, pages = {8846903}, pmid = {41116774}, issn = {2090-2247}, abstract = {Although the World Health Organization has declared that the coronavirus disease (COVID-19) is not a public health emergency of international concern anymore, it has negatively impacted the world, and effective treatment for this pandemic remains a major priority. Vaccine effectiveness has been a matter of concern given the evolution of variants and subvariants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thus, continued protection against SARS-CoV-2 and its variants is still necessary and could work alone or in parallel with vaccinations to treat COVID-19 in the future. Further, findings from in vitro and in vivo studies have noted the effectiveness of high dosages of nitric oxide (NO) as an antimicrobial agent against respiratory pathogens such as bacteria, viruses and fungi. NO has been previously utilized in the management of SARS-CoV and has shown a similar antiviral effect with SARS-CoV-2 in vivo and in vitro. Effective therapy with NO can be used to target several stages of COVID-19 infection to prevent transmission and progression of the disease. The unique properties of NO allow this simple, gaseous molecule to be administered in various forms. NO can be used as an inhalant, in the form of NO donor drugs such as S-nitrosothiols and more recently as NO-releasing nanoparticles (NO-nps). This review summarizes the bioavailability of NO in COVID-19 patients and highlights in vivo and in vitro studies as well as clinical trials with NO administered as a nasal spray, inhalant, or via nanodelivery for therapeutic applications for COVID-19 and other respiratory infections in the future.}, }
@article {pmid41116592, year = {2025}, author = {Mutee, AF and Shareef, A and Jyothi, SR and Panigrahi, R and Abbot, V and Chauhan, AS and Singh, S and Abduvoyitov, B and Sameer, HN and Yaseen, A and Athab, ZH and Adil, M}, title = {Exploring Potential Mechanisms for Epilepsy After mRNA COVID-19 Vaccination: An Extremely Rare Side-Effect.}, journal = {Scandinavian journal of immunology}, volume = {102}, number = {4}, pages = {e70059}, doi = {10.1111/sji.70059}, pmid = {41116592}, issn = {1365-3083}, mesh = {Humans ; *Epilepsy/immunology/etiology ; *COVID-19/prevention &amp; control/immunology ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/adverse effects/immunology ; Vaccination/adverse effects ; BNT162 Vaccine/adverse effects ; 2019-nCoV Vaccine mRNA-1273/adverse effects ; }, abstract = {The rapid rollout of mRNA-based COVID-19 vaccines, including Pfizer-BioNTech's BNT162b2 and Moderna's mRNA-1273, has been instrumental in curbing the pandemic, demonstrating high efficacy and safety in the general population. However, concerns regarding neurological adverse effects, particularly in individuals with epilepsy (PWE), warrant scrutiny. Clinical data from case reports, multicenter studies, and meta-analyses (encompassing over 3000 PWE) indicate that most tolerate vaccination well, with seizure worsening in approximately 5% of cases, often transient and lower than post-COVID-19 infection rates. Rare severe events, such as status epilepticus, highlight vulnerabilities, though background seizure incidence remains comparable or lower than natural rates. This review examines potential neuroimmune mechanisms linking mRNA vaccination to seizure exacerbation, emphasising immune activation, neuroinflammation, and epileptogenesis. mRNA vaccines utilise lipid nanoparticles (LNPs) to deliver spike protein-encoding mRNA, eliciting robust immune responses. Potential triggers for seizures include cytokine storms (e.g., IL-1β, TNF-α, IL-6), blood-brain barrier (BBB) disruption, molecular mimicry with neuronal antigens, and autoantibody production, which may heighten neuronal hyperexcitability in susceptible individuals. Neurological side effects, including Bell's palsy, transverse myelitis, and herpes zoster reactivation, are more prevalent in mRNA platforms, potentially tied to LNP-induced inflammation or cross-reactive immunity. While evidence supports vaccination benefits outweighing risks for PWE, gaps persist in understanding individual predispositions. Future research should prioritise longitudinal studies, EEG monitoring, and AI-driven approaches for personalised risk assessment, mRNA optimisation, and pharmacovigilance. Integrating multi-omics and computational modelling could enhance vaccine safety, ensuring equitable protection for vulnerable populations.}, }
@article {pmid41115503, year = {2025}, author = {Bratzler, DW}, title = {COVID-19 in retrospect: Public health lessons from a global crisis.}, journal = {The American journal of the medical sciences}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.amjms.2025.10.008}, pmid = {41115503}, issn = {1538-2990}, abstract = {The COVID-19 pandemic, emerging in late 2019, rapidly evolved into a global health crisis of unprecedented scale. Initially marked by widespread transmission and severe illness, the pandemic overwhelmed healthcare systems, disrupted economies, and exposed deep-rooted inequalities. Over 775 million cases and an estimated 18-33 million global deaths were recorded by 2024. The crisis illuminated critical vulnerabilities in pandemic preparedness, healthcare infrastructure, and public health communication. Key lessons included the need for resilient supply chains, robust data systems, equitable healthcare access, and sustained investment in public health. Misinformation significantly hindered response efforts, underscoring the importance of aligned scientific and public health messaging. The pandemic also triggered debates over civil liberties and public health authority. While rapid vaccine development was a major achievement, the overall response highlighted systemic gaps. These insights offer a roadmap for improving future pandemic responses and safeguarding global health security.}, }
@article {pmid41115313, year = {2025}, author = {Gualotuña-Suntaxi, J and Pérez-Muñoz, D and Zambrano-Villacres, R and Zambrano, AK and Simancas-Racines, D and Angamarca-Iguago, J}, title = {Available evidence on integrating COVID-19 into sentinel surveillance systems: A scoping review.}, journal = {Medwave}, volume = {25}, number = {9}, pages = {e3026}, doi = {10.5867/medwave.2025.09.3026}, pmid = {41115313}, issn = {0717-6384}, mesh = {Humans ; *COVID-19/epidemiology/diagnosis ; *Sentinel Surveillance ; Pandemics ; Hospitalization/statistics &amp; numerical data ; }, abstract = {INTRODUCTION: The COVID-19 pandemic exposed the weaknesses of epidemiological surveillance systems and highlighted the need to integrate new respiratory viruses into sentinel surveillance systems. However, current evidence on their effectiveness remains limited.<br><br>AIM: This project conducts a scoping review to describe the available evidence on the integration of COVID-19 into sentinel surveillance systems.<br><br>METHODS: The included studies addressed sentinel surveillance in the context of the pandemic following the World Health Organization declaration. A systematic search was performed in databases including MEDLINE, LILACS, EPISTEMONIKOS, and DIMENSIONS, selecting observational studies and systematic reviews. Data collection and analysis were organized into categories such as clinical characteristics, timely detection, geographic representativeness, co-infection, and adaptability with genomic surveillance. Seventeen studies reporting on COVID-19 integration impact and one preliminary WHO report were identified.<br><br>RESULTS: Results identified the most prevalent symptoms in the general population: fever (73%), cough (51.8%), loss of taste or smell (45.1%), hypoxemia (33%), and sputum production (23.9%). A high correlation was obtained between SARI cases or hospitalizations due to respiratory infection and the incidence of COVID-19 (&#x3c1; = 0.78 and &#x3c1; = 0.82 respectively).<br><br>CONCLUSIONS: Integrating COVID-19 into the sentinel surveillance system could improve detection, response, and follow-up capacity. Additionally, implementing standardized case definitions promotes more efficient use of laboratory resources, thereby enhancing the sustainability of the surveillance system.}, }
@article {pmid41113908, year = {2025}, author = {Boraschi, D and Carsetti, R and Chen, L and Tagliabue, A and Tan, AT and Wang, B}, title = {Advocating mucosal immunization: A global need in a viewpoint from China.}, journal = {Innovation (Cambridge (Mass.))}, volume = {6}, number = {10}, pages = {100951}, pmid = {41113908}, issn = {2666-6758}, abstract = {Human mucosal immunization is expected to afford protection against infection and reduce transmission by generating anti-infective immunity at the mucosal entry site of viruses and bacteria. Nasal or oral administration has the advantage of being needle free and self-administered, thereby improving compliance and coverage of large populations. In China, the experience of COVID-19 has promoted substantial efforts in the development of nasal vaccinations in the general health protection strategy. The hurdles we are facing in the development of mucosal vaccines, however, come from the still limited knowledge of the mechanisms controlling mucosal immunity in different anatomical locations and in response to different pathogens/vaccines. Identifying and filling the knowledge gaps in order to develop effective and safe mucosal immunization strategies requires global collaboration, not only at the scientific level but, most importantly, by engaging public and private health organizations, governments, and regulatory authorities. We have highlighted here some of the crucial issues in mucosal immunization and provided suggestions for the way forward toward a global preparedness effort to prevent infectious diseases and ensure vaccine equity.}, }
@article {pmid41112617, year = {2025}, author = {Ding, W and Zhang, Y and Wang, MZ and Wang, S}, title = {Post-pandemic mental health: Understanding the global psychological burden and charting future research priorities.}, journal = {World journal of psychiatry}, volume = {15}, number = {10}, pages = {109502}, pmid = {41112617}, issn = {2220-3206}, abstract = {The coronavirus disease 2019 pandemic has left an indelible mark on global mental health, with widespread psychological consequences that persist beyond the acute phase of the virus. This review synthesizes current evidence on the post-pandemic mental health burden across diverse populations, highlighting elevated rates of depression, anxiety, posttraumatic stress, and substance use disorders linked to prolonged social isolation, economic instability, and grief. We examine disparities in psychological outcomes among vulnerable groups (e.g., healthcare workers, survivors, marginalized communities) and identify key challenges in addressing these issues, including fragmented healthcare systems, stigma, and the limited scalability of interventions. Emerging evidence on resilience factors (e.g., social support and adaptive coping) is also discussed. Finally, we propose critical priorities for future research, including longitudinal studies on the chronic mental health effects, the development of culturally tailored interventions, and the integration of digital mental health solutions. This review distinctively addresses enduring post-pandemic mental health challenges, integrating neurobiological insights, equity-focused interventions, and critical perspectives on digital solutions, gaps underrepresented in prior syntheses. By charting a roadmap for multidisciplinary collaboration, this review aims to inform policymakers and researchers in mitigating the long-term psychological aftermath of the pandemic.}, }
@article {pmid41112575, year = {2025}, author = {Xin, R and Garigliany, MM and Li, J}, title = {KAP1 in antiviral immunity: dual roles in viral silencing and immune regulation.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1618103}, pmid = {41112575}, issn = {2235-2988}, mesh = {*Tripartite Motif-Containing Protein 28/immunology/metabolism/genetics ; Humans ; Animals ; SARS-CoV-2/immunology ; Influenza A virus/immunology ; Protein Processing, Post-Translational ; Host-Pathogen Interactions/immunology ; *Virus Diseases/immunology/virology ; Retroviridae/immunology ; }, abstract = {Krüppel-associated box (KRAB)-associated protein 1 (KAP1), also known as TRIM28 due to its tripartite motif (TRIM) domain, is a member of the transcription intermediary factor 1 (TIF1) family. Since its discovery in 1996, KAP1 has been widely studied as a scaffold protein involved in histone methylation, heterochromatin formation, and genome maintenance. Its function and stability are dynamically regulated by post-translational modifications (PTMs), including phosphorylation, SUMOylation, and acetylation. In addition, KAP1 serves as a signal transducer via its SUMO/ubiquitin E3 ligase activity. This review summarizes current advances in understanding the roles of KAP1 in regulating retroviruses (RVs), herpesviruses, and emerging respiratory viruses such as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and influenza A virus (IAV), with a particular focus on the interplay between its structural domains and physiological functions. Recent findings on human immunodeficiency virus (HIV) are highlighted to address ongoing mechanistic controversies, particularly those involving KAP1-mediated latency control. We further examine novel insights into KAP1's involvement in other viruses, including hepatitis B virus (HBV), porcine reproductive and respiratory syndrome virus (PRRSV), and African swine fever virus (ASFV). as well as its emerging regulatory roles in host innate immune responses through PTM-mediated modulation of antiviral signaling pathways. Although KAP1 exerts both antiviral and proviral effects, the underlying mechanisms remain incompletely defined, especially in systems where conflicting observations exist for the same pathogen. These discrepancies-reflecting both methodological variation and KAP1's inherent regulatory complexity-underscore the need for deeper mechanistic insight. Future studies utilizing precise genetic tools and in vivo models will be critical for elucidating the context-specific roles of KAP1 in viral gene regulation and advancing its translational potential.}, }
@article {pmid41112192, year = {2025}, author = {Cavada, BS and Osterne, VJS and Oliveira, MV and Ferreira, WP and Neto, CC and Nascimento, KS and Pinto-Junior, VR}, title = {Bridging Viral Glycobiology and Lectin Biotechnology for Antiviral and Diagnostic Strategies.}, journal = {ACS bio &amp; med chem Au}, volume = {5}, number = {5}, pages = {792-814}, pmid = {41112192}, issn = {2694-2437}, abstract = {Lectins, proteins that reversibly bind specific glycan motifs, offer dual utility as molecular probes or inhibitors of virus-host interactions. This review explores the molecular interactions between lectins and viral envelope glycoproteins, emphasizing their applications as antiviral agents and diagnostic tools. Enveloped viruses, such as HIV, Influenza, Herpesviruses, and Coronaviruses, exhibit dense glycosylation on their surface proteins, forming a glycan shield rich in high-mannose and complex glycans crucial for viral processes and immune evasion. Lectins exploit these glycan shields by selectively targeting conserved glycosylation sites on key viral proteins like gp120 (HIV), hemagglutinin (Influenza), spike (SARS-CoV-2), and glycoprotein D (HSV), thereby interfering with viral entry. Potent inhibitory activity across diverse virus families has been demonstrated for natural lectins such as griffithsin (GRFT), cyanovirin (CV-N), and banana lectin (BanLec), with novel fungal and algal lectins continually expanding the list. Concurrently, lectin-based biosensors utilizing electrochemical, plasmonic, and microfluidic platforms, often enhanced by nanomaterials or aptamers, enable sensitive and specific detection of glycosylated viral targets. Despite challenges including potential immunogenicity and production scalability, ongoing bioengineering efforts aim to refine lectin specificity, reduce toxicity, and enhance overall functionality. These collective advances showcase the role of lectins as versatile molecular tools for the detection, inhibition, and mechanistic study of viral pathogens.}, }
@article {pmid41111875, year = {2025}, author = {Mohammed, M and Konda, M and Ganti, L}, title = {Deficiency and Development: A Bibliometric Analysis of the Effects of Iron Deficiency on Human Development.}, journal = {Cureus}, volume = {17}, number = {9}, pages = {e92544}, pmid = {41111875}, issn = {2168-8184}, abstract = {Iron is an important micronutrient for biological and neurocognitive function. Iron deficiency is significantly undertreated; yet, for many vulnerable populations, such as women and children, iron deficiency is prevalent and leads to serious developmental consequences. As global trends continue to rise, it is crucial to research trends in this area. Publications were extracted from the Web of Science (WoS) Core Collection database, specifically containing the keywords "iron deficiency" and "development." A total of 6,850 articles were acquired from the search. A bibliometric analysis was then conducted on VOSViewer 1.6.2 to assess data concerning the publication year, country, journal, and keyword frequency. The quantity of published articles on iron deficiency and development has an overall increasing trend, dominated by the United States, China, and India. The top five publishing journals included Nutrients, Journal of Nutrition, and American Journal of Clinical Nutrition, with the Journal of Nutrition having the highest link strength. The frequently co-occurring keywords included iron, anemia, and iron-deficiency. Although COVID-19 had some disruption on publication due to priority on the pandemic-related research, the overall global trend. The occurrence of nutrition journals suggests an emphasis on the nutritional aspects of managing iron deficiency. The recurring keywords highlight the data focus primarily on early pediatric care, plant science, and medical research.}, }
@article {pmid41111765, year = {2025}, author = {Sato, T and Kakuda, K and Sekiguchi, E and Ishiseki, M and Iwanami, M and Akamatsu, Y and Taito, S}, title = {Psychological Safety and Burnout in Nurses: A Scoping Review.}, journal = {Cureus}, volume = {17}, number = {9}, pages = {e92411}, pmid = {41111765}, issn = {2168-8184}, abstract = {Burnout among nurses has become a global problem, with prevalence rates exceeding 40% in high-intensity clinical settings. Psychological safety represents a shared belief about team interpersonal risk-taking safety. These constructs have emerged as potential protective factors in recent research. However, studies that simultaneously examine both constructs remain limited, thereby hindering the development of evidence-based interventions aimed at promoting psychological safety and preventing burnout.Therefore, we conducted a scoping review to evaluate and synthesize existing literature that investigates the direct relationship between psychological safety and burnout among nurses, with emphasis on the conceptualization, measurement, and contextual association of these constructs within the nursing profession. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology and complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive literature search was conducted across Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Excerpta Medica Database, International Clinical Trials Registry Platform, and ClinicalTrials.gov. The search was conducted using terms related to psychological safety, burnout, and nurses. Studies were deemed eligible if they involved nurses employed in hospital-based settings and simultaneously examined the concepts of psychological safety and burnout. All published studies that examined psychological safety and burnout among nurses were included, with data extracted on study design, setting, country of origin, publication year, definitions used, measurement instruments, reported scores, and associated factors. Of 1,021 initially identified studies, six met the inclusion criteria, comprising 4,984 nurses across the United States, China, Pakistan, Japan, and South Korea, published between 2021 and 2025. Study designs included four cross-sectional studies, one longitudinal study, and one non-randomized controlled trial, conducted across diverse healthcare settings, including coronavirus disease 2019 wards, emergency departments, and psychiatric units. Three studies reported a consistent inverse relationship between psychological safety and burnout. Psychological safety was consistently defined in accordance with Edmondson's framework, while burnout was assessed based on Maslach's three-dimensional conceptualization. Leadership style, particularly servant leadership, emerged as a key factor potentially influencing both constructs. Workplace conditions, including patient acuity, exposure to workplace violence, and team dynamics, were identified as significant contextual factors.This review provides evidence of a consistent inverse relationship between psychological safety and burnout among nurses, with Edmondson's and Maslach's frameworks offering appropriate conceptual foundations for future research. These findings suggest that promoting psychological safety serves as a protective organizational strategy in high-intensity clinical settings. They also underscore the need for comprehensive, multi-level interventions focused on leadership development, structured communication protocols, and robust organizational support systems to enhance psychological safety and mitigate the risk of burnout.}, }
@article {pmid41110781, year = {2025}, author = {Borrow, R and Caugant, DA and Clark, SA and Dinleyici, E&#xc7; and Hall, I and Harrison, LH and Hausdorff, WP and Ladhani, SN and Lucidarme, J and Sáfadi, MAP and Smith, V and Taha, MK and Vázquez, J}, title = {Current global trends in meningococcal disease control, risk groups and vaccination: Consensus of the Global Meningococcal Initiative.}, journal = {The Journal of infection}, volume = {91}, number = {5}, pages = {106635}, doi = {10.1016/j.jinf.2025.106635}, pmid = {41110781}, issn = {1532-2742}, mesh = {Humans ; *Meningococcal Infections/prevention &amp; control/epidemiology ; *Meningococcal Vaccines/administration &amp; dosage/immunology ; Neisseria meningitidis/immunology/classification ; Vaccination ; Global Health ; COVID-19/epidemiology ; }, abstract = {This review outlines recent trends on invasive meningococcal disease (IMD) discussed at the latest meeting of the Global Meningococcal Initiative (GMI). There has been a re-emergence of the Hajj strain sublineage (serogroup W; ST-11 clonal complex), with travel to the Kingdom of Saudi Arabia being a critical factor in transmission. The epidemiology of IMD has also changed following the COVID-19 pandemic, with annual IMD cases increasing in many countries. For example, the highest number of IMD cases since 2014 was reported in the USA in 2023-2024. Atypical presentations of IMD have been prominent irrespective of the pandemic. For instance, an increase in cases of meningococcal epiglottitis has been reported in France in 2022-2023 (serogroups W and Y). When considering vaccination, the GMI has identified a need for broader meningococcal serogroup B (MenB) immunisation owing to the potential impact of the vaccines on reducing IMD incidence caused by other serogroups than MenB. There is also a case for using MenB vaccination to protect against Neisseria gonorrhoeae infection based on initial evidence, albeit further studies will need to be conducted.}, }
@article {pmid41110316, year = {2025}, author = {Li, W and Chen, X and Liu, C and Olatunji, OJ and Le, TD and Ashaolu, TJ and Ashaolu, JO}, title = {Vitamin D deficiency and respiratory health: A narrative review bridging gaps in public health through innovative strategies and sustainable solutions.}, journal = {Journal of infection and public health}, volume = {19}, number = {1}, pages = {103013}, doi = {10.1016/j.jiph.2025.103013}, pmid = {41110316}, issn = {1876-035X}, abstract = {Vitamin D deficiency is a global public health issue, highly prevalent in middle-income and Eastern Mediterranean countries. It is associated with increased risks of respiratory infections like COVID-19 and influenza, alongside osteoporosis and cardiovascular disease. Functioning as an immunomodulator, vitamin D enhances macrophage activity, suppresses inflammatory cytokines, and induces antimicrobial peptides. Observational studies link deficiency to a higher risk of infection, although clinical trial results are mixed. Risk factors include dark skin, older age, urban living, and reduced sun exposure. This narrative review synthesized findings from peer-reviewed literature (2000-2025) in databases such as PubMed, Scopus, and Web of Science. It focuses on addressing respiratory infections associated with vitamin D deficiency through multifaceted public health strategies. These include policy-led food fortification, biofortification, public awareness campaigns, and technological innovations to increase dietary vitamin D intake and reduce the global burden of deficiency and respiratory infection.}, }
@article {pmid41109407, year = {2025}, author = {Gentilotti, E and Górska, A and Tacconelli, E}, title = {Research on post-COVID syndrome: current gaps and future perspectives.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {161}, number = {}, pages = {108129}, doi = {10.1016/j.ijid.2025.108129}, pmid = {41109407}, issn = {1878-3511}, mesh = {Humans ; *COVID-19/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {While it is generally assumed that the outcome of an infectious disease is either recovery or death, post-acute infection syndromes have long been documented, representing a substantial healthcare burden with biological drivers remaining poorly understood. Among post-acute infection sequelae, post-COVID syndrome has proved to be an elusive condition with a complex and dynamic presentation. Over the past 3 years, multiple cohorts have been created to understand, prevent, and treat post-COVID-19 condition (PCC). Drawing upon the substantial experience gathered during the pandemic, this viewpoint undertakes a rigorous examination of the methodological challenges inherent in current PCC observational research. By analyzing "real-life" hurdles, we aim to provide clear guidance for future investigations into post-acute infection syndromes and enhance global preparedness for emerging health threats.}, }
@article {pmid41108594, year = {2025}, author = {Akbar, N and Phadke, S and Mehelay, S and Pullattayil, AK and Fakolade, A and Busse, M}, title = {Considerations of race and ethnicity within rehabilitation studies for post COVID-19 condition: A scoping review.}, journal = {PM &amp; R : the journal of injury, function, and rehabilitation}, volume = {}, number = {}, pages = {}, doi = {10.1002/pmrj.70027}, pmid = {41108594}, issn = {1934-1563}, abstract = {Post COVID-19 condition (PCC) or long COVID disproportionately affects racial and ethnic minority communities. There are a growing number of rehabilitation studies for PCC, however, it has yet to be determined whether existing studies take race and ethnicity into account in their study designs and whether existing rehabilitative approaches are equally effective across diverse racial and ethnic groups. The objective of this study was to describe the extent to which rehabilitation studies of PCC consider race and ethnicity in defining eligibility criteria, planning recruitment strategies, designing intervention delivery and adherence promoting approaches, selecting outcome measures, and reporting results. Of the 4845 studies screened, 23 met eligibility criteria and were included in this review. The most common reason for exclusion was a lack of mention of race or ethnicity anywhere within the article. Among the 23 studies included, 13 studies provided data on the race and/or ethnicity characteristics of their sample, with 88% of participants across all of these studies being White. Less than 25% of studies described the incorporation of race and/or ethnicity in their recruitment strategies (n = 3, 13%) or data analysis (n = 5, 22%). Greater racial and ethnic diversity is needed within rehabilitation studies for PCC as there is currently a significant underrepresentation of racial and ethnic minorities in existing studies. Overall, more PCC rehabilitation studies need to incorporate race and ethnicity into their study designs as it is not well understood whether existing rehabilitation strategies are equally effective across different racial and ethnic groups.}, }
@article {pmid41108384, year = {2025}, author = {Lv, Y and Zhu, L and Li, FH and Li, H}, title = {Nonadherence to anti-VEGF intravitreal injections in patients with diabetic macular edema : The names of the authors.}, journal = {Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie}, volume = {}, number = {}, pages = {}, pmid = {41108384}, issn = {1435-702X}, support = {No. GSWSKY2025-086//Health Commission of Gansu Province/ ; }, abstract = {Diabetic macular edema (DME) is a principal cause of impaired vision in individuals with diabetes. The effectiveness of treatment using intravitreal injection (IVI) of anti-vascular endothelial growth factor (anti-VEGF) has been established in clinical trials, and it has become the treatment of choice for the majority of DME patients. However, real-world treatment outcomes for patients with DME have consistently lagged behind those reported in clinical trials. Nonadherence to IVI treatment and loss to follow-up (LTFU) limit the results of clinical treatment for patients with DME in real-world conditions.Herein, we report results from different real-world studies and analyse high levels of nonadherence to anti-VEGF treatment in patients with DME. IVI adherence may involve a variety of patient-related, condition-related, therapy-related, and COVID-19-related factors. Notably, although the overall adherence rate to IVI declined during the COVID-19 pandemic, targeted interventions addressing treatment barriers significantly improved DME patient adherence. In this review, we highlight changes in IVI practices that were implemented to reduce nonadherence in patients with DME during the pandemic, along with other emerging strategies, including assessments of the risk of visual impairment and prioritisation of treatment; distinguishing among types of appointments; modifications of anti-VEGF injection protocols; diversification of medical services, telemedicine, and artificial intelligence (AI); and improvements in patient education.Our analysis identified multifaceted factors associated with nonadherence to IVI among DME patients and proposed corresponding intervention strategies. Future investigations should focus on developing clinically feasible adherence assessment tools and standardised metrics to facilitate individualised therapeutic decision-making. We advocate for the systematic integration of adherence monitoring into standardized clinical workflows as a fundamental component of IVI management protocols. This evidence-based paradigm holds significant promise in addressing the growing practical challenges in contemporary DME management.}, }
@article {pmid41107883, year = {2025}, author = {Zhou, T and Zhang, S and Liu, S and Yu, J}, title = {Digital technology integration in home-based exercise: a systematic review of research evolution, applications, and impact mechanisms.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3528}, pmid = {41107883}, issn = {1471-2458}, mesh = {Humans ; *Digital Technology ; COVID-19/epidemiology ; *Exercise ; *Exercise Therapy/methods ; Telemedicine ; }, abstract = {The integration of digital technologies in home-based exercise (HBE) has emerged as a critical public health intervention, particularly following the COVID-19 pandemic. However, comprehensive understanding of how digital technologies influence HBE research evolution and practice remains limited. This systematic review aims to: (1) map the knowledge evolution of digital technology-supported HBE research, (2) analyze innovative applications and value propositions of digital technologies in HBE, (3) identify key determinants of HBE participation in the digital era, and (4) predict future development trends. Following PRISMA guidelines, we conducted a comprehensive search of the Web of Science database from 2000 to 2024, yielding 311 articles for bibliometric analysis using CiteSpace and VOSviewer. Results indicated that digital technology-supported HBE research has grown exponentially, peaking in 2022. We identified seven core research themes, including intelligent exercise training, AI-driven fall prevention, wearable device interventions, virtual reality rehabilitation, mobile health applications, cancer patient tracking systems, and remote diagnostics. These themes highlight innovative approaches to personalized training, remote monitoring, and immersive rehabilitation experiences, demonstrating significant value in enhancing exercise adherence and health outcomes. Key determinants of HBE participation were identified at personal (social support, professional guidance, self-efficacy) and technological (digital literacy, accessibility, user interface design, data privacy) levels. Digital technologies demonstrate substantial potential for enhancing HBE accessibility, improving adherence, and reducing public health burden. Future research should prioritize addressing digital equity and developing evidence-based implementation frameworks to ensure sustainable and inclusive digital health interventions.}, }
@article {pmid41107683, year = {2025}, author = {Iskuzhina, L and Turaev, Z and Rozhin, A and Romanov, A and Skomorokhova, E and Ishmukhametov, I and Rozhina, E}, title = {Artificial intelligence in biology and medicine.}, journal = {Die Naturwissenschaften}, volume = {112}, number = {6}, pages = {80}, pmid = {41107683}, issn = {1432-1904}, mesh = {*Artificial Intelligence/ethics ; Humans ; COVID-19 ; *Biology/methods ; *Medicine/methods ; SARS-CoV-2 ; }, abstract = {This article explores the role of artificial intelligence (AI) in medicine and biology. Special attention is given to areas of biology such as genomics, proteomics, biotechnology, cell, and synthetic biology. In the field of medicine, the emphasis is on diagnosis, vaccine development, and treatment of various diseases, including COVID-19. The future of AI is explored, including explainable AI and biologically inspired models, as well as the synergy of AI with other advanced technologies, such as robotics and nanotechnology. The limitations and challenges facing AI are also analysed, including ethical and legal aspects, data quality issues, and the need for standardisation. The article emphasises that the potential of AI can both improve the quality of life and accelerate scientific discovery, and increase the occurrence of risks associated with its introduction into the scientific process. It concludes by emphasising the need for responsible use of AI to preserve scientific diversity and innovation.}, }
@article {pmid41106514, year = {2025}, author = {Ma, W and Hu, ZB and Zhu, N and Yu, Y and Shen, W and Fang, WJ}, title = {An overview of needle-free injection technology in human vaccines.}, journal = {International journal of pharmaceutics}, volume = {685}, number = {}, pages = {126287}, doi = {10.1016/j.ijpharm.2025.126287}, pmid = {41106514}, issn = {1873-3476}, mesh = {Humans ; *Vaccines/administration &amp; dosage ; *COVID-19/prevention &amp; control ; *Vaccination/methods ; Injections/methods ; Needles ; *COVID-19 Vaccines/administration &amp; dosage ; }, abstract = {With the outbreak of the COVID-19 pandemic, the harmful effects of infectious diseases have gained widespread attention among the public. Vaccination is one of the most effective means of preventing infectious diseases, and the willingness to receive vaccinations is a key factor influencing the success of vaccination programs. Infants and young children, with relatively low immune levels, are a primary target group for preventive vaccinations. However, they often exhibit strong anxiety, resistance, and crying when facing traditional needle-based injections, which highlights the clinical significance of developing needle-free vaccination methods. In recent years, needle-free injection technology has been widely applied to the administration of various medications, but its application in human vaccines remains limited, with only a few commercially available products. This paper provides a review of needle-free injection technology, covering its classification and development history, research progress in vaccine applications, the advantages of needle-free human vaccines, the current status and prospects of market applications, as well as the technical challenges and considerations involved in developing needle-free human vaccines. The review aims to explore the prospects of developing needle-free vaccine formulations for human use.}, }
@article {pmid41106257, year = {2025}, author = {Sousa, VC and Freitas, FC and Gouveia E Silva, EC and Santos, NO and de Melo, D and da Silva, SCA and Nogueira, DSS and Fu, C and de Godoy, CG and Pompeu, JE and Schmitt, ACB}, title = {Functional impact for indication and access to physical therapy after hospital discharge due to COVID-19.}, journal = {Clinics (Sao Paulo, Brazil)}, volume = {80}, number = {}, pages = {100807}, pmid = {41106257}, issn = {1980-5322}, abstract = {INTRODUCTION: After hospitalization for COVID-19, patients may present impairment in functionality and require physical therapy after hospital discharge for functional recovery.<br><br>OBJECTIVE: To understand the association between Covid-19 functional impacts and physical therapy indication and access 30 days and 1 year after hospital discharge of severely and critically ill patients.<br><br>METHODS: Cross-sectional study with two assessments: 30 days and one year after hospital discharge, in individuals &#x2265; 18 years of age, admitted to a referral hospital in S&#xe3;o Paulo between June 2020 and July 2021. A convenience sample of 345 patients was used. The Poisson test was used to estimate the prevalence ratio for the association between Covid-19 functional impacts and physical therapy indication and access, with &#x2264; 0.05 considered significant.<br><br>RESULTS: Of the 185 patients included, 67 % (n: 104) were indicated for physical therapy and the majority (53 %; n:79) could not access it 30 days after hospital discharge. Post-Covid-19 functional limitations were associated with physical therapy indication (PR: 1.69; 95 %CI 1.1-2.5) and impairment in basic activities of daily living (BADLs) with access 30 days (PR: 1.81; 95 %CI 1.2 -2.6) and 1 year after discharge (PR: 1.70; 95 %CI 1.2-2.3). Physical therapy indication was significant, with a 4.07 and 2.06 likelihood of access 30 days and 1 year after discharge.<br><br>CONCLUSION: Despite the lack of functional criteria at discharge, patients with poor functional performance perceived the need for physical therapy indication and referral. Indication was essential for access to physiotherapy within the healthcare network.}, }
@article {pmid41104805, year = {2025}, author = {Luo, S and Lai, LY and Zhu, R and Gao, Y and Zhao, Z}, title = {Prevalence and duration of common symptoms in people with long COVID: a systematic review and meta-analysis.}, journal = {Journal of global health}, volume = {15}, number = {}, pages = {04282}, pmid = {41104805}, issn = {2047-2986}, mesh = {Humans ; *COVID-19/epidemiology/complications ; Prevalence ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Time Factors ; Fatigue/epidemiology ; }, abstract = {BACKGROUND: During the COVID-19 pandemic, an increasing number of patients have reported persistent symptoms after recovery, a phenomenon known as long COVID. These symptoms may persist for weeks or months, affecting the patient's daily life and health. To systematically understand the long-term impact of long COVID, this study conducted a systematic review and meta-analysis. This study aims to determine the long-term effects of long COVID by identifying, evaluating and summarising the incidence and duration of persistent symptoms after the acute phase of COVID-19.<br><br>METHOD: We searched PubMed, Embase, and medRxiv up to August 2021 for articles and preprints presenting original research on the symptoms of long COVID. Following title/abstract and full-text screening, based on the PICOS framework, we excluded articles that did not clearly report on diagnoses, reported on symptoms lasting less than four weeks, lacked epidemiological data, or did not provide complete data. We assessed the bias of included studies using the Newcastle-Ottawa Scale. For effects reported in more than two studies, we performed meta-analysis of prevalence, and also counted the duration of each symptom.<br><br>RESULTS: We included 19 observational studies in the meta-analysis, through which we determined the incidence and duration of five common long COVID symptoms, including cognitive/memory/attention disorders (36%, unreported duration), fatigue (34%, 5.5 months), mental health problems (including anxiety and depression, 31%, 3.5-3.8 months), and dyspnoea (24%, 6.52 months) and chest pain (23%, 2 months).<br><br>CONCLUSIONS: The symptoms of long COVID usually persist after the acute phase of COVID-19. The clustering of long COVID symptoms provides a direction for studying the aetiology, diagnosis, and management of post-COVID conditions. Our findings provide important baseline data for the prevention and treatment of long COVID.}, }
@article {pmid41104804, year = {2025}, author = {Raza, MW and Uddin, F and Rahman, O and Hossain, MB}, title = {Driving the Consumer Adoption of Halal Cosmetics: A Systematic Review Using PRISMA and TCCM Framework.}, journal = {Journal of cosmetic dermatology}, volume = {24}, number = {10}, pages = {e70479}, pmid = {41104804}, issn = {1473-2165}, mesh = {Humans ; *Consumer Behavior/statistics &amp; numerical data ; *COVID-19/epidemiology/prevention &amp; control ; *Cosmetics ; Marketing ; }, abstract = {BACKGROUND: The COVID-19 epidemic has fuelled increasing anxiety regarding the environment and religiosity. Moreover, the worldwide halal cosmetics industry is expected to experience significant growth in the years ahead. Still, the reasons that drove people all across to choose halal cosmetics are unclear.<br><br>OBJECTIVES: The study aims to find factors influencing halal cosmetics purchases. Based on the findings, the review proposes a conceptual framework and new directions for future research in the context of halal cosmetics.<br><br>METHOD: The PRISMA &amp; TCCM framework systematically evaluates 51 empirical articles on consumers' behaviors regarding the purchase of halal cosmetics from Scopus between 2014 and 2024 for the review.<br><br>RESULTS: The review suggests forthcoming investigations to utilize Consumer Culture theory, Social Practice theory, and the UTAUT model. By highlighting patterns in halal cosmetics literature, the paper helps to guide future research in underexplored domains such as artificial intelligence and e-commerce.<br><br>PRACTICAL IMPLICATIONS: The review contributes to the existing corpus of knowledge regarding the theoretical perspective of contemporary halal marketing through its proposed conceptual framework. In particular, scholars, academicians, and practitioners may delve into the reliable body of literature on halal cosmetics.<br><br>ORIGINALITY/VALUE: This study examines consumer behavior regarding the consumption of halal cosmetics. It pinpoints research gaps and offers future avenues using the TCCM framework. In addition, it provides the conceptual framework for measuring the behavior of halal cosmetics.}, }
@article {pmid41104504, year = {2025}, author = {Kris, LP and Dixon, DL and Bihari, S and Carr, JM}, title = {Revisiting the monocrotaline-treated rat as a model of inflammatory lung disease: COVID-19 and future pandemic threats?.}, journal = {Animal models and experimental medicine}, volume = {8}, number = {10}, pages = {1785-1793}, pmid = {41104504}, issn = {2576-2095}, support = {//College of Medicine and Public Health, MD, Advanced Studies Program/ ; GNT2003683//Australian National Health and Medical Research Council (NHMRC)/ ; }, mesh = {Animals ; *COVID-19 ; Rats ; *Disease Models, Animal ; *Monocrotaline ; SARS-CoV-2 ; Lung/pathology ; Pandemics ; Humans ; Inflammation ; Hypertension, Pulmonary/chemically induced ; Cytokines/metabolism ; }, abstract = {The COVID-19 pandemic posed a challenge for clinical management of a new lung disease that was characterized by inflammation, endothelial cell dysfunction, and thrombosis, which occur after the replication phase of infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There are many laboratory models of active SARS-CoV-2 infection in mice, reflecting an acute lung injury in an otherwise healthy animal, but there is a lack of accurate animal models of the postviral inflammatory phase of the COVID-19 lung reflecting severe disease. The monocrotaline (MCT)-treated rat is a widely used laboratory model of pulmonary hypertension (PH). Not often discussed, however, are the observed changes in inflammation, edema, fibrosis, and microthrombosis in the lung prior to PH. At the cellular level, there is loss of pneumocytes and endotheliopathy, and at the molecular level the MCT rat lung is characterized by a pro-inflammatory cytokine profile, namely elevated interleukin 6, transforming growth factor β and tumor necrosis factor, M1 macrophage phenotype, and dysregulation of the angiotensin converting enzyme (ACE)/ACE2 balance. The systems-level pathophysiology of the MCT-treated rat includes progressive cardiopulmonary dysfunction. The MCT-treated rat clearly differs from the COVID-19 lung in terms of the triggers for pathology, but there are many parallels apparent in both the MCT-treated rat and the COVID-19 lung. The MCT-treated rat lung as a model of the COVID-19 lung may provide an in-depth understanding of the factors that drive the lung to more severe pathology, treatments that benefit lung recovery, or the factors that prove a useful research platform for future emerging respiratory threats of similar pathology.}, }
@article {pmid41103428, year = {2025}, author = {Wang, J and Tao, R and Jiang, Y and Ma, Z and Xia, L}, title = {Risk factors for postherpetic neuralgia: a meta-analysis based on demographic, clinical features, and treatment characteristics.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1667364}, pmid = {41103428}, issn = {1664-3224}, mesh = {Humans ; *Neuralgia, Postherpetic/epidemiology/etiology/therapy ; Risk Factors ; Comorbidity ; Female ; Male ; Age Factors ; Herpes Zoster ; Middle Aged ; }, abstract = {BACKGROUND: This study aims to comprehensively analyze the independent risk factors of postherpetic neuralgia (PHN) through a systematic evaluation, including demographic characteristics, clinical manifestations, treatment regimens, comorbidities, and virological factors, in order to provide evidence-based support for the early identification of high-risk patients and the optimization of preventive strategies in clinical practice.<br><br>METHOD: A systematic search of PubMed, Embase, and the Cochrane Library was conducted to identify studies reporting risk factors for PHN. After screening the literature according to predefined inclusion and exclusion criteria, effect size indicators such as odds ratios (OR) and 95% confidence intervals (95% CI) for each risk factor were extracted. Meta-analyses were performed using RevMan 5.4 and Stata 15.0 software, with a random-effects model applied to pool effect sizes. Publication bias was assessed using Egger's test, and sensitivity analysis was conducted by sequentially removing individual studies to verify the robustness of the result.<br><br>RESULTS: Age (&#x2265;60 years), severe rash manifestations, prodromal pain symptoms, smoking history, alcohol abuse, immunosuppressive status, and comorbidities including diabetes mellitus, chronic obstructive pulmonary disease (COPD), hypertension, malignant tumors, or chronic kidney disease, along with high viral load, have been identified as independent risk factors for the development of PHN(p<0.05). In contrast, gender differences and socioeconomic status were not significantly associated with PHN incidence, with insufficient evidence observed (I&#xb2;>50%, p>0.05).<br><br>CONCLUSION: This meta-analysis confirms that older age (&#x2265;60 years), severe rash, prodromal pain, immunosuppressive therapy, and smoking are significant risk factors for PHN. Furthermore, it identifies alcohol abuse, T2DM, COPD, hypertension, cancer, high pain scores (as measured by VAS or NRS), and high HZ viral load as additional risk factors. COVID-19 may represent a potential risk factor that must be further investigated. The association between socioeconomic status and PHN remains inconclusive, while antibody levels against varicella-zoster virus (VZV) may serve as a protective factor.<br><br>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42025629699.}, }
@article {pmid41103058, year = {2025}, author = {Moghadam, SHP and Sarkoohi, A and Navidi, Z and Amani, B and Amani, B and Khorramnia, S}, title = {Comparing the Effectiveness and Safety of Remdesivir and Molnupiravir in COVID-19: A Systematic Review and Meta-Analysis.}, journal = {Immunity, inflammation and disease}, volume = {13}, number = {10}, pages = {e70289}, pmid = {41103058}, issn = {2050-4527}, mesh = {Humans ; *Adenosine Monophosphate/analogs &amp; derivatives/therapeutic use/adverse effects ; *Alanine/analogs &amp; derivatives/therapeutic use/adverse effects ; *Antiviral Agents/therapeutic use/adverse effects ; *Hydroxylamines/therapeutic use/adverse effects ; SARS-CoV-2 ; COVID-19/mortality ; *Cytidine/analogs &amp; derivatives/therapeutic use/adverse effects ; *COVID-19 Drug Treatment ; Treatment Outcome ; Ribonucleosides/therapeutic use ; Betacoronavirus/drug effects ; Pandemics ; }, abstract = {BACKGROUND: Remdesivir and molnupiravir have been approved and are being used as viable treatment options for patients with coronavirus disease 2019 (COVID-19). This systematic review and meta-analysis sought to evaluate and compare the safety and effectiveness of these two antiviral drugs in the treatment of COVID-19.<br><br>METHODS: An extensive search was conducted across several databases, including Web of Science, PubMed, the Cochrane Library, and medRxiv, up to July 1, 2024. To evaluate the risk of bias, a standardized bias assessment tool was used. Data from the selected studies were analyzed using Comprehensive Meta-Analysis software.<br><br>RESULTS: The analysis included data from 10 studies, encompassing a total of 5766 patients. According to the meta-analysis, remdesivir and molnupiravir showed no statistically significant differences in mortality (odds ratio [OR]&#x2009;=&#x2009;2.54, 95% confidence interval [CI]: 0.67, 9.57), hospitalizations (OR&#x2009;=&#x2009;2.43, 95% CI: 0.81, 7.24), viral clearance rates (OR&#x2009;=&#x2009;1.49, 95% CI: 0.64, 3.46), or average time to viral clearance (standardized mean difference&#x2009;=&#x2009;0.02, 95% CI: -0.40, 0.46). However, the incidence of adverse events was lower in the remdesivir group (OR&#x2009;=&#x2009;0.49, 95% CI: 0.26, 0.93). The certainty of evidence for these findings was evaluated and determined to be low or moderate.<br><br>CONCLUSION: The findings of this study suggest that remdesivir and molnupiravir have similar effectiveness in treating COVID-19 outpatients; however, molnupiravir is associated with a higher rate of adverse events. Additional studies are required to enable a more thorough evaluation of these treatments for COVID-19.}, }
@article {pmid41103004, year = {2025}, author = {Lokesh, BVS and Sreedharan Nair, R and Mohd Hashim, NB and Maw Shin, GS}, title = {Targeted respiratory viral infection therapy using mucoadhesive nanodrug-polymer conjugates: a comprehensive review.}, journal = {Journal of biomaterials science. Polymer edition}, volume = {}, number = {}, pages = {1-32}, doi = {10.1080/09205063.2025.2574939}, pmid = {41103004}, issn = {1568-5624}, abstract = {The pulmonary route presents a highly effective approach for treating respiratory infections, enabling targeted drug delivery with rapid absorption and minimal systemic toxicity. Inhalation therapy, which bypasses first-pass metabolism, offers localized treatment for conditions such as COVID-19 and influenza, providing faster relief and reducing hospitalizations. Polymeric drug-conjugate nanoparticles, proven effective in lung cancer therapies, hold promise for viral infections by enhancing drug bioavailability and targeting precision while minimizing side effects. This review explores the potential of aerosol-based antiviral drug delivery systems, specifically focusing on the design, conjugation, and application of polymeric nanoparticles using natural and biodegradable polymers. We highlight the role of mucoadhesive properties and polymer-drug conjugation to improve drug retention through electrostatic interactions with respiratory mucin, critical for effective delivery. Challenges such as aerosolization efficiency, inhaler device design, particle size, and site-specific release are discussed, along with strategies to overcome these hurdles. The use of biodegradable, pH-responsive polymers for controlled release and targeted delivery is emphasized, considering the physiological differences between healthy and infected lungs. Future strategies for scalable, self-administered inhalable polymeric nanodrug conjugates are outlined, with the potential to reduce viral loads, limit transmission, and minimize systemic side effects in the treatment of respiratory viral infections.}, }
@article {pmid41102745, year = {2025}, author = {Ma, J and Zhang, S}, title = {Prevalence and risk factors of intimate partner violence among pregnant women: a systematic review and meta-analysis.}, journal = {BMC pregnancy and childbirth}, volume = {25}, number = {1}, pages = {1104}, pmid = {41102745}, issn = {1471-2393}, mesh = {Humans ; Female ; Pregnancy ; *Intimate Partner Violence/statistics &amp; numerical data/psychology ; Risk Factors ; Prevalence ; *Pregnant People/psychology ; Adult ; }, abstract = {BACKGROUND: Intimate partner violence (IPV) has adverse physical and psychological effects on pregnant women. With regard to the influencing factors of IPV among pregnant women, discrepancies still exist in clinical studies. By identifying these factors, more targeted and effective interventions can be developed for this population. Consequently, this review aims to examine the impact of IPV on pregnant women and provide an empirical basis for the development of preventive strategies in clinical practice.<br><br>METHOD: Bibliographic databases like PubMed, Embase, Web of Science, Science Direct, Cochrane Library, CBM, VIP, CNKI, and Wan Fang Data were employed in the investigation for retrieving articles. A thorough evaluation of all study designs was conducted to understand the impact of IPV on pregnant women, focusing on articles published before May 2025. In total, 36,214 pregnant women were included in the studies reviewed.<br><br>RESULTS: A total of 33,355 articles were retrieved, and 37 articles were systematically screened to evaluate the influencing factors of IPV among pregnant women. The meta-analysis revealed that the prevalence of IPV in pregnant women was 34%[95%CI (27%-41%)]. Sixteen significant influencing factors were identified: Age of pregnant women<25, Partner's smoking habit, Unemployed, Low level of education, Undesired pregnancy, Partner's Khat chewing habit, Partner's alcohol drinking habit, household income, Experience of violence before the current pregnancy, Parental exposure to IPV, Living alone, Rural dwellers, Income loss due to COVID-19, Household decisions made by husband alone, partner controlling behaviors, and partner has more than one wife.<br><br>CONCLUSION: IPV has detrimental effects on the physical and mental well-being of pregnant women. Consequently, prompt implementation of prevention and intervention strategies is essential to decrease the prevalence of IPV and enhance the quality of life for pregnant women. Numerous factors contribute to IPV during pregnancy. Healthcare providers should systematically identify these high-risk factors and offer targeted preventive guidance to effectively reduce its incidence at its root cause.<br><br>TRIAL REGISTRATION: CRD420251046017.}, }
@article {pmid41102617, year = {2025}, author = {Hui, DSC and Chan, KKP}, title = {Host Immunomodulatory Interventions in Severe Influenza.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S262-S272}, doi = {10.1093/infdis/jiaf328}, pmid = {41102617}, issn = {1537-6613}, support = {INF-CUHK-2//Health and Medical Research Fund Commissioned Research on Influenza/ ; HMRF 19180242//Health and Medical Research Fund Commissioned Research on Influenza/ ; T11-712/19-N//Hong Kong Special Administrative Region; and RGC theme-based research schemes/ ; T11-705/21-N//Hong Kong Special Administrative Region; and RGC theme-based research schemes/ ; }, mesh = {Humans ; *Influenza, Human/immunology/drug therapy/therapy ; COVID-19/immunology ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; *Immunomodulating Agents/therapeutic use ; Adrenal Cortex Hormones/therapeutic use ; Immunization, Passive ; COVID-19 Drug Treatment ; *Immunologic Factors/therapeutic use ; Immunoglobulins, Intravenous/therapeutic use ; }, abstract = {Currently, no immunomodulatory agents have been conclusively shown to benefit severe influenza. The World Health Organization conditionally advises against the use of systemic corticosteroids, macrolides, plasma therapy, mechanistic target of rapamycin inhibitors, and nonsteroidal anti-inflammatory drugs for such patients. High-dose systemic corticosteroids may increase mortality and morbidity in severe influenza; the potential of low-dose corticosteroids merits further study given survival benefits in patients with severe coronavirus disease 2019 (COVID-19). Passive immunotherapy using convalescent plasma or intravenous immunoglobulin (IVIG) from healthy donors has not proven effective, suggesting that future research should focus on hyperimmune plasma or IVIG from recent infections. An open-label randomized controlled trial (RCT) found that a triple combination of oseltamivir, clarithromycin, and naproxen improved outcomes in severe influenza. One RCT has indicated that sirolimus with corticosteroids can expedite liberation from mechanical ventilation and reduce viral load, warranting larger trials of sirolimus alone. In contrast, adding macrolides or nitazoxanide has not consistently improved clinical outcomes. Promising evidence exists for anti-C5a antibodies in COVID-19, while case reports hint that intravenous N-acetylcysteine may benefit severe influenza pneumonia. Observational data on statins remain conflicting. Further studies on COX-2 inhibitors in combination with antivirals and other immunomodulators are needed. Mycophenolic acid, pamidronate, and peroxisome proliferator-activated receptor gamma agonists are low priorities due to toxicity concerns. Research into human mesenchymal stromal cells and herbal medicine remains inconclusive. Overall, these findings support large-scale trials to validate promising results and address limitations in small studies. Treatment of severe influenza requires a multidisciplinary approach that integrates antiviral and immunomodulatory strategies. Clarifying these roles may enhance patient outcomes.}, }
@article {pmid41102609, year = {2025}, author = {Beigel, JH and Oldach, D}, title = {Polyclonal and Monoclonal Antibodies for the Treatment and Prevention of Influenza.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S347-S358}, pmid = {41102609}, issn = {1537-6613}, support = {//National Institute of Allergy and Infectious Diseases/ ; /NH/NIH HHS/United States ; }, mesh = {Humans ; *Influenza, Human/prevention &amp; control/therapy/drug therapy/immunology ; *Antibodies, Monoclonal/therapeutic use ; COVID-19 ; SARS-CoV-2 ; *Antibodies, Viral/therapeutic use ; Clinical Trials as Topic ; }, abstract = {While at least 8 monoclonal and 3 polyclonal antibody products have been tested in clinical trials for the treatment of influenza, no products have been licensed, and most have stopped clinical development. The COVID-19 pandemic demonstrated that these approaches, especially monoclonal antibodies, may have unique potential in certain stages of disease and populations, especially in preventing severe disease in a population without preexisting immunity or in those with a limited capacity to mount an effective humoral immune response. This review summarizes past and ongoing efforts in using monoclonal and polyclonal antibodies for the treatment and prevention of influenza, focusing on products that have entered clinical trials and drawing lessons from COVID-19 to direct future efforts on these strategies.}, }
@article {pmid41102608, year = {2025}, author = {Zambon, M and Myles, P and Sugaya, N}, title = {Use of Influenza Antivirals in Pandemic Response.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S177-S190}, doi = {10.1093/infdis/jiaf307}, pmid = {41102608}, issn = {1537-6613}, support = {//UK Health Security Agency/ ; NIHR201395//National Institute of Health Research/ ; }, mesh = {Humans ; *Antiviral Agents/therapeutic use ; *Influenza, Human/drug therapy/epidemiology/prevention &amp; control ; *Pandemics/prevention &amp; control ; COVID-19 ; SARS-CoV-2 ; History, 20th Century ; History, 21st Century ; }, abstract = {Pandemics of respiratory illness with devastating societal impact have been recognized since antiquity. This article reviews how, in the last 100 years, the response to influenza pandemics has gradually evolved from fragmented crisis response to vaccines and direct acting antivirals (DAAs).The first pandemic to make use of mass antiviral prophylaxis and treatment was in 2009. Introduction of DAAs for seasonal influenza management in 1999/2000 provided a foundation for use in the pandemic response. Lessons from the 2009 pandemic helped inform the response to the COVID-19 pandemic in 2020. DAAs, antibody therapies, and immune modulators may all have a role to play in minimizing the severity of disease from a pandemic virus strain. Rapid clinical studies evaluating potential therapeutic options will likely be necessary; an agile research infrastructure is a crucial element of a pandemic response capability. Preplanning different pandemic influenza scenarios and the likely treatment uncertainties will help maintain healthcare system preparedness.}, }
@article {pmid41102607, year = {2025}, author = {Damhorst, GL and Lam, WA}, title = {Point-of-care and Home Use Influenza Diagnostics for Advancing Therapeutic and Public Health Strategies.}, journal = {The Journal of infectious diseases}, volume = {232}, number = {Supplement_3}, pages = {S314-S326}, pmid = {41102607}, issn = {1537-6613}, support = {//Flu Lab/ ; U54EB027690/NH/NIH HHS/United States ; }, mesh = {Humans ; *Influenza, Human/diagnosis/therapy ; COVID-19/epidemiology ; *Point-of-Care Systems ; *Point-of-Care Testing ; SARS-CoV-2 ; United States ; Public Health ; }, abstract = {Point-of-care (POC) antigen-based diagnostics for influenza that have been granted waived status since the Clinical Laboratory Improvement Amendments of 1988 (CLIA-waived) have been available commercially in the United States for the last 25 years. Improved sensitivity, molecular, CLIA-waived tests have entered the market in the last 10 years. More recently, a new generation of assay technologies authorized for home use and available for over-the-counter sale has been introduced primarily though Emergency Use Authorization pathways during the SARS-CoV-2 pandemic. While evidence for the clinical impact of waived and home use diagnostic technologies is limited, their emerging availability and capabilities carry promise for impact on influenza management. In this review, we discuss the regulatory aspects, history, and capabilities of POC and home use influenza diagnostics. We draw on specific examples from the COVID-19 pandemic to propose ways in which these technologies can advance diagnostic and therapeutic strategies and highlight areas of need for ongoing investigation.}, }
@article {pmid41100177, year = {2025}, author = {Ummer, O and Sarangi, A and Khanna, A and Mohan, D and Scott, K and LeFevre, A}, title = {Lessons Learned From Over 20 Years of Telemedicine Services in India: Scoping Review of Telemedicine Services Initiated From 2000 to 2023.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e63984}, pmid = {41100177}, issn = {1438-8871}, mesh = {India ; *Telemedicine/trends/organization &amp; administration ; Humans ; COVID-19 ; }, abstract = {BACKGROUND: India is home to some of the world's earliest and largest telemedicine services. Since the first telemedicine services emerged in the 1990s, the growing digitization of health care services has highlighted the potential for telemedicine services to increase access to timely and appropriate care seeking, corresponding to improved health outcomes and cost savings to the individual and health system. Despite this potential, little is known about the varied typologies of telemedicine services providing in India, their design and model characteristics, scale of implementation, and the available evidence on their impact.<br><br>OBJECTIVE: This scoping review aims to identify the characteristics of telemedicine services in India, including the type of telemedicine model, details on the timing of delivery, health services provided, and service delivery channel. Additional details are extracted on the scale of implementation, software used, and evidence gathered, including impact on care seeking, health outcomes, and cost.<br><br>METHODS: Telemedicine services in India were identified through searches of Google, the Google Play Store, 3 major scientific databases (Embase, PubMed, and Scopus), and a reference review of identified peer-reviewed articles. Included services were restricted to those implemented in India between January 1, 2010, and July 4, 2023, which included humans, and were published in the English language. Once identified, articles were imported to Covidence, and the process of abstract screening was initiated using 2 independent reviewers and a third person to resolve conflicts. Full-text articles were screened, and data were extracted into Microsoft Excel.<br><br>RESULTS: A total of 2368 articles were identified, 151 of which were included for the full-text review and data extraction. From the 151 studies, a total of 115 unique services were identified and further classified based on a scale-moderate to large (n=89) and small (n=26). Among moderate- to large-scale services (n=89), 75 used specialized software and 14 used nonspecialized software, such as WhatsApp. On average, 3 new telemedicine services were initiated annually from 2000 to 2019, and the growth of new services occurred predominantly in the private sector. Evidence was available for 43% (32/75) of the telemedicine services. While 21 services reported on some facet of the quality of care, no studies systematically assessed quality of care. Where structured surveys were reported, questions were often leading, used longer Likert scale response options, and asked respondents about broad constructs subject to varied interpretations (eg, quality of care or satisfaction). Additional details on model characteristics, reach, and impact are presented.<br><br>CONCLUSIONS: The widespread proliferation of telemedicine services in India has much potential to improve access to and continuity of timely and appropriate care seeking for health. However, improved evidence demonstrating the impact of telemedicine services on care seeking, quality of care, cost, and health outcomes is needed.}, }
@article {pmid41098900, year = {2025}, author = {Modipane, N and Mbambara, S and Serite, T and Sathekge, M and Kgatle, M}, title = {Classification and regulatory interactions of key transcription factors in COVID-19.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1645333}, pmid = {41098900}, issn = {2235-2988}, mesh = {Humans ; *COVID-19/metabolism/virology/genetics/immunology ; *SARS-CoV-2 ; *Transcription Factors/metabolism/classification/genetics ; Protein Processing, Post-Translational ; Host-Pathogen Interactions ; NF-E2-Related Factor 2/metabolism ; Oxidative Stress ; Inflammation ; Ubiquitination ; }, abstract = {SARS-CoV-2, the virus responsible for COVID-19, interferes with the host's transcriptional control systems, triggering widespread disruption of immune regulation and metabolic stability. Key transcription factors (TFs), including AHR, NRF2, NF-κB, IRFs, HIF-1α, PARP, STAT3, ATF3, and PPARγ, play crucial roles in inflammation, oxidative stress defence, anti-viral responses, and immunometabolic adaptation. Their activity and interactions are modulated by post-translational modifications (PTMs) such as phosphorylation, SUMOylation, and ubiquitination, which shape COVID-19 progression. Specifically, SUMOylation of PPARγ suppresses NF-κB-driven inflammation, though impairment under severe disease amplifies macrophage activation and cytokine release. NRF2 degradation via KEAP1-CUL3-mediated ubiquitination is manipulated by the virus to deregulate oxidative stress responses, while SARS-CoV-2 also modulates NF-κB activity through ubiquitination of viral proteins (e.g., NSP6, ORF7a). Dynamic crosstalk between AHR and NRF2 further illustrates TF duality in detoxification and inflammation, with SUMOylation potentially influencing nuclear retention and transcriptional precision. This review classifies transcription factors into four functional categories: inflammatory regulators, antiviral response mediators, stress and pathogen response elements, and metabolic modulators. It further examines how PTM-driven crosstalk contributes to immune dysregulation. Targeting these transcriptional networks presents promising therapeutic strategies to mitigate hyperinflammation, rebalance immune responses, and enhance clinical outcomes in COVID-19.}, }
@article {pmid41098416, year = {2025}, author = {Kuo, WT and Lai, IH}, title = {Medication, Nutrition, and Hygiene in COVID-19 Prevention and Treatment: A Comprehensive Narrative Review.}, journal = {Global challenges (Hoboken, NJ)}, volume = {9}, number = {10}, pages = {e00223}, pmid = {41098416}, issn = {2056-6646}, abstract = {Despite advances in Coronavirus Disease 2019 (COVID-19) prevention and treatment, emerging variants and persistent challenges continue to affect global health. Studies are retrieved from PubMed using title-based searches for COVID-19, SARS-CoV-2, and related therapies from 2020 to 2025, focusing on randomized controlled trials, systematic reviews, and clinical guidelines. This review explores treatments, nutrients, and adjuvant therapies that support the immune system in fighting COVID-19. It highlights the role of antiviral medications such as remdesivir, nirmatrelvir/ritonavir, and molnupiravir in reducing mortality and hospitalizations. Additionally, adjunctive therapies like corticosteroids, interleukin-6 (IL-6) inhibitors, Janus kinase (JAK) inhibitors, and N-acetylcysteine (NAC) are discussed for their potential to modulate inflammation. Nutritional support, including omega-3 fatty acids, vitamins D, C, and A, zinc, selenium, and probiotics, enhances immune function. Preventive measures, such as hygiene practices, wearing masks, and physical distancing, reduce transmission. An integrated approach that combines antiviral treatments with adjunctive therapies, prevention, and nutrition is crucial for improving outcomes.}, }
@article {pmid41098329, year = {2025}, author = {Shyam, T and Atuaka, C and Venigalla, M and Sinokrot, O}, title = {Scars from the pandemic: understanding post-COVID-19 interstitial lung disease.}, journal = {Breathe (Sheffield, England)}, volume = {21}, number = {4}, pages = {250037}, pmid = {41098329}, issn = {1810-6838}, abstract = {Five years after the COVID-19 pandemic, the world continues to record acute cases of COVID-19 infection and witness its residual effects. Lung injury persisting beyond the resolution of acute viral pneumonia has been a known entity since the severe acute respiratory syndrome outbreak in 2005. However, residual interstitial lung disease (ILD) secondary to COVID-19 infection has become a new entity of interest due to the widespread and global impact of COVID-19. Post-COVID-19 ILD (PC-ILD) has emerged as a unique entity with age, male sex, smoking and the severity of acute illness as risk factors. Using current evidence, we discuss possible mechanisms for disease occurrence and the genetic similarities between PC-ILD and idiopathic pulmonary fibrosis. Characteristic radiographic findings, pulmonary function abnormalities and potential therapies are also discussed. As the world moves away from the acute phase of the pandemic, obtaining information on the long-term consequences of this disease becomes even more crucial. Continued research in this field is vital to guide decisions and obtain better outcomes in treatment and follow-up.}, }
@article {pmid41098085, year = {2025}, author = {Arca, KN and Bazarsky, AB and Yuan, DY and Villanueva, R and Friedman, DI and Charles, A and , }, title = {Telemedicine is effective and safe for clinical management of patients with headache disorders: An American Headache Society position statement.}, journal = {Headache}, volume = {}, number = {}, pages = {}, doi = {10.1111/head.15084}, pmid = {41098085}, issn = {1526-4610}, abstract = {OBJECTIVES/BACKGROUND: This study was undertaken to review the published literature and provide a position statement from the American Headache Society regarding the safety, efficacy, and impact on access to care of telemedicine for the clinical management of patients with headache disorders. Access to specialized care in headache medicine is severely limited in the United States and worldwide. Telemedicine has been used as an approach to care delivery in headache medicine for more than a decade, with accelerated adoption during the COVID-19 pandemic. There is now uncertainty regarding the extent to which telemedicine will be accepted by health systems and reimbursed by payers moving forward. The purpose of this position statement is to summarize evidence and clinical experience supporting the utility of telemedicine in headache medicine.<br><br>METHODS: Evidence regarding the safety and efficacy of telemedicine, and patient and clinician satisfaction with the use of telemedicine for headache specialty care, was gathered from a variety of sources, including PubMed, Google Scholar, and ClinicalTrials.gov. The results and conclusions based upon these results were reviewed and discussed by the authors and the Board of Directors of the American Headache Society to confirm consistency with clinical experience and to achieve consensus.<br><br>RESULTS: Several randomized clinical trials and observational studies have been performed to compare telemedicine with in-person visits in the management of patients with headache disorders. These studies showed consistently that telemedicine is noninferior to in-person care based upon multiple outcome measures, including disability measures, patient satisfaction, and clinician satisfaction. In addition, these studies found that telemedicine rarely leads to a missed diagnosis of secondary headache or mismanagement of primary headache. Telemedicine has substantial advantages for patients, including improved access to care and reduced costs associated with obtaining care. Studies evaluating health care utilization indicate no significant differences between patients evaluated and treated virtually versus in person. Obvious limitations of telemedicine include the inability to perform an in-person physical exam or to perform injections. For a substantial number of patients, however, these limitations are outweighed by its advantages. The experience with telemedicine reported in the literature is consistent with the experience of the Board of Directors of the American Headache Society, who endorse its use for patients when feasible and appropriate.<br><br>CONCLUSION: Telemedicine has significantly advanced the care of patients with headache disorders. Its further development and deployment should be supported and reimbursed.}, }
@article {pmid41097203, year = {2025}, author = {Mohib, O and Bomans, S and Jimenez Garcia, B and Leemans, L and Ligneel, C and De Waele, E and Beckwée, D and Janssens, P}, title = {Clinical Benefits of Exogenous Ketosis in Adults with Disease: A Systematic Review.}, journal = {Nutrients}, volume = {17}, number = {19}, pages = {}, pmid = {41097203}, issn = {2072-6643}, support = {G075423N//Research Foundation - Flanders/ ; }, mesh = {Humans ; *Ketosis ; *Ketone Bodies/therapeutic use/administration &amp; dosage ; Adult ; Cardiovascular Diseases ; *Metabolic Diseases ; COVID-19 ; Mental Disorders/drug therapy ; Nervous System Diseases ; }, abstract = {BACKGROUND/OBJECTIVES: Ketone bodies are increasingly studied for their potential therapeutic effects, particularly through exogenous ketosis, in a variety of diseases. This systematic review aimed to rigorously assess the clinical efficacy of exogenous ketosis in adults with medical conditions.<br><br>METHODS: Following PRISMA guidelines, we systematically searched MEDLINE and Scopus databases. Our inclusion criteria were defined according to the PICOS framework, focusing on studies involving exogenous ketosis in adult patients with specific diseases. The study is registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42023492846).<br><br>RESULTS: After a stringent selection process, fifty-one studies were analyzed. Twenty-two studies focused on neurological disorders, one on psychiatric disorders, twenty-two on metabolic disorders, five on cardiovascular disorders, and one on an inflammatory disorder. Exogenous ketosis demonstrated potential benefits across multiple conditions, including Alzheimer's disease, mild cognitive impairment, McArdle's disease, various forms of heart failure, cardiogenic shock, pulmonary hypertension, and COVID-19-related acute respiratory distress syndrome, although evidence is mostly limited to surrogate endpoints with insufficient hard outcome data. Subtherapeutic ketone concentrations induced by medium-chain triglycerides and limited follow-up periods often precluded firm conclusions regarding clinically meaningful outcomes.<br><br>CONCLUSIONS: Exogenous ketosis shows potential in neurological, metabolic, and cardiovascular disorders, while evidence in psychiatric and inflammatory conditions remains scarce and preliminary. Ketone esters appear preferable for effective and tolerable ketosis. Future research should focus on identifying responsive patient populations, optimizing treatment regimens, and conducting long-term clinical trials with hard endpoints to validate these findings.}, }
@article {pmid41097095, year = {2025}, author = {Russell, T and Formiconi, E and Casey, M and McElroy, M and Mallon, PWG and Gautier, VW}, title = {Viral Metagenomic Next-Generation Sequencing for One Health Discovery and Surveillance of (Re)Emerging Viruses: A Deep Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {19}, pages = {}, pmid = {41097095}, issn = {1422-0067}, support = {101132970//European Commission/ ; }, mesh = {Humans ; *Metagenomics/methods ; *High-Throughput Nucleotide Sequencing/methods ; Animals ; One Health ; *Communicable Diseases, Emerging/virology/epidemiology ; *Viruses/genetics ; SARS-CoV-2/genetics ; Genome, Viral ; Zoonoses/virology ; }, abstract = {Viral metagenomic next-generation sequencing (vmNGS) has transformed our capacity for the untargeted detection and characterisation of (re)emerging zoonotic viruses, surpassing the limitations of traditional targeted diagnostics. In this review, we critically evaluate the current landscape of vmNGS, highlighting its integration within the One Health paradigm and its application to the surveillance and discovery of (re)emerging viruses at the human-animal-environment interface. We provide a detailed overview of vmNGS workflows including sample selection, nucleic acid extraction, host depletion, virus enrichment, sequencing platforms, and bioinformatic pipelines, all tailored to maximise sensitivity and specificity for diverse sample types. Through selected case studies, including SARS-CoV-2, mpox, Zika virus, and a novel henipavirus, we illustrate the impact of vmNGS in outbreak detection, genomic surveillance, molecular epidemiology, and the development of diagnostics and vaccines. The review further examines the relative strengths and limitations of vmNGS in both passive and active surveillance, addressing barriers such as cost, infrastructure requirements, and the need for interdisciplinary collaboration. By integrating molecular, ecological, and public health perspectives, vmNGS stands as a central tool for early warning, comprehensive monitoring, and informed intervention against (re)emerging viral threats, underscoring its critical role in global pandemic preparedness and zoonotic disease control.}, }
@article {pmid41096974, year = {2025}, author = {Lagostena, L and Minicozzi, V and Meucci, M and Gradogna, A and Milenkovic, S and Palombi, F and Ceccarelli, M and Filippini, A and Carpaneto, A}, title = {The Two-Pore Channel 2 in Human Physiology and Diseases: Functional Characterisation and Pharmacology.}, journal = {International journal of molecular sciences}, volume = {26}, number = {19}, pages = {}, pmid = {41096974}, issn = {1422-0067}, mesh = {Humans ; COVID-19/metabolism/virology ; Neoplasms/metabolism/drug therapy ; *Calcium Channels/metabolism/chemistry ; Animals ; SARS-CoV-2 ; Calcium Signaling ; *Calcium Release Activated Calcium Channels/metabolism/chemistry ; Two-Pore Channels ; }, abstract = {Two-pore channel 2 (TPC2) is a member of the endolysosomal ion channel family, playing critical roles in intracellular calcium signaling and endomembrane dynamics. This review provides an in-depth analysis of TPC2, covering its structural and functional properties, physiological roles, and involvement in human diseases. We discuss current experimental approaches to studying TPC2, including heterologous expression in plant vacuoles and computational modeling strategies. Particular emphasis is placed on the structural determinants of ion permeation, with a focus on the selectivity filter and the central cavity's influence on channel kinetics. Furthermore, we explore emerging roles of TPC2 in viral infections, particularly SARS-CoV-2, and in cancer, including melanoma progression and neoangiogenesis. The inhibitory potential of natural compounds, such as naringenin, is also examined. By offering a comprehensive overview of current knowledge and methodologies, this review underscores the potential of TPC2 as a promising pharmacological target in both infectious and neoplastic diseases.}, }
@article {pmid41096893, year = {2025}, author = {McCarthy, MW and Chong, C and Riedemann, NC and Guo, R}, title = {A Targeted Blockade of Terminal C5a Is Critical to Management of Sepsis and Acute Respiratory Distress Syndrome: The Mechanism of Action of Vilobelimab.}, journal = {International journal of molecular sciences}, volume = {26}, number = {19}, pages = {}, pmid = {41096893}, issn = {1422-0067}, support = {N/A//Inflarx (Germany)/ ; }, mesh = {Humans ; *Respiratory Distress Syndrome/drug therapy ; *Sepsis/drug therapy ; *Antibodies, Monoclonal, Humanized/therapeutic use/pharmacology ; *COVID-19 Drug Treatment ; *Complement C5a/antagonists &amp; inhibitors/metabolism ; SARS-CoV-2 ; COVID-19 ; Animals ; }, abstract = {Vilobelimab, a first-in-class, human-mouse chimeric immunoglobulin G4 (IgG4) kappa monoclonal antibody, targets human complement component 5a (C5a) in plasma. Unlike upstream complement inhibitors, vilobelimab does not inhibit the generation of the membrane attack complex (C5b-9), necessary to mitigate certain infections. C5a is a strong anaphylatoxin and chemotactic agent that plays an essential role in both innate and adaptive immunity. Elevated levels of C5a have been associated with pathologic processes, including sepsis and inflammatory respiratory disorders such as acute respiratory distress syndrome (ARDS). Blocking C5a with vilobelimab has shown therapeutic promise. A randomized, multicenter placebo-controlled Phase III study of vilobelimab in patients with severe COVID-19 (PANAMO) found that patients treated with vilobelimab had a significantly lower risk of death by day 28 and 60. Based on this study, the United States Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for Gohibic[®] (vilobelimab) injection for the treatment of COVID-19 in hospitalized adults when initiated within 48 h of receiving invasive mechanical ventilation (IMV) or extracorporeal membrane oxygenation (ECMO). In January 2025, the European Commission (EC) granted marketing authorization for Gohibic[®] (vilobelimab) for the treatment of adult patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced ARDS who are receiving systemic corticosteroids as part of standard of care and receiving IMV with or without ECMO. Herein, we review the mechanism of action of vilobelimab in selectively inhibiting C5a-induced inflammation, outlining its bench-to-bedside development from the fundamental biology of the complement system and preclinical evidence through to the clinical data demonstrating its life-saving potential in the management of COVID-19-induced ARDS.}, }
@article {pmid41096176, year = {2025}, author = {Bankov, D and Kostadinova, N and Marinova, J}, title = {The Way of SARS-CoV-2 Pneumonia-An Early-Pandemic Review of the Key Manifestations and Severity.}, journal = {Journal of clinical medicine}, volume = {14}, number = {19}, pages = {}, pmid = {41096176}, issn = {2077-0383}, abstract = {The disease COVID-19, which has befallen mankind in recent years, was a challenge that we had not faced for centuries. The first registered patient case was in China. This review is performed by the inspection of a large body of worldwide investigations conducted in the peak period of the disease's progress. The disease is spread by airborne droplets and develops mainly with fever, cough, sputum, and shortness of breath. Laboratory tests show leukopenia, lymphopenia, a decrease in the levels of sodium, potassium, and calcium, and an increase in the levels of CRP, LDH, and D-dimer. Radiological changes in most cases are bilateral and of the "ground glass" type in the lower parts of the lungs. The most severe complication of COVID-19 pneumonia is ARDS. The risk groups are people with chronic lung diseases, the elderly, and those who are overweight. This article analyzes and summarizes the main characteristics of SARS-CoV-2 pneumonia in order to better understand and apply better clinical management of this condition.}, }
@article {pmid41096157, year = {2025}, author = {Wołowiec, &#x141; and Osiak-Gwiazdowska, J and Jaśniak, A and Mucha, W and Wojtaluk, M and Czerniecka, W and Wołowiec, A and Banach, J and Grześk, G}, title = {Colchicine in Contemporary Pharmacotherapy: Mechanistic Insights and Clinical Horizons.}, journal = {Journal of clinical medicine}, volume = {14}, number = {19}, pages = {}, pmid = {41096157}, issn = {2077-0383}, abstract = {Colchicine, a natural alkaloid, has emerged as a promising anti-inflammatory therapy with applications in cardiovascular diseases, dermatological conditions, and COVID-19 management. Its mechanisms, including the modulation of neutrophil activity, the inhibition of the NLRP3 inflammasome, and the mitigation of cytokine storms, have expanded its therapeutic potential beyond traditional uses. This review synthesizes current evidence on colchicine's clinical applications and mechanisms of action. In cardiovascular medicine, colchicine has been shown to reduce risks of pericarditis, coronary artery disease and atrial fibrillation. In dermatology, most evidence derives from small-scale studies, case series, and retrospective analyses, suggesting potential benefits in conditions such as leukocytoclastic vasculitis, cutaneous amyloidosis, and pemphigus, although these findings require confirmation through randomized controlled trials (RCTs). Emerging studies also indicate a potential role for colchicine in improving outcomes in severe COVID-19. Overall, colchicine demonstrates broad therapeutic utility, warranting further research to clarify its effectiveness across diverse clinical settings.}, }
@article {pmid41096088, year = {2025}, author = {Cotet, IG and Mateescu, DM and Ilie, AC and Guse, C and Pah, AM and Badalica-Petrescu, M and Iurciuc, S and Craciun, ML and Buleu, F and Tudoran, C}, title = {Systematic Review and Meta-Analysis of Myocarditis Prevalence and Diagnostics in COVID-19:Acute, Post-COVID, and MIS-C (2020-2025).}, journal = {Journal of clinical medicine}, volume = {14}, number = {19}, pages = {}, pmid = {41096088}, issn = {2077-0383}, abstract = {Background: Myocarditis is a recognized complication of COVID-19, but prevalence estimates vary by disease phase and diagnostic method. Methods: We conducted a systematic review and meta-analysis of 54 studies including 32,500 patients, stratified by acute COVID-19, post-COVID, and MIS-C phases. Results: The pooled prevalence of myocarditis was 1.2% (95% CI: 0.8-1.6) in acute COVID-19, 7.4% (95% CI: 5.1-9.8) in post-COVID, and 39.8% (95% CI: 32.4-47.2) in MIS-C. CMR-based diagnosis yielded higher prevalence than clinical criteria (8.1% vs. 0.9%). Major cardiac outcomes included reduced LVEF in 22% and ventricular arrhythmias in 15% of cases. Heterogeneity across studies remained high (I[2] = 98%). Conclusions: Myocarditis prevalence in COVID-19 varies widely across phases and diagnostic methods. Findings suggest a need for cautious screening approaches, particularly in MIS-C and selected post-COVID or athlete populations, while emphasizing the importance of standardized reporting and long-term follow-up data.}, }
@article {pmid41096079, year = {2025}, author = {Sandu, A and Bratu, D and Mihețiu, A and Serban, D and Tănăsescu, C}, title = {Spontaneous Retroperitoneal Hematoma in SARS-CoV-2 Patients: Diagnostic and Management Challenges-A Literature Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {19}, pages = {}, pmid = {41096079}, issn = {2077-0383}, abstract = {Background: Spontaneous retroperitoneal hematomas constitute a rare clinical entity, yet their incidence has markedly increased during the SARS-CoV-2 pandemic. The pathophysiological substrate is incompletely elucidated, being influenced by anticoagulant therapy, vascular inflammatory alterations induced by SARS-CoV-2 infection, and comorbidities in critically ill patients that exacerbate hemorrhagic risk. Methods: We performed a comprehensive literature review of published case reports and case series on spontaneous retroperitoneal hematomas in COVID-19 patients, complemented by our institutional experience, in order to synthesize current diagnostic and therapeutic approaches. Results: Available evidence indicates that most cases occur in anticoagulated patients, with clinical manifestations often limited to nonspecific abdominal or lumbar pain. Diagnosis relies primarily on contrast-enhanced CT imaging. Reported therapeutic strategies include conservative management, endovascular embolization, and surgical intervention, with outcomes ranging from complete recovery to fatal progression, particularly in elderly and comorbid individuals. Conclusions: Spontaneous retroperitoneal hematomas in the setting of SARS-CoV-2 infection represent a diagnostic and therapeutic challenge associated with considerable morbidity and mortality. Early recognition, prompt imaging, and individualized multidisciplinary management are essential, while further research is needed to clarify incidence, risk factors, and preventive strategies.}, }
@article {pmid41095193, year = {2025}, author = {Muchtaridi, M and Lestyawan, S and Fakhirah, MA and Rusdin, A and Salsabila, S and Megantara, S and Subarnas, A and Khairul Ikram, NK}, title = {Therapeutic Potential of Erythrina Genus: Bioactive Phytoconstituents with Potent Antiviral and Antimicrobial Activities.}, journal = {Plants (Basel, Switzerland)}, volume = {14}, number = {19}, pages = {}, pmid = {41095193}, issn = {2223-7747}, support = {2097/UN6.0ffU.00/2025//Universitas Padjadjaran/ ; }, abstract = {Infectious diseases present a significant global health challenge, further exacerbated by the rising prevalence of antimicrobial resistance and the limited availability of effective antiviral and antimicrobial agents. The Erythrina genus has garnered scientific interest due to its diverse array of bioactive phytoconstituents, with potential therapeutic relevance. This review aims to synthesize and critically assess the existing literature on the antiviral, antibacterial, antifungal, and antiplasmodial properties of Erythrina species. A comprehensive literature search was conducted using PubMed, Scopus, and Google Scholar databases. Relevant studies were identified through keyword searches combining pathogen-specific terms with "Erythrina". The extracted data were categorized based on the pathogen type and its associated bioactive compounds. Several Erythrina species exhibited substantial antiviral activity against prominent viral pathogens, such as HIV and SARS-CoV-2. Notably, strong antibacterial efficacy was observed against Staphylococcus aureus, including multidrug-resistant strains. Antifungal activity was most pronounced against Candida albicans, while potent antiplasmodial effects were reported against both drug-sensitive and drug-resistant strains of Plasmodium falciparum. These pharmacological effects were predominantly attributed to prenylated flavonoids, isoflavones, pterocarpans, and erythrina-type alkaloids. Further mechanistic studies and in vivo evaluations are essential to fully assess their clinical efficacy and support the development of plant-derived antimicrobial agents.}, }
@article {pmid41094663, year = {2025}, author = {Lemarchand, P and Pape, M and Schwarz, J}, title = {Understanding sex and gender disparities in COVID-19 mortality: a narrative review beyond biology.}, journal = {Biology of sex differences}, volume = {16}, number = {1}, pages = {76}, pmid = {41094663}, issn = {2042-6410}, mesh = {Humans ; *COVID-19/mortality ; Female ; Male ; *Health Status Disparities ; SARS-CoV-2 ; Sex Factors ; *Sex Characteristics ; }, abstract = {BACKGROUND: Men have consistently experienced higher COVID-19 mortality than women across most countries and time periods, prompting widespread investigation into potential biological causes. Early research focused on sex-related genetic, hormonal, and immunological mechanisms to explain these disparities.<br><br>MAIN BODY: This narrative review traces the evolution of scientific explanations for women/men mortality differences in COVID-19, from early biological hypotheses to more nuanced gendered and intersectional models. While some studies suggest sex-linked genetic variants, chromosomal mechanisms, or hormone-regulated expression of viral entry receptors might partially explain men's higher mortality, the overall evidence remains inconsistent and inconclusive. Increasingly, attention has shifted to social and structural factors, including occupational exposure, pre-existing health conditions, healthcare access, and behaviors, that can differently shape vulnerability to COVID-19 in women and men. Data disaggregated by gender and race further revealed significant heterogeneity in outcomes, underscoring the influence of intersecting axes of inequality. International comparisons suggested that gender inequality at the societal level was associated with wider women/men COVID-19 mortality gaps. Analyses that overlook the interaction between sex- and gender-related factors and their intersection with racial disparities and socioeconomic status risk obscuring the underlying drivers of COVID-19 disparities.<br><br>CONCLUSION: Sex-related biological factors may have influenced COVID-19 outcomes, but they do not adequately account for the observed differences in mortality between women and men. Approaching the study of health inequities through a gendered, intersectional framework is essential for accurately identifying and addressing underlying risk factors, and for better understanding how sex- and gender-related factors may interact, not only in COVID-19, but across a broad range of health conditions.}, }
@article {pmid41094650, year = {2025}, author = {D'Angelo, S and Zaballa, E and Ntani, G and Bloom, I and Walker-Bone, K}, title = {The impact of changes to work circumstances enforced by COVID-19 on anxiety: a systematic review.}, journal = {Systematic reviews}, volume = {14}, number = {1}, pages = {195}, pmid = {41094650}, issn = {2046-4053}, support = {22090/VAC_/Versus Arthritis/United Kingdom ; }, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Anxiety/epidemiology/psychology ; *Employment/psychology ; SARS-CoV-2 ; Middle Aged ; *Unemployment/psychology ; Adult ; Return to Work/psychology ; }, abstract = {BACKGROUND: The COVID-19 pandemic enforced changes on employment circumstances for all workers but older workers experiencing job loss are less likely to return to work than younger individuals. Under normal circumstances, job loss is a well-recognised risk factor for poor mental health, while it is unclear whether working from home is beneficial or harmful to mental health. We systematically reviewed the literature to explore the association between enforced changes in employment (job loss, working from home or being furloughed) and anxiety in the adult population, with a particular focus on older workers.<br><br>METHODS: The protocol was registered in June 2021 in the International Prospective Register of Systematic Reviews database. We searched Medline, Embase, PsycInfo and CINAHL (January 2020-July 2023) databases for studies including older adults (some of the study sample were workers aged over 50&#xa0;years). Results were presented by narrative review, complemented by a vote-counting technique and effect direction plots to summarise the relationship between exposures and anxiety.<br><br>RESULTS: Forty-eight studies from several countries met the inclusion criteria, including 39 cross-sectional and nine longitudinal studies. The prevalence of anxiety varied between studies due to different tools and cut-offs chosen, reaching as high as 63% in one study. The vote-counting method showed convincing evidence that job loss since lockdown negatively impacted anxiety overall and among people aged 50 and over. Inconsistent results were observed across studies investigating the effect of working from home or furlough on anxiety.<br><br>CONCLUSION: Disruption of employment during the pandemic and related lockdowns has increased anxiety levels in the adult population and among older workers. More research is needed to know how persistent these effects are and to identify strategies to support those most affected.<br><br>The protocol of the systematic review was registered in June 2021 in the International Prospective Register of Systematic Reviews database (PROSPERO: CRD42021260499), and it is provided as supporting information (Additional File 1).}, }
@article {pmid41094377, year = {2025}, author = {Arab, Z and Shayanfar, N and Mojaver, MR and Khormali, M and Boskabady, MH and Niazmand, S}, title = {Cardiopulmonary crosstalk in Long COVID: a systematic review of emerging evidence.}, journal = {BMC cardiovascular disorders}, volume = {25}, number = {1}, pages = {742}, pmid = {41094377}, issn = {1471-2261}, mesh = {Humans ; *COVID-19/physiopathology/complications ; Renin-Angiotensin System ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Endothelium, Vascular/physiopathology ; *Pulmonary Fibrosis/physiopathology ; }, abstract = {BACKGROUND: Long COVID is a complex, multisystem syndrome with significant cardiopulmonary implications. Persistent inflammation, endothelial dysfunction, and microvascular injury contribute to prolonged symptoms such as dyspnea, chest pain, and exercise intolerance. Despite growing recognition of these complications, the underlying mechanisms of cardiopulmonary interactions remain poorly understood.<br><br>METHODS: A comprehensive literature search was conducted on PubMed, Scopus, Google Scholar, and Web of Science covering studies from 2019 to 2025. Keywords included "Long COVID", "cardiopulmonary interaction", "pulmonary fibrosis", "myocardial inflammation", and "endothelial dysfunction". A total of 102 articles were included, comprising 65 original research studies and 37 review articles.<br><br>RESULTS: Pulmonary sequelae, such as fibrotic remodeling, persistent hypoxia, and microthrombosis, impose significant strain on the cardiovascular system, exacerbating myocardial inflammation, arrhythmias, and endothelial dysfunction. Shared mechanisms, such as oxidative stress, immune dysregulation, and neurohumoral activation, create a vicious cycle of sustained cardiopulmonary impairment. The disruption of the renin-angiotensin-aldosterone system (RAAS) further contributes to systemic vascular dysregulation.<br><br>CONCLUSION: A deeper understanding of cardiopulmonary interactions in Long COVID is essential for developing effective management strategies. Targeting inflammatory pathways, restoring endothelial function, and addressing autonomic instability may provide therapeutic benefits. As the long-term impact of this syndrome continues to evolve, further research is needed to refine treatment approaches and mitigate its burden on global health.}, }
@article {pmid41093597, year = {2025}, author = {Kim, Y and Kim, I}, title = {Medical certification in sickness benefit schemes (I): theoretical perspectives and return-to-work.}, journal = {Annals of occupational and environmental medicine}, volume = {37}, number = {}, pages = {e23}, pmid = {41093597}, issn = {2052-4374}, abstract = {This study explores the theoretical foundations and practical applications of medical certification within the sickness benefit systems, particularly in the context of Korea's pilot program and its planned national rollout. While sickness benefit systems have long existed in many Organization for Economic Cooperation and Development (OECD) countries, Korea has only recently initiated pilot projects, largely prompted by the coronavirus disease 2019 pandemic. These systems aim to compensate for income loss due to illness or injury, and medical certification plays a central role in determining eligibility and work ability. This study defines medical certification as a two-stage process: clinical diagnosis and formal assessment of a worker's ability to return-to-work. The dual nature highlights the distinct objectives of the medical treatment and social security policies. Drawing on international practices, this study reviews the International Classification of Functioning, Disability, and Health (ICF) as a key global framework for assessing disability and work ability, although it acknowledges the limitations of its application to sickness benefits. The research emphasizes a shift in global trends toward return-to-work-oriented certification models, such as the UK's "fit note" system, which focuses on evaluating fitness-for-work rather than merely documenting illness. Sweden and Japan also offer models that integrate rehabilitation with flexible work accommodations. Three key issues were identified in Korea's system: the role of medical certification and concerns about moral hazard, the burden of proof and workload on physicians, and public perceptions of the program's purpose. We believe that medical certification should not only verify illness but also support early intervention and a healthy workforce. Ultimately, this study advocates for a balanced and efficient medical certification system tailored to Korea's healthcare context closely aligning with labor market policies to ensure long-term sustenance and integration of the sickness benefit program.}, }
@article {pmid41093340, year = {2025}, author = {Petka-Nosal, N and Bielska, IA and Badora-Musiał, K and Nowak-Zając, K and Domagała, A and Gałązka-Sobotka, M and Kowalska-Bobko, I}, title = {Skill mix changes in healthcare professions during the COVID-19 pandemic: a scoping review.}, journal = {BMJ open}, volume = {15}, number = {10}, pages = {e100024}, pmid = {41093340}, issn = {2044-6055}, mesh = {Humans ; *COVID-19/epidemiology ; *Health Personnel/psychology ; SARS-CoV-2 ; *Health Occupations ; Pandemics ; }, abstract = {OBJECTIVES: The objective of the scoping review was to systematise the existing knowledge about skill mix changes among the healthcare workforce during the COVID-19 pandemic.<br><br>DESIGN: Scoping review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review.<br><br>DATA SOURCES: Five databases including CINAHL Ultimate, Web of Science, Medline, Embase and Scopus were searched in August 2024.<br><br>ELIGIBILITY CRITERIA: The review encompassed original research studies published from January 2020 to August 2024, on the skill mix of healthcare workers during the COVID-19 pandemic. Quantitative and qualitative studies were included without geographical or linguistic restrictions.<br><br>DATA EXTRACTION AND SYNTHESIS: Data were independently extracted by two researchers, capturing details such as publication year, study title, country, target population, study purpose and methodology, sample size, analysed variables, results and recommendations.<br><br>RESULTS: A total of 13&#x2009;563 records were identified in the databases of which 3962 remained for abstract review. 32 articles were included in the final analysis. 17 of the 32 papers were from Western and Southern Europe. The healthcare professions which were described in the studies were physicians, nurses, midwives, paramedics, pharmacists, physiotherapists, occupational therapists and medical assistants, of which the majority of the studies were conducted among nurses (n=16), pharmacists (n=11) and physicians (n=6). Most studies (n=9) concerned the adding of new tasks/roles and reallocating tasks in combination with teamwork (n=8). Research covered a range of topics, including psychological aspects of work, patient safety, work reorganisation, training and collaboration. Many studies focused on the challenges related to skill mix, such as the blurring of responsibilities and role ambiguity.<br><br>CONCLUSIONS: The research summarised in this review demonstrates the impact of implementing skill mix changes on healthcare workers during the COVID-19 pandemic, particularly in the area of mental health. The research highlights the importance of adaptation in response to pressures among healthcare professions and the entire system. Further research is needed to examine the long-term impact of skill mix on healthcare workers across regions and professions in crisis situations.}, }
@article {pmid41091675, year = {2025}, author = {Nagra, G and Ezeugwu, VE and Bostick, GP and Branton, E and Dennett, L and Drake, K and Durand-Moreau, Q and Guptill, C and Hall, M and Ho, C and Hung, P and Khan, A and Lam, GY and Nowrouzi-Kia, B and Gross, DP}, title = {Return-to-work for people living with long COVID: A scoping review of interventions and recommendations.}, journal = {PloS one}, volume = {20}, number = {10}, pages = {e0321891}, pmid = {41091675}, issn = {1932-6203}, mesh = {Humans ; *Return to Work ; *Post-Acute COVID-19 Syndrome/complications/rehabilitation ; }, abstract = {INTRODUCTION: Long COVID is characterized by the presence of new onset or persistent symptoms 3 months after a suspected or confirmed history of SARS-CoV-2 infection. It is a complex and multi-faceted condition that affects people in different ways. Long COVID affects individuals' labour market participation. While some cannot work, others may return to work (RTW) in a limited capacity. Determining what rehabilitation or related strategies are safe and effective for facilitating RTW is necessary.<br><br>OBJECTIVES: To synthesize evidence on RTW interventions for people living with Long COVID and to identify 'promising' interventions for enhancing work ability and RTW.<br><br>METHODS: We followed Arksey &amp; O'Malley's methodology and the PRISMA extension for scoping reviews. Five electronic bibliographic databases and grey literature were searched. The literature search included various study designs, such as randomized controlled trials (RCT), quasi-experimental designs, and observational studies as well as clinical practice guidelines (CPGs). Two reviewers conducted screening and data extraction, with disagreements resolved through consensus. Intervention studies were categorized as promising (statistically significant RTW outcomes or &#x2265; 50% RTW), somewhat promising (20% to < 50% RTW), not promising (non-statistically significant RTW outcomes or < 20% RTW), or uncertain (did not specify proportion of RTW).<br><br>RESULTS: Twelve CPGs and nineteen intervention studies were identified. Of the intervention studies, 5 were cohort studies, 3 quasi-experimental studies, 4 observational, 2 interventional, 3 RCTs, and 2 case reports. Promising interventions included multimodal and interdisciplinary work-focused rehabilitation, multidisciplinary inpatient and outpatient rehabilitation, psychoeducation, pacing, and breathing strategies, shifting focus from symptom monitoring to optimizing functional outcomes, enhanced external counterpulsation inflatable pressure to improve blood flow, and constraint-induced cognitive therapy.<br><br>CONCLUSION: Many uncertainties remain regarding which RTW interventions are effective or the optimal characteristics of these interventions.}, }
@article {pmid41090939, year = {2025}, author = {Ouchi, K and Oishi, T}, title = {Recent Global Trends of Macrolide-resistant Mycoplasma pneumoniae : Why Has the Macrolide-resistant Rate Decreased in Japan?.}, journal = {The Pediatric infectious disease journal}, volume = {44}, number = {12}, pages = {e446-e449}, doi = {10.1097/INF.0000000000005019}, pmid = {41090939}, issn = {1532-0987}, mesh = {*Mycoplasma pneumoniae/drug effects ; *Macrolides/pharmacology/therapeutic use ; Humans ; Japan/epidemiology ; *Pneumonia, Mycoplasma/epidemiology/drug therapy/microbiology ; *Anti-Bacterial Agents/pharmacology/therapeutic use ; *Drug Resistance, Bacterial ; Global Health ; Taiwan/epidemiology ; COVID-19/epidemiology ; }, abstract = {Mycoplasma pneumoniae pneumonia incidence was much decreased worldwide from 2020 to 2023 due to global infection control measures against the novel coronavirus epidemic. However, it resurfaced in the second half of 2023 following the relaxation of infection control measures, and the threat of macrolide-resistant M. pneumoniae has reemerged, especially in East Asian countries. A reduction of the rate of macrolide-resistant M. pneumoniae was seen in Japan and a part of Taiwan during the pandemic, so it is important to minimize selection pressure favoring macrolide-resistant M. pneumoniae by avoiding overuse of macrolides.}, }
@article {pmid41090740, year = {2025}, author = {Filippatos, F and Matara, DI and Michos, A and Kakleas, K}, title = {Immunological Mechanisms Underlying Allergy Predisposition After SARS-CoV-2 Infection in Children.}, journal = {Cells}, volume = {14}, number = {19}, pages = {}, pmid = {41090740}, issn = {2073-4409}, mesh = {Humans ; *COVID-19/immunology/complications/epidemiology ; Child ; *SARS-CoV-2/immunology ; *Hypersensitivity/immunology/epidemiology ; Disease Susceptibility ; Cytokines/immunology ; }, abstract = {As the pediatric COVID-19 landscape evolves, it is essential to evaluate whether SARS-CoV-2 infection predisposes children to allergic disorders. This narrative review synthesizes current epidemiological and immunological evidence linking pediatric COVID-19 with new-onset atopy. Epidemiological data remain heterogeneous: large Korean and multinational cohorts report increased risks of asthma and allergic rhinitis following COVID-19, whereas U.S. cohorts show neutral or protective associations, highlighting geographic and methodological variability. Mechanistic insights provide biological plausibility: epithelial injury and the release of alarmin cytokines (IL-33, IL-25, TSLP) promote Th2 polarization and ILC2 expansion, while epigenetic "scars" (e.g., LMAN2 methylation changes) and hematopoietic stem cell reprogramming may sustain long-term Th2 bias. Cytokine memory involving IL-7 and IL-15 contributes to altered T- and B-cell homeostasis, whereas disrupted regulatory T-cell function may reduce tolerance thresholds. Paradoxical trade-offs exist, such as ACE2 downregulation in allergic airways, which may lower viral entry but simultaneously amplify type-2 inflammation. Together, these processes suggest that SARS-CoV-2 infection could foster a pro-allergic milieu in susceptible children. Although current evidence is inconclusive, integrating epidemiological surveillance with mechanistic studies is crucial for predicting and alleviating post-COVID allergic outcomes. Longitudinal pediatric cohorts and interventions targeting epithelial alarmins or microbiome restoration may hold promise for prevention.}, }
@article {pmid41089981, year = {2025}, author = {Alamri, A and Alkhathami, A and Alshabab, SQA and Ogran, MAH and Alqahtani, YSYA and Hamdi, AMA and Alshehri, MAA and Aldhabaan, WA and Alwalidi, AK and Alshahrani, ST and Alshehri, DA and Mousa, MSA}, title = {Prevalence of depression anxiety and stress among health professionals during COVID-19 pandemic A systematic review.}, journal = {Journal of family medicine and primary care}, volume = {14}, number = {9}, pages = {3646-3651}, pmid = {41089981}, issn = {2249-4863}, abstract = {The COVID-19 pandemic has posed unprecedented challenges to healthcare systems and the mental well-being of healthcare professionals (HCPs) globally. This systematic review synthesizes existing research on the prevalence of depression, anxiety, and stress among HCPs during the pandemic. We employed a systematic search strategy to identify relevant studies published between December 2019 and December 2023, ultimately including 30 studies that met our inclusion criteria. The findings reveal a significant increase in the prevalence of depression, anxiety, and stress among HCPs compared to pre-pandemic levels. Several risk factors were identified, including direct exposure to COVID-19 patients, female gender, the nursing profession, inadequate resources, and lack of support. This review highlights the detrimental impact of the pandemic on HCPs' mental health and emphasizes the need for urgent interventions and support systems to address this critical public health issue.}, }
@article {pmid41089861, year = {2025}, author = {Hu, S and Song, D and Wan, S and Zhang, S and Luo, C and Li, N and Liu, G and da Graça Espírito Santo Vasconcelos, J and de Carvalho, LLC and Neobísi, E and da Costa, MLB and Etchu Takounjou, J and Neves, KMD and Dos Ramos da Conceição, L and da Costa Encarnação, M and Zhao, LY}, title = {Digital health: current applications, challenges, and future directions for enhancing healthcare quality and safety.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1646802}, pmid = {41089861}, issn = {2296-2565}, mesh = {Humans ; *Telemedicine ; *Quality of Health Care ; COVID-19/epidemiology ; *Patient Safety ; Artificial Intelligence ; *Digital Technology ; SARS-CoV-2 ; Pandemics ; Delivery of Health Care ; Digital Health ; }, abstract = {Digital Health Technologies (DHTs) have become a cornerstone of modern healthcare, significantly improving quality and safety across clinical practice, public health, and medical research. Originating in the mid-to-late 20th century, DHTs have facilitated substantial progress in personalized medicine, predictive analytics, and remote patient monitoring through the implementation of artificial intelligence (AI), wearable devices, and telemedicine platforms. During the Coronavirus Disease 2019 (COVID-19) pandemic, these technologies proved indispensable for epidemic surveillance and precision containment, while also mitigating healthcare access disruptions. Nevertheless, critical challenges including the digital ethics and equity, technical and regulatory policy restrictions, privacy and data security concerns, and clinical workflow integration issues remain to be addressed. This narrative review explores the transformative role of DHTs throughout the disease management continuum-from prevention to prognosis-and evaluates their contributions to healthcare quality and safety. It also provides strategies for stakeholders to address existing barriers. By overcoming these challenges, DHTs can further elevate healthcare standards, fostering a safer and more efficient global healthcare system.}, }
@article {pmid41089699, year = {2025}, author = {Hojecki, CE and Tursi, NJ and Livingston, C and Weiner, DB and Gary, EN}, title = {Advances in molecular adjuvants for nucleic acid vaccines.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1646800}, pmid = {41089699}, issn = {1664-3224}, mesh = {Humans ; *Vaccines, DNA/immunology ; *Adjuvants, Immunologic ; *COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology ; *COVID-19/prevention &amp; control/immunology ; *Nucleic Acid-Based Vaccines/immunology ; Animals ; }, abstract = {As nucleic acid vaccine technology continues to advance, modern adjuvants are being engineered to quantitatively and qualitatively shape immune responses. Since their development in the early 1990's, nucleic acid approaches have garnered significant attention, and numerous platform technologies have been developed both to improve delivery as well as immunogenicity. These advances were highlighted during the COVID-19 pandemic, with the approval of both mRNA-LNP and DNA vaccines for SARS-CoV-2. Early clinical trials with DNA antigens alone displayed suboptimal immunogenicity, supporting interest in adjuvant molecules. Molecular adjuvants, nucleic acid-encoded cytokines, chemokines, and enzymes, among others, are used to enhance and direct nucleic acid antigen-induced immunity in vivo. Additionally, mRNA-LNP vaccines, and more recently DNA-LNP vaccines, have demonstrated robust immunogenicity with intrinsic adjuvant activity based on the delivery mode. This review summarizes the molecular adjuvant landscape and highlights recent findings in the context of nucleic acid vaccines.}, }
@article {pmid41089693, year = {2025}, author = {Pollmann, NS and Dondorf, F and Rauchfuß, F and Settmacher, U and Pollmann, L and Selzner, M}, title = {Impact of recent COVID-19 infection on liver and kidney transplantation - a worldwide meta-analysis and systematic review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1626391}, pmid = {41089693}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/epidemiology/mortality ; *Kidney Transplantation ; *Liver Transplantation ; *SARS-CoV-2 ; Graft Survival ; Tissue Donors ; }, abstract = {INTRODUCTION: The shortage of suitable donor organs represents an ongoing global challenge for organ transplantation. During the COVID-19 pandemic, the number of transplantable organs was especially limited. To date, the impact of recent coronavirus-19 (COVID-19) infection on liver and kidney transplant recipients has not been systematically analyzed, which is essential for the development of future transplant management.<br><br>METHODS: We conducted a systematic review and meta-analysis to assess the clinical outcomes of recent COVID-19 infection in the donor (1) or the recipient (2). A total of 17 studies were considered for systematic review, seven of these were included for meta-analysis.<br><br>RESULTS: Transplantation of COVID-19 positive donors did not result in an impaired graft survival for liver or kidney transplantation up to 180-days of follow up. Additionally, a positive COVID-19 donor status was not associated with decreased overall survival in kidney transplant recipients within 180 days of transplantation. Nevertheless, an association was found with decreased overall survival in liver transplant recipients within the 180-day follow-up period.<br><br>DISCUSSION: However, the heterogeneity of studies investigating COVID-19 infection of the recipient did not allow a classification of the significance of COVID-19 positive recipients. Conclusively, a COVID-19 positive donor status should not be considered as an exclusive factor for declining a suitable liver or kidney for transplantation.<br><br>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024562551.}, }
@article {pmid41089653, year = {2025}, author = {Demaria, F and Pontillo, M and Bertoncini, I and Vicari, S}, title = {Obsessive trajectories in children and adolescents exposed to adverse events (coronavirus disease 2019: global crisis teaches).}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1623629}, pmid = {41089653}, issn = {1664-1078}, abstract = {Adverse events (AEs), such as natural disasters, community violence and public health crises, impact global health and are associated with fear, anxiety and disorientation. AEs are related to both short-term and long-term mental health problems in children and adolescents. Particularly, research has shown a significantly higher prevalence of obsessive-compulsive disorder (OCD) in individuals with a history of trauma. This work aims to explore the obsessive-compulsive (OC) trajectories following an AE, considering the role played by individual vulnerability, anxiety and psychological consequences for children and adolescents. In this direction, Coronavirus Disease 2019 (COVID-19) pandemic has represented an ideal and unique AE of concomitant factors that can help to understand the obsessive trajectory. Our framework shows that intrusive flashbacks, following a traumatic experience, can turn into automatic intrusive thoughts that become persistent and emotionally intense, similar to obsessive reactions. Intrusive thoughts can evolve into obsessive patterns, leading to compulsive behaviors aimed at reducing discomfort. The nature of the traumatic event may influence the development of specific OC symptoms. Risk factors include individual vulnerability, such as developmental stage and emotional reactivity, which can exacerbate obsessive stress responses. Anxiety plays a key role, as increased stress can stimulate automatic intrusive thoughts and amplify OCD reactions, especially in younger individuals. Disruptions in daily life can further increase anxiety and maladaptive behaviors in children and adolescents, affecting psychological well-being. The psychological effects of AEs can continue well beyond the events themselves. It is necessary to monitor and support young people involved to prevent their development. Community and individual resources are essential to promote resilience following such events.}, }
@article {pmid41089625, year = {2025}, author = {Nojomi, M and Babaee, E and Rampisheh, Z and Roohravan Benis, M and Soheyli, M and Rady Raz, N}, title = {AI-Powered Clinical Decision Support Systems in Disease Diagnosis, Treatment Planning, and Prognosis: A Systematic Review.}, journal = {Medical journal of the Islamic Republic of Iran}, volume = {39}, number = {}, pages = {81}, pmid = {41089625}, issn = {1016-1430}, abstract = {BACKGROUND: Artificial intelligence (AI) is transforming healthcare with applications that can surpass human performance in prevention, detection, and treatment. This systematic review aimed to collect and assess the impact and success of AI technologies across various healthcare domains.<br><br>METHODS: A systematic search of major databases (including PubMed, Scopus, and ISI) was conducted for articles published up to 2023. Keywords related to AI-driven disease detection, classification, and prognosis were used. Non-English articles or those with inaccessible full texts were excluded. Data was extracted by two researchers, and the quality of selected articles was evaluated based on the strengths and limitations stated by the authors.<br><br>RESULTS: In total, 123 articles were included. AI contributions were categorized into three areas. For disease detection (n=75), Coronavirus disease 2019 (COVID-19) was the most frequent topic (n=18), followed by oncology. Chest X-rays were the most common input (n=15). In disease classification (n=23), oncology (especially breast cancer) was the most researched field (n=7), primarily using breast imaging. For prediction and prevention (n=25), oncology was again the most studied category, with clinical and laboratory parameters being the most utilized input (n=12).<br><br>CONCLUSION: AI-driven clinical decision support systems (CDSS) exhibit strong diagnostic and prognostic accuracy in imaging and laboratory settings. However, many models function as "black boxes," which limits interpretability and clinician trust. Data bias and challenges in integrating AI tools into practice also persist. The findings suggest that future work should focus on explainable AI and rigorous real-world validation to safely implement these tools in healthcare.}, }
@article {pmid41089587, year = {2025}, author = {Albazee, E and Alajmi, SA and Alkandari, AM and Aladwani, AN and Alenezi, YY and Alsaeed, MA and Uqlah, B and Abu-Zaid, A}, title = {Platelet-Rich Plasma for COVID-19-Related Olfactory Dysfunction: A Systematic Review and Meta-analysis of Randomized Controlled Trials.}, journal = {Cureus}, volume = {17}, number = {10}, pages = {e94386}, pmid = {41089587}, issn = {2168-8184}, abstract = {A notable rise in olfactory dysfunction (OD) prevalence has been observed since the COVID-19 pandemic. COVID-19-related OD is associated with several consequences, especially deteriorated quality of life. Hence, several treatment options have been investigated, with platelet-rich plasma (PRP) showing promising results. A systematic review and meta-analysis summarizing randomized controlled trial (RCT) evidence were retrieved from PubMed, Google Scholar, Scopus, and Web of Science up to June 2025. The risk of bias was assessed using the Cochrane Risk of Bias 2 assessment tool. Data were analyzed using Stata MP version 18 (StataCorp LLC, College Station, TX), pooling dichotomous outcomes as relative risks (RRs) and continuous outcomes as standardized mean differences (SMDs), each with 95% confidence intervals (CIs). Four RCTs, including 198 participants, were included in our meta-analysis. PRP significantly improved objective olfactory scores (SMD = 1.86, 95% CI (0.14, 3.57), p = 0.03) and subjective olfactory scores (SMD = 0.92, 95% CI (0.32, 1.51), p < 0.001). Additionally, PRP significantly increased the response rate (RR = 1.79, 95% CI (1.14, 2.81), p = 0.01). PRP was generally well-tolerated across the included trials, with no major adverse events reported. Two RCTs showed an overall low risk of bias, one trial showed some concerns, and another showed a high risk of bias. With uncertain evidence, PRP may improve both objective and subjective smell function and clinical outcomes in people with long COVID-related OD. PRP treatment was reported to be safe, with minor, temporary side effects primarily related to the procedure. Although initial results are promising, the small number of RCTs requires a cautious approach to interpretation.}, }
@article {pmid41089328, year = {2025}, author = {Blitshteyn, S and Funez-dePagnier, G and Szombathy, A and Hutchinson, M}, title = {Immunotherapies for postural orthostatic tachycardia syndrome, other common autonomic disorders, and Long COVID: current state and future direction.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1647203}, pmid = {41089328}, issn = {2235-2988}, mesh = {Humans ; *Postural Orthostatic Tachycardia Syndrome/therapy/immunology ; *COVID-19/therapy/immunology/complications ; *Immunotherapy/methods/trends ; *Autonomic Nervous System Diseases/therapy/immunology ; Immunoglobulins, Intravenous/therapeutic use ; SARS-CoV-2 ; Plasmapheresis ; Adrenal Cortex Hormones/therapeutic use ; Post-Acute COVID-19 Syndrome ; }, abstract = {Postural orthostatic tachycardia syndrome (POTS), neurocardiogenic syncope, and orthostatic hypotension are the most common autonomic disorders encountered in clinical practice. The autoimmune etiology and association of these conditions with systemic autoimmune and inflammatory disorders, autonomic neuropathy, and post-acute infectious syndromes, including Long COVID, suggest that immunotherapies should be considered as a therapeutic option, at least in a subset of patients. However, the treatment of common autonomic disorders has traditionally included pharmacologic and non-pharmacologic symptomatic therapies as the standard approach. Unfortunately, these symptomatic therapies have been of limited or insufficient efficacy to meaningfully improve functional status or result in recovery, especially in patients with severe symptoms. Case reports, case series, and clinical experience suggest that intravenous and subcutaneous immunoglobulin, as well as other immunologic therapies (such as plasmapheresis, corticosteroids, and rituximab), may be effective in some patients with severe POTS and other common autonomic disorders who are refractory to standard therapies. In this narrative review, we summarize the literature available on the topic of immunotherapies for POTS, other common autonomic disorders, and Long COVID. We also highlight the need for large, multicenter, placebo-controlled trials of immunoglobulin, plasmapheresis, intermittent corticosteroids, and other repurposed immunotherapies in patients with common autonomic disorders who have significant functional impairment.}, }
@article {pmid41088290, year = {2025}, author = {Yang, X and Lou, Z and Wang, X and Li, Z and Liu, Q and Guo, K and Yang, Y and Gong, L and Wang, K and Xu, H and Zheng, B and Liu, W and Fu, C and Chen, H and Jiang, X}, title = {Resistance profile and influence factors of carbapenem-resistant Klebsiella pneumoniae (CRKP) causing infections in China: a systematic review and meta-analysis.}, journal = {Annals of clinical microbiology and antimicrobials}, volume = {24}, number = {1}, pages = {56}, pmid = {41088290}, issn = {1476-0711}, support = {2020YFE0204300//National Key Research and Development Program of China/ ; 82072314//National Natural Science Foundation of China/ ; SYS202202//Shandong Provincial Laboratory Project/ ; 2022ZFJH003//Fundamental Research Funds for the Central Universities/ ; }, mesh = {Humans ; China/epidemiology ; *Klebsiella Infections/microbiology/epidemiology/drug therapy/mortality ; *Klebsiella pneumoniae/drug effects/genetics/isolation &amp; purification ; *Anti-Bacterial Agents/pharmacology/therapeutic use ; COVID-19/epidemiology ; *Carbapenems/pharmacology ; Microbial Sensitivity Tests ; *Carbapenem-Resistant Enterobacteriaceae/drug effects ; Drug Resistance, Bacterial ; SARS-CoV-2 ; Drug Resistance, Multiple, Bacterial ; }, abstract = {The prevalence of carbapenem-resistant Klebsiella pneumoniae (CRKP) infections has surged in China over the past decade, posing a significant public health concern. However, comprehensive data on CRKP antimicrobial resistance patterns and the impact of the COVID-19 pandemic on these patterns in China remain unclear. We conducted a systematic review of CRKP infections in China, utilizing data from PubMed spanning 2006 to July 2023. We focused on resistance rates of CRKP causing infections, examining variations across time, regions, and age groups, as well as factors contributing to antimicrobial resistance. Our analysis included 68 studies from 19 provinces in China, comprising 1,284 CRKP isolates obtained from 779 patients. The overall mortality rate for CRKP infections in China was 27% (95% CI: 0.14-0.41, I[2] = 73%, k = 47), with ST11 being the predominant sequence type (Pooled Rate: 80%, 95% CI: 0.67-0.90, I[2] = 86%, k = 31). Temporal and spatial analyses indicated increased resistance to ciprofloxacin (Random effects model: Qb = 9.88, df = 1, P < 0.010) and levofloxacin (Random effects model: Qb = 7.69, df = 1, P < 0.010) during the COVID-19 pandemic. Resistance to chloramphenicol (Random effects model: Qb = 4.97, df = 1, P = 0.030) and ceftazidime-avibactam (Random effects model: Qb = 8.58, df = 1, P < 0.010) was lower in southern regions, while tetracycline resistance (Random effects model: Qb = 9.69, df = 1, P < 0.010) was lower in the north. Higher resistance rates were observed in adults and the elderly. Age and geographic location were key factors associated with antimicrobial resistance. Fourteen out of thirty-five drugs showed a positive correlation with mortality rates, emphasizing their significant impact on CRKP infection mortality. This study underscores the need for targeted interventions to address regional and age-related variations in CRKP resistance and highlights the critical role of antimicrobial resistance in influencing mortality outcomes.}, }
@article {pmid41088154, year = {2025}, author = {Ríos-Quituizaca, P and Endara-Mina, J and Ramos-Avasola, S and Yánez, A and Armenta-Paulino, N}, title = {Ethnic inequalities and contraception in Latin America and the Caribbean: a scoping review.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {272}, pmid = {41088154}, issn = {1475-9276}, mesh = {Humans ; Latin America ; Caribbean Region ; *Ethnicity/statistics &amp; numerical data ; *Contraception/statistics &amp; numerical data ; Female ; COVID-19/epidemiology ; *Healthcare Disparities/ethnology ; Socioeconomic Factors ; SARS-CoV-2 ; Health Services Accessibility ; }, abstract = {BACKGROUND: One of the Sustainable Development Goals (SDGs) is SDG 3.7. Ensuring universal access to sexual and reproductive health. The COVID-19 pandemic exacerbated pre-existing inequalities, disproportionately impacting ethnic groups in Latin America and the Caribbean (LAC). This review examines 23 years of evidence on contraceptive inequalities among these populations.<br><br>METHODS: A comprehensive literature review was conducted covering the period from 2000 to 2023 across seven databases. A combination of natural language and MESH/DECS terms was used, focusing on ethnicity and contraception in LAC countries. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews (PRISMA-ScR), 856 studies were identified. After title and abstract screening, 92 full texts were reviewed, and 33 studies were included that analyzed or compared contraceptive coverage based on ethnicity.<br><br>RESULTS: The countries with the highest output on this topic are Guatemala, Mexico, and Ecuador. More than half (22) relied on national representative surveys, with most focusing on women of reproductive age, while only five included adolescents. Eight studies analyzed Afro-descendant populations, and 27 studies included indigenous populations. Although some studies reported increases in contraceptive coverage over time, 85% identified lower usage rates or probabilities among ethnic minorities, with persistent gaps.<br><br>CONCLUSION: This review highlights contraceptive coverage gaps related to ethnicity in LAC, revealing enduring inequalities. As post-pandemic efforts aim to reduce disparities, countries with significant indigenous populations must prioritize evidence generation. Further research is needed in countries showing progress and among subgroups, such as adolescents or intra-country ethnic groups, to understand underlying causes and enhance contraceptive Access.}, }
@article {pmid41087797, year = {2025}, author = {Amelimojarad, M and Amelimojarad, M}, title = {The dual role of ACE2 in viral infections and neurodegeneration: mechanisms and therapeutic opportunities.}, journal = {Journal of neurovirology}, volume = {31}, number = {5}, pages = {397-406}, pmid = {41087797}, issn = {1538-2443}, mesh = {Humans ; *Angiotensin-Converting Enzyme 2/genetics/metabolism ; *COVID-19/virology/pathology/genetics/complications ; SARS-CoV-2/pathogenicity ; Renin-Angiotensin System/genetics ; *Alzheimer Disease/genetics/pathology/virology/therapy ; Blood-Brain Barrier/virology/pathology/metabolism ; Amyloid beta-Peptides/metabolism/genetics ; Animals ; Spike Glycoprotein, Coronavirus/metabolism/genetics ; Microglia/pathology/virology ; *Neurodegenerative Diseases ; Cognitive Dysfunction/genetics/pathology/virology ; Genetic Therapy ; tau Proteins/metabolism/genetics ; }, abstract = {Angiotensin-converting enzyme 2 (ACE2), a key regulator of the renin-angiotensin system (RAS), maintains central nervous system (CNS) homeostasis by metabolizing neuroinflammatory peptides like angiotensin II (Ang II) and apelin-13, thereby exerting neuroprotective effects. Recent evidence underscores ACE2's paradoxical roles in neurodegeneration: its loss of function due to SARS-CoV-2 spike protein binding exacerbates neuroinflammation and cognitive decline, while its upregulation may mitigate AD pathology by reducing amyloid-β (Aβ) accumulation and tau hyperphosphorylation. The COVID-19 pandemic has further highlighted ACE2 axis dysregulation as a potential accelerator of AD progression, with studies reporting elevated biomarkers of neurodegeneration in post-COVID patients. Therefore, in this review, we highlight the emerging insights into ACE2's dual role in AD and other neurodegenerative diseases, emphasizing its interactions with microglial activation, blood-brain barrier integrity, and mitochondrial dysfunction. We also critically evaluate novel therapeutic strategies, including recombinant ACE2, ACE2-derived peptides, and gene therapy approaches designed to restore RAS balance without compromising viral defense mechanisms. By integrating mechanistic and clinical insights, this work highlights ACE2 as a promising target for neurodegenerative disease interventions.}, }
@article {pmid41087378, year = {2025}, author = {Yonker, LM and Dredge, D and Munro, A and Di Chiara, C and Cotugno, N and Buonsenso, D}, title = {The second-order effects that the COVID-19 pandemic has had on pediatric populations.}, journal = {Expert review of anti-infective therapy}, volume = {23}, number = {10}, pages = {997-1009}, doi = {10.1080/14787210.2025.2575044}, pmid = {41087378}, issn = {1744-8336}, mesh = {Humans ; *COVID-19/epidemiology/complications/immunology/therapy ; Child ; Adolescent ; Systemic Inflammatory Response Syndrome/epidemiology ; Public Health ; Pandemics ; SARS-CoV-2 ; Autoimmune Diseases/epidemiology ; }, abstract = {INTRODUCTION: SARS-CoV-2 can have long-term health consequences that persist beyond acute infection. While this is evident in adults and the elderly, the impact on children and adolescents remains under recognized. Here we navigate the second-order post-acute effects that the COVID-19 has had on the pediatric populations, with the exception of the mental health implication of social restrictions.<br><br>AREAS COVERED: We outline common scenarios related with SARS-CoV-2 infection encountered in pediatric clinical practice, such as in the Multisystem inflammatory syndrome (MIS-C), Long Covid, neurological and autoimmune complications of Covid-19, immunological impact of the viral infection, as well as epidemiological and public health consequences associated with the implementation of non-pharmacological interventions.<br><br>EXPERT OPINION: SARS-CoV-2 has had several second-order effects on child health, from a biological, epidemiological, and public health perspective, highlighting the complexity of dealing with new infections and the urgent need to implement multidisciplinary interventions that support the health of people at single person and societal level. Funding on modern surveillance system, preventing strategies and research to better understand and cure post-acute complications of viral infections should be a priority of every funding agency.}, }
@article {pmid41086954, year = {2026}, author = {Taxiarchis, A and Antovic, J and Rooyackers, O and Dumitrescu, G}, title = {High complement expression on extracellular vesicles in Covid-19 patients without pulmonary embolism leading to death. Case report.}, journal = {Immunology letters}, volume = {277}, number = {}, pages = {107104}, doi = {10.1016/j.imlet.2025.107104}, pmid = {41086954}, issn = {1879-0542}, mesh = {Humans ; *Extracellular Vesicles/metabolism/immunology ; *COVID-19/immunology ; *SARS-CoV-2 ; Pulmonary Embolism ; Male ; Middle Aged ; Biomarkers ; Female ; *Complement System Proteins/metabolism ; Fatal Outcome ; Aged ; Thromboplastin/metabolism ; }, abstract = {This case report analyzes two severe COVID-19 patients without pulmonary embolism, revealing persistently elevated levels of extracellular vesicles (EVs) carrying tissue factor (TF+), complement proteins (C3a+, TCC+), and endothelial markers (CD144+, CD54+). Temporal trends in these EV subpopulations correlated with clinical deterioration, suggesting their role in endothelial injury, complement hyperactivation, and thromboinflammation. Notably, TF+EV dynamics aligned with anticoagulant treatment responses, while MPO+EVs reflected neutrophil activity without thrombotic complications. Despite differences in patient characteristics, these findings propose that patient-specific EV profiles may serve as potential indicators of disease progression, warranting targeted studies to validate their biomarker potential in severe COVID-19.}, }
@article {pmid41086951, year = {2025}, author = {Marco, M and Luigi, U}, title = {What's the impact of the Covid-19 pandemic on global diabetic foot care?.}, journal = {Diabetes research and clinical practice}, volume = {230}, number = {}, pages = {112942}, doi = {10.1016/j.diabres.2025.112942}, pmid = {41086951}, issn = {1872-8227}, mesh = {Humans ; *COVID-19/epidemiology ; *Diabetic Foot/therapy/epidemiology ; Telemedicine/trends ; Pandemics ; SARS-CoV-2 ; Delivery of Health Care ; }, abstract = {The Covid-19 Pandemic has significantly disrupted diabetic foot care worldwide, leading to several key impacts and changes. Due to the reduced access to care and limited face-to-face consultations, the pathway of clinical assistance is partially shifted to telemedicine and remote monitoring to provide care while minimizing in-person visits. At the same time, new triage systems have been developed to identify high risk patients requiring urgent in-person care versus those who could be managed remotely. Accordingly, in the post-pandemic period there is an increased emphasis on tailoring care plans based on individual patient risk factors and co-morbidities. The pandemic highlighted the importance of coordinated care between specialists, primary care, and community services. There is also a greater focus on educating patients about self-monitoring and when to seek urgent care. The pandemic drove innovation in diabetic care delivery that may lead to more flexible, patient-centered approaches in the future, maintaining crucial the face-to-face visit for many patients.}, }
@article {pmid41086559, year = {2025}, author = {Liu, J and Lai, H and Zhao, W and Huang, J and Pan, B and Estill, J and Ge, L}, title = {Association between COVID-19 infection and risk of mental disorders: a systematic review and meta-analysis.}, journal = {General hospital psychiatry}, volume = {97}, number = {}, pages = {130-143}, doi = {10.1016/j.genhosppsych.2025.10.008}, pmid = {41086559}, issn = {1873-7714}, mesh = {Humans ; *COVID-19/epidemiology ; *Mental Disorders/epidemiology ; Comorbidity ; }, abstract = {OBJECTIVE: To systematically review and meta-analyse the association between COVID-19 and the risk of mental disorders.<br><br>METHODS: We searched PubMed, Embase, CINAHL, PsycINFO, and the reference lists of systematic reviews and included cohort studies assessing the association between COVID-19 and mental disorders. Two reviewers independently performed literature screening, data extraction, and the risk of bias assessment. We conducted a random-effect meta-analysis to assess the association and calculated the pooled risk ratio with 95&#xa0;% confidence interval.<br><br>RESULTS: Twenty-eight cohorts with a total of 977,434,207 participants proved eligible. We revealed a 40&#xa0;% increased risk (RR&#xa0;=&#xa0;1.40, 95&#xa0;%CI: 1.23 to 1.59; absolute risk difference&#xa0;=&#xa0;31 more per 1000 persons, 18 more to 45 more) of mental disorders in patients with COVID-19 compared with non-exposed individuals. Moreover, COVID-19 may be related to the risks of anxiety or fear-related disorders, mood disorders, bipolar or related disorders, depressive disorders, unspecified mood disorders, neurocognitive disorders, dementia, mild cognitive disorders, unspecified neurocognitive disorders, psychotic disorders, stress and adjustment disorders, post-traumatic stress disorder, unspecified stress and adjustment disorders, and prescriptions for psychotropic medications.<br><br>CONCLUSIONS: Our findings suggest an association between COVID-19 and risk of mental disorders, as well as the prescriptions for psychotropic medications. It is imperative for individuals to become vigilant of mental health problems that may arise following COVID-19.}, }
@article {pmid41084514, year = {2025}, author = {Prazeres, PHDM and Costa da Silva, GH and Azevedo, GV and Alves da Silva, NJ and Carvalho Costa, PA and Da Silva, WN and Lobo, AO and Guimaraes, PPG}, title = {Advancing Cancer Immunotherapy Using Lipid Nanoparticle-Based Approaches.}, journal = {International journal of nanomedicine}, volume = {20}, number = {}, pages = {12283-12305}, pmid = {41084514}, issn = {1178-2013}, mesh = {Humans ; *Neoplasms/therapy/immunology ; *Nanoparticles/chemistry ; *Immunotherapy/methods ; *Lipids/chemistry ; Cancer Vaccines/administration &amp; dosage ; Animals ; RNA, Messenger/administration &amp; dosage ; Liposomes ; }, abstract = {Cancer immunotherapy, including adoptive cell therapies, cancer vaccines, and cytokine-based therapies, have revolutionized targeted approaches in the treatment of different tumors. However, the broader application of immunotherapies, such as for engineered T cells expressing a chimeric antigen receptor (CAR-T cells), remains limited by challenges in production, systemic toxicity, and inefficient delivery, especially in solid tumors. Recent advances in nucleic acid delivery technologies, notably ionizable lipid nanoparticles (LNP), offer promising solutions to overcome these barriers. LNPs have shown potential in delivering messenger RNA (mRNA), and DNA for the generation of CAR-T cells, cancer vaccines, bispecific antibodies, and cytokine-based immunotherapies. The clinical success of LNP-based platforms in mRNA COVID-19 vaccines and interference RNA therapies for genetic disorders further validates their effectiveness in gene delivery, highlighting LNPs as versatile carriers for therapeutic nucleic acids. Furthermore, LNPs can be optimized for off-the-shelf formulations, enabling personalized treatments targeting specific patient needs. In this review, we highlight the role of LNP platforms in advancing mRNA and DNA delivery for cancer immunotherapy. We explore their potential to improve CAR-T cell production, advance cancer vaccines, and support the development of bispecific antibody- and cytokine-based therapies, ultimately paving the way for more effective, scalable, and accessible immunotherapeutic strategies.}, }
@article {pmid41082551, year = {2025}, author = {Berihun, G and Walle, Z and Desye, B and Daba, C and Geto, AK and Kumlachew, L and Berhanu, L}, title = {Healthcare waste management practices and associated factors among healthcare workers in Sub-Saharan Africa: A systematic review and meta-analysis.}, journal = {PloS one}, volume = {20}, number = {10}, pages = {e0334290}, pmid = {41082551}, issn = {1932-6203}, mesh = {Humans ; Africa South of the Sahara ; *Health Personnel ; *Waste Management/methods ; *Medical Waste Disposal/methods ; Female ; }, abstract = {INTRODUCTION: Inadequate management of healthcare waste present significant health hazards to healthcare workers, patients, waste handlers, and the whole communities, especially in developing countries. Although various primary studies have been conducted in different countries across the continent, there has been no comprehensive research examining healthcare waste management practices in Sub-Saharan Africa.<br><br>OBJECTIVE: This review aimed to assess healthcare waste management practices and associated factors among healthcare workers in Sub-Saharan Africa.<br><br>METHODS AND MATERIALS: This systematic review and meta-analysis were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 20) guidelines. PubMed, Science-Direct, Google Scholar, Hinari, and Google databases were used to find essential literature. The extracted data were analyzed using statistical software, STATA version 14. Publication bias was assessed using the Egger test and funnel plot, whereas heterogeneity was assessed using the I2 statistic.<br><br>RESULTS: This review include 29 studies comprising 7588 participants. The pooled estimate of good healthcare waste management practices among participants was 49.74% (95% CI: 43.73-55.76) (I2&#x2009;=&#x2009;96.8%, P&#x2009;<&#x2009;0.000). Sex, knowledge, training on healthcare waste management, use of working manuals/guidelines, and working hours were factors significantly associated with healthcare waste management practices among healthcare workers., Studies done in South Africa reported the highest good healthcare waste management practices with a value of 54.34% (95% CI: 48.05, 60.63), I2&#x2009;=&#x2009;0.00%, P&#x2009;<&#x2009;0.00. The pooled estimate of good healthcare waste management practices before the occurrences of COVID-19 pandemic was 50.49% (95% CI: 40.7, 60.25), (I2&#x2009;=&#x2009;97.9%, P&#x2009;<&#x2009;0.000). Public health facilities also reported having lower waste management practices with a value of 46.86% (95%CI: 39.33, 54.38%), I2&#x2009;=&#x2009;96.8%, P&#x2009;<&#x2009;0.000.<br><br>CONCLUSIONS: This review showed that only half of the healthcare workers practiced good healthcare waste management practices. Sex of the healthcare workers, training status, use of working manuals/guidelines, knowledge towards healthcare waste management, and their daily working hours were factors significantly associated with healthcare waste management practices among healthcare workers. Hence, respective healthcare authorities should develop and implement different healthcare waste management strategies, including ongoing in-service training, provision of healthcare waste management manuals, and conducting regular monitoring to enhance healthcare workers' knowledge and practices towards healthcare waste management practices.}, }
@article {pmid41082082, year = {2025}, author = {Wasim, R}, title = {From infection to intervention: post-acute sequelae of SARS-CoV-2 infection and cardiovascular risk.}, journal = {Inflammopharmacology}, volume = {33}, number = {11}, pages = {6577-6588}, pmid = {41082082}, issn = {1568-5608}, mesh = {Humans ; *COVID-19/complications ; *Cardiovascular Diseases/etiology/epidemiology/virology ; Post-Acute COVID-19 Syndrome ; Risk Factors ; SARS-CoV-2 ; Biomarkers ; }, abstract = {COVID is now a worldwide epidemic of non-communicable diseases. The symptoms, which impact several organs, might last for hours, weeks, or even months after the SARS-CoV-2 infection has ended. Electrocardiogram abnormalities (ECG), postural orthostatic tachycardia, and supraventricular or ventricular arrhythmias are among the common signs of long COVID-19. According to data, certain patient groups have persistent, post-infectious perimyocarditis, which may lead to left or right ventricular failure, arterial wall inflammation, or microthrombosis. This information has been made available by cardiac and vasculature imaging, and it may be used to develop efficient treatment plans for the cardiovascular symptoms of long COVID. Long COVID requires a greater understanding of the cellular and molecular processes. There are a variety of approaches that have been put forward, some of which include direct impacts on the heart and others that involve microthrombotic damage to the arteries or heart. When evaluated 3 months after SARS-CoV-2 infection, the currently employed circulating biomarkers, such as coagulation and inflammatory markers, do not serve as a highly predictive predictor for the existence or outcome of long COVID. However, further study is required to better understand the underlying processes and particular biomarkers for future COVID preventive methods.}, }
@article {pmid41081074, year = {2025}, author = {Kotfis, K and Szredzki, P and Maciejewska-Markiewicz, D and Sołek-Pastuszka, J and Wiśniewska, H and Lara, LF and Marlicz, M and Kaczmarczyk, M and Kukla, M and Belina, A and Koulaouzidis, G and Syczewska, M and Jakubczyk, K and Ekstedt, N and Stachowska, E and Kaniewska, M and Rydzewska, G and Łoniewski, I and Koulaouzidis, A and Marlicz, W and Skonieczna-Żydecka, K}, title = {The effect of SARS-CoV-2 infection on the liver function tests: a systematic review and meta-analysis of observational studies.}, journal = {Przeglad gastroenterologiczny}, volume = {20}, number = {3}, pages = {261-271}, pmid = {41081074}, issn = {1895-5770}, abstract = {INTRODUCTION: SARS-CoV-2 infection has been associated with respiratory distress syndrome and hepatic injury. The mechanism of liver injury is not fully understood and may be a combined effect of viral hepatitis, systemic inflammation, gut barrier disruption, microbiome alterations or drug toxicity.<br><br>AIM: We carried out a systematic review and meta-analysis to determine whether SARS-CoV-2 infection affects the level of liver-produced molecules: alanine aminotransferase (ALT), aspartate aminotransferase (AST), &#x3b3;-glutamyl transferase (GGTP), bilirubin, total protein, albumin, and prothrombin (with INR).<br><br>METHODS: Ten authors independently searched PubMed and Embase from their inception until 04/03/2021 for observational studies to evaluate whether SARS CoV-2 infection influences the level of liver-produced molecules. This early search aimed to capture changes associated with the initial variants of SARS-CoV-2 before widespread vaccination efforts. Full-text studies in adult humans in which the aim was liver damage were included. Eligible studies included adult populations with more than 30 subjects, and the analysis adhered to PRISMA guidelines. Data extraction involved a thorough process to ensure accuracy, with inconsistencies resolved by senior clinicians. Statistical analysis was conducted using random effects meta-analysis of outcomes for which &#x2265; 2 studies contributed data, and the risk of bias was assessed using the New Ottawa Scale. The study protocol was registered in the PROSPERO database (CRD42021242958).<br><br>RESULTS: The initial search yielded 3180 hits. 2644 studies were excluded as duplicates and/or after evaluation on the title/abstract level. No additional articles were identified via hand search. There were 536 full-text articles reviewed. Overall, the search strategy yielded 252 studies that were included in the meta-analysis.<br><br>CONCLUSIONS: The overall mean liver parameter values were not altered compared to physiological values, except for GGTP, lactate dehydrogenase activity, and INR values. In the case of AST, ALT and albumin levels, mean point estimates were close to limit values of standards. SARS-CoV-2 infection triggers gut barrier defects, which results in transient elevation of liver enzymes and clotting times.}, }
@article {pmid41080602, year = {2025}, author = {Bai, L and Geng, C and Guan, H}, title = {Rediscovering parainfectious encephalopathy in the post-COVID-19 era.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1634383}, pmid = {41080602}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/complications/immunology ; *SARS-CoV-2 ; *Brain Diseases/diagnosis/therapy/etiology/immunology ; }, abstract = {The COVID-19 pandemic has unveiled the pivotal role of systemic inflammatory responses in neurological complications, particularly parainfectious encephalopathy. Accumulating evidence has established innate immune overreaction-distinct from direct viral neuro-invasion or autoantibody-mediated reaction-as the fundamental mechanism. The clinical manifestations of parainfectious encephalopathy are highly diverse, spanning from mild cases, such as mild encephalopathy with or without a reversible splenial lesion (MERS or ME), to catastrophic syndromes like acute necrotizing encephalopathy (ANE) and febrile infection-related epilepsy syndrome with or without a claustrum lesion (FIRES-C or FIRES). In this article, we summarize the phenotypes, diagnosis, and treatment strategies for parainfectious encephalopathy to enhance clinical recognition and understanding of this re-emerging disorder.}, }
@article {pmid41080537, year = {2025}, author = {Zhang, L and Jin, S and Qin, C and Ma, D and Ye, J and Liu, Q}, title = {Bibliometric analysis of traditional Chinese medicine for viral infections through immune modulation (2015-2025).}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1647900}, pmid = {41080537}, issn = {1664-3224}, mesh = {Humans ; *Bibliometrics ; *Medicine, Chinese Traditional/methods ; *Virus Diseases/immunology/therapy/drug therapy ; *Immunomodulation ; SARS-CoV-2/immunology ; }, abstract = {OBJECTIVES: The immunomodulatory properties of traditional Chinese medicine (TCM) have attracted significant attention as a strategy for addressing viral infections. However, a comprehensive bibliometric analysis is still lacking. This study aims to systematically identify research trends, knowledge hotspots, and emerging themes in TCM applications for viral infections through immune modulation from 2015 to 2025.<br><br>METHODS: We collected publications from the Web of Science database from 2015 to 2025 and performed a comprehensive analysis using R, VOSviewer, and CiteSpace. In addition, clinical trial records published during this period were obtained from the PubMed database to assess clinical advancements in this field.<br><br>RESULTS: A total of 3,370 publications were analyzed in this study. Between 2015 and 2021, the number of publications in this field showed two distinct stepwise increases, separated by a period of relative stability, followed by a modest decline from 2021 to 2025. China contributed the highest volume of publications and demonstrated the broadest international collaborations, establishing itself as the leading country in this area. Frontiers in Immunology published the largest number of articles, while the Journal of Virology was the most frequently cited journal. Core topics included "Infection," "COVID-19," "Expression," "Antiviral," and "Protein." The primary research focus centered on TCM's antiviral effects and its modulation of immune responses, investigating its regulatory impact on inflammation and cytokine storms during viral infections, and examining TCM's role in modulating immune responses to viral vaccines. Clinical trials in this field focus on improving the management of viral infections, and immune reconstitution strategies for chronic infections.<br><br>CONCLUSION: This study systematically analyzes the scientific literature in this field, providing valuable insights into current research trends and highlighting future directions in the application of TCM to the immunomodulation of viral infections.}, }
@article {pmid41080534, year = {2025}, author = {Wang, Z and Xie, J and Li, Q and Liu, Y and Zhang, X and Mi, E and Wang, L and Wang, L and Zhang, F}, title = {Mechanism by which porcine transmissible gastroenteritis virus disrupts host innate immunity.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1675572}, pmid = {41080534}, issn = {1664-3224}, mesh = {Animals ; *Immunity, Innate ; *Transmissible gastroenteritis virus/immunology ; Swine ; *Immune Evasion ; *Gastroenteritis, Transmissible, of Swine/immunology/virology ; *Host-Pathogen Interactions/immunology ; Autophagy ; }, abstract = {Innate immune evasion is a critical aspect of viral infections, as it disrupts the host's defense mechanisms.The innate immune system, as the primary defense against pathogens, detects pathogen-associated molecular patterns (PAMPs) via pattern recognition receptors (PRRs). This recognition triggers the production of interferons (IFNs) and pro-inflammatory factors, initiating the antiviral immune response. During evolution, viruses have found many ways to evade innate immune response in order to increase the replication efficiency, transmission ability and to establish persistent infection through co-evolution with hosts. Pigs act as natural hosts for a variety of significant viruses, including both DNA and RNA viruses. These viruses not only jeopardize animal health but also present a potential risk of interspecies transmission. Among these, porcine transmissible gastroenteritis virus (TGEV) stands out as a highly prevalent and severely detrimental enterovirus in the global swine industry. This review aims to comprehensively analyze the interaction between TGEV and host cells, emphasizing the molecular underpinnings of its immune evasion strategies. In addition, we will describe the programmed cell death types induced by TGEV, including autophagy, apoptosis and pyroptosis. Compared with existing reviews, this article not only provides a systematic integration of the multilayered immune evasion mechanisms of TGEV but also, for the first time, offers a comprehensive overview of its interactions with various forms of programmed cell death. This perspective highlights the complex regulatory networks underlying TGEV's adaptive evolution in the host, thereby enhancing our understanding of the pathogenic mechanisms of porcine coronaviruses and offering novel theoretical foundations for the development of vaccines and antiviral therapeutics.}, }
@article {pmid41080217, year = {2025}, author = {Mohammadi Lapevandani, M and Bazmi, E and Jahani, S and Asgari, N and Sahraian, MA}, title = {Environmental risk factors of neuromyelitis optica spectrum disorder: a systematic review.}, journal = {Therapeutic advances in neurological disorders}, volume = {18}, number = {}, pages = {17562864251363293}, pmid = {41080217}, issn = {1756-2856}, abstract = {BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) may be triggered by environmental risk factors.<br><br>OBJECTIVES: We aimed to explore and integrate the recent research advances in this field. Here we describe relevant studies and summarize current knowledge on non-genetic factors that influence the onset of the disease.<br><br>DESIGN: Systematic review.<br><br>METHODS: We performed a systematic review up to May 21, 2024, following preferred reporting items for systematic reviews and meta-analyses guidelines. Two independent reviewers evaluated the quality of the included studies using the Joanna Briggs Institute checklist for risk of bias assessment.<br><br>DATA SOURCES: MEDLINE, EMBASE, Scopus, and Web of Science databases.<br><br>RESULTS: A total of 15,869 articles were evaluated. Of those 50 studies met the eligibility criteria. A total of 21,410 NMOSD patients were included in the studies; 17,080 patients were females. Totally, 14 risk factors, including vitamin D deficiency, vaccination, virus infections, lifestyle, and dietary factors, were assessed. A total of 37% of the included articles were conducted in East Asia, mainly focusing on the effects of infection and vitamin D deficiency. These studies suggested vitamin D deficiency as a possible NMOSD risk factor. A total of 25% of the studies included Caucasian populations from Western countries. They showed that smoking decreased the odds of NMOSD, in contrast to observations from Eastern studies. Few cases reported NMOSD onset after COVID-19 vaccination. Antibodies against Epstein-Barr virus, Mycobacterium paratuberculosis, and Helicobacter pylori were observed to be more frequently positive in the serum of NMOSD patients. Lower protein and fat and higher carbohydrate intakes were correlated with NMOSD development.<br><br>CONCLUSION: Vitamin D deficiency, cigarette smoking, Mycobacterium avium subspecies paratuberculosis infection, and diet were reported as environmental risk factors for NMOSD. The difference in the onset of NMOSD between Asian and Caucasian populations could be affected by smoking and vitamin D deficiency. Knowledge of modifiable risk factors for NMOSD may be beneficial in preventing and improving disease outcomes.}, }
@article {pmid41079530, year = {2025}, author = {Zhou, K and Lei, Y and Zhou, Y and Zhan, J}, title = {Evolution of split-protein technologies in virology: From mechanistic discovery and diagnostics to therapeutic promise.}, journal = {Journal of virus eradication}, volume = {11}, number = {4}, pages = {100610}, pmid = {41079530}, issn = {2055-6640}, abstract = {The persistent challenge posed by viruses such as HIV, HBV, and SARS-CoV-2 necessitates the continuous evolution of molecular tools for their study and for advancing therapeutic research. Split-protein complementation assays (PCAs), where a reporter protein is divided into two inactive fragments, have evolved from simple reporters of biological events into an increasingly important tool in modern virology. This review traces the evolutionary trajectory of split-protein systems. We begin with their foundational use in mechanistic discovery, where they first visualized viral-host interactions in living cells. We then explore their translation into practical applications, such as high-throughput drug screening and rapid point-of-care diagnostics. A step in this evolution was the development of systematic engineering platforms, dramatically accelerating the creation of novel biosensors. Finally, we discuss the latest frontier: engineering therapeutically active "split effectors." By integrating principles from synthetic biology, these advanced systems can function as programmable logic gates that respond to specific viral signatures. While therapeutic translation remains preclinical, split-protein platforms are emerging as tangible tools for advanced research and potential therapeutic development.}, }
@article {pmid41079451, year = {2025}, author = {Zhou, SC and Dong, YX and Tian, J and Che, GW and Lai, Y}, title = {Advancing the understanding of alveolar regeneration: Global research trends, thematic evolution, and emerging frontiers.}, journal = {Regenerative therapy}, volume = {30}, number = {}, pages = {778-794}, pmid = {41079451}, issn = {2352-3204}, abstract = {BACKGROUND: Alveolar regeneration represents a critical research direction in respiratory disease treatment. Despite the surge in studies following the COVID-19 pandemic, comprehensive bibliometric analysis to systematically evaluate global research trends and future directions remains lacking.<br><br>METHODS: This study employed bibliometric methodology to analyze 1564 publications related to alveolar regeneration from 1974 to 2024 using the Web of Science Core Collection database. Data visualization and analysis were conducted using VOSviewer (version 1.6.19), CiteSpace (version 6.2.R3), and the biblioshiny R package.<br><br>RESULTS: The analysis encompassed 68 countries, 1930 institutions, and 9150 researchers across 658 journals. The United States leads with 601 publications and 32,172 citations, with Harvard University as the most influential institution. The American Journal of Respiratory and Critical Care Medicine has the highest impact factor (19.3), while the American Journal of Physiology-Lung Cellular and Molecular Physiology has the most co-citations (2,402). Edward E. Morrisey is the most prolific author, and C. E. Barkauskas has the highest co-citations. Keyword analysis revealed six major research clusters: stem cells and regenerative medicine, acute lung injury and fibrosis, COVID-19-related research, chronic lung disease repair, cellular behavior and molecular mechanisms, and post-pneumonectomy regeneration. Thematic mapping indicates future research should prioritize lung injury repair mechanisms, matrix environment in tissue regeneration, stem cell therapeutics, and immune regulation in lung injury repair.<br><br>CONCLUSION: This first comprehensive 50-year bibliometric analysis of alveolar regeneration reveals the evolutionary trend from basic mechanistic exploration toward clinical translational applications, providing important reference for researchers and funding agencies.}, }
@article {pmid41077088, year = {2025}, author = {Meerasa, SS and Ahmad, A and Khan, AA and Haque, S and Saleem, I}, title = {Endosomal escape and current obstacles in ionizable lipid nanoparticles mediated gene delivery: lessons from COVID-19 vaccines.}, journal = {International journal of pharmaceutics}, volume = {685}, number = {}, pages = {126263}, doi = {10.1016/j.ijpharm.2025.126263}, pmid = {41077088}, issn = {1873-3476}, mesh = {Humans ; *COVID-19 Vaccines/administration &amp; dosage/chemistry/immunology ; *Endosomes/metabolism ; *Nanoparticles/chemistry/administration &amp; dosage ; *COVID-19/prevention &amp; control/immunology ; *Lipids/chemistry ; *Gene Transfer Techniques ; Animals ; SARS-CoV-2/immunology ; Liposomes ; }, abstract = {During last pandemic of COVID-19, two vaccines based on ionizable lipid nanoparticles (ILNP) were developed for COVID-19 prevention: Pfizer/BioNTech Vaccine (BNT162b2) and Moderna Vaccine (mRNA-1273). The observed efficacy of these two vaccine formulations catalyzed a global intensification of scientific inquiry into the therapeutic potential of these ionizable lipids, driving research efforts aimed at developing novel agents for a diverse range of pathologies. Successful ILNP-based delivery requires both selection of a suitable ionizable lipid and elucidation of its endosomal escape mechanism. This review focuses current knowledge on lipid diversity, emphasizing the structural and functional attributes of ionizable lipids essential for endosomal escape. A detailed analysis of COVID-19 vaccine lipid components, correlating their physicochemical properties with cellular and humoral immune responses, and exploring their implications for therapeutic innovation. Finally, we evaluate current challenges and future directions in ILNP-based therapy development.}, }
@article {pmid41077052, year = {2025}, author = {Rehm, J and Assanangkornchai, S and Hendershot, CS and Franklin, A and Neufeld, M and Hassan, AS and Shield, KD}, title = {Alcohol use disorders.}, journal = {Lancet (London, England)}, volume = {406}, number = {10516}, pages = {2269-2281}, doi = {10.1016/S0140-6736(25)01496-5}, pmid = {41077052}, issn = {1474-547X}, mesh = {Humans ; Alcohol Drinking/epidemiology ; *Alcohol-Related Disorders/epidemiology/therapy/economics ; *Alcoholism/epidemiology/therapy ; COVID-19/epidemiology ; Prevalence ; Social Stigma ; }, abstract = {Alcohol use disorders consist of conditions characterised by compulsive heavy alcohol use and loss of control over alcohol intake. Alcohol use disorders are some of the most prevalent mental disorders globally, with higher prevalence in high-income countries and lower prevalence in low-income countries. The recent COVID-19 pandemic was associated with an increase in fully alcohol-attributable mortality, in part triggered by alcohol-specific interactions with stress. Despite their high prevalence, alcohol use disorders remain undertreated, even though there are scientifically established and cost-effective psychosocial, community, and pharmacological interventions available. In addition, promising new treatment modalities have been developed and are currently being tested. The two main barriers to better access to evidence-based alcohol use disorder treatment are low availability, due to the absence of government or public funding for such treatment, and stigma. The first barrier could be overcome by increasing alcohol excise taxation, which currently falls considerably short of covering the social costs of alcohol use. In addition to generating revenues, increasing excise taxation could reduce health-care costs by reducing hospitalisations for all alcohol-attributable conditions, including alcohol use disorders. Overall, integrated alcohol control policies could improve the prevention of alcohol use disorders, improve access to treatment, and reduce stigma.}, }
@article {pmid41076810, year = {2025}, author = {Tambuzzi, S and Gentile, G and Boracchi, M and James, RI and Calati, R and Zoja, R}, title = {Is self-immolation still a contemporary phenomenon? Forensic evidence from the case studies of Milan (Italy) and literature review.}, journal = {Journal of forensic and legal medicine}, volume = {116}, number = {}, pages = {102985}, doi = {10.1016/j.jflm.2025.102985}, pmid = {41076810}, issn = {1878-7487}, mesh = {Humans ; Italy/epidemiology ; Male ; COVID-19/epidemiology ; Middle Aged ; Female ; *Burns ; *Suicide, Completed/statistics &amp; numerical data/psychology ; Mental Disorders/epidemiology ; Aged ; Adult ; Sex Distribution ; Age Distribution ; }, abstract = {Self-immolation is one of the most extreme methods of suicide and is characterized by an extremely varied framework, with different profiles of forensic and psychopathological relevance in different areas of the world. It can underline social, cultural, religious, protest motivations or develop in the context of psychiatric pathologies and mental alterations. In this context, cases of suicide by self-immolation that occurred between 2017 and 2024 in Milan (Italy) were analyzed and compared with an earlier study from 1993 to 2016 in the same geographical area. Almost a decade has passed since then, society has experienced periods of major crisis, including the Covid 19 pandemic, and migration flows have increased. Suicide by self-immolation appears to be a slightly increasing phenomenon (+18 % compared to the past), confirming a greater involvement of men in particular, but with a prevalence in an older decade (70-79 years compared to 50-59 years). Furthermore, the number of foreigners has quadrupled (31 % compared to 3 %). In 77 % of the cases, they were subjects suffering from psychiatric pathologies and the main reasons given were attributed to mental health problems, family disputes, sentimental, economic problems and existential distress. There was no motivation attributable to religious, cultural or political reasons. In our view, suicidal burns should be considered a mental health issue in the vast majority of cases. The pathological-forensic starting point has thus made it possible to identify further elements that contribute to the enrichment of knowledge about this phenomenon, which is still relevant in the current society.}, }
@article {pmid41076808, year = {2025}, author = {de Melo Araújo, AC and Frugoli, AG and de Sena Gonçalves, JE and Pércio, J and Da Silva, TP and da Fonseca Victer, TN and Matozinhos, FP and Fernandes, &#xc9;G}, title = {Monitoring strategies after the incorporation of vaccines into national immunization programs: a systematic review.}, journal = {Vaccine}, volume = {66}, number = {}, pages = {127850}, doi = {10.1016/j.vaccine.2025.127850}, pmid = {41076808}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention &amp; control ; COVID-19 Vaccines ; *Immunization Programs ; Vaccination ; *Vaccines/administration &amp; dosage ; }, abstract = {INTRODUCTION AND OBJECTIVE: The 2030 Immunization Agenda envisions a global landscape where everyone can equally access the benefits of both new and existing vaccines by expanding equitable coverage. Post-introduction evaluation strategies are essential to ensure efficient and rational use of resources invested in immunization programs. However, a notable gap remains in the literature on how these strategies are applied in low- and middle-income countries. This study identify the main strategies used worldwide to monitor vaccines after their incorporation into immunization programs.<br><br>METHODS: This systematic literature review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and reported following PRISMA guidelines. Studies were retrieved from PubMed (MEDLINE), Web of Science, Core Collection, SCOPUS, and EMBASE (Elsevier) databases. The review included studies on vaccine monitoring after incorporation into immunization programs, with no date restrictions. Excluded were narrative and systematic reviews, meta-analyses, letters, book chapters, posters, COVID-19 vaccine studies, non-human vaccination research, and studies assessing general impact without post-introduction monitoring.<br><br>RESULTS: The search identified 4812 citations, with 1477 duplicates removed. After screening 3335 titles and abstracts, nine studies met the inclusion criteria. While the concept of post-introduction monitoring strategies remains poorly defined, the studies revealed that such monitoring can be performed through evaluation of surveillance systems, economic assessments, and adapted analytical tools. Sentinel surveillance, involving healthcare workers and services, was the most frequently reported strategy, followed by synthetic control methods, pre- and post-introduction comparisons, and use of a World Health Organization tool.<br><br>CONCLUSIONS: Despite the absence of a standardized framework for post-introduction vaccine monitoring, existing studies demonstrate that evaluations can address effectiveness, safety, coverage, and cost. Beyond epidemiological significance, the incorporation of vaccines into immunization programs provides an opportunity to strengthen policies, promote workforce development, and foster social mobilization in support of vaccination.}, }
@article {pmid41076807, year = {2025}, author = {Domingo, JL}, title = {Differentiating COVID-19 vaccine-related adverse events from long COVID: A comprehensive review of clinical manifestations, pathophysiology, and diagnostic approaches.}, journal = {Vaccine}, volume = {66}, number = {}, pages = {127842}, doi = {10.1016/j.vaccine.2025.127842}, pmid = {41076807}, issn = {1873-2518}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage ; *COVID-19/prevention &amp; control/diagnosis/immunology ; SARS-CoV-2/immunology ; Post-Acute COVID-19 Syndrome ; Vaccination/adverse effects ; }, abstract = {The global deployment of COVID-19 vaccines has introduced diagnostic challenges due to overlapping symptoms with long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), prompting a comprehensive review of vaccine safety profiles, long COVID manifestations, and evidence-based differentiation strategies. Through a literature search (PubMed, Scopus, Web of Science) from December 2020 to June 2025, including peer-reviewed studies, clinical trials, and cohort studies, the present review reports that COVID-19 vaccines maintain robust safety, with rare adverse events like myocarditis and thrombosis with thrombocytopenia syndrome, while long COVID affects 10-40 % of SARS-CoV-2 survivors, presenting symptoms such as fatigue, cognitive dysfunction, and dyspnea. Differentiation between these conditions relies on careful analysis of the timing of symptom onset, detailed symptom characterization, and the use of advanced diagnostic tools. Systematic clinical assessment is essential for accurate diagnosis, which is critical for appropriate patient management, maintaining public confidence in vaccination, and guiding future research. Further studies are needed to validate diagnostic biomarkers, develop targeted therapies, and monitor long-term outcomes, with standardized global registries and interdisciplinary collaboration identified as key priorities for improving care and advancing the field.}, }
@article {pmid41076756, year = {2025}, author = {Douglas, KM}, title = {Antecedents and consequences of science-related conspiracy beliefs.}, journal = {Current opinion in psychology}, volume = {67}, number = {}, pages = {102191}, doi = {10.1016/j.copsyc.2025.102191}, pmid = {41076756}, issn = {2352-2518}, abstract = {Many social, political, and psychological factors influence the extent to which people put their trust in science. The current article examines recent evidence for the role of conspiracy beliefs about science. The article examines the consequences of such beliefs, focusing on the domains of health (e.g., vaccinations) and the environment (e.g., climate change). Using the COVID-19 context as an example, the article focuses on the epistemic, existential, and social motives that underpin science-related conspiracy beliefs. Finally, the article considers whether science-related conspiracy beliefs satisfy these psychological motives, and what implications there are for future trust in science.}, }
@article {pmid41076553, year = {2025}, author = {Kappenberg, A and Licandro, U}, title = {One Call Away: Bilingual Teleassessment for Preschool and Elementary Children: A Systematic Review.}, journal = {International journal of language &amp; communication disorders}, volume = {60}, number = {6}, pages = {e70136}, pmid = {41076553}, issn = {1460-6984}, mesh = {Humans ; *Multilingualism ; Child, Preschool ; Child ; COVID-19 ; Telemedicine ; *Language Therapy/methods ; Language Tests ; }, abstract = {BACKGROUND: Despite the growing need for language and communication assessments in both languages for bilingual children, there remains a shortage of bilingual speech and language therapists (SLTs). Teleassessment has emerged as a promising solution to address this gap, but there is a pressing need for a comprehensive understanding of its organisation, implementation and feasibility across children of different ages, language combinations and proficiency levels.<br><br>AIMS: This systematic review aims to synthesise the current studies on bilingual language and communication teleassessment for preschool and elementary-aged children. Specifically, it focuses on the language skills assessed in teleassessments, the tools and technology used and the organisational and implementation factors associated with bilingual teleassessment.<br><br>METHODS: The review was conducted following PRISMA guidelines. A systematic search was performed across five electronic databases as follows: APA PsycInfo, CINAHL, Education Source, Medline and Web of Science. Data from the selected studies were extracted and categorised, with study quality assessed using the Quality Assessment with Diverse Studies (QuADS).<br><br>MAIN CONTRIBUTION: A total of seven studies met the inclusion criteria. The review found that bilingual teleassessment typically focused on assessing productive and receptive vocabulary and grammar, using standardised tests adapted for remote administration. Most assessments were conducted in hybrid formats, combining both tele- and face-to-face elements. The results showed that language skills assessed via teleassessment were generally comparable to those assessed in face-to-face settings, indicating the feasibility of bilingual teleassessment.<br><br>CONCLUSIONS AND IMPLICATIONS: While bilingual teleassessment offers a promising approach to supporting bilingual children, its application should be approached with caution due to the limited number of studies and small sample sizes. Future research should prioritise the development of standardised guidelines for their implementation and the creation of targeted training and networking opportunities for bilingual SLTs. This will help enhance the quality and accessibility of bilingual teleassessment services. WHAT THIS PAPER ADDS?: What is already known on this subject Telepractice has been studied for several decades, particularly during the COVID-19 pandemic. However, research on bilingual teleassessment for children with varying ages, language constellations and competencies remains limited. The variability in study objectives and target populations has made it challenging to identify optimal methods for organising bilingual teleassessment in both research and clinical practice. What this paper adds to existing knowledge This study contributes to the existing literature by synthesising and critically evaluating research on bilingual teleassessment. It provides a comprehensive overview of the language and communication skills assessed, the tools and technologies used and the organisational, implementation and feasibility considerations in bilingual teleassessment. What are the potential or actual clinical implications of this work? Although research on bilingual teleassessment is still evolving, this review highlights several effective organisational methods, best practices and challenges. The findings suggest that, similar to monolingual teleassessment, bilingual teleassessment is generally comparable to face-to-face assessment. To further support evidence-based decision-making in bilingual teleassessment, future studies-both single-case and large-scale-along with further training and networking for bilingual and monolingual SLTs, are essential.}, }
@article {pmid41076270, year = {2025}, author = {Meier, RT and Kapur, R}, title = {Antibody-mediated multicellular pathophysiology of heparin-induced thrombocytopenia and vaccine-induced thrombotic thrombocytopenia: the dynamic roles of platelets, neutrophils, endothelial cells, and monocytes.}, journal = {Journal of thrombosis and haemostasis : JTH}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jtha.2025.09.014}, pmid = {41076270}, issn = {1538-7836}, abstract = {Heparin-induced thrombocytopenia (HIT) is a severe immune-mediated reaction to heparin, characterized by thrombocytopenia and an increased risk of thrombosis. Its pathophysiology is centered around the formation of antibodies directed against platelet factor 4 (PF4)/heparin complexes. These PF4/heparin antibodies engage platelet-FcγRIIa, leading to platelet activation and subsequent degranulation, aggregation, and the release of procoagulant extracellular vesicles (EVs). Activation of neutrophils, monocytes, and endothelial cells have also been suggested to be important features of HIT; neutrophil extracellular traps (NETs) are increasingly recognized as key contributors to thrombus propagation, monocytes may stimulate a prothrombotic state via FcγRIIa-mediated generation of tissue factor and thrombin, and endothelial activation may lead to the exposure of von Willebrand factor, further enhancing platelet recruitment and thrombosis. Importantly, interactions between different cell types, directly or indirectly, for instance, via EVs or dynamic shuttling of PF4, may consequently influence HIT responses. Vaccine-induced thrombotic thrombocytopenia (VITT), also a rare but serious complication of thrombocytopenia and thrombosis reported after administration of adenoviral vector COVID-19 vaccines, shares mechanistic parallels with HIT but is initiated by antibodies directed against PF4. These VITT antibodies also activate platelets via the FcγRIIa and may also induce the release of NETs, which could contribute to thrombus formation. Overall, in both HIT and VITT there appears to be a complex antibody-mediated interplay between various cells in promoting the regulation of thromboinflammatory responses. However, critical gaps remain regarding the precise cellular interactions driving thrombosis and/or thrombocytopenia. Further research is essential for developing improved diagnostic and therapeutic strategies for these life-threatening complications.}, }
@article {pmid41076051, year = {2025}, author = {Lee, SY and Schneider, AB and Walton, H and Isaac, J and Hansell, A and Katsouyanni, K and Wood, D and Evangelopoulos, D}, title = {Investigating links between long-term air pollution exposure and the risk of SARS-CoV-2 infection, COVID-19 hospitalisation and mortality: a systematic review and meta-analysis of cohort studies.}, journal = {Environmental pollution (Barking, Essex : 1987)}, volume = {386}, number = {}, pages = {127222}, doi = {10.1016/j.envpol.2025.127222}, pmid = {41076051}, issn = {1873-6424}, abstract = {Air pollution exposure is suggested to be associated with SARS-CoV-2 infection and COVID-19 outcomes. Available systematic reviews and meta-analyses included studies of various study designs which could be vulnerable to ecological bias. We systematically reviewed the association between particulate matter less than 2.5 aerodynamic diameter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) and the risk of SARS-CoV-2 infection, COVID-19 hospitalisation, and COVID-19 mortality, focusing on cohort studies with individual-level data. A systematic literature search was conducted on MEDLINE and Scopus in July 2023 and subsequently updated in April 2025. The risk of bias of eligible studies was assessed using a modified Risk of Bias assessment instrument developed by the World Health Organization. Qualitative synthesis was performed on all eligible studies, and random-effects meta-analyses were performed when more than three studies were available for an exposure-outcome pair, after removing studies with overlapping populations. Long-term PM2.5 exposure was associated with an increased risk of all outcomes investigated (RR for SARS-CoV-2 infection: 1.04 [1.02-1.07], RR for COVID-19 hospitalisation: 1.11 [1.06-1.15], RR for COVID-19 mortality: 1.09 [1.03-1.15], per 1 μg/m[3] increase), whereas NO2 exposure was associated with an increased risk of COVID-19 hospitalisation (RR: 1.02 [1.01-1.03], per 1 μg/m[3] increase) and COVID-19 mortality (RR: 1.01 [1.01-1.02], per 1 μg/m[3] increase). No associations were found for O3 exposure. Univariate meta-regression suggested that country of study accounted for a substantial proportion of the heterogeneity observed in meta-analyses. This review presents a comprehensive, up-to-date synthesis of the evidence regarding the adverse effects of air pollutant exposure on COVID-19 outcomes based on robustly conducted cohort studies with individual-level information.}, }
@article {pmid41075357, year = {2025}, author = {Zahedipour, F and Gol, TM and Wisser, S and Ramesh, A and Ureña-Bailén, G and Jaafari, MR and Mezger, M}, title = {Revolutionizing pediatric gene and cell therapy: The hope for lipid-based nanoparticles in blood disorders.}, journal = {Current research in translational medicine}, volume = {73}, number = {4}, pages = {103545}, doi = {10.1016/j.retram.2025.103545}, pmid = {41075357}, issn = {2452-3186}, abstract = {The rapidly advancing field of lipid-based nanoparticles (LNPs) as delivery systems for nucleic acids has the potential to revolutionize treatment strategies. LNPs have demonstrated exceptional versatility in delivering genetic material and therapeutic agents to target cells. In gene and cell therapy, LNPs could serve as efficient carriers for introducing genetic materials into the cells, addressing inherited genetic disorders at their root. Their minimal toxicity and immune response make them particularly suitable for pediatric applications. Additionally, the scalability and cost-effectiveness of LNP production offer practical advantages over methods such as viral vectors and electroporation (EP), improving accessibility to advanced therapies for children worldwide. In 2018, the first FDA-approved LNP-based siRNA therapy (Patisiran/ Onpattro®) for treating hereditary amyloidosis brought attention to the feasibility of LNPs for gene therapy. Eventually, authorization and approval of the mRNA-LNP vaccines against COVID-19 (Comirnaty® of BioNTech/Pfizer and SpikeVax® of Moderna) was another milestone for the development of LNP-based nucleic acid therapies. Later, LNPs were applied successfully for the delivery of pDNA, mRNA and siRNA in many types of genetic disorders and cancers. This innovative approach offers a brighter future for pediatric healthcare, where children can look forward to healthier and more fulfilling lives. This review paper provides an overview of the applications of LNPs in gene and cell therapies with a special focus on their pre-clinical application in primary cells, including natural killer cells, T cells, and hematopoietic stem cells, highlighting LNPs' efficacy, safety profile, and potential for transforming the landscape of pediatric healthcare in the future.}, }
@article {pmid41074196, year = {2025}, author = {Liu, Y and Dong, B and Yang, YL and Zhang, YQ and Zhang, Y and Pan, D and Du, EZ and Zhu, SJ and Wang, B and Huang, YW}, title = {Intestinal microbiota dynamics in piglets: the interplay with swine enteric coronavirus infections and implications for disease control.}, journal = {Animal microbiome}, volume = {7}, number = {1}, pages = {107}, pmid = {41074196}, issn = {2524-4671}, support = {32302873//National Natural Science Foundation of China/ ; U22A20521//National Natural Science Foundation of China/ ; }, abstract = {Infections of swine enteric coronavirus (SECoV), including porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), and swine acute diarrhea syndrome coronavirus (SADS-CoV), cause severe diarrhea in piglets and result in substantial losses to the pig industry. The intestinal microbiota plays a crucial role in SECoV disease progression and outcomes, yet current research largely focuses on specific age groups or intestinal segments. This review provides a comprehensive analysis of the dynamic microbiota changes in piglets after SECoV infections across different ages and intestinal regions. It discusses differential microbiota analyses, functional changes, metabolic products, alongside their effects on immune responses. Additionally, we explore fecal bacterial transplantation as a potential intervention and highlight the role of the microbiota in either promoting or inhibiting SECoV infections. The development of advanced research tools, including culturomics, sequencing technologies, and multi-omics approaches, is pivotal in understanding the intricate relationship between the porcine intestinal microbiota and SECoV infections, offering potential strategies for preventing and controlling SECoV-related diseases.}, }
@article {pmid41074055, year = {2025}, author = {Zuo, P and Ramamurthy, C and Gowing, A and De Silva, A and Minas, H}, title = {Factors associated with mental health of Chinese international students in the global context: a systematic review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3460}, pmid = {41074055}, issn = {1471-2458}, mesh = {Humans ; China/ethnology ; *COVID-19/epidemiology/psychology ; *Mental Health ; *Students/psychology ; *East Asian People/ethnology/psychology ; }, abstract = {BACKGROUND: Chinese international students (CIS) form the biggest cohort in popular host countries such as the United States, Australia, and the United Kingdom, but research shows that their mental health is challenged by multifaceted stressors. Despite this, we are unaware of any previous systematic review that has synthesised both quantitative and qualitative findings on factors associated with their mental health across different countries, and no existing review has included studies done during or after the COVID-19 pandemic. This systematic review aims to answer the following questions: What are the factors associated with the mental health of CIS across different countries? Among identified factors which factors emerged during the COVID-19 pandemic, and which were exacerbated during the pandemic?<br><br>METHODS: This review follows PRISMA guidelines. Six English and three Chinese databases were searched in November 2023: PsycINFO, MEDLINE, Embase, ERIC, Scopus, Web of Science, CNKI, Wanfang, and VIP. All types of empirical studies were eligible. Quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Data were extracted and findings were narratively synthesised using a convergent approach.<br><br>RESULTS: Thirty-nine English language papers and one Chinese language paper were included. The mental health of CIS is associated with various factors, including academic issues, parents and family, language proficiency, social support, discrimination, acculturative stress, the COVID-19 pandemic, and other factors. Among these, academic-related issues are their main concern, intertwined with family expectation and Confucian cultural values. Language plays a fundamental role in their daily life. During COVID-19, other than pandemic-related fear, there was an increase in experiences of discrimination and social isolation, associated with poorer mental health. Satisfaction with online learning is related to better mental health. Concerns about face, self-esteem, perfectionism, physical health, green space usage, and other factors were also reported.<br><br>CONCLUSIONS: The mental health of CIS is associated with various factors, and it worsened during the pandemic. Universities, and professionals in education and mental health could provide resources for students to enhance language abilities, academic skills, and social networks. CIS could be more prepared academically and mentally. Suggestions on future research directions were also provided.}, }
@article {pmid41073977, year = {2025}, author = {Teffera, ZH and Belay, WY and Tegegne, BA and Belew, H and Adugna, A and Laykun, Y and Tefera, S and Muche, Y and Melkamu, A and Amare, GA and Abebaw, D and Akelew, Y and Jemal, M and Getinet, M and Fenta Mengist, E and Baylie, T and Haimanot, AB and Hibistu, T and Enchalew, K}, title = {Efficacy of novel SARS-CoV2 vaccines in preventing SARS- CoV- 2 infection: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {1267}, pmid = {41073977}, issn = {1471-2334}, abstract = {BACKGROUND: Efficacious SARS-CoV-2 vaccines are urgently required to prevent the spread of the emerging and re-emerging SARS-CoV-2.<br><br>OBJECTIVE: Aim to assess the efficacy of novel SRAS-CoV-2 vaccines in preventing SARS-CoV-2 infection.<br><br>METHODS: All randomized placebo-controlled clinical trials eligible for this review were included. Scopus, PubMed, the Cochrane Library, and Google Scholar were searched. The risk of bias in the included studies was assessed using the modified Cochrane risk of bias tool 2 for RCTs. Result synthesis was performed using STATA software version 17.4. Forest plots, heterogeneity tests, meta-regression, sensitivity analysis, and publication bias were used to present the results.<br><br>RESULT: Eighteen studies comprising 186,657 participants who took the full dose of SARS-CoV-2 in an RCT were included. Of the participants, 110,768 (59.3%) were males and 111,619 (59.8%) were treatment groups. A total of 5665 (3.0%) participants were infected by SARS-CoV-2. Among the treatment groups, 3140 (2.8%) and 2525 (3.4%) from the placebo group were infected by SARS-CoV-2. The most efficient SARS-CoV-2 vaccine was BNT162B2, with 100% efficacy, whereas mRNA-1273 was the least efficient vaccine, with 36.8% efficacy. The overall efficacy of novel SRAS-CoV-2 vaccines was 70.5% (95% confidence interval (CI), 53.5 to 79.7). The relative risk of being infected was 84% lower in the treatment group compared to the placebo group. The novel SRAS-CoV-2 vaccines are efficient enough to protect 771 people out of 1000 from being infected by SARS-CoV-2.<br><br>DISCUSSION: Novel SARS-CoV-2 vaccines are efficacious inn preventing SARS-CoV-2 infection. However, their efficacy varies.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-025-11717-5.}, }
@article {pmid41073371, year = {2025}, author = {Liu, RY and Yin, KF and He, SY and Su, WM and Duan, QQ and Wen, XJ and Chen, T and Shen, C and Li, JR and Cao, B and Chen, YP}, title = {Viral infections and the risk of neurodegenerative diseases: a comprehensive meta-analysis and systematic review.}, journal = {Translational psychiatry}, volume = {15}, number = {1}, pages = {388}, pmid = {41073371}, issn = {2158-3188}, mesh = {Humans ; *Neurodegenerative Diseases/epidemiology/virology ; *Virus Diseases/epidemiology/complications ; *Amyotrophic Lateral Sclerosis/epidemiology/virology ; *Parkinson Disease/epidemiology/virology ; Risk Factors ; *Alzheimer Disease/epidemiology/virology ; }, abstract = {BACKGROUND: Viral infections have been implicated in the pathogenesis of neurodegenerative diseases (NDs); however, evidence linking specific viruses to Alzheimer's disease (AD), Parkinson's disease (PD), and amyotrophic lateral sclerosis (ALS) remains inconclusive. This study conducted a meta-analysis and systematic review to investigate these associations.<br><br>METHODS: Thorough searches were conducted across Embase, PubMed, Cochrane Library, Web of Science and Scopus until May 18, 2025, to identify observational studies investigating the relationship between viral infections and the risk of NDs, including AD, PD, and ALS. Meta-analyses were executed using a random-effects model with Stata MP18.0.<br><br>RESULTS: A total of 34,417 articles were identified, of which 73 met the eligibility criteria for inclusion in the meta-analysis, and 48 were included in the systematic review. The analysis demonstrated that infections with cytomegalovirus (CMV) (odds ratio [OR]&#x2009;=&#x2009;1.41; 95% confidence interval [CI]: 1.03, 1.93), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (OR&#x2009;=&#x2009;1.88; 95% CI: 1.53, 2.32), hepatitis C virus (HCV) (OR&#x2009;=&#x2009;1.39; 95% CI: 1.14, 1.69), and human herpesvirus (HHV) (OR&#x2009;=&#x2009;1.24; 95% CI: 1.02, 1.51) were associated with an increased risk of AD. Regarding PD, infections with hepatitis B virus (HBV) (OR&#x2009;=&#x2009;1.18; 95% CI: 1.04, 1.35) and HCV (OR&#x2009;=&#x2009;1.29; 95% CI: 1.18, 1.41) were identified as risk factors. Conversely, no significant correlation was found between any viral infection and the risk of ALS.<br><br>CONCLUSION: This meta-analysis supports the role of select viral infections in AD and PD pathogenesis. However, no association was found between viral infections and ALS, warranting further large, multicenter, and longitudinal studies to elucidate mechanisms and confirm causality.}, }
@article {pmid41073313, year = {2025}, author = {Wang, MC and Liu, X and Hu, K}, title = {[Intermittent hypoxia exposure in the rehabilitation of long COVID patients].}, journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases}, volume = {48}, number = {10}, pages = {961-964}, doi = {10.3760/cma.j.cn112147-20250601-00295}, pmid = {41073313}, issn = {1001-0939}, support = {JCRCYG-2022-012//Interdisciplinary Innovative Talents Foundation from Renmin Hospital of Wuhan University/ ; }, mesh = {Humans ; *COVID-19/rehabilitation ; *Hypoxia/rehabilitation ; Quality of Life ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Fatigue ; }, abstract = {Patients recovering from COVID-19 infection often experience "Long COVID", which is characterized by symptoms such as fatigue, reduced exercise capacity or dyspnea, and cognitive dysfunction. These symptoms negatively impact their quality of life. Currently, there is a lack of widely recognized therapeutic approaches or specific pharmacological interventions for managing these conditions. During intermittent hypoxic exposure (IHE), participants are alternated to hypoxic and normoxic exposure, which induced beneficial adaptive responses in the body. Emerging evidence suggests that IHE can alleviate symptoms of Long COVID through mechanisms such as improving ventilatory function, enhancing cardiopulmonary endurance, modulating immune responses, and reducing inflammation. These effects contribute to an improved quality of life and more holistic recovery, highlighting the promising potential of IHE in managing long COVID.}, }
@article {pmid41073150, year = {2025}, author = {Huang, D and Zhang, J and Zeng, X and Zhang, Y and Song, E}, title = {RNA vaccines for cancer: revolutionizing immunization strategies.}, journal = {Trends in cancer}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.trecan.2025.09.003}, pmid = {41073150}, issn = {2405-8025}, abstract = {Cancer vaccines have emerged as a promising strategy in cancer immunotherapy, capable of eliciting robust antitumor immune responses by targeting tumor-associated antigens or tumor-specific antigens. Among the various vaccine platforms, RNA-based vaccines have garnered substantial attention, especially in light of the success of mRNA vaccines during the COVID-19 pandemic. This review outlines the fundamental characteristics of different RNA vaccine modalities, summarizes recent clinical applications in cancer treatment, and highlights strategies aimed at improving their efficacy and safety. Furthermore, we discuss the current challenges facing RNA vaccine development and offer perspectives on future directions in this rapidly advancing field.}, }
@article {pmid41072100, year = {2026}, author = {Kolarič, A and Jukič, M and Bren, U}, title = {Machine learning in antiviral drug design.}, journal = {Bioorganic &amp; medicinal chemistry}, volume = {132}, number = {}, pages = {118426}, doi = {10.1016/j.bmc.2025.118426}, pmid = {41072100}, issn = {1464-3391}, mesh = {*Antiviral Agents/chemistry/pharmacology/therapeutic use ; *Machine Learning ; Humans ; *Drug Design ; COVID-19 Drug Treatment ; SARS-CoV-2/drug effects ; Drug Discovery ; }, abstract = {Viral infections pose a significant health threat worldwide. Due to the high mutation rates of many viruses and their reliance on host cellular machinery, the development of effective antiviral therapies is particularly difficult. As a result, only a limited number of antiviral agents is currently available. In parallel to modern vaccines, traditional antiviral drug development is both time-consuming and costly, underscoring the need for faster, more efficient approaches. In recent years, particularly since the beginning of the COVID-19 pandemic, machine learning (ML) together with broader artificial intelligence (AI), have emerged as powerful methodologies for drug discovery and offer the potential to accelerate the identification and development of antiviral agents. This review examines the application of ML in the early stages of antiviral drug discovery, with a particular focus on recent studies where ML methods have successfully identified hit compounds with experimentally demonstrated activity in biological assays. By highlighting these successful case studies, the review illustrates the growing impact of ML in advancing the discovery of urgently needed novel antivirals.}, }
@article {pmid41071737, year = {2025}, author = {Atmar, RL and Abate, G and Deming, ME and George, SL and Fleming, A and Frey, SE and Lyke, KE and Stephens, DS and Del Rio, C and El Sahly, HM}, title = {Emerging and Pandemic Pathogens: Lessons Learned From a Clinical Research Network.}, journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America}, volume = {81}, number = {Supplement_2}, pages = {S89-S102}, pmid = {41071737}, issn = {1537-6591}, support = {UM1 AI148689/AI/NIAID NIH HHS/United States ; UM1 AI148685/AI/NIAID NIH HHS/United States ; //Infectious Diseases Clinical Research Consortium/ ; UM1AI148576/NH/NIH HHS/United States ; UM1 AI148684/AI/NIAID NIH HHS/United States ; UM1AI148684/NH/NIH HHS/United States ; //Vaccine Treatment and Evaluation Units/ ; UM1AI148575/NH/NIH HHS/United States ; UM1 AI148574/AI/NIAID NIH HHS/United States ; //National Institute of Allergy and Infectious Diseases/ ; UM1 AI148575/AI/NIAID NIH HHS/United States ; UM1 AI148576/AI/NIAID NIH HHS/United States ; UM1AI148574/NH/NIH HHS/United States ; UM1AI148689/NH/NIH HHS/United States ; UM1AI148685/NH/NIH HHS/United States ; }, mesh = {Humans ; *Pandemics/prevention &amp; control ; *Communicable Diseases, Emerging/prevention &amp; control/epidemiology ; COVID-19/prevention &amp; control ; Biomedical Research ; United States ; Clinical Trials as Topic ; SARS-CoV-2 ; COVID-19 Vaccines ; Vaccines/immunology ; National Institute of Allergy and Infectious Diseases (U.S.) ; }, abstract = {Pathogens infecting humans continue to emerge or reemerge to cause outbreaks and widespread disease. The National Institute of Allergy and Infectious Diseases has funded Vaccine Treatment and Evaluation Units (VTEUs) for more than 50 years. VTEUs perform clinical studies to assess the safety and immunogenicity of candidate vaccines and other interventions to mitigate the impact of emerging and ongoing infectious diseases. Here, we review clinical studies conducted in the VTEUs since 2000 that have addressed emerging pathogens and other infectious agents with pandemic potential or of bioterrorism concern. The studies conducted range from phase 1 to phase 3 clinical trials, and they have included vaccines, therapeutics, and epidemiological studies. The results of the trials have guided national and often international recommendations for treatment and prevention of many of the evaluated pathogens, culminating in coronavirus disease 2019 studies that began within three months of severe acute respiratory syndrome coronavirus 2 identification. The VTEU network continues to be a critical public health resource for addressing emerging pathogens and expediting the development of safe and effective vaccines and treatments to protect at-risk populations.}, }
@article {pmid41070480, year = {2025}, author = {Ghandour, M and Gerges, NE and Zeaiter, N}, title = {The Prevalence and Determinants of Mental Health Problems in Lebanon: A Meta-Analytic Study of 3957 Healthcare Workers.}, journal = {Turk psikiyatri dergisi = Turkish journal of psychiatry}, volume = {36}, number = {}, pages = {17}, pmid = {41070480}, issn = {2651-3463}, mesh = {Humans ; Lebanon/epidemiology ; *Health Personnel/psychology/statistics &amp; numerical data ; Prevalence ; *COVID-19/epidemiology/psychology ; *Mental Disorders/epidemiology ; Risk Factors ; Cross-Sectional Studies ; Female ; Male ; }, abstract = {OBJECTIVE: Healthcare workers are continuously exposed to challenging environments, making them liable for poor mental health. The COVID-19 pandemic exacerbated this problem, however available data in Lebanon is scarce. We conducted this investigation to provide comprehensive evidence on the mental health of Lebanese healthcare workers.<br><br>METHODS: In this systematic review, we analyzed 3957 workers reported in 15 cross-sectional studies (10 during and five before the pandemic), identified after searching four databases. Examined mental health problems included depression, anxiety, stress, posttraumatic stress disorder (PTSD), and poor sleep quality. STATA software was used to pool the prevalence across studies. Subgroup analyses were performed based on the pandemic status, severity of mental health problems, and healthcare worker type. Gender and marital status were analyzed as potential risk factors. The methodological quality of all included studies was good as per the National Institute of Health risk of bias tool.<br><br>RESULTS: Anxiety, depression, stress, PTSD, insomnia, and poor sleep quality were reported in 50%, 52%, 50%, 35%, 45%, and 41% of the population, respectively. Most cases had mild anxiety (40%), mild depression (45%), but severe stress (27%). Depression and anxiety were highest among pharmacists (69% and 56%) and nurses (49% and 45%), respectively. Compared to the pre-pandemic period, depression (36% vs. 62%) and anxiety (30% vs. 56%) rates were higher during the pandemic, while stress levels were lower (62% vs. 45%). Both gender and marital status were insignificant predictors of depression, anxiety, stress, or PTSD.<br><br>CONCLUSIONS: Depression, anxiety, posttraumatic stress, insomnia, and poor sleep quality are experienced by approximately one in every two Lebanese healthcare workers. The rate of depression and anxiety almost doubled during the pandemic with higher rates among pharmacists and nurses than physicians and residents. Both gender and marital status were deemed insignificant predictors of reported mental health problems.}, }
@article {pmid41070200, year = {2025}, author = {Yan, C and Lu, P and Jiang, Y and Miao, S and Zhao, L and Xu, X}, title = {2B4/CD244 Signaling in Immune Regulation and Its Role in Infection, Cancer, and Immune Tolerance.}, journal = {ImmunoTargets and therapy}, volume = {14}, number = {}, pages = {1111-1131}, pmid = {41070200}, issn = {2253-1556}, abstract = {2B4 (CD244), the fourth member of the signaling lymphocyte activation molecule (SLAM) family, is expressed by virtually all human and murine hematopoietic lineages and functions as a context-dependent activating or inhibitory receptor. This review provides a comprehensive update on the gene organization, molecular architecture, glycosylation patterns, and alternatively spliced isoforms of 2B4, highlighting how these structural variables dictate ligand (CD48) affinity and downstream signaling outcome. The roles of 2B4 in natural killer (NK) cells, CD8[+] T cells, dendritic cells, myeloid-derived suppressor cells, B cells, eosinophils, and basophils were then systematically demonstrated, emphasizing their dual capacity to either potentiate cytotoxicity and cytokine production or enforce immune tolerance and exhaustion. Mechanistically, the balance between SLAM-associated protein (SAP)-mediated activation and SHP-1/2/SHIP-driven inhibition emerges as a central rheostat that is dynamically tuned by SAP availability, and the microenvironment. Clinically, exaggerated 2B4 signaling is associated with viral persistence in MCMV, HCV, HIV, and SARS-CoV-2 infections, promotes tumor immune escape in melanoma, multiple myeloma, and head-and-neck cancer, and compromises maternal-fetal tolerance, whereas insufficient signaling weakens antimicrobial immunity. Parallel pre-clinical studies validate 2B4 blockade as a rational combinatorial strategy to reinvigorate exhausted CD8[+] T and NK cells, while soluble CD48 emerges as a dynamic biomarker of disease activity. Collectively, these insights redefine 2B4 as a systems-level integrator of immune homeostasis and a tractable precision-immunotherapy node whose therapeutic manipulation can rebalance immunity across infection, cancer, and pregnancy.}, }
@article {pmid41067931, year = {2025}, author = {Liu, S and Zhang, H}, title = {Risk Factors for Maltreatment of Adolescents in Asia: A Systematic Review of the Evidence.}, journal = {Trauma, violence &amp; abuse}, volume = {}, number = {}, pages = {15248380251366255}, doi = {10.1177/15248380251366255}, pmid = {41067931}, issn = {1552-8324}, abstract = {Adolescent maltreatment is a public health issue with far-reaching consequences. This systematic review aimed to identify its risk factors within Asian settings. Seven databases (PubMed, Web of Science, PsycINFO, MEDLINE, ProQuest, CNKI, and Wanfang) were systematically searched for publications published before May 3, 2024. Twenty-four studies from nine Asian countries were included. Results revealed multilevel risk factors across ecological systems. At the individual level, younger age predicted physical abuse, while male gender was associated with higher neglect and overall maltreatment rates. Poor health condition, behavioral problems, and high-risk sexual behaviors/attitudes increased vulnerability. Parental substance use and addictive behaviors consistently predicted maltreatment, while family-level factors, including economic hardship and non-traditional structures, showed robust associations. Within microsystems, poor family relationships and negative parenting patterns were found to be significant. Mesosystem risks centered on academic underperformance, while exosystem influences consistently reflected patterns in neighborhood disorganization and migration status. Evidence at the macrosystem level remains scarce, while findings concerning chronosystem factors-including COVID-19 pandemic impacts and intergenerational transmission of abuse-remain preliminary. These findings underscore the need for both rigorous longitudinal research to establish causal relationships and macro-level investigations to examine societal, cultural, and policy influences in Asian contexts, thereby building comprehensive evidence to inform culturally appropriate and multilevel prevention strategies.}, }
@article {pmid41067656, year = {2026}, author = {Vavougios, GD and Liampas, A and Tseriotis, VS and Hadjigeorgiou, G and de Erausquin, GA}, title = {SARS-CoV-2's influence on tau and Αβ1-42 measurements: A novel potential confounder for the AT(N) framework.}, journal = {Brain, behavior, and immunity}, volume = {131}, number = {}, pages = {106131}, doi = {10.1016/j.bbi.2025.106131}, pmid = {41067656}, issn = {1090-2139}, }
@article {pmid41067618, year = {2025}, author = {Allegue, F and Zulaica, A and Pastor-Nieto, MA and Ballester-Nortes, I and Fernández-Tapia, V and Parera-Amer, ME and García-Doval, I}, title = {[Translated article] Erythema Papulatum Centrifugum: A Clinically Distinct Dermatosis. CLINI-AEDV Case Series.}, journal = {Actas dermo-sifiliograficas}, volume = {116}, number = {10}, pages = {T1126-T1130}, doi = {10.1016/j.ad.2025.10.006}, pmid = {41067618}, issn = {1578-2190}, mesh = {Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; COVID-19/prevention &amp; control ; COVID-19 Vaccines/adverse effects ; *Erythema/pathology/etiology/diagnosis ; Multiple Myeloma/complications ; Paraneoplastic Syndromes/etiology/diagnosis/pathology ; }, abstract = {Erythema papulatum centrifugum is a rare condition marked by a centrifugally growing border dotted with small papules and a relapsing course, often worse in spring and summer. There are not any specific diagnostic tests to confirm it. This study analyzes the clinical characteristics of seven cases, representing the largest series of non-oriental patients to date. Our findings confirm the pruritic and seasonally relapsing nature of this condition. Lesions are typically few, primarily located on the trunk, and generally exceed 5cm in diameter. Interestingly, in one patient, two outbreaks correlated temporally with the COVID-19 vaccine. In two other cases, the condition was linked to hematological malignancies: multiple myeloma and Hodgkin lymphoma. These observations, along with other neoplasm-associated cases reported in the literature, suggest that this entity might function as a paraneoplastic syndrome.}, }
@article {pmid41067176, year = {2025}, author = {Grossi, PA and Burra, P and Cozzi, E and Gesualdo, L and Grandaliano, G and Potena, L and Vitulo, P}, title = {An update on SARS-CoV-2 prevention strategy in solid organ transplant recipients: an expert opinion.}, journal = {Transplantation reviews (Orlando, Fla.)}, volume = {39}, number = {4}, pages = {100966}, doi = {10.1016/j.trre.2025.100966}, pmid = {41067176}, issn = {1557-9816}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology/epidemiology ; *Organ Transplantation ; *COVID-19 Vaccines/therapeutic use ; SARS-CoV-2 ; *Transplant Recipients ; *Pre-Exposure Prophylaxis/methods ; Immunosuppressive Agents ; Vaccination ; }, abstract = {Compared to immunocompetent individuals, solid organ transplant recipients (SOTRs) develop a weaker immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and vaccination. Although anti-SARS-CoV-2 vaccines can prevent symptomatic and severe disease, the SOTR population remains at risk as long as SARS-CoV-2 continues to circulate. To protect transplanted patients against severe COVID-19, two primary preventive strategies have been proposed: anti-SARS-CoV-2 vaccination and pre-exposure prophylaxis (PrEP) with monoclonal antibodies that possess neutralizing activity against SARS-CoV-2. The effectiveness of vaccination varies depending on the type of organ transplanted and the immunosuppressive therapy used, whereas the effectiveness of PrEP does not depend on these factors. The timing of vaccination and PrEP administration is also crucial. A stronger immune response is observed when vaccination is conducted during the nadir of immunosuppressive therapy. However, when PrEP is administered concomitantly with the vaccine, the efficacy of the vaccination could be reduced, both in terms of antibody production and cell-mediated immunity. Therefore, PrEP should be administered at least 15 days after vaccine administration. In addition to the availability of various preventive measures against COVID-19 for the most vulnerable transplant patients, the scientific community strongly recommends adhering to protective measures, such as wearing masks, practicing hand hygiene, and maintaining social distancing. These expert recommendations offer crucial guidance on preventing SARS-CoV-2 infection in solid organ transplant patients and are applicable to everyday clinical practice.}, }
@article {pmid41066926, year = {2026}, author = {Andrews, SJ and Gallagher, O and Miles, A and Crevacore, C and Mills, B}, title = {Nursing leadership and pandemic preparedness via game-based learning simulation: A narrative review (Registered nurses and undergraduate nursing students).}, journal = {Nurse education today}, volume = {156}, number = {}, pages = {106888}, doi = {10.1016/j.nedt.2025.106888}, pmid = {41066926}, issn = {1532-2793}, mesh = {Humans ; *Leadership ; *COVID-19/epidemiology ; *Students, Nursing/psychology ; *Simulation Training/methods ; Education, Nursing, Baccalaureate/methods ; Pandemics ; Pandemic Preparedness ; }, abstract = {BACKGROUND: Early progression of newly registered nurses into leadership roles is commonplace in clinical settings. Nurses and student nurses can prepare for leadership by gaining exposure through simulation-based learning. A novel and expanding modality are game-based learning (GBL) simulation. Nurse leaders play a crucial role during pandemics, guiding their teams through crises and ensuring effective response strategies. Reviewing the literature to identify the content, structure, and effectiveness of current pandemic preparedness and GBL simulation in nursing education is necessary to identify lessons learnt during the COVID-19 pandemic response to guide workforce preparation for future surge planning.<br><br>AIM: The aim of this narrative review was to explore the literature regarding current pandemic preparedness and GBL simulation in nursing education.<br><br>METHODS: This narrative review was conducted in accordance with the sequence outlined by Gregory and Denniss (2018). The review process adhered to the PRISMA protocol and used the population, concept, and context (PCC) framework to define inclusion and exclusion criteria. A search of five major healthcare databases: CINAHL Ultimate (EBSCO), Medline (Ovid), APA PsycInfo, Web of Science, and Scopus was supplemented with a grey literature search via Google Scholar.<br><br>RESULTS: Screening and review identified 48 manuscripts that met inclusion criterion. Analysis revealed variation in duration of pandemic preparedness programs (n&#xa0;=&#xa0;30 articles), theoretical versus practical content, and face-to-face or online modes of delivery. GBL simulation (n&#xa0;=&#xa0;18 articles) was revealed as an emerging modality in nursing education curriculum.<br><br>DISCUSSION: Existing learning strategies in use within the nursing field comprise a raft of various teaching methods which facilitate preparedness of nurses for pandemics, leadership and workforce shortages. Despite implementation challenges such as considerable resource investment and ongoing maintenance, GBL simulation achieves significant improvements in knowledge, confidence, engagement, motivation and skill acquisition among nurses and nursing students.<br><br>CONCLUSION: There is limited evidence describing pandemic preparedness training of nursing students via GBL simulation. Further research is needed to identify if GBL simulation of real-world pandemic scenarios in a low-risk setting could provide learning benefit through integration into nursing education curricula.}, }
@article {pmid41066388, year = {2025}, author = {Mohammed, J and Parveen, A and Ubaid Chhapra, H and Naaz Mashooq, F and Shadan, M}, title = {Iron deficiency and vaccine efficacy: A mini-review of immunological interplay and evidence across vaccine types.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2572195}, pmid = {41066388}, issn = {2164-554X}, mesh = {Humans ; Animals ; *Vaccine Efficacy ; *Iron Deficiencies/immunology ; *COVID-19 Vaccines/immunology ; *Iron ; COVID-19/prevention &amp; control/immunology ; Cytokines/immunology ; *Vaccines/immunology ; T-Lymphocytes/immunology ; }, abstract = {Iron deficiency (ID), the world's most prevalent micronutrient disorder, is known to impair immune function. However, its influence on vaccine efficacy remains under-explored. This mini-review examines the interplay between iron status and immunological responses to vaccines, synthesizing evidence from human and animal studies across various vaccine types. We highlight key immune mechanisms affected by iron, such as T-cell proliferation, B-cell differentiation, and cytokine modulation, and examine how these disruptions alter vaccine responsiveness. While some studies show clear negative effects of iron deficiency, particularly in pediatric and animal models, others find minimal impact, particularly with mRNA and COVID-19 vaccines. Iron supplementation appears to improve immune outcomes in several studies, though evidence varies by pathogen, vaccine type, and severity of deficiency. These findings carry important implications for global immunization strategies, especially in iron-deficient populations. We recommend that future vaccine policy and research incorporate iron status as a critical factor in optimizing vaccine effectiveness.}, }
@article {pmid41065846, year = {2025}, author = {Chang, CC and Li, YH and Chen, HH and Sun, SF}, title = {Clinical applications and molecular mechanisms for intravenous laser blood irradiation: a systematic review.}, journal = {Lasers in medical science}, volume = {40}, number = {1}, pages = {416}, pmid = {41065846}, issn = {1435-604X}, support = {TSGH-D-110120//Tri-Service General Hospital/ ; VTA114-V3-1-2//Taipei, Taichung, Kaohsiung Veterans General Hospital, Tri-Service General Hospital, Academia Sinica Joint Research Program/ ; VTA114-V3-1-1//Taipei, Taichung, Kaohsiung Veterans General Hospital, Tri-Service General Hospital, Academia Sinica Joint Research Program/ ; KAFGH-ZY-A-113016//Zuoying Armed Forces General Hospital/ ; KSVGH-114-102//Kaohsiung Veterans General Hospital/ ; }, mesh = {Humans ; *Blood/radiation effects ; Cardiovascular Diseases/radiotherapy ; COVID-19 ; *Low-Level Light Therapy/methods ; Musculoskeletal Diseases/radiotherapy ; Nervous System Diseases/radiotherapy ; }, abstract = {Intravenous Laser Irradiation of Blood (ILIB) is a therapeutic approach that utilizes low-level laser energy to irradiate blood, showing potential clinical value in treating various diseases in recent years. This systematic review aims to comprehensively examine the basic principles, technological developments, biological effects, and clinical applications of ILIB, while analyzing the level of evidence and limitations of existing research. Through searching relevant literature in databases such as PubMed, this study collected research on ILIB applications in musculoskeletal diseases, respiratory diseases, cardiovascular diseases, and neurological disorders. Results indicate that ILIB exhibits multiple biological effects, including improved blood rheological properties, enhanced erythrocyte oxygen-carrying capacity, immune regulation, and reduction of inflammatory responses and oxidative stress. Clinical studies suggest that ILIB has positive therapeutic effects on musculoskeletal pain, sleep disorders, pulmonary diseases, and long COVID-related cognitive impairments. However, existing research still has limitations such as small sample sizes, lack of large-scale randomized controlled trials, and non-standardized dosage parameters. Future research should focus on developing standardized treatment protocols, exploring mechanisms of action in depth, and strategies for combining with conventional therapies to further establish ILIB's position in clinical practice.}, }
@article {pmid41065785, year = {2025}, author = {Mohmad Misnan, N and Muhamad, A and Mohd Abd Razak, MR and Lam, KW}, title = {How does NMR support SARS-CoV-2 protein-ligand interaction studies?.}, journal = {Analytical and bioanalytical chemistry}, volume = {}, number = {}, pages = {}, pmid = {41065785}, issn = {1618-2650}, support = {NMRR-23-00540-UHV//Kementerian Kesihatan Malaysia/ ; }, abstract = {The COVID-19 pandemic has highlighted the urgent need for effective antiviral strategies against SARS-CoV-2. Nuclear magnetic resonance (NMR) spectroscopy has played a critical role by providing detailed insights into protein-ligand interactions at atomic resolution. This review compiles and critically evaluates recent NMR-based findings, highlighting how these studies have supported the identification and optimization of antiviral compounds targeting viral proteins involved in replication and immune evasion. By revealing structural and dynamic details, NMR has significantly advanced structure-based drug design and enhanced the selection of promising antiviral candidates. Integration of NMR with complementary experimental methods has further improved our understanding of small molecule interactions and mechanisms of action. Looking forward, the review emphasizes the need for greater translational application of NMR findings through interdisciplinary collaboration and recommends increased integration with clinical and preclinical research. These recommendations aim to fully harness NMR's potential, thereby strengthening preparedness for future viral threats and guiding current therapeutic development efforts.}, }
@article {pmid41065710, year = {2025}, author = {Smith, R and Brookes, C and Morris, M and Barran, P}, title = {Twenty-Five Years of High-Throughput Screening of Biological Samples with Mass Spectrometry: Current Platforms and Emerging Methods.}, journal = {Analytical chemistry}, volume = {97}, number = {41}, pages = {22457-22474}, doi = {10.1021/acs.analchem.5c02331}, pmid = {41065710}, issn = {1520-6882}, mesh = {*High-Throughput Screening Assays/methods ; *Mass Spectrometry/methods ; Humans ; COVID-19/diagnosis ; SARS-CoV-2/isolation &amp; purification ; Drug Discovery/methods ; }, abstract = {Robust high-throughput screening (HTS) approaches for discovering new chemical entities are desirable for research and translation. Applications for which high-throughput (HT) methods are particularly required also include the screening of potential therapeutics for drug discovery and development, profiling of biofluids for disease biomarker discovery, and clinical diagnostics. Complementing the demand for HTS from specific application areas are substantial technological advancements in the fields of automation, microfluidics, and ambient ionization that facilitate highly automated and sophisticated analytical workflows. The time period spanning 2000-2025 has witnessed a significant expansion in the mass spectrometry (MS) capabilities and technology. This has included novel ionization approaches that can achieve rapid analysis with minimal solvent and sample consumption, while retaining high sensitivity and specificity in the absence of chromatography. Despite the demand for HTS methods and the well-documented analytical capabilities of MS, optical methods dominate as the HTS detection methods of choice. This perspective provides an overview of the evolution of HTS-MS over the last 25 years, focusing on emerging approaches that also provide efficient and sustainable workflows that compete with optical detection. Additionally, this perspective will highlight challenges in the field that may hinder widespread adoption and consider lessons from the COVID-19 pandemic, as well as the impact of sustainability on the future of HTS-MS and analytical chemistry.}, }
@article {pmid41065536, year = {2025}, author = {Escandell Rico, FM and Pérez Fernández, L}, title = {[Factors associated with adherence to COVID-19 vaccination in young adults: a systematic review].}, journal = {Revista espanola de salud publica}, volume = {99}, number = {}, pages = {}, pmid = {41065536}, issn = {2173-9110}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage ; *COVID-19/prevention &amp; control ; Young Adult ; *Vaccination/statistics &amp; numerical data/psychology ; }, abstract = {OBJECTIVE: Young adults may be more likely to spread COVID-19 as they have low adherence to public health guidelines and are more reluctant to get vaccinated. The purpose of this review was to provide the most current evidence regarding the assessment of adherence to COVID-19 vaccination in young adults.<br><br>METHODS: The bibliographic search was carried out in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, Scielo, MedLine/PubMed, Cochrane databases and in the Google Scholar search engine, with free and controlled language, using the MeSh search terms: "Treatment Adherence and Compliance", "COVID-19 Vaccines", "Young Adult". Ten selected articles were analyzed. The articles were selected based on their relevance, published in peer-reviewed academic journals and published between 2021 and 2024.<br><br>RESULTS: The main study tool represents the adherence of COVID-19 vaccines. The most important discussion topics extracted in the analyzed articles refer to concern about side effects, mistrust, beliefs or low income level.<br><br>CONCLUSIONS: The findings of this study indicate the need to carry out vaccination promotion programs to provide accessible, transparent and age-appropriate information. Thus, it could be considered a useful tool to improve adherence and confidence in the COVID-19 vaccine.}, }
@article {pmid41064518, year = {2025}, author = {El Zawily, A and Eckert, S and Adajar, R and Wagih, N and Elmaidomy, AH and Helmy, AM and Mustafa, M and Elshorbagi, M and Ghali, E and Fadl, RG and Bodem, J and Abdelmohsen, UR and Zaki, MYW}, title = {Comprehensive review on COVID-19: etiology, pathogenicity, and treatment.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1569013}, pmid = {41064518}, issn = {2296-858X}, abstract = {With the unprecedented surge of severe COVID-19 cases in early 2020, researchers and medical professionals worked actively to identify effective viral infection treatments based on a scientific understanding of viruses. Over the past few years, an enormous amount of research has investigated the viral infection and replication processes following the first SARS-CoV-2 case. With this knowledge, many drugs have been explicitly created to inhibit viral replication or decrease the severity of the immune response. Additionally, scientists have utilized decades of research and techniques to expedite SARS-CoV-2 vaccine development. SARS-CoV-2, a positive-strand RNA virus, belongs to the Sarbecovirus subgroup of Betacoronaviruses. Its emergence is not unique; previous outbreaks like SARS and MERS have shaped our understanding of coronavirus-related diseases. Molecular clock analysis suggests that the ancestor of all current coronaviruses existed over 10,000 years ago, with subsequent evolution occurring around 3300-2400 BC. Researchers have explored synthetic and natural treatments alongside other antiviral therapies, corticosteroids, and immunotherapies. Additionally, using artificial intelligence and nano-based technologies enriched SARS-CoV-2 diagnosis and management. In this comprehensive review, we provide recent literature on COVID-19, exploring its evolving etiology, pathogenicity, and pathophysiology, alongside developments in synthetic and natural therapeutic strategies, vaccines, artificial intelligence in diagnosis, and nano-based technologies.}, }
@article {pmid41063995, year = {2025}, author = {Wolszczak-Biedrzycka, B and Cieślikiewicz, B and Studniarz, F and Dąbrowski, &#x141; and Fąs, M and Matyszkiewicz-Suchodolska, K and Harasimowicz, M and Dorf, J}, title = {Chemokines as potential biomarkers for predicting the course of COVID-19 - a review of the literature.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1662643}, pmid = {41063995}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/diagnosis ; Biomarkers/blood ; *SARS-CoV-2/immunology ; *Chemokines/blood/immunology ; Prognosis ; Cytokine Release Syndrome/immunology ; }, abstract = {Since the beginning of the COVID-19 pandemic, research has been ongoing to find the best diagnostic parameters to identify patients with a high risk of severe infection. Numerous studies have examined chemokine biomarkers in COVID-19 as a biomarker for high risk patients. The four main structural proteins of the SARS-CoV-2, spike protein, membrane protein, envelope protein and nucleocapsid protein enable the virus to penetrate host cells and stimulate the immune system. SARS-CoV-2 enters host cells via ACE2 in upper respiratory tract the virus entries by binding to the spike protein. Uncontrolled activation and enhancement of the immune response leads to massive release of cytokines and chemokines known as cytokine storm (CS). Chemokines are described as important cytokines in COVID-19 with a potential role as prognostic factor particularly for the severity of the infection and the risk of death from complications, to identify high-risk patients. Our review contains chemokines (CCL2, CCL3, CCL5, CXCL8, CXCL10), which level is significantly higher in patients with COVID-19 infection vs control individuals.}, }
@article {pmid41063178, year = {2025}, author = {Derakhshani, N and Aghdam, ET and Nafar, H and Tavakoli, ME and Gladkova, L and Pouyan, SN and Joudyian, N}, title = {Identifying the effective strategies in reducing the effects of mental health issues caused by COVID-19 pandemic in healthcare providers: a systematic review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1323}, pmid = {41063178}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Health Personnel/psychology ; SARS-CoV-2 ; *Mental Health ; Pandemics ; *Mental Disorders/prevention &amp; control ; }, abstract = {BACKGROUND: The COVID-19 pandemic was among the most stressful global events that caused a significant workload on healthcare systems and profoundly impacted the mental health of healthcare workers. Therefore, this study aims to determine the effectiveness of strategies to reduce the effects of mental health issues caused by the COVID-19 pandemic on healthcare providers.<br><br>METHODS: The current research is a systematic review. The required data was obtained from the databases ProQuest, Embase, Web of Knowledge, Scopus, PubMed, and Google Scholar search engine using related keywords. The study had no time limit. EndNote 20 was used to manage the articles. Various quality appraisal JBI tools were used to assess the quality of studies. Content analysis was used to analyze the obtained data.<br><br>FINDINGS: Out of the total 7933 primary articles, 20 were selected and entered the current study. The implemented interventions were analyzed based on the utilized strategies and categorized into four primary groups: comprehensive support package strategy, psychological training, psychological support with online consultations, and strategies related to sports and music therapy. These interventions were generally effective in promoting the mental health of healthcare providers in the short term.<br><br>CONCLUSION: The results indicated that appropriate interventions for critical conditions and the utilization of modern technologies positively affected healthcare workers' mental health during the COVID-19 pandemic. To improve the sustainability and effectiveness of such interventions, it is recommended that healthcare systems institutionalize psychosocial support within occupational health programs, develop organizational policies for continuous mental health support, and enhance access to digital platforms. Furthermore, incorporating mental health education, conducting regular psychological assessments, and adapting interventions to local socio-cultural contexts can foster greater acceptance and lead to more sustainable outcomes.}, }
@article {pmid41063084, year = {2025}, author = {Kisa, A and Kisa, S}, title = {Structural racism as a fundamental cause of health inequities: a scoping review.}, journal = {International journal for equity in health}, volume = {24}, number = {1}, pages = {257}, pmid = {41063084}, issn = {1475-9276}, mesh = {Humans ; Health Equity ; *Health Inequities ; *Health Status Disparities ; *Healthcare Disparities ; *Racism ; *Systemic Racism ; }, abstract = {BACKGROUND: Structural racism is increasingly recognized as a fundamental cause of health inequities. It operates through laws, institutional policies, and systemic practices that disproportionately disadvantage racially and ethnically minoritized populations. Although the body of evidence on structural racism and health is expanding, much of it remains fragmented across disciplines and sectors. This scoping review synthesized peer-reviewed research by examining the pathways through which structural racism affects health, the most frequent outcomes, and the interventions and policies implemented to address these disparities.<br><br>METHODS: The review adhered to frameworks by Arksey and O'Malley, Levac et al., and the Joanna Briggs Institute. Six databases (MEDLINE, Embase, Web of Science, CINAHL, PsycINFO, and Scopus) were searched for English-language, peer-reviewed studies published before February 15, 2025, examining structural, systemic, or institutional racism in relation to health. Two reviewers independently screened and extracted data, and findings were analyzed using thematic synthesis.<br><br>RESULTS: Eighty-three studies met the inclusion criteria, covering healthcare, housing, the criminal legal system, environmental exposures, and other intersecting sectors. Structural racism was consistently associated with adverse outcomes in maternal and infant health, cancer, cardiovascular disease, HIV care, mental health, and COVID-19. Key mechanisms included redlining, residential segregation, carceral practices, discriminatory clinical treatment, and environmental injustice. Intersectional burdens were most pronounced among Black, Indigenous, LGBQ, immigrant, and socioeconomically marginalized groups. Although some promising interventions were identified, including culturally tailored perinatal care, community health worker models, and equity-focused quality improvement, few had been rigorously evaluated or embedded in broader structural policy changes.<br><br>CONCLUSION: Structural racism was found to operate across institutional and societal systems to perpetuate health disparities. While targeted interventions show promise, significant gaps remain in the development and implementation of scalable, evidence-based reforms. To achieve health equity, public health strategies must prioritize cross-sectoral actions for confronting and dismantling the structural conditions that maintain racial injustice. This synthesis highlights the urgent need for scalable policy reforms and structural accountability measures across sectors.}, }
@article {pmid41063068, year = {2025}, author = {Aghajafari, F and Guzek, D and Kamal, H and Ness, A and Wall, L and McClurg, C and Pooladi-Darvish, A and Weightman, AM and Coakley, A}, title = {Vaccination models of delivery for refugees and migrants: a global scoping review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3396}, pmid = {41063068}, issn = {1471-2458}, support = {CoRIG II//College of Family Physicians of Canada/ ; }, mesh = {Humans ; *Refugees/statistics &amp; numerical data ; *Transients and Migrants/statistics &amp; numerical data ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/administration &amp; dosage ; *Vaccination ; Global Health ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Refugees and migrants face inequities in healthcare and vaccination access. Diverse vaccination programs have been implemented globally among refugee and migrant populations targeting vaccine hesitancy and other barriers to vaccination. The aim of this scoping review was to provide an overview of current models of vaccination delivery of COVID-19 and other vaccines to inform best practices of vaccine delivery for refugee and migrant populations.<br><br>METHODS: A scoping review was conducted according to PRISMA guidelines. Eleven electronic databases, including SCOPUS, Embase, Medline, and Web of Science, as well as grey literature, were searched with keywords including: 'COVID-19', 'vaccines','immunizations', 'refugees', 'asylum seekers', and 'migrants'. The search included all studies published between January 2000 and October 2023 to capture COVID-19 and other vaccine models of delivery. The main outcome was models of delivery of COVID-19 vaccines and other vaccines for refugee or migrant populations. Models of vaccination delivery were reviewed and analyzed with the 2022 World Health Organization's Strengthening COVID-19 vaccine demand and uptake in refugees and migrants: An operational guide (2022 WHO Guide) as a guiding framework.<br><br>RESULTS: A total of n&#x2009;=&#x2009;11,825 unique studies were identified through database searches. Thirty-three (n&#x2009;=&#x2009;33) studies were included in this review. Fifteen studies (n&#x2009;=&#x2009;15) related to the COVID-19 vaccine and eighteen studies (n&#x2009;=&#x2009;18) focused on other vaccines. Studies were mainly implemented in high-income countries with the majority from the United States (n&#x2009;=&#x2009;17). Studies targeted various migrant groupings (i.e., migrants, immigrants, refugees, and asylum-seekers), ethnic groups, and age groups globally, including various underserved populations including migrant populations. There was general alignment with most of the 2022 WHO Guide priority action areas across both COVID-19 and other vaccine studies, pointing to ongoing understandings of the importance of administratively accessible and culturally/linguistically appropriate models of vaccine delivery for refugee and migrant populations. Increasingly dominant approaches in the COVID-19 pandemic include multipronged strategies with wide community and multisectoral collaborations to co-design strategies addressing barriers. Additionally, COVID-19 vaccination models increasingly utilized innovative social media and customization strategies, including targeted communication campaigns responsive to misinformation. Although there are increased calls for the use of data to design and evaluate interventions, notable gaps remain in the collection, use and reporting of data used to conduct interventions.<br><br>CONCLUSIONS: Findings summarize vaccination models of delivery for COVID-19 and other vaccines for diverse refugee and migrant populations globally. Healthcare professionals, policy makers, and vaccination campaign planners can draw and build from strategies employed in other settings as aligned with WHO priority actions to increase equitable access to vaccines for refugee and migrant communities. Further collection and use of disaggregated and real-time data to inform and evaluate customized strategies for specific migrant groups is recommended to improve understandings of equitable vaccine delivery models.}, }
@article {pmid41063044, year = {2025}, author = {Björk, S and Brännström, M and Isaksson, U}, title = {Psychometric properties of instruments measuring ethical climate among healthcare professionals in care settings pre-pandemic: a systematic review.}, journal = {BMC medical ethics}, volume = {26}, number = {1}, pages = {125}, pmid = {41063044}, issn = {1472-6939}, mesh = {Humans ; *Psychometrics ; *Health Personnel/ethics/psychology ; COVID-19 ; SARS-CoV-2 ; Pandemics ; Reproducibility of Results ; *Organizational Culture ; Job Satisfaction ; Surveys and Questionnaires ; Attitude of Health Personnel ; Workplace ; }, abstract = {BACKGROUND: The ethical climate in healthcare is part of the work environment and a basis for professional nursing practice. The ethical climate is crucial as it is closely associated with staff job satisfaction, the quality-of-care provision, and nurses' intention to stay in their current occupation and position. Even though several instruments assessing ethical climate in healthcare have been developed over the years, their psychometric properties have not been systematically reviewed.<br><br>OBJECTIVES: This study was conducted to identify and critically appraise the psychometric properties of instruments used to measure the ethical climate among healthcare professionals in care settings prior to the COVID-19 pandemic.<br><br>METHODS: A systematic review was performed, covering papers published between 1994 and 2019, excluding grey literature sources. The literature search was performed in October 2019 in Cinahl, PsychINFO, PubMed, and SocIndex. Empirical studies were included describing the psychometric properties of instruments measuring the ethical climate among healthcare professionals in healthcare settings. Data on psychometric properties were extracted and a quality assessment was performed following the quality criteria for measurement properties proposed by Terwee et al. criteria 2007.<br><br>RESULT: Our search yielded 15,150 publications. After title and abstract screening, 611 studies were retained for full-text analysis, of which eight studies describing five instruments were included (five instrument development studies and three translation studies). Four studies concerned the Hospital Environment Climate Scale (HECS). All instruments had been assessed for content validity and internal consistency. Information concerning criterion validity, construct validity, and reproducibility was lacking or intermediate. No information concerning floor/ceiling effect or interpretability was reported in most cases. One study reported having performed a test-retest analysis. None of the included studies fulfilled all the Terwee et al. criteria.<br><br>CONCLUSION: Five instruments were identified as having undergone psychometric testing; however, none fulfilled all the criteria outlined by Terwee et al. Also, only one of the instruments had been subjected to the well-established test-retest analysis. This highlights a need for further well-structured validation studies of instruments assessing the ethical climate among healthcare professionals in care settings.}, }
@article {pmid41062882, year = {2025}, author = {Kovačič, T and Haas, H and Stotsky-Oterin, L and Štrancar, A and Bren, U and Peer, D}, title = {The impact of chemical reactivity on the quality and stability of RNA-LNP pharmaceuticals.}, journal = {Nature reviews. Chemistry}, volume = {9}, number = {11}, pages = {790-802}, pmid = {41062882}, issn = {2397-3358}, mesh = {Humans ; *Nanoparticles/chemistry ; Drug Stability ; *Lipids/chemistry ; SARS-CoV-2 ; *RNA, Messenger/chemistry ; COVID-19 ; Liposomes ; }, abstract = {Lipid nanoparticles (LNPs) are the most established platform for delivery of mRNA payloads. Their tunability and streamlined manufacturing facilitated an unprecedentedly rapid scale-up during the COVID-19 pandemic. However, being multicomponent, complex systems also poses a challenge of controlling their quality and safety. Analytical checkpoints need to be established to characterize LNPs on multiple levels during development and commercialization. This Perspective centres on the chemical reactivity and purity of mRNA-LNP components, which need to be addressed as raw materials, drug substance, excipients, and the fully formed and stored product. Herein, we describe such appropriate orthogonal analytics to design and analyse LNP formulations. For such novel biopharmaceuticals, better controls that go beyond the current analytical workflow and address the nuanced chemical stability, which helps ensure reproducibility, stability and safety, need to be established.}, }
@article {pmid41062406, year = {2026}, author = {George, A and Tikka, T and Conway, D}, title = {Innovative Approaches to Head and Neck Cancer Diagnosis.}, journal = {Otolaryngologic clinics of North America}, volume = {59}, number = {1}, pages = {63-76}, doi = {10.1016/j.otc.2025.08.017}, pmid = {41062406}, issn = {1557-8259}, mesh = {Humans ; *Head and Neck Neoplasms/diagnosis ; *COVID-19/epidemiology ; *Early Detection of Cancer/methods ; Telemedicine ; Machine Learning ; Biomarkers, Tumor/blood ; SARS-CoV-2 ; Triage ; }, abstract = {Diagnosis, positioned between disease prevention and treatment, is essential for head and neck cancer management. Delays in diagnosis contribute to disease upstaging, leading to more complex treatment with poorer survival and functional outcomes. This article focuses on current and future innovative diagnostic approaches, which vary in maturity and implementation, to promote early diagnosis. These include symptom-based triaging, telemedicine, diagnostic hubs, machine learning, and circulating tumor markers. COVID-19 brought about new diagnostic pathways, many of which remained in place, generating encouraging evidence of pathway efficiency. However, nuanced diagnostic tools for early cancer detection remain far from implementation in a real-world setting.}, }
@article {pmid41062170, year = {2025}, author = {Houweling, L and Rots, I and Bloemsma, LD and van Vorstenbosch, R and Del Motto, S and Vermeulen, RCH and Maitland-Van der Zee, AH and Golebski, K and Downward, GS}, title = {Impact of air pollution on COVID-19 severity: a systematic review of underlying biological mechanisms.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {178}, pages = {}, pmid = {41062170}, issn = {1600-0617}, mesh = {Humans ; *Air Pollutants/adverse effects ; *Air Pollution/adverse effects ; *COVID-19/diagnosis/epidemiology/immunology/virology ; Particulate Matter/adverse effects ; SARS-CoV-2 ; Severity of Illness Index ; }, abstract = {BACKGROUND: Our recent systematic review highlighted key associations between ambient air pollution (AAP) exposure and COVID-19 severity. This systematic review aims to summarise toxicological studies on the biological mechanisms underlying these associations.<br><br>METHODS: On 17 July 2025, PubMed, Embase, Scopus and Web of Science were searched for in vitro, in vivo and in silico studies that examined the biological mechanisms of AAP exposure on COVID-19 health outcomes. Two independent reviewers engaged in the selection and data extraction process. The methodological quality of the included studies was assessed with the Toxicological Data Reliability Assessment Tool. The Integrated Network and Dynamical Reasoning Assembler (INDRA) was used to provide visual biomechanistic summaries of the included studies by creating knowledge graphs of the described mechanisms.<br><br>RESULTS: A total of 18 studies were included in this review. Findings consistently indicated that AAP exposure can worsen COVID-19 severity through two key mechanisms 1) increased expression of viral entry factors (e.g. angiotensin-converting enzyme 2 and transmembrane serine protease 2), facilitating infection, and 2) immune dysregulation, resulting in increased inflammation and oxidative stress. These key mechanisms were also identified in the INDRA networks. While studies commonly focused on particulate matter (n=15), similar effects were seen with ultrafine particles and ozone.<br><br>CONCLUSION: These findings highlight the impact of AAP exposure on COVID-19 health outcomes on the molecular level. The findings of this review illustrate the urgent need for air quality improvements to help shape public health strategies to reduce and prevent future health impacts caused by AAP exposure.}, }
@article {pmid41062137, year = {2025}, author = {Daniels, S and Wei, H and McElvenny, DM and van Tongeren, M and Bramwell, D and Coleman, A and Forde, D and Wiggans, R}, title = {Return to work with long COVID: a rapid review of support and challenges.}, journal = {BMJ open}, volume = {15}, number = {10}, pages = {e101698}, pmid = {41062137}, issn = {2044-6055}, mesh = {Humans ; *Return to Work ; Workplace ; *Post-Acute COVID-19 Syndrome/rehabilitation ; }, abstract = {OBJECTIVES: To explore existing evidence for the provision of support for return to work (RTW) in long COVID (LC) patients and the barriers and facilitators to taking up this support.<br><br>DESIGN: A rapid review reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study was preregistered in PROSPERO (ID: CRD42023478126).<br><br>DATA SOURCES: Searches were completed in June 2024 across major databases including MEDLINE, Embase, PsycINFO, evidence-based medicine reviews, Web of Science and Google Scholar.<br><br>ELIGIBILITY CRITERIA: Included studies focused on people with LC (PwLC) symptoms lasting over 12 weeks and addressed either: (1) non-workplace- or workplace-based support for RTW and/or (2) barriers and facilitators to RTW in this population.<br><br>DATA EXTRACTION AND SYNTHESIS: A quality assessment was conducted using the JBI Systematic Reviews critical appraisal tool. The data were summarised in tabular format and a narrative synthesis.<br><br>RESULTS: Twenty-five studies were included. While many studies demonstrated rigorous methodologies and low risk of bias levels, some had high and medium risk levels. Non-workplace-based support was mostly measured quantitatively and included interdisciplinary healthcare programmes, clinical interventions and rehabilitation programmes focusing on pacing and breathing strategies. Compensation and insurance schemes were important funders of these interventions.Workplace-based support was mostly measured qualitatively. Barriers to the provision of support at organisational level included lack of understanding of LC symptoms, insufficient workplace guidance and educational gaps among managers. Individual barriers included threat of income loss, remote working and disconnection from the workplace. Facilitators for support included recognition and validation of LC and its symptoms, and eligibility for disability benefits associated with work.<br><br>CONCLUSIONS: RTW is an important outcome of health-related absence and should be systematically recorded in studies of PwLC. The heterogeneity and unpredictability of LC symptoms create challenges for supporting working age populations. Further research is crucial to better understand the specific RTW needs for PwLC and address potential barriers and facilitators to workplace-based support, particularly through interventions, organisational practices and employ-led policies that enable sustained RTW. Consistent guidelines on LC's definition and disability status may facilitate the provision of support and the development of interventions.<br><br>PROSPERO REGISTRATION NUMBER: CRD42023478126.}, }
@article {pmid41061826, year = {2025}, author = {Sujova, K and Frecer, V}, title = {SARS-CoV-2 N7-methyltransferase inhibitors: Towards selective and potent antivirals.}, journal = {European journal of pharmaceutical sciences : official journal of the European Federation for Pharmaceutical Sciences}, volume = {214}, number = {}, pages = {107312}, doi = {10.1016/j.ejps.2025.107312}, pmid = {41061826}, issn = {1879-0720}, mesh = {*Antiviral Agents/pharmacology/chemistry/therapeutic use ; Humans ; *SARS-CoV-2/drug effects/enzymology ; *COVID-19 Drug Treatment ; *Enzyme Inhibitors/pharmacology/chemistry ; *Methyltransferases/antagonists &amp; inhibitors/metabolism ; Structure-Activity Relationship ; *Viral Nonstructural Proteins/antagonists &amp; inhibitors/metabolism ; S-Adenosylmethionine/analogs &amp; derivatives/metabolism ; Binding Sites ; }, abstract = {Recent studies have identified nsp14 N7-methyltransferase (N7-MTase) as a promising therapeutic target for the development of new antiviral agents against SARS-CoV-2. Utilising S-adenosyl-L-methionine (SAM) as a methyl donor, N7-MTase mediates the first methylation step in viral RNA capping, which is necessary for the replication of SARS-CoV-2 and its immune evasion. To design selective and potent inhibitors of CoV nsp14 N7-MTase, various research groups have focused on targeting the nsp14 binding site for SAM. In this paper, promising CoV N7-MTase inhibitors designed to date are analysed with a particular focus on SAM/S-adenosyl-L-homocysteine (SAH) analogues, which can be further extended to occupy the RNA binding site and/or the adjacent lateral cavity. The structure-activity relationship (SAR) data and binding modes of the inhibitors are also investigated. This study highlights limitations that currently hinder the development of effective antiviral agents, notably limited selectivity and cellular activity, and discusses potential strategies to address them. In particular, the design of C-nucleosides has shown promising results, although no inhibitor has reached clinical trials yet. Thus, further efforts are necessary to identify viable drug candidates.}, }
@article {pmid41061096, year = {2025}, author = {Wodka-Natkaniec, E and Sówka, J and Skoczek-Sygiet, J and Zyznawska, J}, title = {Digitalization and physical activity in the aspects of health and physiotherapy. Using digital methods to improve physical fitness.}, journal = {Folia medica Cracoviensia}, volume = {65}, number = {1}, pages = {143-156}, doi = {10.24425/fmc.2025.156117}, pmid = {41061096}, issn = {0015-5616}, mesh = {Humans ; *Physical Fitness ; *Exercise ; COVID-19 ; *Physical Therapy Modalities ; Telemedicine ; *Health Promotion/methods ; SARS-CoV-2 ; }, abstract = {BACKGROUND: An important task also faces "lifestyle medicine", in connection with the development of IT services and digital possibilities. Practicing physical activity is an important basis for improving the physical and mental condition of patients. The aim of the work was to determine the usefulness of remote and digital forms to improve physical fitness in currently diverse groups of respondents.<br><br>MATERIAL AND METHODS: A review of scientific literature was conducted based on popular science databases Medline, PubMed. Only articles from the last 8 years (2017-2025.03) were taken into account. The search criteria were the following phrases: digital health, sport, physiotherapy, activity. 32 studies containing the above phrases in keywords and article content were included in the study. Papers not related to physical activation or physiotherapy through digital or remote form were rejected.<br><br>RESULTS: Almost all studies indicated the usefulness of digital physical activation and, through it, improving physical fitness in various types of subjects. Two of the studies indicated that digital activation should be additionally personalized for specific groups of subjects and that the integration of e-exercise with the stationary form should be improved or e-coaching should be used. One study did not ultimately confirm the effectiveness of the digital physical activation program due to COVID-19.<br><br>CONCLUSIONS: It is necessary to optimize the recommendations of online exercise programs and expand existing programs for different groups of exercisers. Digital activation of movement: improves physical fitness, eliminates stress, helps to shape movement habits, is a form of relaxation or fun, is a form of encouragement and motivation, allows to monitor changes or progress of health.}, }
@article {pmid41060732, year = {2025}, author = {Gaspar Botelho Funari de Faria, M and De Paula Andrade Gonçalves, RL and Maria Lopes, L and Fransiscon Naves, E and Oliveira Bonfim, R and Mendes da Silva, DH and Marques Valença, AB and Roberto Bollela, V and Perón Rujula, MJ and Alexandre Arcêncio, R and Carvalho Pinto, I and Fredemir Palha, P and Garcia de Almeida Balestero, J and Gomes, D and Guo, Z and Farley, J and Reynolds, N and Aparecida Monroe, A}, title = {Impact of the COVID-19 pandemic on the temporal trend of indicators for access to tuberculosis diagnosis: A systematic review.}, journal = {Journal of infection in developing countries}, volume = {19}, number = {9}, pages = {1314-1321}, doi = {10.3855/jidc.21045}, pmid = {41060732}, issn = {1972-2680}, mesh = {Humans ; *COVID-19/epidemiology ; *Tuberculosis/diagnosis/epidemiology ; SARS-CoV-2 ; *Health Services Accessibility ; Incidence ; Pandemics ; }, abstract = {INTRODUCTION: The COVID-19 pandemic influenced the behaviour of numerous diseases, overloading health systems and weakening public health infrastructure and access.<br><br>METHODOLOGY: This study aimed to analyse the repercussions of the COVID-19 pandemic on tuberculosis diagnosis indicators. A systematic review was conducted, examining studies published between 2020 and 2024 in Portuguese, English, or Spanish across five databases and Google Scholar. The search, performed in March 2024, led to the identification of 6,378 studies, of which 23 were included after an independent review of titles, abstracts, and full texts. Data were extracted and narratively synthesized following a methodological quality assessment.<br><br>RESULTS: The review revealed significant declines in TB incidence, detection, notification, and diagnosis during the pandemic, alongside reduced etiological confirmation of cases.<br><br>CONCLUSIONS: The findings highlight a need to reorganize and enhance health service responses to address the disruptions caused by the pandemic. Strengthening these services is crucial to recover missed TB cases and improve indicators, supporting the goal of eliminating TB by 2030.}, }
@article {pmid41059901, year = {2025}, author = {Santos, WSD and Carrión-Torres, O and Mussalem, MGVB and Baptista, VS and Yarak, S}, title = {Association between the use of midazolam, fentanyl, propofol, ketamine, and dexmedetomidine and the incidence of delirium in elderly patients in intensive care units: a systematic review.}, journal = {Sao Paulo medical journal = Revista paulista de medicina}, volume = {143}, number = {6}, pages = {e20240311}, pmid = {41059901}, issn = {1806-9460}, mesh = {Humans ; Dexmedetomidine/adverse effects ; *Intensive Care Units/statistics &amp; numerical data ; Propofol/adverse effects ; Aged ; Midazolam/adverse effects ; *Delirium/chemically induced/epidemiology ; Incidence ; Ketamine/adverse effects ; *Hypnotics and Sedatives/adverse effects ; Fentanyl/adverse effects ; Randomized Controlled Trials as Topic ; Male ; }, abstract = {BACKGROUND: Delirium is a common and serious complication among elderly patients in intensive care units (ICUs), and is often associated with increased morbidity and mortality rates. The choice of sedoanalgesic may influence the incidence of delirium; however, the evidence remains unclear, particularly in the elderly population.<br><br>OBJECTIVES: To evaluate the association between the use of different sedoanalgesics and the incidence of delirium in elderly ICU patients, based on data from randomized clinical trials.<br><br>DESIGN AND SETTING: This systematic review was conducted using data from randomized clinical trials performed in various ICU settings.<br><br>METHODS: A systematic search of the MEDLINE, Embase, and CENTRAL databases was performed in January 2024. The review included randomized clinical trials involving patients aged 60 years or older that examined the relationship between sedoanalgesics (midazolam, fentanyl, propofol, ketamine, and dexmedetomidine) and delirium incidence. Studies involving COVID-19 patients and non-randomized studies were excluded.<br><br>RESULTS: A total of 1,331 patients from six studies were included. The mean age of the patients ranged from 71 to 74.7 years. Four studies compared dexmedetomidine with propofol; two found no significant difference in delirium incidence, whereas two suggested a lower incidence with dexmedetomidine. The remaining studies compared propofol with ketamine and dexmedetomidine with midazolam and showed no significant differences in the incidence of delirium.<br><br>CONCLUSIONS: Dexmedetomidine may be associated with a lower incidence of delirium than propofol or midazolam in elderly ICU patients. However, further research is needed to confirm these findings and explore the factors contributing to delirium in this population.<br><br>Registered with PROSPERO, CRD42024575693, available at https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=575693.}, }
@article {pmid41059883, year = {2025}, author = {Onocko-Campos, R and Salgado, JD and Rover, BO and Poderoso, RE and Miranda, L}, title = {Mental Health Studies Published in the last five years in the Journal Ciência &amp; Saúde Coletiva: time as king.}, journal = {Ciencia &amp; saude coletiva}, volume = {30}, number = {9}, pages = {e12842025}, doi = {10.1590/1413-81232025309.12842025}, pmid = {41059883}, issn = {1678-4561}, mesh = {Adolescent ; Child ; Humans ; COVID-19/epidemiology ; *Mental Disorders/epidemiology ; *Mental Health ; *Periodicals as Topic/trends/statistics &amp; numerical data ; Primary Health Care/organization &amp; administration ; *Publishing/statistics &amp; numerical data/trends ; }, abstract = {Systematic review of articles on mental health published between 2020 and 2025 in the journal Ciência &amp; Saúde Coletiva. Building on a previous study covering the first twenty-five years of the journal's publications, this review aimed to identify continuities and changes in the most frequent approaches, as well as the emergence of underexplored themes such as mental health in relation to race, gender, violence, and the climate crisis. A total of 162 articles were analyzed, categorized into: epidemiological studies/psychiatric classifications; sociocultural transformations of madness; clinical care in substitute services; implementation and expansion of the service network; the role of Primary Health Care; mental health of children and adolescents; substance use; legislative changes; and others (including mental health of workers, the COVID-19 pandemic, the prison system, housing, race, and therapeutic communities). A significant increase was observed in discussions about child and adolescent mental health, along with advances in topics related to Primary Health Care and clinical practices in substitute services. However, emerging issues such as gender, race, aging, and mental health related to disasters and the environment remain underrepresented in the journal's publications.}, }
@article {pmid41059308, year = {2025}, author = {Heath, V and Price, CL}, title = {Addressing Health Disparities: How Having a More Diverse Biomedical Workforce Can Contribute to Addressing Health Disparities in Communities that Are Often Underrepresented in the Healthcare System.}, journal = {British journal of biomedical science}, volume = {82}, number = {}, pages = {14973}, pmid = {41059308}, issn = {2474-0896}, mesh = {Humans ; *Healthcare Disparities ; COVID-19/epidemiology ; *Cultural Diversity ; *Delivery of Health Care ; SARS-CoV-2 ; *Health Status Disparities ; Minority Groups ; }, abstract = {Health disparities that are seen in underserved and underrepresented communities are a pressing issue in healthcare. These disparities are embedded into our society through structural inequalities that lead to poorer health outcomes in those from minoritised communities. In its place as the heart of modern healthcare, the biomedical science workforce has the potential to play a crucial role in mitigating these disparities by fostering greater cultural competence, improving patient outcomes and driving innovative solutions. This study reviewed the current literature on the impact of diversity within the biomedical science workforce on health disparities in underserved communities. The review demonstrated where embedded inequities in healthcare lead to worse health outcomes for underserved communities. These disparities are found across healthcare education, diagnostic processes as well as within research and innovation, and this work uses the COVID-19 Pandemic as an example of where health disparities have significant consequences for the communities impacted. This review demonstrates that a diverse biomedical science workforce can not only contribute to better health outcomes, but also to inclusive research agendas and clinical studies by ensuring that research priorities are more representative of a broader population. A more diverse biomedical science workforce can serve as role models and mentors, inspiring the next-generation of biomedical scientists from underrepresented backgrounds creating a continuous cycle of inclusion and representation, helping to reduce health disparities over time. Therefore, a key strategy in promoting health equity is by increasing diversity in the biomedical science field. After review of current published works, the authors have proposed a list of recommendations that outline steps institutions, professional bodies and policymakers could take to a strategic and sustained commitment to improving biomedical science workforce diversity in an effort to reduce health disparities.}, }
@article {pmid41059247, year = {2025}, author = {Muto, T and Machida, S and Imaizumi, S and Kamoi, K}, title = {Relationship Between COVID-19 and Retinal Vein Occlusions.}, journal = {Journal of ophthalmology}, volume = {2025}, number = {}, pages = {6507997}, pmid = {41059247}, issn = {2090-004X}, abstract = {The relationship between coronavirus disease 2019 (COVID-19) infection or vaccination and retinal vein occlusions (RVOs) remains controversial. RVOs include central and branch RVOs. Previous studies have indicated a link between RVOs and COVID-19. RVOs develop when the retinal blood vessels are clogged by thrombin or lipid deposition. The retina, an important component of the visual apparatus, relays the visual information to the brain after light stimulation. When retinal veins are clogged, the damage can range from slightly reduced vision to complete blindness. SARS-CoV-2, the causative agent for COVID-19, leads to endothelial dysfunction and increased von Willebrand factor (VWF) antigen levels in the blood, which activate the coagulation process and platelet aggregation. Activation of tissue factors initiates the coagulation cascade, leading to fibrin formation through thrombin. Because arteries and veins sometimes cross in the retina, the vein, with its thin vessel wall, may be compressed. As a result, blood flow slows due to venous constriction, and clotting is more likely to occur at the crossing point. RVO ultimately develops through these processes. Patients with COVID-19 have significantly elevated levels of VWF antigen and activity, which likely contribute to the increased risk of thrombosis observed in COVID-19-associated coagulopathy. As RVOs align with conventional approaches, ophthalmologists should consider COVID-19 as a potential etiological factor when evaluating patients presenting with acute vision loss. Enhanced awareness of this association may facilitate timely diagnosis and tailored patient care in affected populations.}, }
@article {pmid41059130, year = {2025}, author = {Valencia-Arias, A and Jimenez Garcia, JA and Agudelo-Ceballos, E and Oré León, AJA and Martínez Rojas, E and Leyrer Henríquez, J and Ramírez-Ramírez, DM}, title = {Machine learning applications in risk management: Trends and research agenda.}, journal = {F1000Research}, volume = {14}, number = {}, pages = {233}, pmid = {41059130}, issn = {2046-1402}, mesh = {Humans ; Bibliometrics ; COVID-19/epidemiology ; *Machine Learning/trends ; Risk Assessment ; *Risk Management/methods/trends ; SARS-CoV-2 ; }, abstract = {Risk management has become a foundational aspect in numerous industries, propelling the implementation of machine learning technologies for impact assessment, prevention, and decision-making processes. Nevertheless, lacunae in the extant literature persist, particularly with regard to the identification of emergent trends and transversal applications. This study addresses this limitation through a bibliometric analysis of scientific production in Scopus and Web of Science, adhering to the PRISMA-2020 declaration. The findings reveal a substantial growth in publications on machine learning applied to risk management, with an increase of 98.99% between 2018 and 2023. China, South Korea, and the United States are identified as the primary research-producing countries. The analysis also identifies emerging trends, such as the application of machine learning in the evaluation of urban trees and the management of risks associated with the pandemic of severe acute respiratory syndrome (SARS-CoV-2). Key terms include random forest, support vector machines (SVM), and credit risk assessment, while terms such as prediction, postpartum depression, big data, and security emerge as new areas of study. Furthermore, there is a transition from traditional approaches such as stacking to advanced deep learning and feature selection techniques, reflecting the evolution of the discipline.}, }
@article {pmid41058315, year = {2025}, author = {Delli Carpini, G and Mammadov, Z and Leeson, S and Hammer, A and Grigore, M and Ciavattini, A}, title = {The effect of healthcare disruptions during the COVID-19 pandemic on colposcopy services and practice: A systematic review and meta-analysis.}, journal = {Acta obstetricia et gynecologica Scandinavica}, volume = {104}, number = {12}, pages = {2215-2225}, pmid = {41058315}, issn = {1600-0412}, mesh = {Humans ; *COVID-19/epidemiology ; *Colposcopy/statistics &amp; numerical data ; Female ; *Uterine Cervical Neoplasms/diagnosis/prevention &amp; control ; Early Detection of Cancer/statistics &amp; numerical data ; SARS-CoV-2 ; Pandemics ; *Delivery of Health Care/organization &amp; administration ; }, abstract = {INTRODUCTION: The healthcare reorganization during the COVID-19 pandemic affected colposcopy services and cervical cancer prevention, particularly in those countries where healthcare systems were already under-resourced. This review aimed to quantify the reduction in colposcopy services across countries during the COVID-19 pandemic and to determine whether the data source per study and cervical cancer screening coverage per country influenced the extent of these reductions.<br><br>MATERIAL AND METHODS: Studies reporting comparative data on colposcopy services between the COVID-19 pre-pandemic and pandemic period were included. MEDLINE, Embase, EMCare, Covid-19 Research, British Nursing Index, APA PsycINFO, and Allied and Complimentary Medicine databases were searched for studies published from March 2020 to December 2023. The Newcastle-Ottawa scale was used for risk of bias assessment. The number of colposcopies, cervical treatments, pre-invasive lesions diagnoses, and cervical cancer diagnoses per month were compared between the pre-pandemic (before March 2020) and pandemic period (after March 2020). The effect measure was the standardized mean difference. Heterogeneity was evaluated with the chi-squared test and quantified with the I[2] method. A meta-regression was performed, considering the data source (regional/national databases/registries or institutional databases) and the screening coverage according to World Health Organization data (&#x2265;70% or <70%) as moderators. The review was registered on PROSPERO (CRD42023447188).<br><br>RESULTS: Thirteen studies were included. Twelve were of good/high quality according to the Newcastle-Ottawa scale. The standardized mean difference between the pre-pandemic and pandemic periods was -1.60 (95% CI -2.49 to -0.72, p&#x2009;=&#x2009;0.004) for colposcopies (4 studies, I[2]&#x2009;=&#x2009;60.97%, p&#x2009;=&#x2009;0.075), -1.70 (95% CI -2.50 to -0.90, p&#x2009;<&#x2009;0.001) for cervical treatments (5 studies, I[2]&#x2009;=&#x2009;52.92%, p&#x2009;=&#x2009;0.081), -4.61 (95% CI -7.90 to -1.33, p&#x2009;=&#x2009;0.006) for pre-invasive lesion diagnoses (4 studies, I[2]&#x2009;=&#x2009;92.45%, p&#x2009;<&#x2009;0.001), and -0.85&#x2009;(95% CI -1.52 to -0.19, p&#x2009;=&#x2009;0.012) for cervical cancer diagnoses (9 studies, I[2]&#x2009;=&#x2009;71.07%, p&#x2009;=&#x2009;0.002). At meta-regression, further reductions for cervical treatments and pre-invasive lesion diagnoses were observed in the case of screening coverage <70%.<br><br>CONCLUSIONS: During the COVID-19 pandemic, a reduction in colposcopies, cervical treatments, pre-invasive lesions diagnoses, and invasive cancer diagnoses was observed. Since a screening coverage of <70% heightened these declines, increasing such coverage could lead to better resilience of cervical cancer prevention services to future crises.}, }
@article {pmid41057923, year = {2025}, author = {Gidey, K and Niriayo, YL and Asgedom, SW and Lubetkin, E}, title = {Health-related quality of life in COVID-19 patients: a systematic review and meta-analysis of EQ-5D studies.}, journal = {Health and quality of life outcomes}, volume = {23}, number = {1}, pages = {97}, pmid = {41057923}, issn = {1477-7525}, support = {1627-RA//EuroQol Research Foundation/ ; 1627-RA//EuroQol Research Foundation/ ; 1627-RA//EuroQol Research Foundation/ ; 1627-RA//EuroQol Research Foundation/ ; }, mesh = {Humans ; *Quality of Life/psychology ; *COVID-19/psychology ; SARS-CoV-2 ; Female ; Male ; Health Status ; }, abstract = {BACKGROUND: COVID-19 has affected millions globally, with a significant proportion experiencing long-COVID and impaired health-related quality of life (HRQoL). This systematic review and meta-analysis aimed to synthesize the existing literature on HRQoL in COVID-19 patients.<br><br>METHODS: We conducted a systematic search of PubMed, Embase, Web of Science, Scopus, and the Cochrane Library for studies published between December 2019 and March 2025. Eligible studies were peer-reviewed and assessed HRQoL in COVID-19 patients using the EQ-5D instrument. Study quality and risk of bias were evaluated using the Newcastle-Ottawa Scale. Pooled health utility values were estimated using a random-effects model, and heterogeneity was assessed via I[2] statistics. Predictors of poor HRQoL were qualitatively narrated.<br><br>RESULTS: Out of 3539 references, 187 studies with 116,525 participants were analyzed. The majority (80.2%) used the EQ-5D-5&#xa0;L version. The pooled mean EQ-5D utility score was 0.76 (95% CI 0.74-0.79, I[2] = 99.9%) while the mean EQ-5D Visual Analogue Scale (VAS) score was 70.76 (95% CI 68.48-73.04; I[2] = 99.7%). Pain/discomfort and anxiety/depression were the most affected domains, reported by 51% and 46% of patients, respectively. Subgroup analysis showed significant differences in HRQoL based on national income status (p&#x2009;=&#x2009;0.038) and geographic region (p&#x2009;<&#x2009;0.001). Common predictors of lower HRQoL included older age, female gender, disease severity, comorbidities, and post-COVID-19 symptoms.<br><br>CONCLUSION: This systematic review demonstrates a substantial reduction in HRQoL among COVID-19 patients compared to the general population. The pooled utility values of COVID-19 contribute to understanding patients' HRQoL and can assist in calculating Quality-Adjusted Life Years. This provides essential data for future economic evaluations and informs health policy decisions.}, }
@article {pmid41057797, year = {2025}, author = {Bessaguet, C and Bonilla, A and Polin, C and Lacroix, A and Cartz-Piver, L}, title = {A systematic review to find link between past psychiatric history and development of long covid.}, journal = {BMC psychiatry}, volume = {25}, number = {1}, pages = {942}, pmid = {41057797}, issn = {1471-244X}, mesh = {Humans ; *COVID-19/psychology/complications/epidemiology ; *Mental Disorders/epidemiology/psychology/complications ; Risk Factors ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; *Anxiety/epidemiology/psychology ; *Depression/epidemiology ; }, abstract = {BACKGROUND: Covid-19 is a pandemic acute infectious disease that emerged in 2019. It is estimated that 10-20% will develop persistent symptoms, known as long Covid or post-Covid syndrome. The risk factors for the development of this syndrome are still being studied. Psychosocial factors are known to increase the duration and severity of respiratory infections.<br><br>AIMS: (i) to review current knowledge of the link between past psychiatric history and the development of long Covid; (ii) to obtain information on the psychological experience of the initial infection; (iii) to establish a link between the presence of psychiatric symptoms during the acute phase and the development of long Covid.<br><br>METHOD: We conducted a systematic review according to PRISMA standards using the Pubmed, Science Direct and Scopus databases. We included observational studies of adult subjects with long Covid whose psychiatric and/or addictive histories were searched.<br><br>RESULTS: A total of 36 articles were included in our review. Depression and anxiety appear to be risk factors for the development of long Covid. There is no consensus on the contribution of smoking to the onset of the syndrome. The negative psychological experience of the acute infection favours the persistence of symptoms. Psychological symptoms during the acute phase, studied in only one of our articles, seem to contribute to the persistence of concentration and attention problems.<br><br>CONCLUSION: Psychological comorbidities pre-existing COVID-19 infection, in particular depression and anxiety, as well as a poor psychological experience of the acute phase, may favour the development of long Covid.<br><br>TRIAL REGISTRATION NUMBER: PROSPERO registration number CRD42023391720.}, }
@article {pmid41057795, year = {2025}, author = {Mousavi, SM and Younesian, S and Yunesian, M and Fotouhi, A}, title = {The efficacy and effectiveness of COVID-19 vaccines in Iran: a systematic review and meta-analysis.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {1245}, pmid = {41057795}, issn = {1471-2334}, mesh = {Humans ; Iran/epidemiology ; *COVID-19/prevention &amp; control/epidemiology/mortality ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; *Vaccine Efficacy ; *SARS-CoV-2/immunology ; Randomized Controlled Trials as Topic ; Hospitalization/statistics &amp; numerical data ; Vaccination ; Observational Studies as Topic ; }, abstract = {BACKGROUND: With the end of the COVID-19 pandemic, there is an increasing demand for comprehensive data on vaccine effectiveness disaggregated by country. Such information will provide insights into national immunization policy differences and lay the groundwork for future pandemic readiness plans. This study evaluates the efficacy and effectiveness of COVID-19 vaccines in Iran.<br><br>METHODS: A systematic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar up to February 1, 2025. Studies assessing COVID-19 vaccine effectiveness or efficacy in Iran without restrictions on variants or vaccine platforms were included in the systematic review. Meta-analysis using the random effects model was performed to estimate the pooled effectiveness of combined vaccination platforms against hospital admission and death outcomes.<br><br>RESULTS: Two randomized controlled trials (RCTs) and 11 observational studies were included in the systematic review, and five observational studies were included in the meta-analysis. Based on the meta-analysis, considering all vaccination platforms combined, the pooled effectiveness of 2-dose COVID-19 vaccines against hospital admission and death was 51.1% (21.8 to 69.5) and 55.7% (-1.5 to 80.7), respectively. Against infection, RCTs reported efficacies of 50.2% and 49.7%, while observational studies reported effectiveness ranging from 63.9% to 87.1% for different vaccines.<br><br>CONCLUSION: Vaccine effectiveness varied substantially across the studies, with unique patterns related to Iran's situation during the pandemic, including the high number of different deployed vaccines. The lack of sufficient studies and high heterogeneity between the included studies have limited the understanding of COVID-19 vaccines' effectiveness in Iran.}, }
@article {pmid41057790, year = {2025}, author = {Nicolai, M and Ullrich, A and Ruck, J and Jaspers, B and Bialobrzeski, A and Degutsch, R and Oechsle, K and Radbruch, L and Gágyor, I and Hettich-Damm, N}, title = {Unravelling the complexities: a scoping review of the collateral effects on bereaved relatives during and beyond the COVID-19 pandemic.}, journal = {BMC palliative care}, volume = {24}, number = {1}, pages = {244}, pmid = {41057790}, issn = {1472-684X}, mesh = {Humans ; *COVID-19/psychology ; *Family/psychology ; *Bereavement ; Pandemics ; Stress, Psychological ; SARS-CoV-2 ; Adaptation, Psychological ; }, abstract = {The dying phase and the loss of a loved one, as well as the grief that follows, are a difficult process in the lives of relatives. These processes have been exacerbated by the COVID-19 pandemic, as numerous restrictions on contact and care for the dying and deceased have placed an additional burden on relatives. A review was conducted to identify these specific stress factors and their risk factors, as well as support options for bereaved individuals who lost a loved one during the COVID-19 pandemic. The scoping review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews, and the search was conducted in April 2024 (PubMed, Cochrane COVID-19 Study Register, and EBSCO Host, including APA PsychArticles, APA PsychInfo, CINAHL, and Medline). Studies involving adults who had lost a loved one during the official period of the COVID-19 pandemic were included, as well as various quantitative and qualitative study types. Studies that focused exclusively on palliative care and the evaluation of interventions were excluded. Studies were selected according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) phases. A total of 58 primary studies and five review articles with a total of 118,062 participants met the inclusion criteria and were included in the review. The main findings were that the pandemic and the associated measures placed additional burdens on bereaved individuals and exacerbated mental health problems. Visiting restrictions during the dying phase and restrictions on funerals were perceived as particularly stressful. Participants primarily experienced isolation and loneliness, as well as a lack of professional (e.g., from staff accompanying the dying process and the initial grieving process) and social support (e.g., from family and friends). In addition to personal resources and finding meaning, professional and social support were described as the most important factors in coping with grief during and after the pandemic. Consequently, professional, flexible, and comprehensive support from medical and nursing staff in cooperation with counselling centres and psychologists, as well as promotion of social support through networking services, are key issues for future crises.}, }
@article {pmid41057112, year = {2025}, author = {Viswanathan, V and Boulton, AJM}, title = {Introduction "global progress in diabetic foot care".}, journal = {Diabetes research and clinical practice}, volume = {229}, number = {}, pages = {112933}, doi = {10.1016/j.diabres.2025.112933}, pmid = {41057112}, issn = {1872-8227}, }
@article {pmid41056585, year = {2025}, author = {Klapper, P and Kulasegaran-Shylini, R and Dodgson, A and Sudhanva, M and Blandford, E and Tunkel, S and Hill, S and Hopkins, S and Fowler, T}, title = {Climate change and diagnostic samples - Opening Pandora's (post) box.}, journal = {Public health}, volume = {249}, number = {}, pages = {105983}, doi = {10.1016/j.puhe.2025.105983}, pmid = {41056585}, issn = {1476-5616}, mesh = {*Climate Change ; Humans ; United Kingdom/epidemiology ; *COVID-19/diagnosis ; SARS-CoV-2 ; *Specimen Handling/standards/methods ; *COVID-19 Testing/methods ; }, abstract = {OBJECTIVES: To reflect on how climate change is reshaping the practicalities of diagnostic testing, using the UK's COVID-19 home-based testing programme as a case study, and to call for an urgent review of international standards governing the transport of biological samples.<br><br>STUDY DESIGN: Narrative-based analysis drawing on operational experience during the UK National Testing Programme's response to COVID-19.<br><br>METHODS: We examine the design and implementation of a large-scale home testing model for COVID-19, which relied on the routine postal service to transport biological samples from homes to laboratories. These samples were transported without temperature control, across widely varying environmental conditions. This approach tested the limits of existing logistical assumptions and exposed critical regulatory gaps.<br><br>RESULTS: Despite the lack of temperature-controlled logistics, the UK's home testing programme functioned at scale, with internal validation assuring sample stability during both winter and summer extremes. However, this success occurred in the absence of any applicable international standards-such as ISO guidelines-that account for environmental factors in postal transport of biological samples. The experience highlighted a significant blind spot in regulatory frameworks, which currently assume controlled conditions that do not reflect real-world practice in emergency or climate-affected contexts.<br><br>CONCLUSIONS: The changing climate and evolving models of healthcare delivery-particularly the move toward near-patient and home-based diagnostics-require a rethinking of how we assure the quality and reliability of biological samples in transit. Existing international standards are no longer fit for purpose in this regard. There is an urgent need to acknowledge environmental resilience as a core requirement in diagnostic logistics, and to develop new standards that are robust to the realities of climate variability and decentralised healthcare.}, }
@article {pmid41055867, year = {2025}, author = {Felix, E and Green, JG}, title = {Changes in Child and Youth Mental Health Following the Return To In-Person Learning Post-COVID-19 Pandemic.}, journal = {Current psychiatry reports}, volume = {27}, number = {12}, pages = {704-710}, pmid = {41055867}, issn = {1535-1645}, mesh = {Humans ; Child ; *COVID-19/psychology ; Adolescent ; *Mental Health ; *Education, Distance ; }, abstract = {PURPOSE OF REVIEW: Changes in youth mental health during the pandemic have been well documented globally, but research on how mental health changed when schools returned to in-person learning is just emerging. This review summarizes the available global research on child and youth mental health following school reopening for in-person learning.<br><br>RECENT FINDINGS: Results varied by the mental health indicator being assessed and by subgroups of children and youth, with age-related differences, and possible gender-related influences. Some modifiable risk and protective factors examined included time spent on homework; internet and social media use; physical activity; communication/conflict with others; optimism; social relationships with family, teacher and peers; parental mental health; and inconsistent discipline. Some youth fared better when schools reopened in-person, but for others mental health challenges persisted. Mental health services shifted during the height of the pandemic, and some supports are no longer available. Continued monitoring is needed to help with recovery and resilience.}, }
@article {pmid41055070, year = {2025}, author = {Ren, S and Li, T and Zhang, Y and Bai, S and Zhou, Z and Li, S}, title = {Preparing for Potential Health and Safety Risks at the Olympic Games: Scoping Review.}, journal = {JMIR public health and surveillance}, volume = {11}, number = {}, pages = {e66829}, pmid = {41055070}, issn = {2369-2960}, mesh = {Humans ; *Sports/statistics &amp; numerical data ; *Terrorism/prevention &amp; control/statistics &amp; numerical data ; *Anniversaries and Special Events ; Athletic Injuries/epidemiology/prevention &amp; control ; Crowding ; }, abstract = {BACKGROUND: The Olympic Games are an example of a mass gathering that involves a complex and large crowd composition, with a large number of illnesses and injuries occurring at previous Olympic Games, and the Olympic Games also becoming a target for terrorist attacks.<br><br>OBJECTIVE: With the help of mass-gathering medicine as a guide, this study aims to critically summarize and analyze the state of illness, injury, and terrorism during the Olympic Games in order to reduce the incidence of illnesses and injuries in crowds and to offer lessons for the organization of major international sporting events such as the Olympics.<br><br>METHODS: The procedure for this scoping review followed the 5-step methodological framework of Arksey and O'Malley. We searched electronic databases such as PubMed, Web of Science, and Scopus. We extracted, summarized, and categorized general information on each study, game characteristics, illness and injury profiles, terrorism characteristics, preventive measures, and surveillance paradigms.<br><br>RESULTS: We conducted a database search and retrieved a total of 9587 studies on 2 occasions. After removing duplicates and screening, we included 120 studies. Only 12 studies on the Summer, Winter, and Paralympic Games published before 2000, and 108 studies from 2000 onward, comprise the 120 studies, marking an unprecedented number of studies in this field of research, particularly in recent times. Of the 120 studies, 80 were illness-related, 81 were injury-related, and 2 were terrorism-related. Nine studies explicitly assessed body parts, including shoulders, feet, and dentistry; 26 studies specifically investigated certain illnesses and injuries, such as COVID-19 disease, heat-related illnesses, and concussions. Of the 120 research studies, 18 specifically analyzed sports such as gymnastics and weight lifting, with 11 studies focusing especially on COVID-19 disease. The most studied games were the Tokyo 2021 Olympic or Paralympic Games, the London 2012 Olympic or Paralympic Games, and the Rio 2016 Olympic or Paralympic Games. The system of injury and illness surveillance in the Olympic Games goes through 3 stages of development: the first trial of information technology, the construction of networks, and the enhancement of intelligence.<br><br>CONCLUSIONS: A critical summary of studies of illness, injury, and terrorist attacks at previous Olympic Games is important for injury and terrorism prevention at major sporting events such as the Olympic Games. Surveillance methods require improvements in surveillance technology, data sharing, and privacy protection.}, }
@article {pmid41054502, year = {2025}, author = {Focosi, D and Franchini, M and Maggi, F and Casadevall, A}, title = {The Emergence of Escape Mutations in COVID-19 Following Anti-Spike Monoclonal Antibody Treatment: How Do We Tackle It?.}, journal = {Infection and drug resistance}, volume = {18}, number = {}, pages = {5207-5217}, pmid = {41054502}, issn = {1178-6973}, abstract = {Treatment-emergent resistance to anti-Spike monoclonal antibody (mAb) was a largely unexpected and dramatic finding along the COVID-19 pandemic. Emergence of resistant strains was particularly common in immunocompromised patients, who often harbored very high SARS-CoV-2 loads when treated with mAb monotherapies. Concerns were raised regarding the risk for some of those resistant variants to propagate in communities. In this review, we will summarize the experience thus far and suggest recommendations to prevent and manage mAb treatment-emergent resistance such as comboing and reliance over polyclonal immunoglobulins.}, }
@article {pmid41053920, year = {2025}, author = {Muthuka, JK and Mbari-Fondo, DK and Wambura, FM and Oluoch, K and Nzioki, JM and Nyamai, EM and Nabaweesi, R}, title = {Effects of Interventions for the Prevention and Management of Maternal Anemia in the Advent of the COVID-19 Pandemic: Systematic Review and Meta-Analysis.}, journal = {JMIRx med}, volume = {6}, number = {}, pages = {e57626}, pmid = {41053920}, issn = {2563-6316}, abstract = {BACKGROUND: The COVID-19 pandemic presented many unknowns for pregnant women, with anemia potentially worsening pregnancy outcomes due to multiple factors.<br><br>OBJECTIVE: This review aimed to determine the pooled effect of maternal anemia interventions and associated factors during the pandemic.<br><br>METHODS: Eligible studies were observational and included reproductive-age women receiving anemia-related interventions during the COVID-19 pandemic. Exclusion criteria comprised non-English publications, reviews, editorials, case reports, studies with insufficient data, sample sizes below 50, and those lacking DOIs. A systematic search of PubMed, Scopus, Embase, Web of Science, and Google Scholar identified articles published between December 2019 and August 2022. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool for randomized trials and the National Institutes of Health's assessment tool for observational studies. Pooled rate ratios (RRs) with 95% CIs were calculated in Review Manager 5.4.1. Synthesis included subgroup analysis, meta-regression, and publication bias checks to assess intervention effectiveness.<br><br>RESULTS: This meta-analysis included 11 studies with 6129 pregnant women. Of these, 3591 (59%) were in the intervention group and 2538 (41%) were in the comparator group. Effects were recorded for 1921 (53.4%) women in the intervention group and 1350 (53.1%) in the comparator group. The cumulative impact ranged from 23% to 81%, averaging 56%. The initial analysis showed no significant effect on anemia prevention (RR 0.79, 95% CI 0.61-1.02; P=.07), with high heterogeneity (I&#xb2;=97%). Sensitivity analysis excluding 4 outlier studies improved the effect size to a significant level at 39% (RR 0.61, 95% CI 0.43-0.87; P=.006). Subgroup analysis revealed substantial heterogeneity (I&#xb2;=87.2%). Intravenous sucrose had a poor impact (RR 1.31, 95% CI 1.17-1.47; P<.001), while medicinal or herbal interventions showed benefit (RR 0.81, 95% CI 0.73-0.90; P=.006). Educational interventions yielded a 28% effect (RR 0.72), medicinal administration 19% (RR 0.81), iron supplementation 17% (RR 0.83), and intravenous ferric carboxylmaltose 15% (RR 0.85; P<.02). Additional sensitivity analysis confirmed a pooled positive effect of 17% (RR 0.83, 95% CI 0.79-0.88; P<.001), with minimal heterogeneity (I&#xb2;=0%). Regionally, effectiveness was highest in Africa (RR 0.84, 95% CI 0.79-0.89; P<.001). Multicenter studies and those with 2020 data were predictive of better outcomes (RR 0.84 and RR 0.50, respectively). Despite initial heterogeneity and publication bias, interventions showed utility in mitigating maternal anemia in targeted subgroups and regions.<br><br>CONCLUSIONS: Maternal anemia interventions during the COVID-19 pandemic showed modest, context-specific effectiveness, with declining impact from 2020 to 2022. Although high heterogeneity and study inconsistencies limited generalizability, significant benefits were observed particularly in African and multicenter studies. The pandemic exposed gaps in maternal health systems, emphasizing the need for tailored interventions, stronger data infrastructure, and resilient care strategies in future global crises.}, }
@article {pmid41053865, year = {2025}, author = {Morrison, C and Natale, I and Branchflower, A and Harvey, C and Lundin, RM}, title = {Harm reduction approaches for the use of benzodiazepines: a scoping review.}, journal = {Harm reduction journal}, volume = {22}, number = {1}, pages = {162}, pmid = {41053865}, issn = {1477-7517}, mesh = {Humans ; *Benzodiazepines/adverse effects/therapeutic use ; *Harm Reduction ; *Substance-Related Disorders/prevention &amp; control ; }, abstract = {BACKGROUND: Benzodiazepines are widely prescribed but are associated with significant risks, particularly when used long-term. The anxiolytic and hypnotic properties of these medications increase their risk of dependence, which can lead to nonmedical and illicit use. Illicit use further compounds these harms, particularly with the emergence of potent novel benzodiazepines on the unregulated market. While tapering remains the standard treatment, not all individuals seek discontinuation. In such cases, harm reduction becomes a key approach to minimise associated risks. This review aimed to identify and synthesise existing harm reduction approaches for people using benzodiazepines.<br><br>METHOD: A systematic search was conducted across four databases, PsycINFO (n&#x2009;=&#x2009;183), MEDLINE (n&#x2009;=&#x2009;345), Web of Science (n&#x2009;=&#x2009;382), and Embase (n&#x2009;=&#x2009;940), following the PRISMA guidelines. Searches were carried out between February 14 and March 30, 2024, using terms related to harm reduction and benzodiazepines. The search was re-run on July 7, 2025, using the same strategy across all four databases.<br><br>RESULTS: Thirty-five studies were included and grouped into the following themes: direct interventions (n&#x2009;=&#x2009;16), policy approaches (n&#x2009;=&#x2009;9), and population-specific approaches (n&#x2009;=&#x2009;10). Among direct interventions, drug checking was the most frequently reported approach, with advanced techniques improving the detection of novel benzodiazepines and prompting safer use practices. Benzodiazepine agonist prescribing during the COVID-19 pandemic has yielded positive outcomes; conversely, policy responses such as rescheduling and prescribing changes indicated mixed results. While some studies reported reduced use and improved treatment engagement, others highlighted unintended consequences that may displace or exacerbate harm. Specific populations, such as young people, those who inject benzodiazepines, and members of online communities, highlight the diverse demographics of people who use benzodiazepines and emphasise the importance of developing tailored responses to address unique needs.<br><br>CONCLUSION: Drug checking emerged as the most widely reported harm reduction approach for benzodiazepine use, with consistent positive outcomes across studies. Prescribing and policy interventions demonstrated variable impacts, often influenced by broader systemic factors. Critically, a clear gap remains in harm reduction approaches for those not seeking treatment, highlighting a need for inclusive, flexible and pragmatic responses. There is also a need for more robust evaluation of harm reduction interventions to strengthen the evidence base and inform practice.}, }
@article {pmid41053189, year = {2025}, author = {Ulaş, S and Seçer, &#x130;}, title = {Secondary traumatic stress and burnout in healthcare professional: systematic review and a meta-analysis based on correlation coefficient.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {34680}, pmid = {41053189}, issn = {2045-2322}, mesh = {Humans ; *Health Personnel/psychology ; *Burnout, Professional/epidemiology/psychology ; *COVID-19/psychology/epidemiology ; SARS-CoV-2 ; Pandemics ; Compassion Fatigue ; }, abstract = {The challenging conditions faced by healthcare professionals (HCPs) during the pandemic have been extensively discussed in the literature, particularly concerning Secondary Traumatic Stress (STS) and Burnout (BO). This study systematically compiled studies meeting the inclusion criteria and examining the relationship between STS and BO between 2019 and 2024 in the Web of Science and PubMed databases, conducting a correlational meta-analysis. While the PRISMA was adhered to in all stages of this manuscript, the Quality Assessment and Validity Tool for Correlational Studies was adhered to in evaluating the articles that met the inclusion criteria. This analysis included 61 publications involving 33.906 HCPs. When raw r coefficients were transformed into Fisher's z values, the correlation coefficients ranged between 0.1820 and 1.1881, with a 100% positive direction, and the weighted correlation coefficient was 0.6305 (95% CI: 0.5888 to 0.6721). The results indicate a strong positive relationship between the levels of STS and BO among HCPs during the pandemic. The validation of the strong relationship between STS and BO during the COVID-19 period underscores the critical need for the development of information dissemination, resources, support, or policies to strengthen HCPs against STS and BO in the face of future epidemics, pandemics, or situations that could negatively impact the functioning of the healthcare system. In other words, it can be suggested to develop training and awareness programs for HCPs in terms of STS and BO, strengthen support systems, improve workload and working conditions, ensure continuity in monitoring and evaluating HCPs in terms of BO and STS, etc.}, }
@article {pmid41053126, year = {2025}, author = {Mauti, E and Hosseinichimeh, N and Abedi, V and Zand, R and Zhou, S and Tian, Z}, title = {Factors associated with post-stroke readmission: a systematic review and meta analysis.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {34772}, pmid = {41053126}, issn = {2045-2322}, mesh = {Humans ; *Patient Readmission/statistics &amp; numerical data ; *Stroke/epidemiology/therapy ; Risk Factors ; Patient Discharge/statistics &amp; numerical data ; United States/epidemiology ; }, abstract = {Readmissions following strokes are a significant concern due to their association with adverse outcomes. The Centers for Medicare and Medicaid Services regard hospital readmissions as a measure of suboptimal hospital care and have made reducing readmission rates a national healthcare reform goal. This systematic review and meta-analysis aimed to identify factors associated with 30-day, 90-day, and 1-year ischemic stroke readmissions. We reviewed the databases PubMed and Web of Science for English-language studies on stroke readmissions published between January 1, 2000, and February 5, 2024. A total of 135 studies from 18 countries met the inclusion criteria. Higher 30-day readmissions were linked to advanced age, insurance type, employment status, socioeconomic disadvantage, discharge destination, and conditions such as heart failure and diabetes. Reduced 30-day readmissions were associated with effective discharge planning, post-primary care visits, and thrombolytic therapy administration. Weekend admissions and the COVID-19 period were not significant contributing factors. Our meta-analysis on 30-day readmissions in the U.S. found increased odds with atrial fibrillation (OR, 1.24 [95% CI, 1.12-1.36]), and cancer (OR, 1.50 [95% CI, 1.19-1.89]), while discharge to home (OR, 0.75 [95% CI, 0.55-1.02]) and private insurance (OR, 0.70 [95% CI, 0.66-0.75]) decreased the odds. Advanced age, comorbidities, and discharge planning impacted 90-day readmissions, while 1-year readmissions were influenced by advanced age, discharge location, functional independence, and diseases including diabetes and coronary artery disease. The study highlights the importance of hospital discharge procedures and follow-up care as modifiable factors for mitigating the risk of readmission in stroke patients. Prioritization in care transition enhancements and proper discharge planning for at-risk patients could help improve stroke readmission rates.}, }
@article {pmid41052610, year = {2025}, author = {Xu, H and Li, B and Tang, K and Yang, J and Zhan, P}, title = {Privileged scaffold repurposed: the evolving role of quinolone derivatives in antiviral therapy.}, journal = {Bioorganic &amp; medicinal chemistry letters}, volume = {130}, number = {}, pages = {130427}, doi = {10.1016/j.bmcl.2025.130427}, pmid = {41052610}, issn = {1464-3405}, abstract = {Significant advancements have been made in the field of antiviral drug development; however, existing therapies still face considerable challenges regarding safety and efficacy. Moreover, with the frequent emergence of outbreaks caused by viruses such as SARS-CoV-2, monkeypox virus, and Chikungunya virus in recent years, there is an urgent need to develop novel antiviral drugs that are highly effective, low-toxic, and possess broad-spectrum activity against drug-resistant strains. Exploring antiviral agents from privileged structures has long been a tacit shortcut for researchers, and quinolone derivatives, as a class of privileged structures with diverse antiviral activities, have attracted extensive attention in recent years, providing a crucial material basis for the development of next-generation antiviral drugs. This review focuses on the discovery, mechanisms of action, potential clinical applications, and research progress of quinolone derivatives with typical structural characteristics or potent antiviral activity, aiming to provide insights for current and future antiviral drug research.}, }
@article {pmid41051924, year = {2025}, author = {Ghadirian, MZ and Sarmiento, I and Reinoso Chávez, N and Andersson, N and Cockcroft, A}, title = {Experience of the COVID-19 Pandemic in Rural Nigeria: A Scoping Review of the Literature Contextualized With Local Knowledge Using Fuzzy Cognitive Mapping.}, journal = {Community health equity research &amp; policy}, volume = {}, number = {}, pages = {2752535X251384511}, doi = {10.1177/2752535X251384511}, pmid = {41051924}, issn = {2752-5368}, abstract = {AimCollate and summarise published evidence of the non-clinical effects of the COVID-19 pandemic in rural Nigeria and compare the findings with community stakeholder experiences.MethodsWe searched PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for peer-reviewed papers published up to January 2024. Included studies used quantitative, qualitative, or mixed methods to examine the influence of the COVID-19 pandemic on the lives of rural Nigerians. Two reviewers conducted title, abstract, and full-text screening independently. We used narrative descriptions and fuzzy cognitive maps to summarise the findings of the review and compared the maps with those previously created by stakeholders in rural communities in Bauchi State, rural Nigeria.ResultsPoverty, hunger and lack of food, and stress and mental health problems were leading themes in both the literature and stakeholder maps. Stakeholder maps highlighted job loss and household conflicts. These topics were rarely explored in the literature, which emphasized reduced health services.ConclusionThis review and stakeholder perspectives confirm the importance of non-clinical impacts of the COVID-19 pandemic in rural Nigeria. Some issues highlighted by local community stakeholders were absent in the literature. Contextualizing published research with local experience provides specific insights to inform recovery policies.}, }
@article {pmid41050627, year = {2025}, author = {Lin, C and Jennison, AV and Leong, LEX and Speers, DJ and Meumann, EM and Cooley, L and Kennedy, K and Arnott, A and Winter, D and Rawlinson, W and Robson, J and Harris, P and Donald, A and Seemann, T and Ballard, SA and Kirk, M and Sintchenko, V and Williamson, DA and Howden, BP and , }, title = {Communicable diseases genomics network: promoting and harmonising pathogen genomics implementation for public health in Australia.}, journal = {The Lancet regional health. Western Pacific}, volume = {63}, number = {}, pages = {101692}, pmid = {41050627}, issn = {2666-6065}, abstract = {Globally, the utility of pathogen genomics for public health was highlighted by the COVID-19 pandemic. Approaches to enhance coordination and improve implementation of pathogen genomics for public health are needed. The Communicable Diseases Genomics Network (CDGN) was established in 2015 in Australia. The network, embedded at the public health laboratory interface and supported by the Australian Government, has facilitated a coordinated model in Australia for public health pathogen genomics. CDGN activities have facilitated pilot projects to demonstrate use cases, harmonisation of data sharing and governance arrangements, outbreak and pandemic response, translational research, policy development and workforce capacity building. The impact of CDGN has been enabling the significant progress towards public health genomics implementation in Australia, and providing a model that could be applied in other federated settings, aligned with international best practice.}, }
@article {pmid41050344, year = {2025}, author = {Kapar, A and Li, H and He, Q and Lin, D and Tang, D and Peng, K and Wang, Y and Wang, K}, title = {Real-World Evaluation Study of Azvudine for the Treatment of Patients With COVID-19: A Systematic Review and Meta-Analysis.}, journal = {The Canadian journal of infectious diseases &amp; medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2025}, number = {}, pages = {3645253}, pmid = {41050344}, issn = {1712-9532}, abstract = {Background: Azvudine, as an antiviral drug, has been approved for the treatment of COVID-19, and multiple randomized controlled trials (RCTs) and retrospective cohort studies have been conducted. This study aimed to systematically evaluate the efficacy and safety of Azvudine in treating COVID-19 patients. Methods: As of December 1, 2023, we searched databases including PubMed, Web of Science, Ovid, ICTRP, Cochrane Library, Clinical Trials, MedRxiv, and Springer Link for relevant RCTs and retrospective cohort studies. EndNote X9 was used for literature screening and management, and R software was employed for meta-analysis. Results: A total of 1142 COVID-19 patients from five RCTs were included, with 575 patients receiving Azvudine treatment. Azvudine significantly reduced the hospitalization time and the time to nucleic acid conversion to negative in patients with mild to moderate COVID-19. However, compared to the control group, Azvudine did not significantly reduce the incidence of adverse events (AEs) (risk ratio: 0.89, 95% confidence interval [CI]: 0.80, 1.00). Additionally, eight ongoing clinical trials were included to evaluate the efficacy and safety of Azvudine. In fourteen retrospective cohort studies, a total of 6602 COVID-19 patients were analyzed, with 3118 patients receiving Azvudine treatment. Azvudine significantly reduced all-cause mortality (odds ratio [OR]: 0.49, 95% CI: 0.38, 0.63). The incidence of AEs in the Azvudine group and the Nirmatrelvir/Ritonavir group was 4.13% (60/1453) and 5.08% (67/1319), respectively, indicating that Azvudine significantly reduced the incidence of AEs compared to Nirmatrelvir/Ritonavir (OR: 0.68, 95% CI: 0.47, 0.98). Conclusions: Azvudine significantly reduced the hospitalization time and the time to nucleic acid conversion to negative in COVID-19 patients and significantly lowered all-cause mortality (Grading of Recommendations Assessment, Development, and Evaluation [GRADE]: high-certainty evidence). In terms of safety, Azvudine demonstrated a favorable safety profile (GRADE: moderate-certainty evidence because of suspected publication bias and residual confounding). Further large-scale studies are needed to validate its efficacy and safety.}, }
@article {pmid41049923, year = {2025}, author = {Pedraza, A and Bonnice, S and Won, MN and Kesselman, MM and Demory Beckler, M}, title = {Impact of COVID-19 on the Gut Microbiome: A Review.}, journal = {Cureus}, volume = {17}, number = {9}, pages = {e91470}, pmid = {41049923}, issn = {2168-8184}, abstract = {Coronavirus Disease 2019 (COVID-19) has resulted in over 6 million deaths worldwide in fewer than four years and is a result of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The protein that mediates SARS-CoV-2 host cell entry is the angiotensin-converting enzyme 2 (ACE2), which is highly expressed on the membrane of gastrointestinal (GI) cells. Consequently, infection can lead to direct damage to the GI tract and gut dysbiosis, which is associated with an imbalance of microbiota, inflammation, and other systemic infections and diseases. In this review, we will focus on the impact of COVID-19 on the GI system. We will examine the pathophysiology of gut dysbiosis in COVID-19 patients, as well as emphasize the significance of probiotics in addressing this condition. Additionally, we will identify key areas of interest that warrant further investigation.}, }
@article {pmid41049897, year = {2025}, author = {Castellano, B and Castellano, C and Sobczak, A and Khanna, D}, title = {Long-Term Manifestations of COVID-19: A Review.}, journal = {Cureus}, volume = {17}, number = {9}, pages = {e91492}, pmid = {41049897}, issn = {2168-8184}, abstract = {Although most coronavirus disease 2019 (COVID-19) cases resolve within a few weeks after the onset of infection, a considerable number of patients still suffer from prolonged or recurrent symptoms evident after weeks or months post-COVID-19 recovery. This paper analyzed the current literature related to long-term manifestations of COVID-19 and aimed to identify the common symptoms reported four weeks or more after the initial onset of the disease. COVID-19 has been shown to have lasting systemic effects on an array of organ systems, such as the lungs, heart, brain, and gastrointestinal systems. Common symptoms include, but are not limited to, fatigue, brain fog, respiratory difficulties, and loss of taste and smell. The impact of COVID-19 on multiple organ systems is thought to be associated with its ability to bind angiotensin-converting enzyme 2 (ACE2) receptors throughout the body and promote cytokine release. This study provides insight into common long-term manifestations of COVID-19. Future studies should look at how long COVID-19 syndrome affects various subpopulations differently.}, }
@article {pmid41049734, year = {2025}, author = {Gao, Y and Zhang, J}, title = {The role of SARS-CoV-2 main protease in innate immune regulation: From molecular mechanisms to therapeutic implications.}, journal = {Acta pharmaceutica Sinica. B}, volume = {15}, number = {9}, pages = {4497-4510}, pmid = {41049734}, issn = {2211-3835}, abstract = {The main protease (M[pro]) of SARS-CoV-2 plays a pivotal role in viral replication and immune evasion. Accumulating evidence highlights its significant role in suppressing innate immunity. In this review, we provide a comprehensive overview of how M[pro] modulates host innate immune responses, including its interference with retinoic acid-inducible gene I (RIG-I)-like receptor (RLR) and cyclic GMP-AMP synthase (cGAS)-stimulator of interferon gene (STING) signaling pathways, inhibition of interferon production, and disruption of inflammasome activities. As a protease, M[pro] cleaves a variety of host proteins to attenuate antiviral innate immunity, a process dependent on its catalytic dyad (Cys145-His41), which is crucial for its proteolytic activity. Meanwhile, M[pro] also exerts innate immune regulatory functions in a protease-independent manner. Notably, inhibitors targeting M[pro] have demonstrated efficacy in restoring immune functions and suppressing viral replication, offering potential therapeutic strategies against SARS-CoV-2 infection.}, }
@article {pmid41048938, year = {2025}, author = {Wang, Y and Zhu, J and Ma, Q and Zhou, W and Yang, L and Sheng, S and Zhu, F and Xia, Z}, title = {Trends in mesenchymal stem cell-derived extracellular vesicles clinical trials 2014-2024: is efficacy optimal in a narrow dose range?.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1625787}, pmid = {41048938}, issn = {2296-858X}, abstract = {BACKGROUND: Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) are emerging as promising cell-free therapeutic agents due to their immunomodulatory and regenerative properties. However, the lack of standardized protocols and dose optimization strategies has limited their clinical translation. While procedures for the isolation, expansion, and therapeutic use of mesenchymal stem cells (MSCs) have been standardized, there remains a lack of standardized protocols for the isolation and purification of EVs and exosomes (Exos).<br><br>METHODS: This review Comprehensive statistical summary global clinical trials involving MSC-EVs and Exos registered between 2014 and 2024, with a particular focus on dose-effect relationships and administration routes. Data were collected from ClinicalTrials.gov, the Chinese Clinical Trial Registry, and the Cochrane Register of Studies. A total of 66 eligible trials were included after screening.<br><br>RESULTS: Intravenous infusion and aerosolized inhalation were identified as the predominant administration methods, especially in trials targeting respiratory diseases. Notably, dose-effect results revealed that nebulization therapy achieved therapeutic effects at doses around 108 particles, significantly lower than those required for intravenous routes. This suggests a relatively narrow and route-dependent effective dose window. However, large variations in EVs characterization, dose units, and outcome measures were observed across trials, underscoring the lack of harmonized reporting standards.<br><br>CONCLUSION: This review highlights dose-response as a critical but underappreciated gap in current MSC-EVs clinical research. The findings emphasize the urgent need for standardized dosing frameworks, potency assays, and harmonized clinical protocols to advance the safe and effective translation of MSC-EVs therapies. The analysis underscores the need for standardized protocols, global collaboration, and a deeper understanding of the biological mechanisms underlying MSC-EVs and Exos therapies to advance clinical applications and ensure safety and efficacy.}, }
@article {pmid41048920, year = {2025}, author = {Ferreira, DBB and Santos, RMS and Machado, MCL and Rezende, VHM and de Marco, PG and Romano-Silva, MA and de Miranda, DM}, title = {Suicidality and self-harm in adolescents before and after the COVID-19 pandemic: a systematic review.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1643145}, pmid = {41048920}, issn = {1664-0640}, abstract = {INTRODUCTION: Adolescent mental health, self-harm, and suicidality are critical concerns during this developmental stage, marked by intense physical, emotional, and social changes. The COVID - 19 pandemic has further intensified these vulnerabilities by disrupting daily routines, increasing social isolation, limiting access to mental health services, and exacerbating academic and emotional stressors.<br><br>METHODS: This systematic review followed the PRISMA 2020 guidelines and employed the PECO strategy to identify relevant studies. A total of 55 quantitative studies published between 2010 and 2024 were included. These studies examined the prevalence and risk factors of self-harm and suicidal behaviors among adolescents aged 10 to 19 years, comparing findings from the pre-pandemic and pandemic periods. Psychosocial, economic, and cultural determinants were also evaluated.<br><br>RESULTS: The analysis revealed a consistent increase in self-harm and suicidality during the pandemic, with adolescent girls being disproportionately affected. Gender disparities were observed across diverse cultural contexts. Contributing factors included social isolation, excessive screen time, reduced access to education and healthcare, and increased family or financial stress. Cultural variability shaped both prevalence and clinical expression.<br><br>DISCUSSION: These findings underscore the amplifying effect of the COVID - 19 pandemic on adolescent mental health vulnerabilities and highlight the need for culturally sensitive, gender-informed preventive strategies. Public policies should prioritize mental health support for youth and address systemic inequities to mitigate the psychological consequences of global crises. This review offers important insights into adolescent mental health in times of collective adversity.<br><br>CLINICAL TRIAL REGISTRATION: PROSPERO https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024538641, identifier CRD42024538641.}, }
@article {pmid41048326, year = {2025}, author = {Abdul-Mutakabbir, JC}, title = {Area-based Deprivation Indices and Healthcare-Associated Infections: A Narrative Review of Evidence.}, journal = {Current infectious disease reports}, volume = {27}, number = {1}, pages = {20}, pmid = {41048326}, issn = {1523-3847}, abstract = {PURPOSE OF REVIEW: Since the coronavirus disease-19 (COVID-19) pandemic started, there has been a rise in published studies using area-based deprivation indices to explore the link between neighborhood-level social determinants of health (SDoH) and susceptibility to infectious diseases. However, questions remain about how these deprivation indices were developed and how effective they are at identifying and addressing healthcare-associated infection (HAI) disparities. This review aims to clarify the origins of the most commonly used deprivation indices in HAI epidemiology research and to offer key considerations and recommendations for their use to enhance prevention strategies and advocacy efforts.<br><br>RECENT FINDINGS: The two most frequently used area-based deprivation indices in HAI epidemiology research are the area deprivation index and the social vulnerability index. Of interest, both indices use data from the American Community Survey disseminated by the US Census Bureau to describe area-level socioeconomic and material deprivation across various geographic areas nationwide. Researchers have combined these area-based indices with clinical and individual-level sociodemographic variables and found that higher levels of disadvantage correlate with an increased occurrence of HAIs. Despite similarities in findings when using these indices, they have distinct differences that should be considered.<br><br>SUMMARY: Area-level deprivation can increase an individual's risk of HAIs, and deprivation indices are tools that can quantify this relationship. Despite the availability of relevant data, there is a need to expand the existing literature using deprivation indices in HAI research. Ultimately, this exploratory research has the potential to inform prevention strategies and policy reforms aimed at reducing disparities in HAIs.}, }
@article {pmid41048263, year = {2025}, author = {Verma, A and Naidu, SV and Sulthana, H and Ullah, A and Shabil, M and Sah, R and Mehta, R and Jan, A and Ain, NU and Rahim, A and Abu Nahla, U}, title = {Musculoskeletal manifestations in post-acute sequelae of SARS-CoV-2 infection: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1662953}, pmid = {41048263}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Musculoskeletal Diseases/epidemiology/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Prevalence ; Incidence ; Myalgia/epidemiology ; }, abstract = {BACKGROUND: The COVID-19 pandemic has highlighted a spectrum of long-term sequelae, with musculoskeletal symptoms being a substantial component of Post-Acute Sequelae of SARS-CoV-2 infection (PASC). This systematic review and meta-analysis aimed to evaluate the incidence and nature of musculoskeletal manifestations in individuals recovering from COVID-19.<br><br>METHODS: A systematic search across PubMed, Embase, and Web of Science was performed up to February 15, 2024, to identify studies reporting on musculoskeletal symptoms post-COVID-19. Observational studies which reported any musculoskeletal symptoms of PASC were included. Data were pooled using a random-effects model to calculate the incidence of symptoms, with subgroup analyses based on time since infection. Statistical analysis were conducted in R software (V 4.3).<br><br>RESULTS: Sixty-four studies were included, demonstrating a pooled prevalence of muscle pain at 28% (95% CI: 22%-35%), which increased to 25.9% (95% CI: 20.7%-31.7%) at 12 months post-infection. Joint pain showed a pooled prevalence of 14.8% (95% CI: 10.6%-20.2%), with no significant temporal change. Muscle weakness was observed in 12.9% (95% CI: 4.2%-32.9%) of patients. Notable heterogeneity was observed across studies (I [2] > 89% for all symptoms).<br><br>CONCLUSION: Musculoskeletal symptoms are prevalent in individuals with PASC, with muscle pain being the most common. The findings highlight the need for comprehensive clinical management and continuous research to create targeted treatments and revise care protocols as the pandemic evolves.}, }
@article {pmid41048103, year = {2025}, author = {Pariano, M and Puccetti, M and Fabi, C and Nunzi, E and Balucchi, S and Perioli, L and Ricci, M and Giovagnoli, S and Garaci, E and Romani, L}, title = {Updates on Candida albicans infections: pathogenesis, resistance, and emerging nanopharmaceutical strategies.}, journal = {Expert review of anti-infective therapy}, volume = {23}, number = {10}, pages = {951-967}, doi = {10.1080/14787210.2025.2569831}, pmid = {41048103}, issn = {1744-8336}, mesh = {Humans ; *Candida albicans/drug effects/pathogenicity/isolation &amp; purification ; *Antifungal Agents/administration &amp; dosage/pharmacology ; Drug Resistance, Fungal ; *Candidiasis/drug therapy/microbiology/diagnosis/epidemiology ; COVID-19 ; Biofilms/drug effects/growth &amp; development ; Animals ; Probiotics/administration &amp; dosage ; }, abstract = {INTRODUCTION: Candidiasis comprises a spectrum of infections ranging from superficial mucosal to life-threatening systemic infections caused by the opportunistic yeast, Candida, a genus containing several species of heterogeneous behavior and unique pathogenesis in the human host. Candida albicans is the most prevalent species. The aim of this review is to provide an update on pathogenesis, resistance and emerging therapeutic strategies in candidiasis, with a focus on C. albicans.<br><br>AREAS COVERED: We discuss recent advancements that have deepened our understanding of Candida pathogenesis, particularly the roles of morphological plasticity, metabolic flexibility, biofilm formation, multidrug resistance and gut dysbiosis. We interrogated three major databases, mainly PubMed, Scopus and Google Scholar for the latest (with emphasis on the works published in the last 5&#x2009;years) developments in antifungal resistance trends, diagnostic innovations, and novel therapeutic strategies, including next-generation antifungals, combination therapies and nanopharmaceuticals. Additionally, we explore emerging strategies, such as probiotics, vaccines, and antifungal stewardship, and discuss the impact of post-COVID-19 immunosuppression, cancer therapies, and climate change on candidiasis epidemiology.<br><br>EXPERT OPINION: The future of C. albicans management lies in personalized approaches, leveraging genomics, host-pathogen interactions and advanced drug-delivery platforms to combat resistance, overcome the limitations of current systemic therapy and improve patient outcomes.}, }
@article {pmid41047164, year = {2025}, author = {Gram, EG and Moynihan, R and Copp, T and Shih, P and Albarqouni, L and Akl, E and Smith, C and Hardiman, L and Nickel, B}, title = {Addressing misleading medical information on social media: a scoping review of current interventions.}, journal = {BMJ evidence-based medicine}, volume = {30}, number = {6}, pages = {420-433}, doi = {10.1136/bmjebm-2025-113704}, pmid = {41047164}, issn = {2515-4478}, mesh = {*Social Media ; Humans ; *Medical Overuse/prevention &amp; control ; Communication ; }, abstract = {BACKGROUND: Misleading information about medical products on social media may cause overuse.<br><br>OBJECTIVES: Explore interventions targeting the problem of misleading medical information and marketing on social media, with a focus on preventing medical overuse including overdiagnosis.<br><br>ELIGIBILITY CRITERIA: We included peer-reviewed studies with original data on an intervention targeting misleading medical information on social media and governmental/institutional responses with and without evaluation. We excluded responses relating to COVID-19.<br><br>SOURCES OF EVIDENCE: four electronic databases: MEDLINE/PubMed, PsycINFO, Academic Search Complete and Web of Science, and searches of grey literature on Google and Google Scholar. Search date: 9 June 2025.<br><br>DATA CHARTING: We used prespecified data forms populated in duplicate by two reviewers.<br><br>RESULTS: We identified 27 peer-reviewed articles and 25 organisational and governmental responses (grey literature). 20 (74%) of the peer-reviewed interventions targeted the consumer to enhance 'media literacy', support decision-making or warn about misinformation trends. Approaches included education, such as videos or information materials, to improve detection of misinformation, as well as correcting misinformation and rebutting claims. Only two (7.4%) of the peer-reviewed approaches were sensitive to the problem of medical overuse: a risk-of-deception tool and an informed decision-making service. The grey literature about government and organisational responses chiefly comprised general advertising regulations and other educational resources for consumers to identify and navigate misinformation. The advertising regulations ranged from self-regulatory codes of practice to mandatory regulations, requiring pre-approval of social media marketing material. Most regulations stated advertising should be truthful, presenting both benefits and harms and not be misleading. Most of the grey literature (64%) was sensitive to medical overuse, though none referred explicitly to the problem.<br><br>CONCLUSIONS: Current efforts to address misleading medical marketing on social media often overlook the critical issue of medical overuse and fail to provide sufficient consumer protections in this rapidly evolving digital landscape of social media, such as the speed of dissemination, reach and the role of third-party advertising. These gaps in research, regulation and practice present significant opportunities to strengthen evidence-based policies and public health responses. TRIAL REGISTRATION DETAILS: https://doi.org/10.17605/OSF.IO/2NJSH.}, }
@article {pmid41046898, year = {2025}, author = {Fadaee, M and Mahrooghi, D and Lahouty, M and Oskouei, SA and Nezhadi, J}, title = {Postbiotics and extracellular vesicles: Mechanisms of action and clinical promise in respiratory infections and inflammation.}, journal = {Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases}, volume = {135}, number = {}, pages = {105837}, doi = {10.1016/j.meegid.2025.105837}, pmid = {41046898}, issn = {1567-7257}, mesh = {Humans ; *Extracellular Vesicles ; *Probiotics/therapeutic use ; *Respiratory Tract Infections/therapy/microbiology ; *Inflammation/therapy ; COVID-19 ; SARS-CoV-2 ; Animals ; }, abstract = {Postbiotics are bioactive metabolites and structural components derived from probiotic microorganisms that exert health benefits without the requirement for live bacteria. These include short-chain fatty acids, peptides, polysaccharides, and bacterial cell wall fragments, all of which demonstrate immunomodulatory, anti-inflammatory, and antimicrobial properties. Compared with probiotics, postbiotics are more stable, safer, and increasingly recognized as potential therapeutic agents. Extracellular vesicles (EVs) released by probiotics have likewise emerged as important mediators of host-microbe interactions. In respiratory diseases such as pneumonia, influenza, coronavirus disease 2019 (COVID-19), asthma, cystic fibrosis, tuberculosis, and allergic rhinitis, postbiotics strengthen epithelial barriers, regulate immune responses, disrupt pathogenic biofilms, and enhance the effectiveness of conventional therapies. Their capacity to influence the gut-lung axis further extends their benefits beyond the respiratory system, contributing to systemic immune balance and microbiota homeostasis. Moreover, postbiotics show potential in mitigating antimicrobial resistance by selectively targeting pathogens while preserving commensal microbes. Taken together, the safety, versatility, and therapeutic promise of postbiotics highlight their potential as adjuncts to standard treatments and as innovative strategies for infection control and respiratory health management.}, }
@article {pmid41046876, year = {2025}, author = {Khabarov, IA and Sergazy, SD and Amanzhan, A and Maikenova, AS and Zhabayeva, AN and Adekenov, SM}, title = {Polyphenolic phytosomes for targeted drug delivery.}, journal = {Fitoterapia}, volume = {187}, number = {}, pages = {106920}, doi = {10.1016/j.fitote.2025.106920}, pmid = {41046876}, issn = {1873-6971}, mesh = {Humans ; *Polyphenols/pharmacokinetics/chemistry ; *Drug Delivery Systems ; Biological Availability ; *COVID-19 Drug Treatment ; Animals ; Drug Carriers ; Curcumin ; Phytosomes ; }, abstract = {Currently, the attention of researchers is attracted by natural polyphenolic compounds, including flavonoids, which exhibit pronounced antioxidant, anti-inflammatory, and antitumor properties. More than 8500 phenolic compounds have been isolated and characterized from plant sources. Despite their therapeutic potential, clinical translation is limited by low water solubility, poor membrane permeability, and extensive first-pass metabolism, resulting in suboptimal bioavailability. This review provides a comprehensive analysis of phytosome technology, including the mechanism of complex formation, structural advantages compared to traditional nanocarriers, and its impact on pharmacokinetics and bioefficacy. Polyphenolic compounds, such as silybin, curcumin, quercetin, epigallocatechin gallate (EGCG), and grape seed proanthocyanidins, have been successfully formulated into phytosomes, resulting in a significant enhancement of oral bioavailability and therapeutic efficacy in both preclinical and clinical studies. It also highlights evidence from clinical trials involving phytosomal formulations in various disease contexts, including cancer, liver and metabolic disorders, neurodegeneration, and COVID-19. The safety profile of phytosomes is favorable, with most formulations well-tolerated even under long-term use. Current limitations, including formulation instability, lack of regulatory clarity, and challenges in industrial scale-up, are discussed alongside future directions in targeted delivery and combination therapies. Phytosomes represent a clinically viable platform that bridges natural product pharmacology with modern drug delivery technologies, offering a scalable and biocompatible strategy for improving the clinical impact of polyphenols.}, }
@article {pmid41046202, year = {2025}, author = {Mutsonziwa, GA and Glew, P and Pillay, R}, title = {The influences of nursing students' prevention and control practice behaviours on emerging and re-emerging respiratory viral illnesses: An integrative review and narrative synthesis.}, journal = {Nurse education in practice}, volume = {88}, number = {}, pages = {104564}, doi = {10.1016/j.nepr.2025.104564}, pmid = {41046202}, issn = {1873-5223}, mesh = {Humans ; COVID-19/prevention &amp; control ; Education, Nursing, Baccalaureate ; *Infection Control/methods ; *Respiratory Tract Infections/prevention &amp; control/virology ; *Students, Nursing/psychology ; *Virus Diseases/prevention &amp; control/nursing ; }, abstract = {AIM: To gather, analyse and synthesise empirical evidence regarding the influences of Infection Prevention and Control practice (IPC) behaviours for nursing students on emerging and re-emerging respiratory viral illnesses.<br><br>BACKGROUND: In many countries, undergraduate nursing students are often deployed at the point-of-care, as part of their Professional Experience Placement; where they provide direct care to patients with respiratory viral illnesses. Despite this exceptional situation offering learning opportunities for them, nursing students often endure challenging experiences that have an impact on their learning trajectories. To set up strategies for improvement, an understanding of the influences of their behaviours on IPC practices and care responsibilities in the context of common respiratory viral illnesses is warranted.<br><br>DESIGN: An integrative systematic review and narrative synthesis.<br><br>METHODS: Whittemore and Knafl's (2005) five-step framework was adopted. The databases searched were CINAHL, MEDLINE, Scopus and PsycINFO (August to November 2024). The search process identified sixteen studies, which were screened for quality using the Covidence tool and appraised using Joanna Briggs' checklist. A Synthesis Without Meta-analysis (SWiM) reporting tool was used to ensure transparency in the review process.<br><br>RESULTS: The review included sixteen studies that explored the topic in the context of COVID-19, MERS and Influenza. The overarching influences emerged as Academic Support, Personal Attributes and Point-of-Care Support.<br><br>CONCLUSION: Academic Support, Personal Attributes and Point-of-Care Support influences emphasise a direction for the future nursing workforce's readiness to respond effectively to existing and re-emerging respiratory viral illnesses. Reinvisioning IPC practices for nursing students is crucial for promoting a strong safety culture.}, }
@article {pmid41046104, year = {2025}, author = {Ristroph, KD and Pinkerton, NM and Markwalter, CE and D'Addio, SM and Gindy, ME and Pagels, RF}, title = {20 years of Flash NanoPrecipitation - from controlled precipitation to global medicine.}, journal = {Advanced drug delivery reviews}, volume = {227}, number = {}, pages = {115700}, doi = {10.1016/j.addr.2025.115700}, pmid = {41046104}, issn = {1872-8294}, mesh = {Humans ; *Nanoparticles/chemistry ; *COVID-19 Vaccines/chemistry/administration &amp; dosage ; Chemical Precipitation ; COVID-19/prevention &amp; control ; SARS-CoV-2 ; Drug Delivery Systems/methods ; Nanomedicine/methods ; Lipids/chemistry ; }, abstract = {In the twenty years since the development of Flash NanoPrecipitation (FNP) technology, an antisolvent precipitation technique that uses rapid turbulent mixing to drive self-assembly of polymeric or lipid nanoparticles, the platform has been used for a wide variety of drug delivery applications in research and industry - most notably as the enabling technology for the global manufacture of the Pfizer-BioNTech COMIRNATY® mRNA lipid nanoparticle vaccine against SARS-CoV-2. Importantly, this makes FNP the only publicly-known manufacturing technology for global commercial-scale lipid nanoparticle formulation. This situation makes the technique remarkable and noteworthy and worth discussing broadly, which this article aims to do. It also sets FNP mixing as the benchmark technology against which other LNP manufacturing processes should be compared. Here we review the principles underpinning this continuous antisolvent precipitation technique, its scalability and use with downstream unit operations, and its utility in nanomedicine research. We discuss the current intellectual property landscape surrounding FNP technology and give examples of its industrial implementation for SARS-CoV-2 and low-cost antimalarial formulations. We end with a survey on recent improvements and extensions to the platform that enable the encapsulation of new classes of molecules and greater flexibility in manufacturing as FNP moves into its third decade.}, }
@article {pmid41045746, year = {2026}, author = {Sulaiman, KA and Alharthi, AF and Alqahtani, R and Aljouie, A and Khan, A and Al-Jedai, A and Almoeen, A and Alshennawi, M and Badreldin, HA and Alnasser, LA and Alshehri, AM and Alzahrani, M and Alhaidal, HA and Alhajaji, R and Alotaibi, S and Redhwan, EZ and Alharthi, F and Alghamdi, BG and Alquayt, A and Aljuhani, O}, title = {Ethical, data security, and resource allocation considerations in AI integration for healthcare during Hajj: task force insights and future directions.}, journal = {International journal of medical informatics}, volume = {205}, number = {}, pages = {106123}, doi = {10.1016/j.ijmedinf.2025.106123}, pmid = {41045746}, issn = {1872-8243}, mesh = {Humans ; *Artificial Intelligence/ethics ; *Computer Security/ethics ; *Islam ; Saudi Arabia ; *Resource Allocation/ethics ; *Mass Gatherings ; Advisory Committees ; *Delivery of Health Care/ethics ; COVID-19 ; }, abstract = {BACKGROUND: Hajj represents one of the largest mass gatherings globally, attracting millions of pilgrims annually from various cultural and geographical backgrounds, all coming together to participate in its holy rituals. The unprecedented scale of this event necessitates advanced strategies to ensure safety, and efficiency in resource management. As the use of artificial intelligence (AI) technology becomes increasingly prevalent in managing large-scale gatherings, it raises vital ethical questions regarding privacy, data use, and the risk of mass surveillance. This paper explores the integration of AI during Hajj, with a specific focus on ethical considerations, data security measures, and strategies for allocating limited healthcare and logistical resources.<br><br>METHODS: A task force was formed consisting of experts, including healthcare providers, AI specialists, and representatives from the Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), the Saudi Critical Care Pharmacy Research Platform (SCAPE platform), the Saudi Society of Clinical Pharmacy (SSCP), policymakers, and frontline healthcare practitioners involved in Hajj. The task force initially agreed on the framework and voting system, and consensus was achieved through a voting system that required over 80% agreement.<br><br>RESULTS: The task force identified key focus areas: 1) AI Ethics: Bias, Fairness, Transparency and Explainability. 2) Ethical Deployment in Hajj Healthcare 3) Data Security Considerations: Key Challenges in Data Security, Advanced Security Measures, and Saudi Arabia's Cybersecurity Framework 4) Resource Allocation Considerations: AI for Dynamic Resource Management, Enhancing Healthcare Supply Chain, and Stakeholder Collaboration. The task force developed a comprehensive set of statements designed to provide direction for future initiatives.<br><br>CONCLUSION: Enhancing the integration of AI in healthcare during mass gatherings neccessitates a strong focus on ethical considerations and data security measures. Addressing ethical concerns is crucial to ensure that AI systems are used responsibly and transparently. Robust protocols for data protection must be implemented to safeguard patient information and maintain trust in healthcare systems.}, }
@article {pmid41045689, year = {2025}, author = {Xia, W and Hau, C and Burns, J and Ryan, S and Firth, J and Linardon, J and Torous, J}, title = {Smartphone intervention apps for schizophrenia: A review of the academic literature and app stores.}, journal = {Schizophrenia research}, volume = {285}, number = {}, pages = {204-214}, doi = {10.1016/j.schres.2025.09.007}, pmid = {41045689}, issn = {1573-2509}, mesh = {Humans ; *Schizophrenia/therapy ; *Mobile Applications ; *Smartphone ; *Psychotic Disorders/therapy ; Telemedicine ; COVID-19 ; }, abstract = {BACKGROUND: While the interest and use of apps for anxiety and depression accelerated with COVID-19, less is known about the status of apps for people with schizophrenia and psychosis-spectrum disorders. This study aims to offer a comprehensive overview of the research and commercial app marketplaces (Apple, Android) to assess how recent technological advances translate into tools patients can use today.<br><br>METHODS: In December 2024, we conducted a narrative review for apps related to schizophrenia and coded a brief overview of the studies, eligibility, outcomes and experiences, engagement and features, attrition and adherence, and app availability. We simultaneously conducted a search on the U.S. Google Play and the U.S. Apple App Store for apps denoted in the research literature and other commercially available apps.<br><br>RESULTS: The academic literature search yielded 3753 articles, of which 34 were included. Across these 34 studies, 32 unique apps related to schizophrenia and psychosis were featured. A search of the U.S. app marketplaces yielded only one relevant app peer-reviewed in the last decade and that was broadly accessible to patients.<br><br>CONCLUSION: To realize the full clinical utility of these apps, it is essential to shift the focus toward their specific features and functionalities, supported by more rigorous research and follow-up studies. There is a pressing need for greater standardization in outcome measures and record-keeping practices to ensure consistency and reliability across the field. While the number of commercially available apps has increased, the lack of robust, large-scale controlled studies and standardized controls has resulted in inconsistent findings. Findings highlight the importance of conducting more controlled studies and randomized clinical trials with appropriate controls to strengthen the evidence base and guide the effective implementation of digital health interventions in mental health care.}, }
@article {pmid41045582, year = {2025}, author = {Inoda, A and Suzuki, K and Tomita, H and Okada, H}, title = {Glycocalyx shedding as a clinical biomarker in critical illness.}, journal = {Experimental and molecular pathology}, volume = {144}, number = {}, pages = {104997}, doi = {10.1016/j.yexmp.2025.104997}, pmid = {41045582}, issn = {1096-0945}, abstract = {The endothelial glycocalyx, a carbohydrate-rich layer lining the vascular endothelium, plays a critical role in maintaining vascular homeostasis by regulating permeability, leukocyte adhesion, and inflammatory signaling. Its degradation has been implicated in endothelial dysfunction and organ damage in various diseases. Biomarkers derived from glycocalyx components, particularly Syndecan-1 (SDC-1) and heparan sulfate (HS), can be detected in blood and urine, providing a potential window into vascular injury. In this narrative review, we explore the clinical potential of glycocalyx-derived biomarkers, with a focus on SDC-1, in a broad spectrum of conditions, including sepsis, coronavirus disease, acute respiratory distress syndrome, kidney diseases, cardiovascular disorders, autoimmune diseases, cancer, trauma, and pregnancy-related complications. We highlight the pathophysiological mechanisms of glycocalyx degradation, assess the diagnostic and prognostic utility of SDC-1, and summarize emerging therapeutic strategies to preserve glycocalyx integrity. Given their strong association with disease severity and outcomes, glycocalyx-derived biomarkers may enable earlier diagnosis, improved risk stratification, and personalized treatment, supporting more informed clinical decision-making across diverse medical conditions.}, }
@article {pmid41045404, year = {2025}, author = {Ahmed, H and Abideen, ZU and Azmat, A and Irfan, M and Anjum, S and Dirie, A}, title = {Impact of COVID-19 on the prevalence of multi-drug-resistant bacteria: a literature review and meta-analysis.}, journal = {Antonie van Leeuwenhoek}, volume = {118}, number = {11}, pages = {165}, pmid = {41045404}, issn = {1572-9699}, mesh = {Humans ; *COVID-19/epidemiology ; *Drug Resistance, Multiple, Bacterial ; Prevalence ; SARS-CoV-2 ; *Bacterial Infections/epidemiology/microbiology ; Anti-Bacterial Agents/pharmacology/therapeutic use ; *Bacteria/drug effects ; }, abstract = {The COVID-19 pandemic affected the global healthcare delivery system, raising concerns about its influence on antimicrobial resistance (AMR). This systematic review and meta-analysis assessed the impact of the COVID-19 pandemic on the prevalence of MDR bacteria in different healthcare environments. A systematic search was carried out in PubMed-MEDLINE, Embase, Web of Science, BIOSIS, Scopus, and Google Scholar for articles published from December 2019 to January 2024. After screening 77 full-text studies, 28 studies were included in the analysis. The inclusion criteria included original human studies presenting MDR bacteria incidence before and during/after COVID-19 with reference to Carbapenem-resistant Acinetobacter baumannii, Carbapenem-resistant Enterobacteriaceae, Vancomycin Resistant Enterococci, Carbapenem-Resistant Pseudomonas aeruginosa, Methicillin-resistant Staphylococcus aureus, and Extended-Spectrum Beta-Lactamase-producing Enterobacteriaceae. The overall odds ratio (OR = 0.91, 95% CI: 0.70-1.17) indicates no significant change in the prevalence of multidrug-resistant (MDR) bacterial infection between the pre-COVID-19 and the COVID-19 period. There was no significant change in the prevalence of MRSA, ESBL, and VRE pre- and post-COVID. However, there was a significant reduction in the prevalence of CR-Ab, CRE, and CRPA pre- and during/after-COVID-19. MDR prevalence was significantly increased in Asia (18%) while it decreased slightly in North America (10.3%), showing variations in antibiotic use. The findings show that COVID-19 has different effects on the prevalence of MDR bacteria across geographical regions and healthcare facilities.}, }
@article {pmid41045051, year = {2025}, author = {Longacre, MM and Ibla, JC}, title = {TEG and ROTEM: Technology and Clinical Applications, 2026 Update.}, journal = {American journal of hematology}, volume = {100}, number = {12}, pages = {2357-2370}, doi = {10.1002/ajh.70074}, pmid = {41045051}, issn = {1096-8652}, mesh = {Humans ; *Thrombelastography/methods/instrumentation ; COVID-19/blood ; *Blood Coagulation Disorders/diagnosis/blood ; SARS-CoV-2 ; }, abstract = {Viscoelastic testing (VET) has evolved significantly since its inception in the mid-20th century, when it was first developed to guide transfusion strategies in trauma and surgical patients. Initially, VET technologies such as TEG and ROTEM assessed clot formation by measuring the mechanical resistance of a pin or piston within a blood sample. Recent advances have introduced automated, cartridge-based systems and novel detection methods-including resonance frequency and ultrasound-based sonorheometry-these new systems allow for more precise, rapid, and user-friendly assessment of clot dynamics at the point of care. VET is now indicated for a wide range of clinical scenarios where complex coagulopathy is anticipated, including trauma, cardiac surgery, liver transplantation, obstetric hemorrhage, and hematologic disorders such as DIC. Its use is expanding into new populations, including pediatric cardiac surgery, patients with inflammatory bowel disease, and those with COVID-19. However, VET remains limited in its ability to reliably detect therapeutic anticoagulants and certain congenital bleeding disorders, such as von Willebrand disease and deficiencies of protein C, S, and antithrombin. Technical limitations, including potential discrepancies between in vitro and in vivo clot formation, and lack of FDA approval for pediatric use have imposed implementation barriers to centers interested in pediatric VET. Looking forward, the integration of VET data with electronic medical records, the development of predictive models, artificial intelligence, and continued innovation in platelet function assessment and detection technologies are poised to enhance the clinical utility of VET. As guidelines and evidence continue to evolve, VET is positioned to become an increasingly important tool for real-time, individualized management of coagulopathy in diverse patient populations.}, }
@article {pmid41044982, year = {2025}, author = {Yıldız, E}, title = {Ethical Big Data for Personalised Mental Health Nursing: A P4 and Systems View.}, journal = {Journal of psychiatric and mental health nursing}, volume = {32}, number = {6}, pages = {1404-1411}, doi = {10.1111/jpm.70038}, pmid = {41044982}, issn = {1365-2850}, mesh = {Humans ; *Big Data ; *Psychiatric Nursing/ethics ; *Precision Medicine/ethics ; *COVID-19 ; }, abstract = {BACKGROUND: Mental health nursing faces transformation through big data and metadata integration. These technologies create new opportunities but introduce ethical and practical complexities. Digital adoption accelerated during COVID-19, making it essential to understand implications for nursing practice.<br><br>AIM: This perspective paper aims to critically examine the transformative potential and ethical dilemmas of leveraging big data in mental health nursing, guided by systems biology and P4 (Predictive, Preventive, Personalised, and Participatory) medicine principles. It seeks to define the evolving roles of mental health nurses in this new digital landscape.<br><br>METHOD: This perspective essay utilises a focused literature review of key studies in nursing, psychiatry, informatics, and ethics, alongside theoretical approaches including systems biology, P4 medicine, and a personalist ethical framework. The analysis explores the integration of big data, focusing on potential benefits, risks, and ethical considerations.<br><br>RESULTS: Big data contributes meaningfully to early diagnosis, personalised treatments, and prevention strategies. However, these contributions must supplement, not substitute, traditional nursing approaches. AI diagnostic tools and digital phenotyping for relapse prediction demonstrate practical applications. Excessive algorithmic dependence risks damaging patient-nurse relationships. Data privacy, algorithmic bias, and access inequities present significant ethical challenges requiring careful attention.<br><br>CONCLUSION: Big data implementation should enhance, not replace, human interaction in mental health nursing. A new synthesis is proposed where data-driven insights support efficiency, allowing nurses more time for complex emotional needs. Key recommendations include strengthening data literacy in nursing education, developing robust data governance policies, and establishing comprehensive ethical principles to preserve the essential human dimension of care and ensure equitable access.}, }
@article {pmid41044254, year = {2025}, author = {Nayak, S and Reddy, BN and Kintali, SV}, title = {The invisible agitators: exploring the viral interplay in psoriatic immune dysregulation.}, journal = {Immunologic research}, volume = {73}, number = {1}, pages = {140}, pmid = {41044254}, issn = {1559-0755}, mesh = {Humans ; *Psoriasis/immunology/virology ; *Virus Diseases/immunology/complications ; *SARS-CoV-2/immunology ; Animals ; *COVID-19/immunology ; Cytokines/metabolism ; }, abstract = {This review explores the complex interplay between viral infections and psoriasis. It emphasizes how viruses like HIV, hepatitis, herpes, human papillomavirus, and SARS-CoV-2 can provoke and worsen psoriatic inflammation by disturbing immune balance. A key focus of the discussion is the IL-23/Th-17 pathway, which drives the production of proinflammatory cytokines that promote keratinocyte overgrowth and perpetuate chronic skin inflammation. Our article further investigates how disrupted intracellular pathways-such as those involving PI3K, Wnt signaling, and caveolin-affect the severity of the disease. This review supports the idea that viral infections can not only trigger psoriatic lesions but may also increase the risk of additional viral reactivation, thereby complicating the clinical picture of psoriasis. This thorough evaluation highlights the necessity for focused research to create innovative therapeutic strategies aimed at these viral triggers.}, }
@article {pmid41042687, year = {2025}, author = {McElrone, M and Holden, E and Brown, C and Ballew, J}, title = {Evaluating the Implementation of Public Health Strategies to Address COVID-19 Disparities in a Community Setting: A Qualitative Study Using the RE-AIM Framework.}, journal = {Public health nursing (Boston, Mass.)}, volume = {}, number = {}, pages = {}, doi = {10.1111/phn.70021}, pmid = {41042687}, issn = {1525-1446}, support = {//Office of the Assistant Secretary for Health/ ; #1CPIMP211293-01-00//Office of Minority Health (OMH)/ ; }, abstract = {BACKGROUND: Health disparities, particularly among racial and ethnic minority populations, were exacerbated by the COVID-19 pandemic due to factors like social determinants of health, vaccine hesitancy, and pre-existing health conditions. Local government leaders within an urban city received federal funds to address these disparities by improving health literacy and engaging in culturally responsive outreach and education among Black and Latinx communities within a mid-sized city in the southeastern United States.<br><br>OBJECTIVE: To identify facilitators and barriers to implementing public health strategies aimed at addressing COVID-19 health disparities in a community guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.<br><br>DESIGN: The research team conducted qualitative, semi-structured interviews via telephone, Zoom, or in person between March 20th and April 12th, 2024.<br><br>PARTICIPANTS/SETTING: Fifteen participants, including local governmental health office staff (e.g., nurse navigators, administrative staff) and employees from community center partner sites, were included in the study.<br><br>ANALYSIS: Two coders applied both a priori codes guided by the RE-AIM framework and data-driven inductive codes to transcripts in NVivo 14. A final interrater reliability measurement, Cohen's kappa coefficient (k&#xa0;=&#xa0;0.74), was calculated, indicating a moderate level of agreement between coders. NVivo 14 data visualization tools (e.g., coding matrices) were used to inform thematic content analysis.<br><br>RESULTS: Themes were identified within each RE-AIM dimension, highlighting various facilitators and barriers to implementing the selected public health strategies. Working in synergy with community center staff and other community partners to create tailored services and resources was vital for successful implementation. Transparency and timely communication, additional full-time program implementers (i.e., nurse navigators), and sustainable funding sources were identified as key elements to enhance effective implementation.<br><br>CONCLUSIONS: Insights from the local governmental health office and community center staff's experiences in this study highlight recommendations for effective implementation of locally tailored public health strategies to address COVID-19 health disparities in similar community-based settings. Future research should capture the perceptions and experiences of community members to better understand acceptability, accessibility, and utilization in similar initiatives.}, }
@article {pmid41041753, year = {2025}, author = {Theofilou, PE and Bonotis, P and Angelidis, P}, title = {Real-World Breast Cancer Mobile Applications for Patients in the Treatment Stage: A Post-Pandemic Scoping Review.}, journal = {Studies in health technology and informatics}, volume = {332}, number = {}, pages = {93-97}, doi = {10.3233/SHTI251503}, pmid = {41041753}, issn = {1879-8365}, mesh = {Humans ; *Mobile Applications ; *Breast Neoplasms/therapy ; *COVID-19/epidemiology ; Female ; *Telemedicine ; SARS-CoV-2 ; Pandemics ; }, abstract = {Many current digital health tools are not designed to support the complex needs of breast cancer patients undergoing active treatment, even though they frequently endure severe physical and emotional burdens. This gap is particularly important given the growing dependence on mobile health (mHealth) technologies, which have been accelerated by the COVID-19 pandemic. This scoping review aims to identify mobile health applications for breast cancer published since 2020, and to analyze their core functionalities, target populations, and reported limitations. Following PRISMA-ScR guidelines, we included primary studies describing real-world use beyond prototype or pilot phases. Five unique apps were identified, most offering lifestyle coaching, symptom tracking, or psycho-oncological support. This review serves as an initial step toward understanding the current digital landscape, with the goal of informing the development of a new application grounded in real patient needs and designed through participatory methodologies.}, }
@article {pmid41041361, year = {2025}, author = {Dascalu, S and Raiu, CV and Olteanu, E and Comanici, AV and Comanici, MM and Toma, TP and Robu, BI and Mihailov, R and Mina-Raiu, L and Dumitra, GG and Azoicai, D and Popovici, ED and Apetrei, C}, title = {The deadly triple M (mistrust, misinformation, and missed opportunities): understanding Romania's COVID-19 vaccination campaign and its lasting impact on public health.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1631799}, pmid = {41041361}, issn = {2296-2565}, mesh = {Humans ; Romania/epidemiology ; *COVID-19/prevention &amp; control/epidemiology ; *Public Health ; *Communication ; *COVID-19 Vaccines/administration &amp; dosage ; *Vaccination Hesitancy/psychology ; *Trust ; *Immunization Programs ; SARS-CoV-2 ; Politics ; *Vaccination ; Health Policy ; }, abstract = {Romania's COVID-19 vaccination campaign presents a compelling case study on the intersection of public health policy, societal dynamics, and political influences in pandemic response. Despite an initially promising rollout, Romania ultimately achieved one of the lowest vaccination rates in the European Union, with severe consequences during the subsequent pandemic waves. This review examines the key factors contributing to the campaign's shortcomings, including pre-existing vaccine hesitancy, widespread misinformation, inadequate governmental communication strategies, and the politicisation of public health efforts. We explore the deep-seated mistrust in governmental institutions, exacerbated by restrictive measures implemented without adequate public engagement, as well as the influential role of religious communities and the rise of populist political forces that actively opposed vaccination efforts. Additionally, we discuss the impact of media sensationalism, conspiracy theories, and the failure to regulate anti-vaccine rhetoric within the medical profession. While logistical and infrastructural challenges were largely addressed, the inability to effectively engage key societal stakeholders led to lagging of vaccine uptake. The consequences of this failure extended beyond COVID-19, contributing to a severe measles outbreak in 2023, which underscored the long-term deleterious effects of vaccine hesitancy. Drawing from Romania's experience, we highlight critical lessons for future public health campaigns, emphasising the need for trust-building initiatives, targeted misinformation countermeasures, stronger community engagement, and enhanced collaboration with religious and cultural institutions. By addressing these challenges, countries worldwide can strengthen their public health frameworks and improve the resilience of their immunisation programmes in the face of future crises.}, }
@article {pmid41041302, year = {2025}, author = {Chen, Z and Wan, C and Chen, B and Mo, Q and Ju, M and Deng, K and Li, X and Qin, D}, title = {Immunogenicity and safety of the booster COVID-19 vaccine among people with HIV: a systematic review and meta-analysis.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1668576}, pmid = {41041302}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology ; *COVID-19 Vaccines/immunology/adverse effects/administration &amp; dosage ; *HIV Infections/immunology ; *Immunization, Secondary/adverse effects ; *SARS-CoV-2/immunology ; *Immunogenicity, Vaccine ; Seroconversion ; Antibodies, Viral/blood ; }, abstract = {BACKGROUND: Human immunodeficiency virus (HIV) and COVID-19 continue to pose significant global public health challenges. Although vaccination is essential for preventing COVID-19 in people with HIV (PWH), evidence on the immunogenicity and safety of booster doses remains limited. This systematic review aimed to assess the immunogenicity and safety of COVID-19 booster vaccination in PWH.<br><br>METHODS: We conducted a comprehensive literature search in PubMed, EMBASE, and the Cochrane Library. Eligible studies included PWH who had received three or more doses of a COVID-19 vaccine.<br><br>RESULTS: Across 54 included studies, 4,685 of 5,229 PWH achieved seroconversion following a third or subsequent COVID-19 vaccine dose-an improvement over rates observed after the primary vaccine series. In 23 studies comparing 2,284 PWH with 1,813 healthy controls (HC), no significant differences in seroconversion rates were found (p &#x2265; 0.05). Among PWH, 22 studies reported significantly higher seroconversion rates in individuals with CD4[+] T cell counts >200 cells/mm&#xb3; compared to those with counts <200 cells/mm&#xb3;. Booster vaccination enhanced CD4[+] T cell responses to levels comparable to HC, although CD8[+] T cell responses remained markedly lower. Five studies reported adverse events following booster doses, none of which were classified as serious.<br><br>CONCLUSION: COVID-19 booster vaccination is effective in enhancing immune protection and reducing severe disease in PWH. Optimal vaccine dosing is especially important in individuals with low CD4[+] T cell counts. Tailoring booster strategies may improve seroconversion and overall immune response in this population.<br><br>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024605151.}, }
@article {pmid41041288, year = {2025}, author = {Jiang, Q and Jiang, M and Lv, Y and Zhang, X and Wang, S and Zhao, J}, title = {Disulfiram as an anti-inflammatory agent: mechanisms, nano-delivery strategies, and applications in non-oncologic diseases.}, journal = {RSC advances}, volume = {15}, number = {43}, pages = {36344-36364}, pmid = {41041288}, issn = {2046-2069}, abstract = {Disulfiram (DSF), an FDA-approved drug for alcoholism, has recently emerged as a potent anti-inflammatory agent. It achieves this by targeting gasdermin D (GSDMD)-mediated pyroptosis, a key driver of inflammatory responses. This review explores the multifaceted anti-inflammatory mechanisms of DSF, including its inhibition of GSDMD pore formation, modulation of the STING pathway, suppression of RIPK1-dependent necroptosis, and disruption of FROUNT-mediated macrophage migration. Despite its promising in vitro efficacy, DSF's clinical application is hindered by its poor solubility, low bioavailability, and rapid metabolism. To overcome these limitations, advanced nano-delivery carriers-such as lipid-based nanoparticles, polymeric carriers, metal-organic frameworks, and peptide conjugates-have been developed to enhance targeted delivery, prolong circulation, and reduce off-target effects. These innovations hold significant promise for the treatment of diverse inflammatory diseases, including respiratory disorders (e.g., COVID-19 and acute lung injury), autoimmune conditions (e.g., lupus and graft-versus-host disease), and metabolic ailments (e.g., hepatitis and colitis). While challenges remain in clinical translation, integrating DSF with nanotechnology offers a transformative approach to harnessing its anti-inflammatory properties. This review highlights current advancements, unresolved questions, and future directions for optimizing DSF-based therapies in inflammation management.}, }
@article {pmid41041226, year = {2025}, author = {Bhardwaj, P and Joshi, NK and Bhati, Y and Goel, AD and Jain, YK and Soni, JK and Singh, P}, title = {Effectiveness of pressure swing adsorption oxygen plants: A scoping review in Indian context.}, journal = {Journal of family medicine and primary care}, volume = {14}, number = {8}, pages = {3179-3185}, pmid = {41041226}, issn = {2249-4863}, abstract = {CONTEXT: Pressure swing adsorption (PSA) is a gas separation technique that separates some gas species from a mixture of gases under pressure based on the species' molecular characteristics and affinity for an adsorbent material. During the peak of the coronavirus pandemic, the need for medical oxygen was critical due to the overwhelming surge in respiratory-related cases. The establishment of PSA plants across the country was a strategic move to ensure a continuous and reliable supply of oxygen to healthcare facilities.<br><br>OBJECTIVES: The objective of this review was to systematically collect and assess evidence regarding the effectiveness of PSA.<br><br>DESIGN: A scoping review was carried out using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist.<br><br>STUDY SELECTION: Studies, reports, review articles, and gray literature that addressed the economic viability, ease of operation, overall feasibility, and reliability of PSA plants in the Indian context were particularly considered for inclusion.<br><br>MAIN OUTCOME MEASURES: This review aims to assess the effectiveness of PSA technology, focusing on its cost efficiency, user-friendliness, overall feasibility, and reliability. The goal is to offer a clear understanding of the practical implications and outcomes related to the adoption of PSA plants in the Indian context.<br><br>RESULTS: Sixty-four relevant records were reviewed and analyzed. After considering all the eligibility criteria 33 records were included. The scoping review revealed the different characteristics of PSA plant. A total of six studies from the reviewed literature collectively state that this advancement marks a significant progress toward establishing a dependable and renewable supply of medical-grade oxygen, eliminating the dependency on external sources, and thereby enhancing hospital security.<br><br>CONCLUSION: This review showed that properly maintained, and operated, PSA oxygen plants can be highly effective in providing a reliable source of medical-grade oxygen, especially in higher level of health facility where patient load is more.}, }
@article {pmid41039591, year = {2025}, author = {Katzmarzyk, D and Holle, D and Roes, M}, title = {Implementing PTSD interventions for hospital nurses and physicians during COVID-19: A scoping review.}, journal = {Archives of public health = Archives belges de sante publique}, volume = {83}, number = {1}, pages = {235}, pmid = {41039591}, issn = {0778-7367}, abstract = {BACKGROUND: Nurses and physicians in hospitals are particularly affected by the impacts of the COVID-19 pandemic as shown in the high prevalence of post-traumatic stress disorder (PTSD). To handle the urgent and high demand for psychological support, PTSD-related interventions had to be applied rapidly. Thus, interventions that were already evidence-based were adapted to pandemic conditions, or new interventions were developed. To implement these interventions sustainably, and be prepared for future disease outbreaks, we need to identify which strategies are necessary for the successful implementation. From this perspective, four years after the COVID-19 outbreak, we address the following: What are the [1] interventions that address symptoms of post-traumatic stress disorder in hospital-based nurses and physicians during the COVID-19 pandemic? What are the [2] implementation strategies for the identified interventions?<br><br>METHODS: We used a scoping review approach and conducted a literature search from February to April 2023 in PubMed, PsychINFO and CINHAL. Primary studies (protocols) and concept papers focused on PTSD-related interventions for nurses and physicians and their implementation in hospitals during the COVID-19 pandemic, and published between 2020 and 2023 were included. Data extraction and analysis were performed in MaxQDA using deductive content analysis based on the (a) template for intervention description and replication (TIDieR) and the (b) Expert recommendations for implementing change (ERIC) framework.<br><br>RESULTS: A total of 16 interventions were adapted or developed world wide&#xa0;during the COVID-19 pandemic between 2020 and 2023. Evidence of effectiveness exist in only&#xa0;six of the 16 interventions. Most of them were designed using digital approaches and were&#xa0;primarly delivered through iterative implementation cycles,&#xa0;whereas the implementation of face-to-face interventions focused on interactions with various stakeholders.<br><br>CONCLUSION: Our findings can be used to support the implementation of PTSD-related interventions for nurses and physicians in hospitals under pandemic conditions. Future research should focus on evaluating the effectiveness of these interventions and identifying strategies for a&#xa0;beneficial and sustainable implementation.}, }
@article {pmid41039517, year = {2025}, author = {Sänger, N and Elling, JM and Hetzel, C and Schwarz, B}, title = {Return to work for people with chronic health conditions after medical or vocational rehabilitation during the COVID-19 pandemic: a scoping review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3292}, pmid = {41039517}, issn = {1471-2458}, support = {0421/40-64-50-91//German Pension Insurance/ ; 0421/40-64-50-91//German Pension Insurance/ ; 0421/40-64-50-91//German Pension Insurance/ ; 0421/40-64-50-91//German Pension Insurance/ ; }, abstract = {PURPOSE: This review aimed to identify factors that acted as facilitators or barriers for returning to work (RTW) for people with chronic conditions following medical or vocational rehabilitation during the COVID-19 pandemic.<br><br>METHODS: A scoping review was conducted on PubMed, Web of Science, EBSCOHost and Epistemonikos. Additional articles were identified via Google Scholar and citation tracking. All retrieved reports were screened, narratively reported and consolidated into a model aligned with the International Classification of Functioning, Disability and Health (ICF). This model illustrates how the COVID-19 pandemic may have influenced RTW for people with chronic health conditions.<br><br>RESULTS: The search yielded n&#x2009;=&#x2009;1,720 hits. After removing duplicates (n&#x2009;=&#x2009;807) and screening for eligibility, n&#x2009;=&#x2009;57 articles met the inclusion criteria. Further articles were identified via Google Scholar (n&#x2009;=&#x2009;23) and citation tracking (n&#x2009;=&#x2009;18), resulting in a total number of n&#x2009;=&#x2009;98 included reports. n&#x2009;=&#x2009;3 articles explicitly examined RTW during the pandemic. Further articles addressed medical rehabilitation (n&#x2009;=&#x2009;39), occupational health management (n&#x2009;=&#x2009;21), work ability and labor market (n&#x2009;=&#x2009;17), health services (n&#x2009;=&#x2009;10) and vocational rehabilitation (n&#x2009;=&#x2009;7). Most reports were published in scientific journals (83%). A variety of possible barriers and facilitators of RTW during the pandemic were identified, clustered according to the ICF components and integrated into a corresponding model.<br><br>CONCLUSION: RTW during the COVID-19 pandemic has not been extensively studied yet. However, several facilitators (e.g., flexibility, remote work, time for recovery) but also barriers (e.g., therapy interruptions, increased stress, risk of infection) for RTW of people with chronic health conditions were identified. Despite mixed outcomes, these findings provide a broad overview of how the pandemic likely impacted RTW processes. Further research is needed to directly assess its effects on RTW outcomes.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-24769-8.}, }
@article {pmid41039149, year = {2025}, author = {Chilton, CH and Viprey, V and Normington, C and Moura, IB and Buckley, AM and Freeman, J and Davies, K and Wilcox, MH}, title = {Clostridioides difficile pathogenesis and control.}, journal = {Nature reviews. Microbiology}, volume = {}, number = {}, pages = {}, pmid = {41039149}, issn = {1740-1534}, abstract = {Clostridioides difficile infection (CDI) continues to be a notable burden worldwide, both in terms of patient mortality and morbidity, and the economic costs associated with treatment, diagnosis and management. The epidemiology of C. difficile has changed markedly over the decades, with high CDI rates driven by clinical pressures exacerbated by the severe acute respiratory syndrome coronavirus 2 pandemic, antibiotic resistance and selective pressures caused by antimicrobial use. C. difficile is challenging to diagnose and treat as it forms spores and can persist asymptomatically within the gut. Some strains express multiple virulence factors, including adhesins and toxins. The gut microbiota is crucially important in CDI, as a healthy microbiota is resistant to colonization with C. difficile. Dysbiosis, often caused by antimicrobial exposure, enables C. difficile spores to germinate and produce toxin, causing symptoms that can range from mild diarrhoea to fulminant colitis and death. This Review describes changes in epidemiology and effects on diagnosis, discusses recent breakthroughs in the understanding of pathogenesis and antibiotic resistance and explores the role of microbiota dysbiosis in CDI and novel microbiota therapies in CDI treatment.}, }
@article {pmid41038267, year = {2025}, author = {Thomas, D and Yang, PC and Wu, JC and Sayed, N}, title = {Decoding long COVID-associated cardiovascular dysfunction: Mechanisms, models, and new approach methodologies.}, journal = {Journal of molecular and cellular cardiology}, volume = {209}, number = {}, pages = {37-50}, pmid = {41038267}, issn = {1095-8584}, support = {R01 HL161002/HL/NHLBI NIH HHS/United States ; R01 HL130020/HL/NHLBI NIH HHS/United States ; R01 HL176822/HL/NHLBI NIH HHS/United States ; R01 HL146690/HL/NHLBI NIH HHS/United States ; K01 HL135455/HL/NHLBI NIH HHS/United States ; R35 HL150698/HL/NHLBI NIH HHS/United States ; K99 HL163443/HL/NHLBI NIH HHS/United States ; R01 HL145676/HL/NHLBI NIH HHS/United States ; R01 HL158641/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/virology/pathology ; *Cardiovascular Diseases/etiology/virology/physiopathology/pathology ; *SARS-CoV-2 ; Animals ; Induced Pluripotent Stem Cells ; Post-Acute COVID-19 Syndrome ; }, abstract = {The COVID-19 pandemic has revealed that the impact of SARS-CoV-2 infection extends well beyond the acute phase, with long-term sequelae affecting multiple organ systems, most notably, the cardiovascular system. Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by persistent symptoms such as fatigue, dyspnea, chest pain, and palpitations, which can last for months or even years after initial recovery. Increasing evidence implicates immune dysregulation, endothelial dysfunction, persistent viral antigens, and coagulopathy as central drivers of cardiovascular complications. Mechanistic studies demonstrate that direct viral infection of cardiac and vascular cells, along with autoantibody formation and cytokine-mediated injury, contribute to myocardial inflammation, fibrosis, and arrhythmias. Sex-based immunological differences and underlying comorbidities further influence individual susceptibility and disease trajectory. Large-scale epidemiological studies have confirmed significantly increased risks of pericarditis, cardiomyopathy, dysrhythmias, and heart failure among COVID-19 survivors. In parallel, the emergence of advanced preclinical platforms, including patient-derived induced pluripotent stem cell (iPSC)-based cardiac organoids, engineered heart tissues, and organ-on-a-chip systems has enabled mechanistic dissection of Long COVID pathophysiology. These human-relevant models, when integrated with clinical datasets and artificial intelligence (AI)-driven analytics, offer powerful tools for biomarker discovery, risk stratification, and precision therapeutic development. This review synthesizes the current understanding of cardiovascular involvement in Long COVID, highlights key mechanistic insights from both clinical and preclinical studies, and outlines future directions for diagnostic and therapeutic innovation.}, }
@article {pmid41037996, year = {2025}, author = {Beran, RK and Vijjapurapu, A and Nair, V and Du Pont, V}, title = {Host-targeted antivirals as broad-spectrum inhibitors of respiratory viruses.}, journal = {Current opinion in virology}, volume = {73}, number = {}, pages = {101492}, doi = {10.1016/j.coviro.2025.101492}, pmid = {41037996}, issn = {1879-6265}, mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use ; *Respiratory Tract Infections/drug therapy/virology ; Animals ; Virus Replication/drug effects ; *Viruses/drug effects ; *Host-Pathogen Interactions/drug effects ; SARS-CoV-2/drug effects ; }, abstract = {Respiratory viruses, including influenza virus, respiratory syncytial virus, human rhinovirus, and severe acute respiratory syndrome coronavirus 2, are among the leading causes of acute respiratory infections worldwide. Strategies for antiviral drug development include direct-acting antivirals (DAAs), which inhibit viral proteins, or host-targeting antivirals (HTAs), which target host factors required for the viral life cycle. DAAs are often virus-specific, leaving gaps for emerging viruses such as novel coronaviruses and influenza viruses, or less common respiratory viruses such as human metapneumovirus. Moreover, DAAs are prone to viral resistance due to the low fidelity of viral polymerases, whereas HTAs act on conserved host proteins that are less susceptible to viral escape due to greater genetic stability. A variety of HTAs are currently being investigated that target viral entry, replication, assembly, or egress. The key challenges for the development of effective broad-spectrum HTAs are related to safety and translation of in vitro potency to in vivo efficacy. This review examines host factors crucial for respiratory virus lifecycles - including sialic acid receptors, lipids, phosphoinositide kinases, mitogen-activated protein kinases, cellular helicases, and nucleotide biosynthesis pathways - and the small-molecule inhibitors and biologics that are being explored to target them.}, }
@article {pmid41037977, year = {2026}, author = {Muñoz, J and Ruíz-Cacho, R and Fernández-Araujo, NJ and Candela, A and Visedo, LC and Muñoz-Visedo, J}, title = {Systematic review and meta-analysis of artificial intelligence models for diagnosing and subphenotyping ARDS in adults.}, journal = {Heart &amp; lung : the journal of critical care}, volume = {75}, number = {}, pages = {144-163}, doi = {10.1016/j.hrtlng.2025.09.017}, pmid = {41037977}, issn = {1527-3288}, mesh = {Humans ; *Respiratory Distress Syndrome/diagnosis ; *Artificial Intelligence ; Adult ; Phenotype ; }, abstract = {BACKGROUND: Artificial intelligence (AI) has emerged as a promising tool to improve the diagnosis and characterization of ARDS, including the identification of subphenotypes.<br><br>OBJECTIVES: To evaluate the diagnostic performance and methodological quality of AI models for identifying ARDS and its subphenotypes in adults.<br><br>METHODS: We conducted a systematic review and meta-analysis of 63 studies (n = 135,762) published between 2013 and 2024 in PubMed, Embase, and the Cochrane Library. Extracted outcomes included sensitivity, specificity, AUROC, and validation methods. Risk of bias was assessed with PROBAST, and AI-specific metrics (overfitting, generalization, interpretability, discrimination, calibration) were reported.<br><br>RESULTS: Pooled sensitivity was 0.89 (95 % CI 0.84-0.93), specificity 0.88 (95 % CI 0.83-0.92), and AUROC 0.90 (95 % CI 0.86-0.94), with high heterogeneity (I&#xb2; > 85 %). Twenty-two studies (31 %) were rated high quality, with sensitivity 0.86 (95 % CI 0.82-0.89) and specificity 0.82 (95 % CI 0.78-0.85). Deep learning models (n = 14) achieved sensitivity 0.91, while machine learning models (n = 19) showed 0.87. Imaging-based models (n = 15) outperformed non-imaging approaches. COVID-19 studies (n = 9) reported sensitivity 0.90 with comparable AUROC and specificity. Only seven studies (18 %) investigated subphenotyping, identifying hyperinflammatory and hypoinflammatory profiles with potential therapeutic relevance. Calibration reporting was missing in 47 % and external validation in most (29/63).<br><br>CONCLUSION: AI models for ARDS demonstrate promising diagnostic accuracy but are limited by poor calibration and scarce external validation. Subphenotyping remains exploratory but suggests opportunities for real-time patient stratification. Prospective validation and standardized reporting are essential for clinical adoption.}, }
@article {pmid41037751, year = {2025}, author = {Johnson, KL and Gordon, MS and Gordon, HG}, title = {Comparing Prevalence of Burnout in Psychiatric Doctors Before and After the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.}, journal = {The Journal of clinical psychiatry}, volume = {86}, number = {4}, pages = {}, doi = {10.4088/JCP.24r15697}, pmid = {41037751}, issn = {1555-2101}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Burnout, Professional/epidemiology ; Prevalence ; *Psychiatry/statistics &amp; numerical data ; *Physicians/psychology/statistics &amp; numerical data ; Pandemics ; SARS-CoV-2 ; }, abstract = {Objective: To determine the prevalence of burnout among psychiatry residents, fellows, and attendings ("psychiatry doctors") prior to and following the COVID-19 pandemic. Data sources: A systematic search of MEDLINE, Embase, PsycINFO, and PubMed databases was performed to identify studies reporting the prevalence of burnout pre-COVID-19 (pre-March 2020) and post-COVID-19 (post March 2020). The search was limited to articles written in English and published in peer-reviewed journals from January 1, 2010, until June 27, 2024. Study selection: There were 1,825 studies screened by 2 independent reviewers, with 36 eligible for inclusion. Observational studies and randomized controlled trials reporting the prevalence of burnout using validated tools were eligible for inclusion. Data extraction: Prevalence data were independently extracted by 2 authors and pooled using a random effects model. A subgroup analysis was performed, stratifying burnout by country income status. Results: The prevalence of burnout was 37.5% (95% confidence interval [CI], 28.2-47.3; 25 studies; 12,524 psychiatry doctors) prior to the COVID-19 pandemic and 32.0% (95% CI, 18.6-47.0; 12 studies; 7,458 psychiatry doctors) following the COVID-19 pandemic. Almost 1 in 2 psychiatry doctors from middle-income countries reported burnout pre-COVID-19 (49.8% [95% CI, 34.5-65.1]; 3 studies), with no studies reporting the prevalence of burnout in low-income countries. There was significant heterogeneity between studies. Conclusions: Burnout among psychiatry doctors is common, affecting 1 in 3 both prior to and following the COVID-19 pandemic. Additional studies are needed from psychiatrists in low- and middle-income countries to better characterize the prevalence of burnout in this cohort.}, }
@article {pmid41037459, year = {2025}, author = {Masuoka, S and Hiyama, T and Ishiguro, T and Saida, T and Kano, S and Miyazaki, O and Matsuki, M and Minami, M and Chernyak, V and Mori, H and Nakajima, T}, title = {Practical Imaging Approach to Determining the Cause of Nonneoplastic Lymphadenopathy.}, journal = {Radiographics : a review publication of the Radiological Society of North America, Inc}, volume = {45}, number = {11}, pages = {e240147}, doi = {10.1148/rg.240147}, pmid = {41037459}, issn = {1527-1323}, mesh = {Humans ; *Lymphadenopathy/diagnostic imaging/etiology ; Diagnosis, Differential ; *Lymphatic Diseases/diagnostic imaging/etiology ; }, abstract = {In the daily clinical practice of radiologists, unexpected lymphadenopathy is frequently encountered, the majority of which is nonneoplastic. The causes of nonneoplastic lymphadenopathy are variable, and nonspecific histologic findings may challenge the accurate diagnosis. Therefore, inferring or identifying the cause based on imaging findings carries substantial clinical relevance. The causes of nonneoplastic lymphadenopathy can be broadly categorized as follows: (a) infections that lead to lymphadenitis; (b) systemic disorders such as sarcoidosis, Kawasaki disease, rheumatoid arthritis, systemic lupus erythematosus, immunoglobulin G4-related disease, Castleman disease, dermatopathic lymphadenopathy, and histiocytosis; (c) iatrogenic causes including drug-induced lymphadenopathy and COVID-19 vaccine-related lymphadenopathy; and (d) miscellaneous causes including congestion from heart failure, foreign body lymphadenopathy from substances such as silicone, epithelial inclusions in lymph nodes, and tumor-associated reactive lymphadenopathy. The distribution of lymphadenopathy, imaging characteristics of the enlarged lymph nodes themselves (eg, necrosis, cystic changes, hypervascularity, or calcification), and additional imaging findings in other organs can help narrow down the differential diagnosis and potentially identify the most likely cause. Even when the underlying cause of lymphadenopathy does not require treatment, establishing the likely cause and correctly excluding malignancy can prevent unnecessary tests and excessive interventions, such as biopsies. Thus, radiologists can play a crucial role in directing the management of such patients and must be familiar with the various conditions that result in nonneoplastic lymphadenopathy, their imaging findings, and their clinical manifestations. The authors provide an overview of these conditions and their imaging appearances and discuss approaches for identifying the cause of nonneoplastic lymphadenopathy based on imaging findings as well as clinical information. [©]RSNA, 2025 Supplemental material is available for this article.}, }
@article {pmid41037346, year = {2025}, author = {Eastman, RT and Rusinova, R and Herold, KF and Huang, XP and Voss, T and White, AD and Hemmings, HC and Andersen, OS and Dahlin, JL}, title = {Membrane Perturbations and Assay Interferences by Ivermectin Explain Its In Vitro SARS-CoV-2 Antiviral Activities and Lack of Translatability.}, journal = {Journal of medicinal chemistry}, volume = {68}, number = {20}, pages = {20979-21002}, pmid = {41037346}, issn = {1520-4804}, support = {R01 GM021342/GM/NIGMS NIH HHS/United States ; R01 GM058055/GM/NIGMS NIH HHS/United States ; R35 GM122481/GM/NIGMS NIH HHS/United States ; }, mesh = {*Ivermectin/pharmacology ; *Antiviral Agents/pharmacology/chemistry ; *SARS-CoV-2/drug effects ; Humans ; *COVID-19 Drug Treatment ; Drug Repositioning ; *Cell Membrane/drug effects/metabolism ; Animals ; COVID-19/virology ; Cell Survival/drug effects ; Vero Cells ; Chlorocebus aethiops ; }, abstract = {The antiparasitic drug ivermectin was proposed as a repurposed drug for the treatment of SARS-CoV-2 infection based on in vitro studies, but proved ineffective in high-quality clinical trials. When exploring possible reasons for this disconnect, we found that ivermectin interferes with AlphaScreen assays by quenching singlet oxygen transmission, calling into question the original justifications for pursuing ivermectin as an antiviral agent. Furthermore, at the low micromolar concentrations where ivermectin reduced SARS-CoV-2 viral burden in vitro, ivermectin decreased cell viability, modified membrane bilayer properties, and nonspecifically dysregulated membrane protein functions. In this Perspective, we provide molecular-level rationale for why ivermectin, an effective and safe antiparasitic drug at low nanomolar concentrations, becomes cytotoxic at low micromolar concentrations and, in turn, why ivermectin has not translated into an effective antiviral agent. We highlight lessons learned from the failed ivermectin repurposing effort and provide a workflow for identifying membrane-perturbing bioactivity early in drug development.}, }
@article {pmid41036706, year = {2025}, author = {Hussein, M}, title = {Advancing regenerative therapies with umbilical cord-derived mesenchymal stem cells: A review.}, journal = {Biomolecules &amp; biomedicine}, volume = {}, number = {}, pages = {}, doi = {10.17305/bb.2025.13147}, pmid = {41036706}, issn = {2831-090X}, abstract = {Umbilical cord-derived mesenchymal stem cells (UC-MSCs) are a clinically attractive regenerative and immunomodulatory platform that combines ethical accessibility, low immunogenicity, rapid expansion, genetic stability, and a potent paracrine secretome. This study aimed to synthesize evidence on safety, efficacy, and translational readiness by conducting a focused PubMed review (2014-2024) restricted to clinical studies and trials, using predefined inclusion and exclusion criteria and structured data extraction. Across indications, UC-MSCs show a consistent safety profile and signals of benefit mediated by tissue repair and immune regulation: in musculoskeletal disease they improve osteoarthritis pain and function and may slow osteonecrosis; in hepatology they sustain gains in decompensated cirrhosis, mitigate acute allograft rejection, and aid recovery from ischemic-type biliary lesions; as induction in renal transplantation they are feasible with early graft benefits; in type 2 diabetes responders improve glycemic control and inflammation, while maternal and obstetric factors can shape intrinsic cell properties; in neurology, studies in cerebral palsy, chronic spinal cord injury, and traumatic optic neuropathy report motor, sensory, and visual improvements; in COVID-19-related acute respiratory distress syndrome (ARDS) trials show better oxygenation, radiological recovery, quality of life, and modulation of the TNF-sTNFR2 axis; in immune-mediated and transplant settings they reduce graft-versus-host disease, with signals in systemic lupus erythematosus, refractory immune thrombocytopenia, Crohn's fistulas, and as cotransplant support in aplastic anemia. The limitations of this study encompass small sample sizes, single-center designs, and short-duration trials. Additionally, there is significant heterogeneity concerning the source, manufacturing processes, dosage, administration routes, and endpoints. Other challenges include adherence to good manufacturing practices (GMP), issues related to potency, biobanking, logistical constraints, cost factors, and regulatory obstacles. Large multicenter randomized trials with standardized protocols and long-term follow-up, and combination strategies with biomaterials, gene engineering, and extracellular vesicle or exosome products, are needed to confirm durable benefit and enable routine clinical integration.}, }
@article {pmid41036688, year = {2025}, author = {Saif-Ur-Rahman, KM and Nurdin, N and Movsisyan, A and Kothari, K and Gleeson, C and Conway, T and Tierney, M and Taneri, PE and Mulholland, D and Tricco, AC and Dinnes, J and Devane, D}, title = {Effectiveness of SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths.}, journal = {The Cochrane database of systematic reviews}, volume = {10}, number = {10}, pages = {CD016192}, pmid = {41036688}, issn = {1469-493X}, mesh = {Humans ; Asymptomatic Infections ; Controlled Before-After Studies ; *COVID-19/mortality/diagnosis ; COVID-19 Nucleic Acid Testing/methods ; *COVID-19 Testing/methods ; *Hospitalization/statistics &amp; numerical data ; Non-Randomized Controlled Trials as Topic ; Randomized Controlled Trials as Topic ; *SARS-CoV-2/isolation &amp; purification ; }, abstract = {RATIONALE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has substantially affected daily life. Sustainable testing practices are essential to balance the resource demands of widespread testing with the need to reduce the health impacts of COVID-19. However, the effectiveness of specific testing strategies for symptomatic and asymptomatic individuals in reducing COVID-19 cases, hospitalisations, and deaths remains uncertain.<br><br>OBJECTIVES: To evaluate the effectiveness of different SARS-CoV-2 testing strategies in reducing COVID-19 cases, hospitalisations, and deaths amongst suspected cases and asymptomatic individuals.<br><br>SEARCH METHODS: We searched CENTRAL, MEDLINE (Ovid), Embase (Elsevier), Europe PMC, ClinicalTrials.gov, and the World Health Organization (WHO) International Clinical Trials Registry Platform. We also conducted reference checks, citation searches, and contacted study authors to identify eligible studies. The most recent search was conducted on 07 October 2024.<br><br>ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs), non-randomised studies of interventions (NRSIs), controlled before-and-after studies (CBA), matched cohort studies, and observational studies with a comparison group involving suspected or asymptomatic individuals. Eligible studies compared testing strategy versus no testing or standard care or usual practice; one testing strategy with another, such as antigen-detecting rapid diagnostic tests (RDTs) versus nucleic acid amplification testing (NAAT), including reverse transcription polymerase chain reaction (RT-PCR); home-based versus provider-administered testing; one-time testing versus repeated testing at different frequencies; and targeted testing versus widespread testing. Combinations of these components were also considered. In this review, we define 'SARS-CoV-2 testing strategy' as a complex intervention comprising multiple varying components, including test type (e.g. NAAT, antigen-detecting RDT), sample type (e.g. nasopharyngeal swab, saliva), target population (e.g. symptomatic, contacts), setting (e.g. home, clinic, congregate), frequency of testing (e.g. one-time, weekly, daily), and response protocol (e.g. isolation, confirmatory testing, treatment). We excluded single-arm studies, reviews, theses, editorials, letters, commentaries, studies reported solely in abstract form, laboratory or animal studies, mathematical modelling studies, and diagnostic test accuracy studies.<br><br>OUTCOMES: Our critical outcomes were: COVID-19 cases avoided (reduction in new cases); COVID-19-related hospitalisations avoided (reduction in hospital admissions); COVID-19-related deaths avoided (reduction in mortality); and serious adverse events related to testing, including unnecessary interventions, employment impacts, isolation effects, and psychological harms.<br><br>RISK OF BIAS: We used the Risk of bias 2 (RoB 2) tool to assess the risk of bias in RCTs and the ROBINS-I tool to assess the risk of bias in NRSIs, CBA studies, and matched cohort studies.<br><br>SYNTHESIS METHODS: As a meta-analysis was not feasible due to the nature of the data, we applied Synthesis Without Meta-analysis (SWiM) methods. We assessed the certainty of the evidence for each outcome using the GRADE approach.<br><br>INCLUDED STUDIES: We included 21 studies (10 RCTs and 11 NRSIs) with 13,312,327 participants. Among these, 13 studies-comprising eight RCTs and five NRSIs-either reported one or more prespecified outcomes (four studies), provided relevant information through proxy measurements (five studies), or supplied information following author correspondence (four studies).<br><br>SYNTHESIS OF RESULTS: We present the prioritised comparisons and critical outcomes. For the comparison testing strategy versus no testing or standard care or usual practice, one included study measured two critical outcomes. The study did not measure the other critical outcomes: COVID-19 cases avoided, and serious adverse events related to testing. No studies measured any critical outcomes for the other prioritised comparison: antigen-detecting RDT versus NAAT testing. Benefits and harms of testing strategy versus no testing or standard care or usual practice One observational study with a comparison group, conducted in a long-term care facility in Israel, compared weekly SARS-CoV-2 RT-PCR testing with no testing and measured two of our critical outcomes. Based on the analysis, the evidence is very uncertain about the effect of SARS-CoV-2 RT-PCR testing on reducing hospitalisation (decrease in the hospitalisation rate from 13.59% to 11.41%; 1 study, 162,205 participants, very low-certainty evidence) and mortality (33.8% decrease in expected mortality; 1 study, 162,205 participants, very low-certainty evidence) compared to no testing. We downgraded the certainty of the evidence because of methodological limitations, indirectness, and imprecision.<br><br>AUTHORS' CONCLUSIONS: The available data are of very low-certainty. Only one of the 21 included studies reported hospitalisations or deaths; therefore, we cannot draw conclusions about the effects of testing strategy versus no testing on reducing hospitalisation and mortality. No studies evaluated other critical outcomes i.e. COVID-19 cases avoided, and serious adverse events related to testing. Future research should aim for consistency and relevance by using clearly defined outcomes, preferably based on a standardised core outcome set. A qualitative evidence synthesis (QES) would help identify barriers and facilitators to routine SARS-CoV-2 testing in healthcare settings, which could help inform intervention development. The QES would explore factors affecting the implementation of routine testing, drawing on the perspectives of healthcare providers, patients, and other interest holders.<br><br>FUNDING: This Cochrane review was partially funded by the World Health Organization (WHO) and the Health Research Board of Ireland.<br><br>REGISTRATION: Protocol (2025) DOI: 10.1002/14651858.CD016192.}, }
@article {pmid41036636, year = {2025}, author = {Liu, H and Deng, Y and Liu, J and Wang, Z and Hu, XQ and Duan, Y and Chen, Y and Xie, Z}, title = {Plasma Kallikrein Inhibitors for Multiple Disorders: Current Advances and Perspectives.}, journal = {Journal of medicinal chemistry}, volume = {68}, number = {20}, pages = {21012-21034}, doi = {10.1021/acs.jmedchem.5c02234}, pmid = {41036636}, issn = {1520-4804}, mesh = {Humans ; *Plasma Kallikrein/antagonists &amp; inhibitors/metabolism ; Structure-Activity Relationship ; Angioedemas, Hereditary/drug therapy ; Animals ; COVID-19 Drug Treatment ; *Serine Proteinase Inhibitors/pharmacology/therapeutic use/chemistry ; COVID-19 ; }, abstract = {Plasma kallikrein (PKal) is a pivotal serine protease involved in the regulation of the kallikrein-kinin system, the complement system, and several other biological pathways. Inhibition of PKal has become a key therapeutic strategy for hereditary angioedema, with four PKal-targeting agents approved by the U.S. FDA. The therapeutic potential of PKal inhibition is also being actively explored in other conditions, such as diabetic macular edema and COVID-19, through ongoing clinical trials. Here, we provide a comprehensive analysis of the biological functions of PKal across diverse signaling pathways, PKal-associated diseases, and recent clinical advancements of PKal-targeting agents. Furthermore, we spotlight the optimization strategies and key structure-activity relationships underlying the discovery and development of small-molecule PKal inhibitors, offering insights that may inform future PKal drug development for hereditary angioedema and other PKal-related diseases.}, }
@article {pmid41035849, year = {2025}, author = {Cepni, AB and Kirschmann, JM and Rodriguez, A and Johnston, CA}, title = {When Routines Break: The Health Implications of Disrupted Daily Life.}, journal = {American journal of lifestyle medicine}, volume = {}, number = {}, pages = {15598276251381626}, pmid = {41035849}, issn = {1559-8284}, abstract = {Disruptions to daily routines, such as those caused by holidays or the COVID-19 pandemic, have been linked to unhealthy changes in physical activity, sleep, and diet. The Structured Days Hypothesis (in children) and the Social Zeitgeber Model (in adults) provide theoretical frameworks that explain how routines influence lifestyle behaviors. Together, these models highlight daily routines as a modifiable behavioral risk factor that can promote healthier lifestyles. Integrating routine-building strategies into clinical practice, especially during times when routines are most vulnerable to disruption, represents a low-cost and scalable approach to health promotion. This article outlines practical strategies that health care providers can use to help patients establish and sustain daily routines.}, }
@article {pmid41035096, year = {2025}, author = {Fenta, ET and Endeshaw, D and Adal, O and Tareke, AA and Kebede, N and Delie, AM and Bogale, EK and Anagaw, TF and Tiruneh, MG}, title = {Determinants of antenatal care dropout among pregnant women in Africa: a systematic review and meta-analysis.}, journal = {Systematic reviews}, volume = {14}, number = {1}, pages = {186}, pmid = {41035096}, issn = {2046-4053}, mesh = {Humans ; Female ; Pregnancy ; *Prenatal Care/statistics &amp; numerical data ; Africa/epidemiology ; *Patient Dropouts/statistics &amp; numerical data ; Pregnancy Complications/epidemiology ; *Pregnant People/psychology ; }, abstract = {BACKGROUND: Antenatal care (ANC) is a comprehensive healthcare service designed to support pregnant women through education, monitoring, and interventions to promote a healthy pregnancy and ensure a positive childbirth. Regular ANC visits play a crucial role in preventing complications, managing existing health conditions, and promoting the overall well-being of both the mother and the unborn child. Dropout from ANC visits results in potential complications during pregnancy, and these complications can involve the mother's health, the fetus's health, or both. Common complications of pregnancy include high blood pressure, gestational diabetes, anemia, preeclampsia, preterm labor, stillbirth, and miscarriage. The objective of this study is to estimate the prevalence of dropout from antenatal care and determinant factors among pregnant women in Africa.<br><br>METHODS: This systematic review and meta-analysis included with open or free access to full text all full, English-language original research articles, and doctoral dissertations on observational studies (cross-sectional, case control, or cohort) conducted worldwide between 2000 and December 15, 2023, which were published in peer-reviewed journals that report dropout rates from prenatal care and its determinants. We follow PRISMA checklist. Using keywords, papers were retrieved from the electronic databases PubMed, Cochrane Library, Google Scholar, and gray literature. Stata 17 was used to conduct the meta-analysis. The Egger's regression, Begg's test, and funnel plot were employed to investigate publication bias. To ascertain the level of heterogeneity, the I[2] statistics were employed.<br><br>RESULTS: The overall magnitude of antenatal care dropout among pregnant women, as pooled from the 16 studies, was found to be 29.44%, with a 95% confidence interval (CI) ranging from 19.16% to 39.72%. The pooled odds ratio showed that rural pregnant women (AOR&#x2009;=&#x2009;3.55, 95 CI (1.17-5.92). women who had no formal education (AOR&#x2009;=&#x2009;3.88, 95 CI (-&#x2009;0.24-8.00), inaccessible PHC facilities (AOR&#x2009;=&#x2009;5.90, 95 CI (0.54-11.26), lack of support from family or husband (AOR&#x2009;=&#x2009;4.91 CI (-&#x2009;1.31-11.19), and women with poor economic status (AOR&#x2009;=&#x2009;2.50, 95 CI (1.19-3.81) were determinant factors for maternal dropout from antenatal care service.<br><br>CONCLUSIONS: This systematic review and meta-analysis revealed that the prevalence of antenatal care dropout was high based on the included 16 articles. According to the review, pregnant women's antenatal care dropout was significantly correlated with living in a rural area, being unable to access a primary health facility, lacking formal education, not having support from her husband or family, and having low socioeconomic status. These findings suggest that various socio-economic and geographical factors play a significant role in determining whether pregnant women continue with antenatal care services. Addressing these determinants, such as improving access to healthcare facilities, providing educational support, and enhancing economic conditions, may contribute to reducing the dropout rates and improving overall maternal healthcare outcomes. Additionally, understanding these factors is essential for tailoring interventions to specific populations and regions to ensure effective ANC retention.}, }
@article {pmid41033372, year = {2025}, author = {Alshammari, A}, title = {Immunological insights and vaccine advances against apicomplexan parasites: Emerging concepts and innovations.}, journal = {Microbial pathogenesis}, volume = {209}, number = {}, pages = {108074}, doi = {10.1016/j.micpath.2025.108074}, pmid = {41033372}, issn = {1096-1208}, mesh = {*Protozoan Vaccines/immunology ; Animals ; Humans ; *Apicomplexa/immunology ; Vaccine Development ; Vaccines, Attenuated/immunology ; COVID-19/prevention &amp; control ; Toxoplasma/immunology ; *Protozoan Infections/prevention &amp; control/immunology ; Vaccines, Subunit/immunology ; }, abstract = {The apicomplexan parasites are globally considered as the major cause of numerous infectious diseases in humans and animals. Apicomplexan parasites include Plasmodium, Toxoplasma gondii, Cryptosporidium, Eimeria and Babesia. The rise in the drug resistance have made the traditional control measures, such as chemotherapy and vector management, inadequate against them. These are the intracellular infectious agent and possess complex life cycles, antigenic variability, and immune evasion abilities. These different abilities hinder the development of vaccines against them. Hence, there is urgent need for development of effective vaccines by novel measures. However, notable progress has been made in past years due to the advancements in immunology, molecular biology, and biotechnology. Different types of vaccines including subunit vaccines have been developed and have demonstrated favorable efficiency. In the meantime, live-attenuated vaccines (LAV) continue to provide protection in animals. Apart from that, there are different innovations like CRISPR/Cas9 gene editing that have enabled the creation of genetically attenuated strains for T. gondii and Eimeria. These attenuated strains are used for the development of vaccines. Furthermore, mRNA vaccine technology, which was successfully utilized during the COVID-19 pandemic, is now being used against parasitic infections. It is now offering fast and rapid development along with vigorous cellular immunity. The use of nanoparticles and novel adjuvants such as TLR agonists and saponins has improved the stability and effectiveness of vaccines. Approaches like mucosal delivery, especially for enteric parasites such as Cryptosporidium and Eimeria, is achieving attention for their ability to provide the localized protection. In spite of these advancements some challenges still persist. Antigenic diversity, short-lived immunity, regulatory barriers, and limited funding need to be addressed. Some of the emerging technologies including systems vaccinology, reverse vaccinology, and vectored delivery platforms, are paving the way for more targeted and effective vaccination. There is need for concerted effort incorporating multidisciplinary research, One Health integration, and scalable manufacturing methodologies for effective translation of these scientific innovations into solutions. By harnessing these emerging technologies within a One Health framework, the next generation of vaccines has the potential to transform the management of apicomplexan diseases worldwide.}, }
@article {pmid41033120, year = {2025}, author = {Singh, G and Singh, A and Kainth, T and Menon, SS and Jain, S and Spektor, V and Prasanna, P and Manjila, S}, title = {Extended reality in the changing landscape of cranial neurosurgery: Role of image fusions and connectomics in precision and safety.}, journal = {Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia}, volume = {142}, number = {}, pages = {111652}, doi = {10.1016/j.jocn.2025.111652}, pmid = {41033120}, issn = {1532-2653}, mesh = {Humans ; *Neurosurgical Procedures/methods ; *Connectome/methods ; *Augmented Reality ; COVID-19 ; *Neurosurgery/methods ; *Virtual Reality ; }, abstract = {Recently, augmented reality (AR), virtual reality (VR) and mixed reality (MR) technologies, collectively termed Extended Reality (XR), have been adopted to support enhanced visualizations for neurosurgeons by augmenting the clinical environment with relevant digital content. These groundbreaking technologies, including connectomics, have been successfully integrated into neurosurgery as tools for preoperative rehearsals, surgical simulation, and intraoperative augmentation. Adaptation of XR within the surgical field has assisted neurosurgeons with preoperative planning using connectomics and anticipation of potential complications. XR enables neurosurgeons to explore operative fields from various angles and visualize hidden neurovascular anatomy, enhancing precision in keyhole approaches. It also addresses resident work hour restrictions and challenges like COVID-19, offering advanced training tools for novices and experts alike. Additionally, XR facilitates telecasting, patient education, remote telecollaboration, and helps bridge global educational gaps in neurosurgery, including credentialing and recertification. This paper outlays the conceptual differences between AR, VR, and MR, emphasizing the benefits and limitations of XR, along with the growing role of connectomics in micro-neurosurgery and endoscopic neurosurgery. The role of 2D versus 3D imaging, merger of preoperative versus real-time imaging, fusion of additional imaging data such as ICG, 5-ALA, or fluorescein angiography, and utilization of emerging technologies like Surgical Theater, QuickTome, etc. are highlighted. We also bring forth the pivotal role of visuo-spatial orientation of co-participants, apart from shared intentions and varied competence during the use of MR in neurosurgery. We explore the latest XR applications in neurosurgery and discuss exciting future directions, limitations, and ethical implications for the trailblazing technology.}, }
@article {pmid41033047, year = {2025}, author = {Godat, A and Chistoforidis, D and Greuter, T}, title = {COVID-19 and inflammatory bowel disease - what to know.}, journal = {Current opinion in immunology}, volume = {97}, number = {}, pages = {102661}, doi = {10.1016/j.coi.2025.102661}, pmid = {41033047}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/epidemiology/immunology/complications ; *SARS-CoV-2 ; *Inflammatory Bowel Diseases/epidemiology/immunology/complications ; }, abstract = {Inflammatory bowel disease (IBD) represents a chronic inflammation of the gastrointestinal tract that arises from a complex interplay between a dysregulated immune response in genetically predisposed individuals. IBD can further be classified into its two main subtypes, Crohn's disease and ulcerative colitis. Both subtypes have shown increasing prevalence and incidence rates worldwide, and IBD is now considered a global epidemic. About three million patients are estimated to suffer from this disease, both in the US and Europe, with most of them requiring maintenance treatment including immunosuppressive agents, putting them at risk for opportunistic infections. In 2020, coronavirus disease 2019 (COVID-19) hit the world with a long pandemic period resulting in dramatic numbers of hospitalizations, Intensive care unit (ICU) admissions, and deaths. Patients with chronic illnesses, such as IBD, were rapidly considered to be at an increased risk for both infection and infection-related complications. For IBD and its treatment, however, evidence over the last few years showed no increased risk for SARS-CoV-2 infection or COVID-related complications. In this review, we will discuss the latest insights about COVID-19 in IBD patients with a particular focus on the disease course of COVID-19 and on IBD-related adverse outcomes.}, }
@article {pmid41031563, year = {2025}, author = {Shi, S and Zhai, M and Wu, B and Sun, W}, title = {Mitochondrial Disruption in Viral-Mediated Neuronal Injury: A Mechanistic Perspective.}, journal = {Journal of medical virology}, volume = {97}, number = {10}, pages = {e70626}, doi = {10.1002/jmv.70626}, pmid = {41031563}, issn = {1096-9071}, support = {//This work was supported by grants from the National Natural Science Foundation of China (No. 82171378, 82401438), Shenzhen Municipal Science, Technology and Innovation Commission (No. JCYJ20240813114512016, and No. JCYJ20240813152049062), Shenzhen Nanshan District Healthcare System Science and Technology Key Projects (No. NSZD2023003), Medical-Engineering Interdisciplinary Research Foundation of Shenzhen University (2023YG031)./ ; }, mesh = {Humans ; *Mitochondria/pathology/virology/metabolism ; *Neurons/virology/pathology ; COVID-19/virology/pathology ; SARS-CoV-2/pathogenicity ; Hepacivirus/pathogenicity ; HIV Infections/virology/pathology ; }, abstract = {Neuronal injury is a major pathological issue that cannot be ignored during viral infections. Mitochondria, the energy factories of the cell, play a unique role in this scenario and are severely impacted when viruses infect host cells. Viruses invade and infect cells via specific mechanisms, causing changes in cellular structure and function. These changes not only directly affect mitochondria but also disrupt their normal function through indirect pathways. This paper reviews the mechanisms of mitochondrial damage induced by infections with SARS-CoV-2, herpesviruses, human immunodeficiency virus (HIV), and hepatitis C virus (HCV), providing new insights and strategies for preventing and treating neuronal injury.}, }
@article {pmid41030634, year = {2025}, author = {Johnson, BL}, title = {"In-Flu-Enza and Out-Flew Hair:" Post-Epidemic Health and the Importance of the History of Epidemics.}, journal = {The Yale journal of biology and medicine}, volume = {98}, number = {3}, pages = {341-348}, pmid = {41030634}, issn = {1551-4056}, mesh = {Humans ; *COVID-19/epidemiology/history ; History, 20th Century ; *Influenza, Human/epidemiology/history ; SARS-CoV-2 ; *Epidemics/history ; Pandemics/history ; History, 21st Century ; Influenza Pandemic, 1918-1919/history ; }, abstract = {When COVID-19 survivors reported ongoing symptoms or new health concerns following their infections in 2020 and early 2021, many medical practitioners and health agencies questioned the connection between novel viruses and long-term health impacts. Medical historians studying epidemics understand the connection between viral infection and health complications emerging immediately or years or decades later. In this essay, I explore the similarities between the medical fallout of the 1918 influenza and COVID-19 pandemics. Despite the differences between the viruses, these novel strains produced similar medium- and long-term health difficulties, including cardiovascular dysfunction and crushing fatigue. As I demonstrate, a significant difference between these two pandemics is in the response by medical practitioners. Following influenza, practitioners expected new and worsening health issues and took their patients' complaints seriously, offering support through food delivery, convalescent care, specialist oversight, and in-home nursing. Early in the COVID-19 pandemic, many practitioners characterized ongoing or new symptoms as anxiety. Patients led efforts to recognize Long COVID as an authentic medical condition, and today, physicians around the country refer their patients to Long COVID clinics. The value of medical history is apparent in this comparison-if practitioners understand how historical epidemics impacted various populations, they expect that in the epidemic aftermath or the period following an acute epidemic crisis, not all patients get well. Including the history of epidemics in public health education, continuing education programming, and even medical school curricula can resist epidemic erasure and empower medical practitioners to expect the unexpected.}, }
@article {pmid41029595, year = {2025}, author = {Numbere, NK}, title = {Post-steroid rebound in COVID-19 pneumonitis: a case series and review of the literature.}, journal = {BMC pulmonary medicine}, volume = {25}, number = {1}, pages = {440}, pmid = {41029595}, issn = {1471-2466}, mesh = {Humans ; Middle Aged ; Aged ; Male ; *COVID-19/complications ; Female ; Retrospective Studies ; Aged, 80 and over ; *COVID-19 Drug Treatment ; SARS-CoV-2 ; Recurrence ; *Glucocorticoids/therapeutic use ; *Pneumonia/drug therapy ; }, abstract = {UNLABELLED: We report a retrospective case series of COVID-19 pneumonitis (C19P) patients in hypoxic respiratory failure who experienced a symptom rebound upon cessation or weaning of steroids following an initial positive response. The post-steroid rebound phenomenon in C19P is not well described in the literature and we aim to add to the body of evidence exploring this pathology.<br><br>METHODS: Post-steroid rebound COVID-19 pneumonitis (PSRCP) cases at our institution were identified for notes review from respiratory department follow-up records. The inclusion criteria were as follows: 1. Hospital admissions with radiologically and PCR-confirmed C19P. 2. Administration of a corticosteroid course for the indication of hypoxia due to C19P. 3. An objective relapse of the index presentation with differential diagnoses other than post-steroid rebound excluded by appropriate clinicians. A literature search was performed using Medline, Ovid and Google Scholar and the search terms "rebound and COVID-19", "rebound and COVID-19 and pneumonitis" "post-COVID and pneumonitis" "relapse and COVID-19", "relapse and coronavirus and pneumonitis".<br><br>RESULTS: Eighteen patients were identified between 2021 and 2024 with ages ranging from 48 to 80&#xa0;years. The most common comorbidities were hypertension (50%) and obesity (39%) while 89% had a history of regular smoking. Seventeen of the 18 had evidence of hyperinflammation at first C19P presentation with a C-reactive protein (CRP)&#x2009;&#x2265;&#x2009;75&#xa0;mg/dl. Notably, 15 patients had a CRP blood test at least 48&#xa0;h prior to discharge, steroid cessation or weaning and of these, 11 (73%) showed persisting CRP elevation. Seventeen of the 18 responded upon diagnosis of PSRCP to steroid rechallenge with survival to discharge.<br><br>CONCLUSIONS: As COVID-19 becomes endemic, clinicians should remain wary of the risk of PSRCP. Greater recognition of the importance of steroid weans and rechallenges in C19P narratives will help avoid poor outcomes, readmissions and the risk of post-C19P sequelae. Awareness of the PSRCP phenomenon should lower the threshold for slow steroid weans upon an initial C19P diagnosis over the standard UK regimen of a 10-day duration or less dexamethasone course. A definition for PSRCP is proposed as well as a decision aid around steroid strategies in patients both with and at risk of PSRCP.}, }
@article {pmid41029573, year = {2025}, author = {Yang, X and He, Y and Guo, T and Fang, J and Chen, S and Zhang, Q and Lin, Y and Xu, N and Pan, X and Li, H}, title = {The efficacy analysis of neoadjuvant chemoimmunotherapy followed by surgery in stage III locally advanced non-small cell lung cancer: a systematic review and meta-analysis.}, journal = {BMC cancer}, volume = {25}, number = {1}, pages = {1443}, pmid = {41029573}, issn = {1471-2407}, support = {2021CXA001//Research on intelligent recommendation decision model of geriatrics based on big data/ ; 00902409//Research on the development and prevention and control strategies of key viral infectious diseases in the post-COVID-19 era/ ; 82002457//the National Natural Science Foundation of China/ ; 2019-ZQNB-1//the Young and Middle-aged Backbone Research Fund of Fujian Provincial Health Care Commission/ ; 2023J01117//the Natural Science Foundation of Fujian Province/ ; 2020Y9023//Fujian Provincial Medical Science and Technology Innovation Joint Fund Project/ ; }, mesh = {Humans ; *Carcinoma, Non-Small-Cell Lung/pathology/therapy/drug therapy/mortality/surgery ; *Lung Neoplasms/pathology/therapy/drug therapy/mortality ; *Neoadjuvant Therapy/methods ; Neoplasm Staging ; Treatment Outcome ; Immunotherapy/methods ; Immune Checkpoint Inhibitors/therapeutic use ; Pneumonectomy ; *Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; }, abstract = {BACKGROUND: Locally advanced non-small cell lung cancer (NSCLC) has the potential for surgical cure after neoadjuvant immunotherapy in the era of immunotherapy. In this study, we conducted a meta-analysis of published data to systematically assess the efficacy and safety of neoadjuvant chemoimmunotherapy for stage III NSCLC.<br><br>METHODS: A comprehensive search was conducted on the Cochrane Library, PubMed, Web of Science, and Embase databases from January, 2000 to September, 2024 to identify studies concentrated on neoadjuvant chemoimmunotherapy followed by surgery for treating stage III NSCLC. The effectiveness and safety data were collected for meta-analysis. Study endpoints included resection rate, major pathological response (MPR), pathological complete response (pCR), objective response rate (ORR), treatment-related adverse events (TRAEs), severe adverse events (SAEs). Data analysis was conducted using R 4.1.3 software, and P&#x2009;<&#x2009;0.05 was considered statistically significant.<br><br>RESULTS: A total of 1043 patients from 22 studies were included in this meta-analysis, of whom 892 cases underwent surgery. The pooled MPR rate, pCR rate, and ORR rate were 65%, 38%, and 73%, respectively. The pooled incidence of TRAEs was 84% and the pooled incidence of SAEs was 13%. The results of the subgroup analysis showed that nivolumab- and pembrolizumab-based neoadjuvant chemoimmunotherapy showed a higher MPR rate (nivolumab 69%, pembrolizumab 68%) and pCR rate (nivolumab 51%, pembrolizumab 38%) than other immune checkpoint inhibitors (ICIs).<br><br>CONCLUSION: Neoadjuvant chemoimmunotherapy demonstrates clinical benefits for patients with stage III NSCLC.}, }
@article {pmid41028928, year = {2025}, author = {Creswell, L and Pandya, P and Stott, D and Peebles, D and Attilakos, G and Nastouli, E and Alchin, H and Baruteau, KP and Napolitano, R}, title = {Parvovirus: Conservative management of fetal anemia and hydrops.}, journal = {Acta obstetricia et gynecologica Scandinavica}, volume = {104}, number = {11}, pages = {2028-2037}, pmid = {41028928}, issn = {1600-0412}, mesh = {Humans ; *Hydrops Fetalis/therapy/virology/diagnosis ; Female ; Pregnancy ; *Parvoviridae Infections/therapy/complications/diagnosis/congenital ; Blood Transfusion, Intrauterine ; *Anemia/therapy/virology ; *Conservative Treatment/methods ; Parvovirus B19, Human ; COVID-19/epidemiology ; *Fetal Diseases/therapy/virology ; *Pregnancy Complications, Infectious/therapy/virology ; Ultrasonography, Prenatal ; }, abstract = {Following the COVID-19 pandemic, Northwestern Europe has experienced a marked increase in congenital parvovirus infections. This rise is attributed to social distancing measures which disrupted the usual seasonal variation of parvovirus B19. Fetal infection may cause severe anemia, thrombocytopenia, and hydrops fetalis, with significant risk of intrauterine death. Therefore, when acute parvovirus B19 infection is confirmed by maternal serology, serial ultrasound surveillance of the middle cerebral artery peak systolic velocity is recommended. Intrauterine transfusion remains the only established therapeutic option for cases of suspected fetal anemia or hydrops but carries risks of fetal loss and procedural-related complications including fetal hemorrhage and exsanguination. This review critically examines current literature on diagnosis, management, perinatal outcomes, and long-term neurodevelopmental sequelae following congenital parvovirus infection and intrauterine transfusion. Additionally, we report our tertiary fetal medicine center's experience during the 2024 epidemic, highlighting a novel conservative management approach for fetuses with parvovirus-related anemia and hydrops fetalis.}, }
@article {pmid41027462, year = {2025}, author = {Nunes Nóra de Souza, L and Coimbra, DR and Bueno, JCA and Andrade, A}, title = {Effects of home-based exercise on the mental and physical health of older adults: a systematic review and meta-analysis of randomized clinical trials.}, journal = {Aging &amp; mental health}, volume = {29}, number = {10}, pages = {1746-1763}, doi = {10.1080/13607863.2025.2541186}, pmid = {41027462}, issn = {1364-6915}, mesh = {Humans ; Aged ; Randomized Controlled Trials as Topic ; *COVID-19/psychology ; *Depression/therapy/prevention &amp; control ; *Exercise Therapy/methods ; *Mental Health ; Postural Balance/physiology ; *Exercise ; }, abstract = {OBJECTIVES: This study aimed to analyze the effects of home-based exercise programs on the mental and physical health of older adults during the COVID-19 pandemic, through a systematic review and meta-analysis.<br><br>METHOD: Searches were conducted in PubMed, Web of Science, SCOPUS, EBSCO, and Embase until June 2024. In total, 14 Randomized Clinical Trials (RCTs) were included.<br><br>RESULTS: Home-based exercise presented a small effect on depressive symptoms (standard mean difference [SMD]: -0.38; 95% Confidence Interval [CI]: -0.65 to -0.12) and a large effect on dynamic balance [SMD]: 0.81; 95% CI: 0.49 to 1.13). No effects were found for home-based exercise on other outcomes.<br><br>CONCLUSION: This meta-analysis found that home-based exercise was effective in reducing depression and improving dynamic balance in older adults. However, further studies are needed due to methodological issues related to the intervention and some concerns identified about the risk of bias.<br><br>PROSPERO NUMBER: CRD42023397441.}, }
@article {pmid41027405, year = {2025}, author = {Lemoine, J and Svenne, S and Ulrich, R and Hensel, J}, title = {Crisis and Post-Crisis Virtual Mental Health Care: A Scoping Review.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {}, number = {}, pages = {}, doi = {10.1177/15305627251381632}, pmid = {41027405}, issn = {1556-3669}, abstract = {Objectives: Crisis services are often a first point of contact for individuals needing mental health assessment and intervention. The rapid expansion of virtual care in recent years has enabled remote assessment and introduced novel ways to support crisis stabilization in the community. This scoping review aims to summarize the extent of the literature on virtual crisis assessment and intervention models. Methods: PubMed, PsycINFO, CINAHL, and ProQuest databases were searched for English- and French-language literature published between January 1, 2018, and June 30, 2024. Database search results were imported into the online Covidence review management program. A minimum of two reviewers screened titles and abstracts. Target information was extracted from included full texts and summarized thematically across study characteristics and outcomes. Results: A total of 5,345 titles were reviewed, with 45 publications included. Publications represented models from around the globe supporting youth and/or adult service users. Data synthesis highlighted the feasibility and potential for virtual care models supporting comprehensive crisis assessment (services that go beyond hotline de-escalation and triage), inpatient admission alternatives, and post-crisis follow-up. Conclusion: The available literature suggests that virtual crisis care options are growing, especially during and in the aftermath of the COVID-19 pandemic. Although few rigorous evaluations exist, there is strong evidence of feasibility with emerging and encouraging evidence for effectiveness. Further research focused on outcomes, comparisons of virtual and in-person models, and cost-effectiveness is warranted. Additional research could focus on virtual care models for the geriatric population, which is underrepresented in the available literature.}, }
@article {pmid41027283, year = {2025}, author = {Mello Sampaio, JL and Cunha, A and Lima Santos, DWC and Junior, AP}, title = {Brazilian guide for the diagnosis of severe community-acquired pneumonia and hospital-acquired pneumonia.}, journal = {Clinics (Sao Paulo, Brazil)}, volume = {80}, number = {}, pages = {100793}, pmid = {41027283}, issn = {1980-5322}, abstract = {UNLABELLED: Pneumonia is one of the main causes of intensive care unit admission and death in Brazil. There is a need to standardize the use of microbiological tests for the diagnosis of pneumonia.<br><br>OBJECTIVE: To evaluate microbiological diagnostic data for severe pneumonia.<br><br>METHOD: Comparative studies that evaluated the microbiological diagnosis of community pneumonia and hospital-acquired pneumonia were analyzed. The literature review was guided by two questions and used flowcharts prepared by experts.<br><br>RESULTS AND DISCUSSION: Diagnostic tests for pneumonia should be requested based on the severity of the disease, the patient&#xb4;s immune status, and the risk of infection by multidrug-resistant bacteria. Gram staining may aid in excluding S. aureus pneumonia and evaluating the quality of respiratory samples, while culture of these clinical samples may identify the infectious agent in up to half of the cases and allow antimicrobial susceptibility testing to be carried out. Blood cultures have a low sensitivity but may be useful for diagnosing extrapulmonary infections or situations involving sepsis or septic shock. Rapid molecular panels have high sensitivity and specificity for viral and bacterial targets for both types of pneumonia, and their use can reduce the length of hospital and intensive care stays and allow optimization of antimicrobial therapy. RT-PCR is highly accurate in diagnosing SARS-CoV-2 pneumonia.<br><br>CONCLUSION: The rational use of molecular panels for the diagnosis of severe pneumonia can reduce the length of hospital and intensive care stays and 90-day mortality.}, }
@article {pmid41027235, year = {2025}, author = {Wang, J and Yan, X and Li, H and Shen, Y and Yun, C and Zhang, J}, title = {MAP4K3/GLK: Structure, molecular pharmacology and drug development.}, journal = {Bioorganic chemistry}, volume = {165}, number = {}, pages = {109043}, doi = {10.1016/j.bioorg.2025.109043}, pmid = {41027235}, issn = {1090-2120}, mesh = {Animals ; Humans ; Autoimmune Diseases/drug therapy/metabolism ; COVID-19/metabolism ; *Drug Development ; Neoplasms/drug therapy/metabolism ; *Protein Kinase Inhibitors/pharmacology/chemistry ; *Protein Serine-Threonine Kinases/metabolism/antagonists &amp; inhibitors/chemistry ; SARS-CoV-2 ; Signal Transduction/drug effects ; }, abstract = {GLK (also known as MAP4K3), classified as a member of the MAP4K family, is a Ste20-like serine/threonine kinase. GLK plays a pivotal role in multiple cellular signaling pathways, including TCR-mediated immune responses, as well as the JNK, mTOR, and NF-κB signaling pathways. Due to its critical role in these key regulatory networks, GLK has been implicated in the pathogenesis of various diseases, including autoimmune diseases, cancer, aging, and COVID-19 infection. Consequently, GLK represents a promising molecular target for the development of novel therapeutic interventions for immunotherapy and oncotherapy. This review comprehensively summarizes the signaling pathways and human diseases regulated by GLK, focusing on GLK protein kinase structure, GLK-specific regulators, and profiling strategies for developing GLK-specific small-molecule inhibitors.}, }
@article {pmid41027126, year = {2025}, author = {Baumbusch, J and Sloan Yip, I and Bandara, NA}, title = {Always on duty - Fostering climate resilience in the nursing profession: A discussion paper.}, journal = {International journal of nursing studies}, volume = {172}, number = {}, pages = {105227}, doi = {10.1016/j.ijnurstu.2025.105227}, pmid = {41027126}, issn = {1873-491X}, mesh = {Humans ; *Climate Change ; *COVID-19/epidemiology/nursing ; *Resilience, Psychological ; Female ; }, abstract = {BACKGROUND &amp; PURPOSE: As with the SARS-CoV-2 pandemic, climate change is a global phenomenon reshaping the nursing profession. While nursing organizations have produced numerous position statements on nursing and climate change, these tend to focus exclusively on the profession's important role in mitigating and adapting health systems and providing climate-informed patient care. However, to adequately prepare for the acceleration of climate change impacts, we also need to focus on supporting the health and wellbeing of the nursing workforce. The purpose of this discussion paper is to examine key areas of climate vulnerability for nursing and provide recommendations that address these factors.<br><br>DISCUSSION: We consider three factors that may negatively impact on nurses' health and well-being in relation to climate change. First, there are social locations at the individual and population level, in particular gender, as the majority of nurses are women, and age, as the global workforce is aging. Both of these social locations are well documented areas of climate vulnerability. Second, the aging infrastructure of healthcare facilities puts nurses at risk by exposing them to harmful environments, such as extreme heat and poor air quality. Third, there are consequences for nurses' mental health as a result of providing care during climate-related weather emergencies and growing awareness of the impacts of climate change.<br><br>RECOMMENDATIONS: In response to these risk factors, we recommend urgent actions that will support and promote nurses' health and well-being. For example, workplace policies and environments should be adjusted to address the unique healthcare issues of an aging workforce that is primarily women. As well, actions that promote climate-resilient healthcare systems are needed. These actions include updating physical infrastructures as well as ensuring adequate staffing during climate-related weather emergencies. There is also a pressing need for interventions that provide mental health supports and psychological safety in the workplace for nurses.}, }
@article {pmid41027080, year = {2025}, author = {Li, D and Ye, Q and Bai, J and Wan, W}, title = {Emerging and Re-emerging viral infections and their ocular manifestations: A focus on ocular neovascularization.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101396}, doi = {10.1016/j.mam.2025.101396}, pmid = {41027080}, issn = {1872-9452}, abstract = {Emerging and re-emerging viral infections represent a significant and escalating global health concern, frequently associated with a spectrum of systemic complications. Among these, ocular manifestations are increasingly recognized, contributing substantially to visual morbidity. The present review aims to provide an overview of the ocular sequelae of major emerging and re-emerging viral pathogens, highlighting their suggested and established roles in ocular neovascularization (ONV). It discusses the virological and immunological mechanisms, including direct viral cytopathic effects, virally-induced inflammation, dysregulation of angiogenic and anti-angiogenic factors (e.g., Vascular Endothelial Growth Factor), and activation of hypoxia-inducible pathways, which can contribute to neovascular processes in various ocular compartments such as the cornea, iris, retina, and choroid. The major viral agents addressed in this review are Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Human Immunodeficiency Virus (HIV), West Nile virus (WNV), Dengue Virus (DENV), and other viruses with known or suspected ONV association. This study reviewed and summarized the literature regarding case reports and experimental models describing the association of these viral agents with ONV. Furthermore, it addresses diagnostic considerations and therapeutic strategies. Understanding the intricate interplay between these viral infections and ocular neovascular pathways is crucial for developing targeted therapeutic strategies to prevent vision loss in affected populations.}, }
@article {pmid41026493, year = {2025}, author = {Rozelle, M and Haslam, A and Prasad, V}, title = {Methods of Pediatric Post-COVID Condition Studies in High-Impact Journals: A Systematic Review.}, journal = {JAMA network open}, volume = {8}, number = {9}, pages = {e2529659}, pmid = {41026493}, issn = {2574-3805}, mesh = {Humans ; *COVID-19/complications/epidemiology ; Child ; Adolescent ; *Journal Impact Factor ; SARS-CoV-2 ; Female ; *Research Design ; Male ; Pediatrics ; }, abstract = {IMPORTANCE: Preexisting health conditions complicate post-COVID condition diagnosis in children and adolescents, while the lack of standardized clinical phenotypes challenges its definition and epidemiological estimates. Prospective studies with robust methodologies are needed to minimize bias and confounders, yet they remain scarce in high-impact factor journals.<br><br>OBJECTIVE: To review, characterize, and assess the methodology used in studies examining post-COVID condition in children and pediatric populations in highly cited studies, which have greater visibility and are likely to be used in informing policy.<br><br>EVIDENCE REVIEW: Studies on PubMed and studies with high citations on Web of Science published through July 2024 were reviewed. Pediatric studies from journals with an impact factor of 5 or higher were included if they employed observational or risk-benefit designs. Studies were classified based on whether they included a SARS-CoV-2 test-negative control group or a non-test-negative group, which included studies with either no comparator or a different type of comparator. Joanna Briggs Institute and Risk of Bias in Nonrandomized Studies of Exposures tools assessed the risk of bias.<br><br>FINDINGS: Of 426 publications, 24 were analyzed; 9 studies (38%) used test-negative controls, while 15 studies (63%) did not (P&#x2009;<&#x2009;.001). Among studies with test-negative groups, 4 (44%) used prospective cohort designs vs 5 (33%) studies without a test-negative group. Demographic reporting of post-COVID condition cases varied. Sex was reported in 12 studies (50%), but the median (IQR) sample size was small (27 female patients [14-110]; 21 male patients [10-79]). Psychiatric history was often not reported (20 patients [83%]), as well as a lack of history of comorbidities (16 patients [67%]) or body mass index (15 patients [63%]). Among 9 test-negative control studies, 4 (44%) used matched control design, while only 1 (11%) accounted for confounders by sex-stratifying results.<br><br>CONCLUSIONS AND RELEVANCE: These findings highlight the need for rigorous study designs that minimize bias and confounding, ensuring a clearer definition of pediatric post-COVID condition and its sequelae. Employing true test-negative matched controls is essential for distinguishing common symptoms and assessing risk factors, while standardizing demographic reporting strengthens comparability and ensures consistency in patient selection.}, }
@article {pmid41026135, year = {2025}, author = {Farkas, K and Kaya, D and Maal-Bared, R and Al-Mustapha, AI and Tandukar, S and Keenum, I and Gunnar, T and Bivins, A and J Wade, M and Bibby, K and Pitkänen, TM and Tiwari, A}, title = {Communicating wastewater-based surveillance data to drive action.}, journal = {Journal of water and health}, volume = {23}, number = {9}, pages = {1095-1108}, pmid = {41026135}, issn = {1477-8920}, mesh = {Humans ; *COVID-19/epidemiology ; *Wastewater/virology ; *Communication ; Public Health ; SARS-CoV-2 ; *Wastewater-Based Epidemiological Monitoring ; *Information Dissemination ; }, abstract = {As exemplified during the COVID-19 pandemic, wastewater-based surveillance (WBS) can deliver near real-time, population-level pathogen data to guide public health action. Its impact, however, hinges on timely, transparent, and context-specific communication to stakeholders, including health authorities, policymakers, scientists, clinicians, and the public. This review examines current WBS communication practices, identifies persistent challenges, and proposes strategies to enhance relevance. Key challenges include data complexity, lack of standardised communication frameworks, ethical and privacy concerns, and variable stakeholder capabilities. The strategic use of digital platforms, such as dashboards, reports, press releases, and social media, alongside traditional media, can broaden reach and aid interpretation. Rapid, accurate, and empathetic communication is essential during health crises to maintain trust and counter misinformation. Standardised messaging, simplified data visualisations, and integration with clinical surveillance systems enhance credibility and usability. Strengthening cross-sector collaboration, improving data interpretation, and translating findings into actionable insights are essential to maximising the public health benefits of WBS. Immediate efforts should prioritise building globally coordinated, adaptive communication networks that can evolve alongside surveillance technologies and emerging health threats. Overall, the review underscores the key role of strategic communication in advancing WBS for global health preparedness and optimising public health actions.}, }
@article {pmid41025538, year = {2025}, author = {Masoudi, MR and Sadeghi, R and Salehi, S and Pour, ER and Nezhad, MZ and Kazemi, S and Rafati, A}, title = {Lessons from the field: a systematic review of global and continental prevalence and challenges of People Living with HIV (COVID-19).}, journal = {AIDS care}, volume = {37}, number = {12}, pages = {2085-2093}, doi = {10.1080/09540121.2025.2562562}, pmid = {41025538}, issn = {1360-0451}, mesh = {Humans ; *COVID-19/epidemiology ; *HIV Infections/epidemiology/drug therapy ; Global Health ; Prevalence ; Health Services Accessibility ; SARS-CoV-2 ; Pandemics ; Delivery of Health Care ; }, abstract = {ABSTRACTCOVID-19, caused by SARS-CoV-2, accounts for 186 million infections and more than 4 million deaths globally. This systematic review concentrates on the epidemiological profiling of HIV/AIDS, along with the unique challenges posed by COVID-19 in delivering health services across different regions of the world. This review includes 16 studies and documents from various world regions that show the negative effects of the pandemic on HIV treatment and services. A reduction in medication compliance, missing appointments, and interruption of both clinical and non-clinical HIV-related services has been reported. Additional barriers to obtaining HIV care include fear of infection, lack of transportation and poverty. The review calls for formal agreements between governments, health systems and public health expert communities to make health systems more responsive to the needs of PLWH during and after the COVID-19 pandemic.}, }
@article {pmid41025094, year = {2025}, author = {Kelleni, MT}, title = {Real-life practice of Kelleni's protocol in treatment and post exposure prophylaxis of SARS-CoV-2 HV.1 and JN.1 subvariants.}, journal = {World journal of virology}, volume = {14}, number = {3}, pages = {107903}, pmid = {41025094}, issn = {2220-3249}, abstract = {This article discusses the evolving real-world practice using nitazoxanide, non-steroidal anti-inflammatory drugs (NSAIDs) and/or azithromycin (Kelleni's protocol) to manage the evolving manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron EG.5.1, its descendant HV.1 as well as BA.2.86 and its descendant JN.1 subvariants in Egypt in 2024. These subvariants are well-known for their highly evolved immune-evasive properties and the manifestations include some peculiar manifestations as persistent cough besides high fever in young children as well as high fever, persistent severe cough, change of voice, loss of taste and smell, epigastric pain, nausea, vomiting, diarrhea, generalized malaise and marked bone aches in adults including the high-risk groups. It's suggested that the ongoing SARS-CoV-2 evolution is continuing to mostly affect the high-risk groups of patients, to some of whom we've also successfully prescribed nitazoxanide and/or NSAIDs for post-exposure prophylaxis of all household contacts. We also continue to recommend starting the immune-modulatory antiviral Kelleni's protocol as soon as possible in the course of infection and adjusting it in a personalized manner to be more aggressive from the beginning for the high risk patients, at least until the currently encountered surge of infections subsides.}, }
@article {pmid41025090, year = {2025}, author = {Gavkare, AM and Nanaware, NL and Sonar, MN and Dhotre, SV and Mumbre, SS and Nagoba, BS}, title = {Gut microbiome and viral infections: A hidden nexus for immune protection.}, journal = {World journal of virology}, volume = {14}, number = {3}, pages = {111912}, pmid = {41025090}, issn = {2220-3249}, abstract = {The gut microbiome plays a crucial role in regulating immune responses, influencing susceptibility to viral infections, shaping disease progression, and its outcomes. Emerging research highlights the intricate relationship between gut microbial communities and viral pathogenesis, demonstrating that dysbiosis can compromise antiviral defenses while a balanced microbiome enhances immune resilience. This review explores key microbial mechanisms, including microbiome-mediated immune modulation, interactions with viral replication, and the impact of microbiome on systemic inflammation, highlighting how dietary interventions, such as probiotics, prebiotics, and bioactive compounds, offer potential strategies to modulate gut microbiota and mitigate viral infections. Special emphasis is placed on viruses affecting the gastrointestinal and respiratory systems, including severe acute respiratory syndrome coronavirus 2, norovirus, and influenza. Furthermore, we explore how nutrition-driven microbiome interventions may serve as adjunct therapeutic strategies, improving vaccine efficacy and post-viral recovery. Understanding the role of gut microbiome in viral infections can pave the way for microbiome-driven strategies to combat viral diseases and improve overall health outcomes.}, }
@article {pmid41025000, year = {2025}, author = {Terrington, I and Cox, O and Copley, P and Eastwood, B and Webb, E and McKenzie, C and Saeed, K and Conway-Morris, A and Grocott, MPW and Dushianthan, A}, title = {The role of corticosteroids in the management of non-COVID-19 severe community-acquired pneumonia in the intensive care unit: A narrative review.}, journal = {Journal of the Intensive Care Society}, volume = {}, number = {}, pages = {17511437251374816}, pmid = {41025000}, issn = {1751-1437}, abstract = {Severe community-acquired pneumonia (sCAP) is associated with a significant health burden, both in the UK and globally, with intensive care support needed for many patients. The high morbidity and mortality associated with sCAP has led to the exploration of adjunctive therapies that may help reduce disease burden and improve clinical outcomes. One such proposed treatment is corticosteroids, aiming to moderate the disproportionate inflammation caused by sCAP. Despite several studies suggesting potential benefits, the use of corticosteroids in patients with sCAP remains contentious, with recent large trials producing conflicting results. These variations in trial outcomes have resulted in conflicting national and international guidelines. Such discrepancies align with findings from a recent national survey that indicated ongoing clinical uncertainty regarding the use of corticosteroids for sCAP in UK intensive care units. Several factors contribute to these conflicting outcomes, including patient population, the severity classification utilised, the type and duration of interventions provided, and, perhaps most importantly, the lack of pre-phenotyping to identify patients who may benefit most from the treatment. This narrative review aims to examine the recent literature, current guidelines, and evidence for using corticosteroids in sCAP, while exploring the candidate phenotypes of relevance in the design of clinical trials.}, }
@article {pmid41024950, year = {2025}, author = {Gembillo, G and Peritore, L and Spadaro, G and Cuzzola, F and Calderone, M and Messina, R and Di Piazza, S and Sudano, F and Gambuzza, ME and Princiotto, M and Soraci, L and Santoro, D}, title = {Kidney involvement and anemia in COVID-19 infection.}, journal = {World journal of nephrology}, volume = {14}, number = {3}, pages = {107582}, pmid = {41024950}, issn = {2220-6124}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease 2019 (COVID-19), has infected > 700 million people and led to > 7 million deaths worldwide. Although COVID-19 primarily affects the lungs, it can also affect the kidneys through various pathways. SARS-CoV-2 affects the kidney via several common mechanisms, such as dysregulation of angiotensin-converting enzyme 2, transmembrane serine protease 2 and tissue proteinase L expression in kidney tissue. People with chronic kidney disease (CKD) and COVID-19 have an increased risk of mortality and hospitalization in the intensive care unit. Anemia, a common consequence of CKD, is also associated with worsening outcomes in COVID-19 patients. In these patients with multiple comorbidities, there is a sharp increase in D-dimers, inflammatory parameters, creatinine and blood urea nitrogen. COVID-19 patients also present with resistance to erythropoietin (EPO)-stimulating agents, which necessitates elevated dosages even several months post-infection. In CKD, anemia is exacerbated by decreased EPO production, red blood cell (RBC) fragmentation due to impairment of the renovascular endothelium in situations such as glomerulopathy and malignant hypertension. Other factors include iron and/or folic acid deficiency, bleeding due to platelet dysfunction, inflammation, reduced RBC lifespan, poor iron utilization, uremia, and atypical blood loss after dialysis. Excessive hepcidin synthesis impairs the absorption of dietary iron and the mobilization of iron from endogenous reserves, thus contributing significantly to anemia and poor iron regulation in CKD. These findings suggest that CKD may contribute to the occurrence of anemia in COVID-19 patients, especially in older people with comorbidities. Our review aims to explore the complex relationship between CKD, COVID-19 and anemia to improve our understanding of the underlying mechanisms of the disease and the potential cofactors that worsen outcomes in these patients.}, }
@article {pmid41024407, year = {2025}, author = {Zhou, R and Shi, K and Li, S and Zhou, W}, title = {Intervention Effectiveness of Health Behaviors During COVID-19: A Systematic Review and a Network Meta-Analysis.}, journal = {PsyCh journal}, volume = {}, number = {}, pages = {}, doi = {10.1002/pchj.70054}, pmid = {41024407}, issn = {2046-0260}, support = {21XXJC04ZD//Zhejiang Province Philosophy and Social Sciences Emerging (Cross disciplinary) Major Project "Research on Public Risk Perception, Behavioral Patterns, and Countermeasures under Major Public Health Emergencies"/ ; }, abstract = {In the context of a global public health crisis, such as COVID-19, developing interventions to improve population health behaviors has emerged as a pivotal element of health management strategies. The efficacy of various interventions implemented during this period has varied, and the impact of different variables on these intervention outcomes remains to be fully elucidated. This study screened 57 papers (n = 47,264) by searching electronic databases and revealed the optimal intervention through pairwise meta-analysis and network meta-analysis, as well as the changes in intervention effectiveness under different conditions. Our research findings indicate that interventions for preventive health behaviors and health-promoting behaviors have significant effects. For preventive health behaviors, the intervention method of health education and low-risk information framework under information intervention was the optimal intervention. For health-promoting behaviors, the exercise intervention and the prosocial information framework with information intervention were the optimal interventions. Accordingly, future research should focus on the in-depth exploration of specific interventions to establish and improve the effectiveness of interventions.}, }
@article {pmid41024361, year = {2025}, author = {Stolte, KN and Slots, J and Dommisch, H}, title = {The Role of Viruses in the Pathogenesis of Periodontitis.}, journal = {Journal of periodontal research}, volume = {}, number = {}, pages = {}, doi = {10.1111/jre.70039}, pmid = {41024361}, issn = {1600-0765}, abstract = {Periodontitis is a multifactorial inflammatory disease, traditionally attributed to a bacterial biofilm. Increasing evidence indicates that viruses, especially members of the Herpesviridae family, are frequently detected in periodontal lesions and may influence disease onset and progression. This review provides an overview of viruses present in the oral cavity, including Herpesviridae, Papillomaviridae, Retroviridae, SARS-CoV-2, and emerging viral taxa such as Redondoviridae and bacteriophages, and summarizes their reported associations with periodontitis. Proposed mechanisms of viral contribution include modulation of local immune responses, facilitation of bacterial overgrowth, direct cytopathic effects on periodontal tissues, and synergistic interactions with classical periodontal pathobionts. Clinical correlations link viral load and co-infections with increased disease severity. Identification of direct causal relationships and therapeutic aspects, such as antiviral and combined antimicrobial approaches, is the subject of current research; however, clinical evidence remains limited. Overall, specific viruses show direct influence on periodontal bacterial pathogens and affect the host immune response, warranting further longitudinal and functional studies to clarify their exact role in periodontitis onset, progression, and treatment.}, }
@article {pmid41023991, year = {2025}, author = {Najafi-Olya, Z and Heydarifard, Z and Looha, MA and Ahmadi, AS and Yarhamadi, N and Safaei, M}, title = {Antibiotic resistance and bacterial co-infections in COVID-19 patients in Iran: a systematic review and meta-analysis of hospitalized and non-hospitalized cases.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {1197}, pmid = {41023991}, issn = {1471-2334}, abstract = {BACKGROUND: The COVID-19 pandemic exacerbated antimicrobial resistance (AMR) in Iran, where up to 100% of hospitalized patients received antibiotics despite low bacterial co-infection rates. However, no comprehensive review has evaluated the burden of bacterial co-infections, antibiotic resistance (AR), and multi-drug resistance (MDR) across both hospitalized and non-hospitalized Iranian COVID-19 patients. This systematic review and meta-analysis aimed to determine the prevalence of bacterial infections, AR, and MDR during the COVID-19 era in Iran.<br><br>METHODS: Following PRISMA 2020 guidelines, we systematically searched MEDLINE (PubMed), Embase, Scopus, Web of Science, and Iranian regional databases for studies published from January 2020 to March 2025. The review protocol was registered with the Open Science Framework (OSF; 10.17605/OSF.IO/SCBRX). Fifteen studies comprising 36,403 COVID-19 patients&#x2014;33,989 inpatients (including 22,875 treated in intensive-care units) and 2,414 outpatients&#x2014;met the inclusion criteria. We combined results from multiple studies to determine overall rates of bacterial infections, antibiotic resistance, and multi-drug resistance, using methods that account for differences between studies.<br><br>RESULTS: The pooled prevalence of bacterial co-infection among Iranian COVID-19 patients was 19.6% (95% CI: 17.8&#x2013;21.4%) across hospitalized and non-hospitalized settings. Among hospitalized patients, secondary bacterial infections were predominantly caused by Gram-negative pathogens: Klebsiella pneumoniae (36.2%), Acinetobacter baumannii (28.4%), Escherichia coli (24.8%), and Pseudomonas aeruginosa (11.7%). High heterogeneity (I&#xb2; >90%) was observed across most pooled estimates. Critical antimicrobial resistance rates were observed particularly in hospitalized settings, with carbapenem resistance reaching 91% for imipenem and 88% for meropenem in A. baumannii. Given that 63% of the cohort were ICU patients, the high secondary bacterial infection and resistance rates likely reflect risk factors such as mechanical ventilation and prolonged hospitalization.<br><br>CONCLUSION: Iran&#x2019;s AMR crisis during the COVID-19 era affects both hospitalized and non-hospitalized patients, with particularly concerning rates in healthcare settings. The predominance of hospitalized cases in available literature (ICU-heavy cohorts) reflects the urgent need for antimicrobial stewardship programs targeting hospital-based carbapenem-sparing regimens, while highlighting the need for improved surveillance across all COVID-19 care settings.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-025-11643-6.}, }
@article {pmid41023941, year = {2025}, author = {Fang, J and Xu, J and Zhou, X and Wang, Z and Guo, X and Zhang, Y and Jiang, Y and Xu, Y and Zhou, X and Cust, H and Correa, A}, title = {The impact of the COVID-19 pandemic on smoking in adolescents: a scoping review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {3145}, pmid = {41023941}, issn = {1471-2458}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Adolescent ; *Smoking/epidemiology/psychology ; *Adolescent Behavior/psychology ; Pandemics ; Young Adult ; Child ; }, abstract = {BACKGROUND: The COVID-19 pandemic and associated policies have influenced adolescent smoking behaviours, with potential impacts on smoking initiation, cessation, and addiction. This scoping review aims to summarise existing evidence on how the pandemic affected adolescent smoking behaviour across various contexts.<br><br>METHODS: A systematic search was conducted in September 2023 across three databases-Embase, APA PsycInfo, and Medline-using terms related to adolescents, COVID-19 exposure, and smoking behaviours. Studies were included if they focused on adolescents aged 12-21, examined smoking-related outcomes during or after the pandemic, and were published from 2019 onwards. Study quality was not assessed in this research. The search identified 18 studies, which were independently screened by two reviewers, with conflicts resolved by a third reviewer. Thematic analysis was used to categorise the studies.<br><br>RESULTS: Of the 18 studies, most were retrospective and focused on high-income countries, including the United States, Israel, and the Netherlands. Trends in smoking behaviour varied, with some studies reporting increased smoking during the pandemic, particularly in regions like the United States and Netherlands; others observed reductions in smoking, such as in France and Spain; and others observed mixed results, such as South Korea. The impact of mental health was significant, with increased anxiety and depression linked to higher smoking rates, especially in the United States and Israel. Several known risk factors, such as peer influence, parental smoking habits, and family dynamics, also played a role. Reduced peer interactions and time spent with family were associated with reductions in smoking behaviour. In contrast, adverse family dynamics or the presence of smoking family members contributed to higher smoking rates. Further, the impact of COVID-19 on these factors varied: peer influence decreased due to social distancing measures, while mental health issues such as increased anxiety and depression were associated with higher smoking rates.<br><br>CONCLUSION: This review highlights the complex and heterogeneous impacts of COVID-19 on adolescent smoking behaviours. Mental health, social interactions, and family dynamics were key factors influencing smoking patterns. These findings can inform the development of targeted smoking cessation and prevention strategies for adolescents, particularly in the context of future public health crises.}, }
@article {pmid41023525, year = {2025}, author = {McGuigan, A}, title = {CT-P47/Tocilizumab-anoh: A Tocilizumab Biosimilar.}, journal = {Clinical drug investigation}, volume = {45}, number = {12}, pages = {1007-1011}, pmid = {41023525}, issn = {1179-1918}, mesh = {Humans ; *Antibodies, Monoclonal, Humanized/therapeutic use/pharmacokinetics/adverse effects ; *Biosimilar Pharmaceuticals/therapeutic use/adverse effects/pharmacokinetics ; COVID-19 Drug Treatment ; Arthritis, Rheumatoid/drug therapy ; }, abstract = {CT-P47/tocilizumab-anoh (AVTOZMA[®]) is a biosimilar of reference tocilizumab, an IL-6R inhibitor. CT-P47 is approved for treating rheumatoid arthritis, giant cell arteritis, polyarticular juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, Coronavirus disease 2019 and cytokine release syndrome in the USA and the EU. CT-P47 has similar physicochemical properties to those of reference tocilizumab, with demonstrated pharmacokinetic comparability in patients with moderate to severe rheumatoid arthritis. In this patient population, CT-P47 demonstrated clinical efficacy equivalent to reference tocilizumab and was generally well tolerated. The overall safety and immunogenicity profiles of CT-P47 were similar to those of reference tocilizumab, and switching from reference tocilizumab to CT-P47 did not affect safety or efficacy. The role of reference tocilizumab in the management of inflammatory diseases is well established and CT-P47 provides an effective biosimilar alternative for patients requiring tocilizumab therapy.}, }
@article {pmid41022351, year = {2025}, author = {Danysz, M and De Aguiar, RC and Pindolia, H and Stuart, B and Spensley, K and Ashmore, E and Frumento, N and Haouidji-Javaux, N and Hutchinson, C and Iles, R and Lau, S and Rolt, J and Uwenedi, G and Wagg, H and Barnes, E and Lim, SH and Richter, A and Willicombe, M}, title = {Association between COVID-19 vaccine immunogenicity and protection against infection and severe disease in clinically vulnerable patient populations: a systematic review and meta-analysis of observational studies.}, 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.2025.09.020}, pmid = {41022351}, issn = {1469-0691}, abstract = {BACKGROUND: The use of measured immune responses in informing risk of breakthrough COVID-19 infection and infection outcomes after vaccination against SARS-CoV-2 in clinically vulnerable patients has not been applied clinically.<br><br>OBJECTIVES: The aim of this study was to investigate the association between measured vaccine immunogenicity and vaccine effectiveness in clinically vulnerable populations.<br><br>DATA SOURCES: PubMed, MEDLINE, EMBASE, and Cochrane Library.<br><br>STUDY ELIGIBILITY CRITERIA: Studies published between March 2020 and January 2025, which reported data on COVID-19 vaccine immunogenicity (antibody and T-cell) and subsequent infection outcomes.<br><br>PARTICIPANTS: Patients defined as clinically vulnerable by QCOVID criteria, who had received at least the primary course of COVID-19 vaccination.<br><br>ASSESSMENT OF RISK OF BIAS: The Newcastle-Ottawa Quality Assessment Scale was used to assess the risk of bias.<br><br>METHODS OF DATA SYNTHESIS: A random effects meta-analysis model was used to pool relative risks of COVID-19 breakthrough infection (BTI), hospitalization, and death. Unadjusted data were used for the primary analysis due to the lack of adjusted data available in individual studies.<br><br>RESULTS: We identified 3305 articles, of which 45 observational studies were included in the review. Negative antibody response following COVID-19 vaccination was associated with higher risks of BTI (Relative Risk (RR), 1.82 (1.45-2.29), p < 0.01, I[2] = 84.03%), COVID-19-related hospitalization (RR, 5.88 (4.08-8.47), p < 0.01, I[2] = 25.59%) and death (RR, 3.66 (1.87-7.15), p < 0.01), I[2] = 0%). Lack of T-cell response was associated with a higher risk of BTI (RR, 2.08 (1.08-4.04), p 0.03, I[2] = 65.99). Using the Newcastle-Ottawa Quality Assessment Scale, 5 (11%) studies were of good quality, 2 (7%) of fair quality, and 37 (82%) of poor quality.<br><br>CONCLUSIONS: Within the methodological limitations, this study has shown that lack of antispike antibody responses was associated with BTI and severe infection outcomes in clinically vulnerable populations. Further research is required to investigate the current utility of testing to inform the ongoing management of clinically vulnerable persons, such as vaccine booster schedules.}, }
@article {pmid41022213, year = {2025}, author = {Vardon, F and Fleischmann-Struzek, C and Latronico, N and Cinotti, R}, title = {Post-intensive care syndrome. What clinicians and researchers must know.}, journal = {Anaesthesia, critical care &amp; pain medicine}, volume = {45}, number = {1}, pages = {101620}, doi = {10.1016/j.accpm.2025.101620}, pmid = {41022213}, issn = {2352-5568}, abstract = {The COVID-19 pandemic has highlighted intensive care as a cornerstone of modern medicine. In spite of global aging and the increase of comorbidities in the general population, a large proportion of patients survive their hospitalization in the Intensive Care Unit (ICU). Nevertheless, these positive results are challenged by the higher mortality rates than other non-critically ill populations after discharge. Moreover, there is growing evidence that ICU survivors display a high rate of mental health disorders (anxiety and depression symptoms, post-traumatic stress disorders), somatic impairment (muscle atrophy, neuropathy, and myopathy with persistent muscle weakness, chronic kidney disease, chronic respiratory failure), or cognitive impairment. Patient's relatives also suffer from mental health disorders (anxiety and depression symptoms, complicated bereavement). All these chronic health issues significantly impair the quality of life and increase healthcare costs. Post-Intensive Care Syndrome (PICS) is a term that encompasses all these complications. The COVID-19 pandemic has highlighted PICS as a public health concern. This review summarizes the most recent findings on PICS. It addresses epidemiological data about the frequency of somatic disorders, cognitive impairment, and mental health problems in both patients and their relatives and describes the pathophysiology mechanisms underlying PICS. The review also provides insights into management experimentations and treatment interventions that have been tested so far to improve the outcome of critically ill survivors. Finally, the review proposes measures to implement PICS management in follow-up centers and a research agenda to pave the future research on this topic.}, }
@article {pmid41020600, year = {2025}, author = {Sengupta, S and Williamson, PR}, title = {mGem: When immunity turns against itself-GM-CSF autoantibodies drive opportunistic infection risk.}, journal = {mBio}, volume = {16}, number = {11}, pages = {e0138025}, pmid = {41020600}, issn = {2150-7511}, support = {AI001123, AI001124//National Institute of Allergy and Infectious Diseases/ ; }, mesh = {Humans ; *Autoantibodies/immunology ; *COVID-19/immunology ; *Granulocyte-Macrophage Colony-Stimulating Factor/immunology ; *Opportunistic Infections/immunology ; SARS-CoV-2/immunology ; Antibodies, Neutralizing/immunology ; }, abstract = {Anti-cytokine autoantibodies represent an expanding field in immunology, and their study has revealed crucial insights into immune cell dysfunction. These autoantibodies are now classified by the International Union of Immunological Societies (IUIS) as phenocopies of primary immunological deficiencies within the broader category of inborn immunity defects. Indeed, the critical importance of these autoantibodies became starkly apparent during the COVID-19 pandemic when patients with type I interferon autoantibodies showed significantly higher rates of severe illness. This review examines how neutralizing autoantibodies, exemplified by those targeting granulocyte monocyte stimulating factor, can compromise immune function in otherwise immunocompetent individuals, making them more susceptible to specific fungal and bacterial infections. This understanding highlights the crucial role of anti-cytokine antibodies in infection susceptibility and immune system regulation.}, }
@article {pmid41019515, year = {2025}, author = {Zeitouni, J and Osazuwa-Peters, N and Dundar, Y and Zimet, G and Varvares, MA}, title = {Two decades of the HPV vaccine: its promise, progress, prospects, projections, and posterity.}, journal = {Lancet regional health. Americas}, volume = {51}, number = {}, pages = {101243}, pmid = {41019515}, issn = {2667-193X}, abstract = {Since its 2006 FDA approval, the Human Papillomavirus (HPV) vaccine has transformed the prevention of cervical, oropharyngeal, and other HPV-associated cancers in the United States. Despite notable progress, with 78.2% of adolescents initiating and 62.9% completing vaccination, support for the vaccine is at a critical point. Because the Department of Health and Human Services (HHS) mainly provides recommendations, state-level action is crucial. Only five states and territories have adopted school-entry HPV vaccination requirements, but with varying enforcement policies. Uptake varies across the U.S., from Massachusetts' 79.8% completion to Mississippi's 39.1%. Evidence shows that school-entry requirements can significantly improve vaccination rates. As we approach the vaccine's twentieth anniversary, maintaining the current gains and achieving the 80% Healthy People 2030 target for series completion demands a multipronged approach. State policies must become more robust, especially if federal support wanes. Preventing HPV-related cancers for future generations depends on continued progress. By prioritizing policy that strengthens prevention and access, states can safeguard this progress.}, }
@article {pmid41018819, year = {2025}, author = {Nasr, R and Swaidan, E and Hachem, S and Yazbek, N and Rizk, M and Abdel Rahman, A and H Alami, N}, title = {Immunization safety monitoring: addressing vaccine hesitancy and enhancing coverage in crisis-affected regions-insights from Lebanon, Ukraine, and Sudan.}, journal = {Therapeutic advances in vaccines and immunotherapy}, volume = {13}, number = {}, pages = {25151355251380220}, pmid = {41018819}, issn = {2515-1355}, abstract = {Global vaccine hesitancy, intensified by crises such as the COVID-19 pandemic, represents a significant threat to immunization coverage. This narrative review discusses immunization safety monitoring frameworks and vaccine hesitancy in crisis-affected regions, particularly in Lebanon, Ukraine, and Sudan. By examining and reflecting on these case studies, this review aims to examine challenges, highlight context-specific strategies, and propose solutions for enhancing vaccine uptake and trust in fragile and conflict-affected areas. A structured narrative review was conducted, collecting evidence from global frameworks and region-specific case studies. The review explored factors impacting vaccine hesitancy, the role of adverse events following immunization (AEFI) monitoring systems, and innovative technological interventions. Key sources included peer-reviewed articles, reports from humanitarian organizations, and systematic reviews. The review showed that vaccine hesitancy is affected by interconnected factors, including sociopolitical and cultural conflicts, and misinformation. Lebanon's persistent economic and political instability, Ukraine's disruptions caused by the ongoing war, and Sudan's fragile healthcare infrastructure pose challenges to vaccine coverage. Successful interventions to address hesitancy included transparency in AEFI reporting, integration of real-time monitoring systems, and community-led initiatives. It is critical to mitigate vaccine hesitancy in crisis-affected regions through robust safety monitoring frameworks and tailored communication strategies. Global cooperation and frameworks, technological innovations, and context-specific approaches are imperative for improving the resilience of immunization systems and ensuring health security in fragile settings. Furthermore, these insights are crucial in informing public health communication policies and behavior change interventions to improve public trust and thus reduce vaccine hesitancy.}, }
@article {pmid41018222, year = {2025}, author = {Thomas, SM and Veerabathiran, R}, title = {Influence of COVID-19 on pediatric immunocompromised children: mechanism and implications for pathogenesis.}, journal = {Virusdisease}, volume = {36}, number = {2}, pages = {263-274}, pmid = {41018222}, issn = {2347-3584}, abstract = {The global coronavirus disease 2019 (COVID-19) outbreak, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has substantially impacted both health and the economy. It is essential to comprehend the effects of COVID-19 on children with compromised immune systems to develop effective strategies for management and mitigation. This review aims to provide comprehensive insights into various aspects related to pediatric COVID-19 infection and the effects of COVID-19 on the pediatric immunocompromised population. It covers epidemiology, pathogenesis, diagnosis, management, complications, long-term effects, and special considerations and challenges in diagnosis and management. A comprehensive examination of existing literature was undertaken to gather and integrate current understanding of COVID-19 in pediatric immunocompromised demographics. Key aspects such as viral pathogenesis, immune responses, diagnosis methods, management strategies, and nonpharmacological interventions were analyzed and discussed. Pediatric patients generally exhibit milder symptoms and better outcomes than adults, with differences in immune responses contributing to reduced severity. Immunocompromised individuals face a heightened risk of severe COVID-19 and complications due to impaired immune function. Diagnosis methods and management strategies must consider each population's unique characteristics and challenges. A deeper scientific inquiry is needed to explicate immune responses, potential long-term effects, and the best management strategies for pediatric immunocompromised COVID-19 patients. Multidisciplinary collaboration and advancements in diagnostics and therapeutics will enhance our understanding and improve outcomes for these vulnerable populations, ultimately contributing to effective pandemic control efforts.}, }
@article {pmid41017950, year = {2024}, author = {Madani, E and Dizani, A and Saeedi Tehrani, S and Madani, M}, title = {Introducing the ethical cycle model for resolving ethical conflicts in medical practice: addressing challenges in treating pandemic patients.}, journal = {Journal of medical ethics and history of medicine}, volume = {17}, number = {}, pages = {15}, pmid = {41017950}, issn = {2008-0387}, abstract = {Ethical dilemmas are among the most important ethical problems in medicine. With the advent of COVID-19, the moral problems of physicians have taken on new dimensions as the specific features of this disease pose additional ethical challenges that require particular solutions. One common way to solve ethical dilemmas is to use ethical decision making models. One of the most recent models in ethics of technology is the "ethical cycle" developed by Ibo van de Poel. By describing and comparing several models, this paper examines the application of the ethical cycle to physicians' ethical problems and medical ethics. This model can help solve complex problems in consultations and ethics committee meetings because it is comprehensive and covers various aspects of the discussion. In this model, first the ethical problem is formulated and analyzed and then the potential options for action are proposed. Subsequently, by referring to ethical theories and professional codes of conduct in the medical field, as well as applying the method of "reflective equilibrium," an ethical decision is reached. This decision is specific to each case and may not necessarily be the best solution for other individuals or situations.}, }
@article {pmid41017906, year = {2025}, author = {Rumpler, E and Lipsitch, M}, title = {Equity considerations in COVID-19 vaccine allocation modelling: a methodological study.}, journal = {Interface focus}, volume = {15}, number = {4}, pages = {20240037}, pmid = {41017906}, issn = {2042-8898}, abstract = {We conducted a methodological study of COVID-19 vaccine allocation modelling papers, specifically looking for publications that considered equity. We found that most models did not take equity into account, with the vast majority of publications presenting aggregated results and no results by any subgroup (e.g. age, race, geography, etc.). We then provide examples of how modelling can be useful to answer equity questions, and highlight some of the findings from the publications that did. Finally, we describe eight considerations that seem important to consider when including equity in future vaccine allocation models.}, }
@article {pmid41017820, year = {2025}, author = {Vinhas, R and Oliveira, F and Fonseca, L and Hodel, K and Mafra, C and Minafra, C and Gonçalves, M and Machado, B}, title = {The Role of BSL-3 Laboratories in Pandemic Preparedness: A Focus on Brazil's Infrastructure for Biosafety and Disease Control.}, journal = {TheScientificWorldJournal}, volume = {2025}, number = {}, pages = {9104904}, pmid = {41017820}, issn = {1537-744X}, mesh = {Brazil/epidemiology ; Humans ; *Containment of Biohazards/methods/standards ; *COVID-19/prevention &amp; control/epidemiology ; *Laboratories/standards/organization &amp; administration ; *Pandemics/prevention &amp; control ; SARS-CoV-2 ; Pandemic Preparedness ; }, abstract = {BSL-3 laboratories are fundamental for the safe handling of infectious microorganisms that require high-containment measures. Through a literature review, this work was aimed at highlighting the importance of these laboratories in supporting research and public health responses, especially during health emergencies. The review presents an overview of the global distribution of BSL-3 facilities, the impacts of the COVID-19 pandemic on laboratory investments, and future perspectives on their role in national development. It was observed that the pandemic exposed limitations in laboratory capacity, leading many countries to operate in suboptimal environments, underscoring the need for strict biosafety standards and preparedness infrastructure. This review also identifies disparities in global BSL-3 capacity-particularly in low- and middle-income countries-and examines the Brazilian context, where the absence of a unified regulatory framework hinders progress. By synthesizing international trends and Brazil's recent initiatives, including the development of its first BSL-4 laboratory, this work contributes to understanding the challenges and opportunities for strengthening biosafety infrastructure in support of equitable pandemic preparedness.}, }
@article {pmid41017701, year = {2025}, author = {Habibi, SAH and Eissazade, N and Lotfi, T and Parvaresh-Rizi, M and Shahidi, G and Rohani, M}, title = {Parkinsonism-Hyperpyrexia Syndrome Following Deep Brain Stimulation Battery Depletion during the COVID-19 Pandemic: A Case Series and Review of the Literature.}, journal = {Movement disorders clinical practice}, volume = {}, number = {}, pages = {}, doi = {10.1002/mdc3.70320}, pmid = {41017701}, issn = {2330-1619}, abstract = {BACKGROUND: Parkinsonism-hyperpyrexia syndrome (PHS) is a rare but life-threatening complication in Parkinson's disease (PD), typically triggered by abrupt withdrawal of dopaminergic therapy. It can also occur following deep brain stimulation (DBS) failure, most often due to battery depletion. Limited access to elective neurological care during the COVID-19 pandemic increased the risk of such DBS-related complications.<br><br>CASES: We present seven patients with advanced PD who developed PHS following DBS battery depletion during the COVID-19 pandemic. All patients exhibited motor deterioration, autonomic symptoms, and elevated creatine phosphokinase levels. Despite varied outcomes, five patients recovered following urgent battery replacement and supportive care. Two patients died due to delayed intervention and systemic complications.<br><br>LITERATURE REVIEW: A review of 38 published cases of PHS following DBS failure revealed that to date, it has occurred in patients with more than 11&#x2009;years of PD and at least 2&#x2009;years of DBS. IPG battery depletion was the leading cause of failure (68.4%), with 76.3% of patients recovering after timely device replacement. Delayed or absent intervention was associated with higher mortality, underscoring the importance of prompt diagnosis and management.<br><br>CONCLUSION: Timely intervention, remote monitoring, and virtual follow-up are critical to prevent PHS, especially during healthcare disruptions like the COVID-19 pandemic.}, }
@article {pmid41016951, year = {2025}, author = {Atoom, AM and Abdulsahib, WK and Jyothi, SR and Nayak, PP and Chauhan, AS and Singla, S and Polatova, D and Sead, FF and Yazdi, F}, title = {β-Glucan in antiviral defense: mechanisms, immune modulation, and therapeutic prospects.}, journal = {Folia microbiologica}, volume = {}, number = {}, pages = {}, pmid = {41016951}, issn = {1874-9356}, abstract = {β-Glucans, naturally occurring β-D-glucose polysaccharides from fungi, yeast, bacteria, algae, and cereals, have emerged as promising immunomodulatory agents in antiviral defense. Their structural diversity-encompassing β-1,3, β-1,6, and β-1,4 linkages-underpins varied solubility, bioavailability, and biological activity, driving their therapeutic potential. Unlike conventional antivirals that target viral replication, β-glucans enhance host immunity by activating innate and adaptive responses through receptors such as dectin-1, toll-like receptors, and complement receptor 3, thereby stimulating macrophages, neutrophils, and natural killer cells to produce antiviral cytokines (e.g., interferons, interleukins) and induce trained immunity for long-term protection. This review explores β-glucans's mechanisms in combating viral infections, including SARS-CoV-2, HPV, HBV, influenza, and HIV, highlighting direct antiviral effects (e.g., inhibiting viral entry via sulfated derivatives), immune modulation (e.g., enhancing T-cell responses and antibody production), and inflammation control (e.g., mitigating cytokine storms). Preclinical and clinical evidence underscores their ability to reduce viral load, enhance vaccine efficacy, and support tissue repair, as seen in HPV-related lesions. β-Glucans also modulate the gut microbiota, bolstering mucosal immunity. Despite promising outcomes, challenges like structural heterogeneity and limited large-scale trials persist. This article outlines the therapeutic prospects of β-glucans, emphasizing their potential as safe and versatile adjuncts to address emerging viral threats and enhance global health resilience.}, }
@article {pmid41016805, year = {2025}, author = {Tamura, T}, title = {[Study on the pathogenicity and tropism of positive-strand RNA viruses].}, journal = {Uirusu}, volume = {75}, number = {1}, pages = {59-72}, doi = {10.2222/jsv.75.59}, pmid = {41016805}, issn = {0042-6857}, mesh = {*Viral Tropism/genetics ; Animals ; Humans ; Genome, Viral/genetics ; *Flaviviridae/pathogenicity/genetics/physiology ; *RNA Viruses/pathogenicity/genetics ; Viral Proteins/physiology ; Virulence ; }, abstract = {Many of the emerging and re-emerging viral diseases that have caused global outbreaks in recent years -such as severe acute respiratory syndrome (SARS), dengue fever, Zika virus disease, and COVID-19 -are caused by positive-sense single-stranded RNA (+ssRNA) viruses. This review focuses on members of the Flaviviridae family, a diverse group of +ssRNA viruses that exhibit distinct host and tissue tropisms, and summarizes our recent efforts to elucidate the molecular determinants underlying their pathogenicity and tropism. By refining reverse genetics systems that enable precise manipulation of viral genomes, we have uncovered the functional roles of specific viral proteins in pathogenesis through experimental infections using animal models that recapitulate disease phenotypes. In addition, by analyzing structural variations within viral genomes, we successfully identified key elements responsible for determining viral specificity. We have also developed innovative viral reporter assays that incorporate advanced imaging technologies, enabling real-time visualization of viral dynamics in vivo and facilitating diagnostic applications. This review integrates these findings to provide insights into how pathogenicity and tissue tropism evolve through repeated interspecies transmission, and discusses the potential of such approaches as a foundational platform for future infectious disease research and countermeasures.}, }
@article {pmid41016804, year = {2025}, author = {Ishii, H}, title = {[Elucidation of virus-host interaction using animal models towards vaccine development].}, journal = {Uirusu}, volume = {75}, number = {1}, pages = {51-58}, doi = {10.2222/jsv.75.51}, pmid = {41016804}, issn = {0042-6857}, mesh = {Animals ; CD8-Positive T-Lymphocytes/immunology ; Antibodies, Neutralizing/immunology ; Humans ; *Vaccine Development ; COVID-19/prevention &amp; control ; SARS-CoV-2/immunology ; Disease Models, Animal ; Antibodies, Viral/immunology ; Simian Immunodeficiency Virus/immunology ; COVID-19 Vaccines ; Macaca ; Virus Replication ; *Host Microbial Interactions/immunology ; AIDS Vaccines/immunology ; }, abstract = {HIV replication highly interacts with host immunity resulting in life-long persistent virus replication in the presence of adaptive immune responses. Development of an effective vaccine is a key for control of global HIV epidemic, but immunization methods to induce effective anti-HIV immune responses have not been established. We have been focusing on analyzing virus-host immune interaction in vivo using animal models and applying findings to the development of vaccines. We have developed a novel immunogen selectively inducing virus-specific CD8+ T-cell responses and showed protective efficacy of vaccines against intrarectal SIV challenge. We have also worked on antibody responses, and determined the polymorphism in germline immunoglobulin genes in macaques and its association with induction of a particular class of anti-SIV neutralizing antibody. We applied the knowledge in HIV research to HTLV and COVID-19, showing protective efficacy of vaccine-induced neutralizing antibody against HTLV infection and viral suppression by vaccine-induced CD8+ T-cell responses against SARS-CoV-2 in macaque models.}, }
@article {pmid41016800, year = {2025}, author = {Tanaka-Taya, K}, title = {[Epidemiology of measles in Japan].}, journal = {Uirusu}, volume = {75}, number = {1}, pages = {23-34}, doi = {10.2222/jsv.75.23}, pmid = {41016800}, issn = {0042-6857}, mesh = {Humans ; *Measles/epidemiology/prevention &amp; control ; Japan/epidemiology ; Measles Vaccine/administration &amp; dosage ; Child ; Disease Outbreaks/prevention &amp; control ; Child, Preschool ; Infant ; Vaccination ; Vaccination Coverage ; Adolescent ; }, abstract = {As of May 2025, measles outbreaks have been occurring worldwide. Japan has reported the highest number of cases since the beginning of the COVID-19. Unvaccinated measles cases are highly contagious and at high risk for serious illness, so it is important to ensure that children receive the live attenuated measles-rubella (MR) vaccine as soon as they become one year old. Additionally, the second routine immunization coverage rate must be raised to 95% or higher among five-to six- year-old children (one year before entering elementary school). For elementary school students and older individuals, it is important to check the vaccine records showing two doses of a measles-containing vaccine administered at or after one year of age. Those born on or after April 2, 1990, had the opportunity to receive two routine vaccinations; however, their records must be checked to confirm receipt. We also recommend checking vaccination records before traveling abroad. Additionally, rapid active epidemiological surveillance should be conducted in the event of a single measles case. Emergency vaccination within 72 hours of exposure for susceptible individuals may prevent the disease. For individuals ineligible for vaccination, health insurance covers the prevention of severe disease through an intramuscular injection of human immunoglobulin within six days of exposure. The most important measure is prophylaxis prior to exposure to the measles virus.}, }
@article {pmid41016568, year = {2025}, author = {Li, J and Yang, W and Liu, X and Yang, K and Zhou, J and Yang, X}, title = {Research progress of lung organoids in infectious respiratory diseases.}, journal = {European journal of pharmacology}, volume = {1006}, number = {}, pages = {178201}, doi = {10.1016/j.ejphar.2025.178201}, pmid = {41016568}, issn = {1879-0712}, mesh = {*Organoids/virology/pathology/drug effects ; Humans ; *Lung/virology/pathology/cytology ; Animals ; COVID-19/virology/pathology ; SARS-CoV-2 ; }, abstract = {Infectious respiratory diseases are common epidemics that often exhibit phased outbreaks, increasing the healthcare burden. Past research models for these diseases were relatively simplistic, but the emergence of organoids has transformed this landscape. Organoids, three-dimensional in vitro tissue analogs that recapitulate specific spatial organ structures derived from stem cell culture, have advanced significantly over the decade since their inception. Compared to conventional animal models, organoids circumvent interspecies variations, enabling a more precise representation of human physiological and pathological traits. Relative to two-dimensional cell cultures, organoids exhibit enhanced complexity, incorporating diverse cell types and maintaining stable genomes, which facilitates a more faithful simulation of cellular interactions within the extracellular microenvironment. Consequently, as a three-dimensional in vitro model, lung organoids are pivotal for investigating lung organ development, infectious disease pathogenesis, and drug screening. Although SARS-CoV-2 is receding from the spotlight, advancing lung organoid development for addressing infectious respiratory diseases like influenza remains a priority. This review demonstrated the differentiation culture process of lung organoids and outlined advancements in utilizing organoids to elucidate pathogenic infection mechanisms, reveal virus-host interactions and screen therapeutic drugs over the past seven years. Additionally, we have summarized the advances in lung organoid model technologies and outlined their developmental directions.}, }
@article {pmid41016477, year = {2025}, author = {Zhao, A and Tang, Y and Shi, X and Fan, W}, title = {Interstitial drug delivery system: Physiological basis and (pre)clinical progress.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {388}, number = {Pt 1}, pages = {114275}, doi = {10.1016/j.jconrel.2025.114275}, pmid = {41016477}, issn = {1873-4995}, mesh = {Humans ; *Drug Delivery Systems/methods ; Animals ; COVID-19 ; *COVID-19 Vaccines/administration &amp; dosage ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; *Extracellular Fluid ; }, abstract = {The interstitial drug delivery system, with a long-standing history in pharmaceutical science, has recently regained significant attention due to its pivotal role in enhancing drug transport to lymphatic vessels and improving lymph node targeting. The success of mRNA vaccines against SARS-CoV-2 during the COVID-19 pandemic has ushered in a new era for interstitial-based drug delivery strategies. Consequently, advancing the development of next-generation interstitial delivery systems necessitates a deeper understanding of interstitial physiology. This review systematically summarizes the physiological composition and functions of the interstitium, discusses the distinct characteristics of diverse interstitial administration routes, evaluates recent advances in formulation design and clinical translation efforts of advanced delivery systems, and highlights current challenges and future directions in the field. By providing this comprehensive analysis, we aim to stimulate the wider clinical application of interstitial delivery systems in therapeutic practice.}, }
@article {pmid41016268, year = {2025}, author = {Carvalho-Silva, JM and Dos Reis, AC}, title = {Antiviral activity of silver and selenium nanoparticles against SARS-CoV-2: A comprehensive systematic review of in vitro, in vivo, and clinical evidence.}, journal = {Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS)}, volume = {92}, number = {}, pages = {127768}, doi = {10.1016/j.jtemb.2025.127768}, pmid = {41016268}, issn = {1878-3252}, abstract = {OBJECTIVES: This systematic review aimed to answer the following question: "Do silver (AgNPs) and selenium (SeNPs) nanoparticles, either individually or incorporated into materials and products, exhibit antiviral activity against SARS-CoV-2 strains?"<br><br>METHODS: This review was registered in PROSPERO and conducted following the PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive search was performed in PubMed, Scopus, Embase, LILACS, ScienceDirect, Google Scholar, and ProQuest in March 2025 to identify studies evaluating the effects of isolated or material-incorporated AgNPs and SeNPs against SARS-CoV-2.<br><br>RESULTS: AgNPs and SeNPs exhibit strong virucidal and antiviral activity against SARS-CoV-2 and its Spike glycoprotein, both as isolated nanoparticles and when incorporated into masks, goggles, polymers, sprays, coatings, mouthwashes, and solutions. High efficacy has been demonstrated across in vitro, in vivo, and clinical studies, with enhanced outcomes associated with smaller particle sizes, higher concentrations, and longer contact times.<br><br>CONCLUSION: Both isolated and material-integrated AgNPs and SeNPs exhibit high antiviral and virucidal effectiveness against multiple SARS-CoV-2 strains in vitro, in vivo, and in clinical studies.}, }
@article {pmid41016229, year = {2025}, author = {Chaudhry, T and Tum, P and Morrow, F and Hargreaves, S and Kielmann, K and Kunst, H and Griffiths, C and Campbell, NJC and Zenner, D}, title = {Facilitators to strengthening vaccine uptake post-pandemic amongst underserved populations considering social norms and health beliefs: a global systematic review.}, journal = {Vaccine}, volume = {65}, number = {}, pages = {127769}, doi = {10.1016/j.vaccine.2025.127769}, pmid = {41016229}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; *COVID-19 Vaccines/administration &amp; dosage ; Ethnicity ; Global Health ; Health Knowledge, Attitudes, Practice ; Minority Groups/psychology ; Pandemics ; Patient Acceptance of Health Care ; SARS-CoV-2 ; *Social Norms ; Trust ; *Vaccination/psychology/statistics &amp; numerical data ; Vaccination Hesitancy/psychology ; *Vulnerable Populations/psychology ; }, abstract = {UNLABELLED: Reasons for low vaccine uptake include personal, physical, and societal barriers, which are not well understood for specific underserved communities, particularly ethnic minority and migrant groups. We reviewed gaps to understanding low vaccination uptake in underserved populations globally and summarise key determinants associated with vaccination uptake considering social norms and health beliefs.<br><br>METHODS: Published literature was searched using PubMed, MEDLINE, EMBASE; PSYCHINFO and Web of Science from 2020 to 2024 for primary research, with no restrictions on language; to understand uptake of COVID-19 and other vaccinations considering social norms and health beliefs in underserved groups. 55, 925 papers were screened, and 37 studies included from regions including Europe, USA, UK, African, South-Asian, and South-East Asian regions.<br><br>FINDINGS: A total of 37 studies were included. Four themes pertinent to behavioural outcomes were identified in relation to vaccine uptake across ethnic groups, ethnic minority, and underserved groups, including: Influences of Health Belief Systems, Behaviours and Vaccine Uptake; Role of Social and Cultural norms, and Vaccine Uptake; Provision of Information and Vaccine Uptake; and Trust and Vaccine Uptake. We found vaccine uptake was linked with socio-demographic factors, particularly age, gender and ethnicity. There were similarities between first generation migrants and ethnic minority groups from USA or UK, and those from other regions. Younger, male and individuals from rural regions from their own native countries were also less likely to take up vaccination. Societal influences and norms were found to be significant predictors of vaccine uptake.<br><br>DISCUSSION: We reviewed, how social norms and health beliefs interplay with vaccine uptake in underserved groups and report facilitators to overcome vaccine hesitancy across these population groups. There is a need to provide adequate, tailored information to combat misinformation, through trusted messengers or gatekeepers to overcome the misconceptions around vaccine, by gaining the trust of underserved groups.<br><br>DISCUSSION: This review provides an overview of how social norms and health beliefs interplay with vaccine uptake in underserved and ethnic groups. It reports facilitators to overcome the barriers associated with vaccine hesitancy across these population groups. There is a need to provide and spread adequate and tailored information to combat misinformation, through trusted messengers or gatekeepers, which in turn could overcome misconceptions around vaccination, by gaining the trust of underserved groups, through support programmes facilitating vaccine uptake.}, }
@article {pmid41016093, year = {2025}, author = {Fekrvand, S and Esfahani, ZH and Yarahmadi, M and Saeedi-Boroujeni, A and Salehi, H and Hakimelahi, A and Almasi-Hashiani, A and Rahmati, M and Afshar-Ghasemlou, S and Fard, NNG and Monfared, FT and Afkham, EK and Fathi, N and Shad, TM and Babaha, F and Nazari, F and Nirouei, M and Farid, AS and Sanadgol, N and Rafiemanesh, H and Marzbali, MY and Hassanpour, G and Olbrich, P and Condino-Neto, A and Morio, T and Gennery, AR and Meyts, I and Ochs, HD and Abolhassani, H and Rezaei, N and Yazdani, R}, title = {Mortality rate and causes of death in inborn errors of immunity: A systematic review and meta-analysis.}, journal = {Mutation research. Reviews in mutation research}, volume = {796}, number = {}, pages = {108564}, doi = {10.1016/j.mrrev.2025.108564}, pmid = {41016093}, issn = {1388-2139}, abstract = {BACKGROUND: Patients with inborn errors of immunity (IEI) experience severe infectious and non-infectious complications, leading to an increased risk of mortality. Delayed diagnosis or misdiagnosis significantly contributes to the heightened mortality rates observed in IEI patients.<br><br>OBJECTIVES: This study systematically reviews the causes of mortality in IEI patients with a meta-analysis to determine the mortality rate among patients with various IEI.<br><br>METHODS: Embase, ISI Web of Science, PubMed, and Scopus were searched (up to July 2024) using terms related to IEI and mortality.<br><br>RESULTS: A total of 12,581 deceased IEI patients were included, with an overall reported mortality rate of 24.0&#x202f;% (95&#x202f;% confidence interval: 23.0-26.0&#x202f;%) among all published IEI cases. This represents an approximately 27-fold higher mortality rate among IEI patients compared to the mean global mortality rate (24&#x202f;% vs. 0.874&#x202f;%). Severe combined immunodeficiency, chronic granulomatous disease, and ataxia-telangiectasia had the highest numbers of reported deceased cases (2304, 962, and 820 cases, respectively). However, familial hemophagocytic lymphohistiocytosis exhibited the highest mortality rate (49.0&#x202f;%). The most common causes of death were infections, transplant-related mortality and non-infectious pulmonary complications, (3429, 2749, and 1141 cases), respectively. Among infectious causes of death, COVID-19 infection accounted for 10.8&#x202f;% (370 cases).<br><br>CONCLUSION: This study identifies specific types of IEI with the highest mortality rates and numbers, alongside immune component defects most strongly associated with increased mortality. Patients with immune dysregulation, defects in cellular immunity, and phagocyte function were particularly linked to higher mortality rates, underscoring the urgent need for improved management strategies for these IEIs.}, }
@article {pmid41016005, year = {2025}, author = {Nasim, AK and Khalid, I and Isa, MR}, title = {Patient satisfaction and experience for virtual consultation services in the Malaysian government health clinics: A review.}, journal = {The Medical journal of Malaysia}, volume = {80}, number = {5}, pages = {627-634}, pmid = {41016005}, issn = {0300-5283}, mesh = {Humans ; *Patient Satisfaction ; Malaysia ; COVID-19/epidemiology ; Telemedicine ; Primary Health Care ; *Remote Consultation ; Surveys and Questionnaires ; }, abstract = {INTRODUCTION: Virtual consultation (VC) has emerged as a vital mode of healthcare delivery, particularly accelerated by the COVID-19 pandemic. The Ministry of Health (MOH) has progressively implemented VC services across government health clinics in Malaysia, guided by national digital health strategies. As VC becomes integral to primary care, evaluating patient satisfaction and experience becomes essential to ensure service quality. Despite the global availability of various tools, a lack of validated instruments remains in the context of Malaysian primary care, particularly in Malay. This narrative review aims to identify existing instruments used to assess patient satisfaction and experience with VC, evaluate their relevance and psychometric robustness, and highlight gaps in measurement, particularly for public primary care in Malaysia.<br><br>MATERIALS AND METHODS: A systematic search was conducted using PubMed, employing a comprehensive search strategy combining MeSH terms and text words related to "patient satisfaction," "patient experience," "surveys and questionnaires," and "telemedicine." The search was restricted to English-language publications involving adult populations and returned 876 articles. After applying the free full-text filter, 397 articles were screened. Title and abstract screening yielded 83 potentially eligible studies, from which only eight were found to involve original development or adaptation of relevant instruments and were included for further analysis.<br><br>RESULTS: Among the seven included studies, most questionnaires were focused primarily on domains related to usability and acceptability, such as interface ease, access, and convenience. However, few instruments addressed core components of clinical care quality, including communication, diagnostic confidence, care continuity, and coordination. Furthermore, none of the reviewed questionnaires underwent complete validation and reliability assessment within the context of Malaysian primary care. Four studies were conducted in Malaysia; however, these either lacked robust validation processes or focused solely on acceptability. Additionally, no tools were validated in Malay or tailored specifically to the cultural and healthcare delivery context of Malaysia's government clinics.<br><br>CONCLUSION: The findings reveal a significant methodological gap in assessing patient satisfaction and experience with VC in Malaysian primary care. Existing tools largely derive from models focused on technology usability or service acceptability, with limited attention to the clinical dimensions of virtual care. Instruments such as the Telemedicine Satisfaction Questionnaire (TSQ), the Telemedicine Usability Survey (TUS) and the Service User Technology Acceptability Questionnaire (SUTAQ) offer partial frameworks but lack comprehensive validation or contextual adaptation. In Malaysia, while efforts have been made to develop VC-related surveys, these are insufficiently validated and often lack specificity for primary care. Moreover, tools currently in use do not capture the broader service quality domains emphasised by frameworks like SERVQUAL or Picker's Patient Experience Principles. As VC services expand in Malaysian public healthcare, there is an urgent need to develop and validate culturally appropriate, linguistically accessible, and psychometrically sound questionnaires to assess patient satisfaction and experience. These instruments must integrate both technological usability and the core clinical components of healthcare delivery. Such efforts are essential to guide quality improvement and ensure that VC services align with patients' needs and expectations in the primary care setting.}, }
@article {pmid41016003, year = {2025}, author = {Mogan, S and Samprith, A and Muthusamy, V and Samuganathan, D and Zaigham, MT and Idrees, Z and Mogan, L}, title = {Systematic review of challenges of telehealth-based intervention in managing cancer pain.}, journal = {The Medical journal of Malaysia}, volume = {80}, number = {5}, pages = {600-611}, pmid = {41016003}, issn = {0300-5283}, mesh = {Humans ; *Telemedicine ; *Cancer Pain/therapy ; *Pain Management/methods ; COVID-19/epidemiology ; *Neoplasms/complications ; }, abstract = {INTRODUCTION: Understanding the challenges of telehealth interventions is essential to determining their future direction in cancer pain management, as these are considered complex interventions. This systematic review aimed to identify the challenges associated with telehealthbased interventions in cancer pain management.<br><br>MATERIALS AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A systematic search was conducted from January 19 to February 2, 2022, covering the past 10 years. Databases searched included PubMed and EBSCO. Inclusion criteria were articles published in English focusing on cancer pain in patients with any cancer diagnosis. Data were extracted on participants, interventions, and outcomes, with a particular focus on challenges reported in each study. A total of 320 publications were retrieved and screened; 38 articles met the inclusion criteria.<br><br>RESULTS: The most reported challenge was limited or slow Internet access, followed by lack of technological expertise among healthcare teams and low computer literacy. Human resource-related challenges were also frequently reported, including inadequate reimbursement mechanisms, concerns over malpractice, increased staff workload, and absence of formal organisational structures. In studies conducted after the COVID-19 pandemic, data-related issues such as data security and management were also highlighted.<br><br>CONCLUSION: Telehealth is a rapidly growing technology with the potential to transform healthcare delivery. Addressing the challenges identified in this review may help guide the development and implementation of more effective telehealth interventions in cancer pain management.}, }
@article {pmid41015960, year = {2025}, author = {Goleij, P and Amini, A and Abolfazli, S and Heidari, MM and Tabari, MAK and Aschner, M and Larsen, DS and Khan, H and Daglia, M}, title = {Interleukin-10 family cytokines: key regulators and novel therapeutic targets for respiratory diseases.}, journal = {Inflammopharmacology}, volume = {33}, number = {10}, pages = {5909-5932}, pmid = {41015960}, issn = {1568-5608}, mesh = {Humans ; Animals ; *Interleukin-10/metabolism/immunology ; *Respiratory Tract Diseases/drug therapy/immunology/metabolism ; COVID-19/immunology ; Inflammation/drug therapy/immunology ; }, abstract = {Respiratory disorders such as asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), pulmonary fibrosis, and infectious conditions including COVID-19 and tuberculosis continue to rank among the foremost causes of illness and death worldwide. Although vaccines, antimicrobial treatments, and anti-inflammatory agents have improved disease management, their overall impact remains limited because of the intricate regulation of immune responses at epithelial surfaces. Within this context, the interleukin-10 (IL-10) cytokine family (comprising IL-10, IL-19, IL-20, IL-22, IL-24, and IL-26) has been identified as a key immunological axis in the respiratory tract. These cytokines possess structural homology and predominantly transmit signals through heterodimeric class II receptors via the JAK-STAT cascade. However, their functions are far from uniform: IL-10 primarily exerts suppressive effects on inflammation, whereas IL-19, IL-20, IL-24, and IL-26 are commonly associated with tissue injury, chronic inflammation, and airway remodeling. IL-22 occupies an intermediate role, promoting epithelial regeneration under certain conditions but aggravating inflammation or tumorigenesis in others. This article reviews recent findings on the IL-10 family in a range of respiratory diseases, emphasizing their context-dependent activity, value as potential biomarkers, and relevance as therapeutic targets. A clearer understanding of how protective versus pathogenic signals are balanced within this cytokine network is essential for designing targeted interventions that preserve host defense while restoring airway integrity.}, }
@article {pmid41015887, year = {2025}, author = {Lim, H and Kim, C}, title = {Understanding Police Response in Intimate Partner Violence Research Before COVID-19: A Systematic Review of Studies Using Police Response as an Outcome Variable.}, journal = {Trauma, violence &amp; abuse}, volume = {}, number = {}, pages = {15248380251375490}, doi = {10.1177/15248380251375490}, pmid = {41015887}, issn = {1552-8324}, abstract = {To provide an overview of research trends and commonly measured variables in intimate partner violence (IPV) studies before COVID-19, this study conducted a systematic review to examine how various types of police responses to IPV have been studied and what factors influence the outcomes of those responses. A comprehensive literature search was conducted across multiple databases using predefined inclusion and exclusion criteria. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-P guidelines, 1,259 articles initially identified were filtered and screened for relevance. The final set of 23 selected articles was independently coded following the developed coding scheme, and all codings were cross-checked and validated to ensure accuracy and consistency. The systematic review found that the majority of the selected studies focused on identifying the factors associated with police response to IPV (69.5%), used a quantitative research design (91.3%), and utilized secondary data (91.3%). Notably, 70% of the studies did not incorporate a theoretical framework. Arrest was the most frequently tested outcome variable in police response, appearing in 91.3% of the studies. Additionally, 65% of the studies offered one or more practical policy recommendations. This study also highlighted a gap in the literature, underscoring the need for research that examines dynamic and different types of police responses to IPV. By identifying prevailing research trends, commonly used methodologies, and frequently measured variables, the study provides a comprehensive overview of how police responses have been studied as an outcome variable and what factors have been examined with it. The study findings advance academic understanding, future research directions, and policy development to improve police responses to IPV.}, }
@article {pmid41015614, year = {2025}, author = {Shah, SSTH and Naeem, I and Bhutta, NK and Han, G and Noor, F}, title = {hMPV co-infections: Distinct immunopathogenic mechanisms and clinical implications of viral and bacterial pathogenesis.}, journal = {Folia microbiologica}, volume = {}, number = {}, pages = {}, pmid = {41015614}, issn = {1874-9356}, abstract = {Human metapneumovirus (hMPV) co-infections with viral and bacterial pathogens are increasingly recognized as major contributors to severe respiratory disease, especially in children, older adults, and immunocompromised individuals. This review summarizes current knowledge of hMPV co-infections with respiratory viruses (e.g., hRSV, influenza, SARS-CoV-2) and bacteria (e.g., Streptococcus pneumoniae, Haemophilus influenzae), highlighting both shared and distinct pathogenic pathways. Viral co-infections often intensify inflammation through prolonged replication and type I interferon (IFN) suppression, whereas bacterial co-infections exploit epithelial injury and mucin overproduction to enhance adhesion, biofilm formation, and antimicrobial resistance. Converging mechanisms include epithelial disruption and IL-6/TNF-α-driven cytokine dysregulation, both of which contribute to worsened outcomes. A structured literature search of PubMed, Scopus, and Web of Science identified studies on hMPV co-infections, immune responses, and clinical outcomes. The novelty of this review lies in its comparative perspective, distinguishing viral from bacterial interactions to clarify overlapping versus pathogen-specific mechanisms. Clinically, this distinction informs diagnostics, highlights gaps in therapeutic strategies, and emphasizes the need for targeted interventions to reduce the burden of severe hMPV-associated respiratory disease.}, }
@article {pmid41015338, year = {2025}, author = {Nemser, SM and Ceric, O and Guag, J and Pauley, S and Jones, A and Proia, K and Miller, MR and Tkachenko, A and Rotstein, D and Hodges, A and Reimschuessel, R and Tyson, GH}, title = {The Veterinary Laboratory Investigation and Response Network: 15 Years of Promoting Human and Animal Health by Collaborating with the Veterinary Diagnostic Laboratory Community.}, journal = {Journal of food protection}, volume = {88}, number = {12}, pages = {100625}, doi = {10.1016/j.jfp.2025.100625}, pmid = {41015338}, issn = {1944-9097}, mesh = {Humans ; Animals ; Laboratories ; United States ; *Veterinary Medicine ; United States Food and Drug Administration ; }, abstract = {The Veterinary Laboratory Investigation and Response Network (Vet-LIRN), a collaborative network established in 2010, is a partnership between the Food and Drug Administration's Center for Veterinary Medicine (FDA CVM) and 48 veterinary diagnostic laboratories (VDLs) across North America. Vet-LIRN actively supports the CVM mission of protecting human and animal health by leveraging its network of VDLs. Initially focused on issues in animal foods, including by testing animal diagnostic samples, Vet-LIRN now addresses a broad range of CVM's priorities. These include responding to animal foodborne illness outbreaks, developing new methods to detect potential microbial and chemical contaminants in animal foods, tracking antimicrobial resistance (AMR), promoting antimicrobial stewardship in veterinary medicine, and preparing for emerging One Health threats such as COVID-19 and Highly Pathogenic Avian Influenza (HPAI). Over the past 15 years, Vet-LIRN has played a pivotal role in many high-profile and important public health success stories, such as responding to multidrug-resistant Campylobacter outbreaks in puppies, aflatoxin contamination in pet food, Salmonella in pig ear treats, and botulinum toxin in alfalfa cubes. Additionally, Vet-LIRN's AMR monitoring program collects data to understand AMR trends and assist in the response to foodborne and zoonotic outbreaks. Through collaboration with other key stakeholders such as CVM regulatory colleagues and external partners at the United States Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC), Vet-LIRN ensures rapid responses to critical issues. Looking ahead, Vet-LIRN remains dedicated to continuous improvements, reinforcing its commitment to the sustained protection of human and animal health.}, }
@article {pmid41014797, year = {2025}, author = {Shen, W and Guo, Y and Ai, C and Wang, X and Li, G}, title = {The double-edged sword: How SARS-CoV-2 might fuel lung cancer: Investigating the potential oncogenic mechanisms of the novel coronavirus in lung carcinogenesis.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101413}, doi = {10.1016/j.mam.2025.101413}, pmid = {41014797}, issn = {1872-9452}, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has had far-reaching consequences beyond acute respiratory illness, with growing evidence suggesting potential long-term oncogenic effects. Lung cancer, a leading cause of cancer-related mortality, may intersect with COVID-19 through shared molecular pathways and altered disease dynamics. SARS-CoV-2 can exacerbate outcomes in existing cancer patients and potentially contribute to de novo lung carcinogenesis or accelerate progression via chronic inflammation, oxidative stress, immune dysregulation, cellular senescence, cell cycle disruption, metabolic reprogramming, and autophagy impairment. It has been proven that although the SARS virus is not capable of integrating into the host genome, it uses the mechanisms of other human oncoviruses to cause lung cancer. Post-COVID-19 pulmonary fibrosis, observed in up to one-third of severe cases, may act as a tumor precursor bridge through sustained tissue remodeling, extracellular matrix stiffness, and hypoxia-induced epithelial-mesenchymal transition. Epidemiological studies indicate increased cancer-related mortality, metastatic reactivation of dormant cancer cells, and diagnostic delays, shifting presentations toward advanced stages during the pandemic. Synergistic risk factors, including smoking, air pollution, occupational exposures, and genetic predispositions, may further amplify oncogenic potential. The convergence of viral, environmental, and host factors creates a critical need for vigilant surveillance, biomarker development, and preventive strategies. This study aims to synthesize current epidemiological evidence, elucidate the molecular and cellular mechanisms by which SARS-CoV-2 may influence lung carcinogenesis, and highlight clinical implications to guide future research, screening, and therapeutic interventions.}, }
@article {pmid41014724, year = {2025}, author = {Frahsa, A and Liwanag, HJ and Kobler Betancourt, C and Ipekci, AM and Minder, B and Schow, D}, title = {A scoping review of community participation in public health research and action during the COVID-19 pandemic: Exploring approaches on the continuum between utilitarianism and empowerment.}, journal = {Social science &amp; medicine (1982)}, volume = {385}, number = {}, pages = {118556}, doi = {10.1016/j.socscimed.2025.118556}, pmid = {41014724}, issn = {1873-5347}, mesh = {Humans ; *COVID-19/epidemiology ; *Community Participation/methods ; *Public Health/methods ; *Empowerment ; Pandemics ; Community-Based Participatory Research ; SARS-CoV-2 ; }, abstract = {Community participation played a crucial role in addressing health inequities during the COVID-19 pandemic, particularly in reaching marginalized populations and fostering resilience. Amid the wide variation of participatory approaches in community health-from information dissemination to co-decision-making-, there remains a lack of comprehensive analysis on their implementation, impact, and effectiveness. This scoping review synthesizes participatory approaches used during the pandemic, addressing three key gaps: (1) the depth and breadth of participation, (2) the types of communities engaged and the public health issues addressed, and (3) the impact of participation on community health. Following the Joanna Briggs Institute (JBI) methodology, we systematically searched nine bibliographic databases, identifying 20,672 records. After removing duplicates and screening articles based on predefined inclusion criteria, we included 127 studies. Our analysis included mapping participation depth using Arnstein's ladder, categorizing motivations as utilitarian or emancipatory, and identifying the types of communities engaged and the community health issues addressed. We also examined community health outcomes and developed a conceptual heuristic framework to better characterize participatory approaches. Based on our findings, we propose eight key recommendations for improving the implementation and reporting of participatory approaches in community health. These include providing clear definitions of community and community health, ensuring transparency in participation levels and phases, elaborating on participatory methods, avoiding (re)stigmatization, and promoting community-driven research and action. By enhancing participatory practice and evaluation, these recommendations can support more equitable, effective, and sustainable community health interventions in pandemic contexts and beyond.}, }
@article {pmid41014516, year = {2025}, author = {Reeves, B and Pufulete, M and Harris, J and Dumville, J and Adderley, U and Burton, A and Burton, M and Atkinson, R and Clout, M and Cullum, N and O'Connell, A and O'Connor, L and Palmer, S and Ridd, M and Rodrigues, J and Wong, J}, title = {Effectiveness of surgical interventions in patients with severe pressure ulcers: the SIPS mixed-methods exploratory study.}, journal = {Health technology assessment (Winchester, England)}, volume = {29}, number = {47}, pages = {1-150}, pmid = {41014516}, issn = {2046-4924}, mesh = {Humans ; *Pressure Ulcer/surgery ; Quality of Life ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome ; Male ; *Plastic Surgery Procedures/methods ; Female ; Technology Assessment, Biomedical ; }, abstract = {BACKGROUND: Surgical reconstruction to close a severe pressure ulcer has not been evaluated.<br><br>AIM AND OBJECTIVES: We aimed to investigate the feasibility of research to evaluate surgical reconstruction for severe pressure ulcers by: systematically reviewing evidence about: the effectiveness of surgical reconstruction for severe pressure ulcers; the impact of pressure ulceration on health-related quality-of-life (review 2) surveying primary and secondary care healthcare professionals about surgical referrals of patients with severe pressure ulcers and severe pressure ulcer management, including surgical reconstruction describing patients with incident pressure ulcers and with severe pressure ulcers having surgical reconstruction comparing outcomes in patients with severe pressure ulcers having/not having surgical reconstruction seeking consensus about treatments and management strategies for severe pressure ulcers.<br><br>DESIGN: Systematic reviews; surveys; binary choice experiment; retrospective cohort studies using routine data; consensus meeting.<br><br>PARTICIPANTS: General practitioners; nurses; and surgeons managing pressure ulcers; people with incident pressure ulcers and hospitalised with severe pressure ulcers.<br><br>INTERVENTION: Surgical reconstruction.<br><br>COMPARATOR: No surgical reconstruction.<br><br>OUTCOMES: Surgical reconstruction, time to next admission with a severe pressure ulcer time to next admission, hospital stay, all-cause mortality, surgical reconstruction after discharge.<br><br>RESULTS: Review 1 included three studies comparing different surgical reconstruction techniques. None reported wound-free time. Recurrence occurred in &#x2248;&#x2005;20%. Review 2 included three randomised controlled trials measuring health-related quality of life, but none observed benefits of interventions evaluated. Among primary care survey respondents, 54% did not know surgical reconstruction can treat severe pressure ulcers; >&#x2005;50% had never referred a patient to a surgeon. Among nurses, 72% had considered surgical reconstruction for a severe pressure ulcer; 54% believed surgical reconstruction should be more available. Among surgeons, 39% had never offered surgical reconstruction and 52% offered surgical reconstruction to <&#x2005;50%; 68% believed surgical reconstruction should be more available. Routine data recorded 367,884 admissions with severe pressure ulcer diagnoses in England over 7.5 years; surgical reconstructions were performed in at least 404 and at most 1018 admissions. Twenty English hospitals performed >&#x2005;70% of the surgical reconstructions. Comparing surgical reconstruction (n&#x2005;=&#x2005;325) versus no surgical reconstruction (n&#x2005;=&#x2005;1474) patients, time to next admission with a severe pressure ulcer was longer in patients having surgical reconstruction (hazard ratio&#x2005;=&#x2005;0.79, 95% confidence interval 0.61 to 1.03; p&#x2005;=&#x2005;0.07). Estimated pressure ulcer incidence in primary care was &#x2248;&#x2005;5/10,000, but the true incidence was believed to be &#x2248;&#x2005;7 times higher. Episodes of pressure ulcer care could not be identified. There was consensus about a referral pathway for severe pressure ulcer patients wanting surgical reconstruction, including both community-led and surgically led multidisciplinary team meetings, and about the influence of several patient and severe pressure ulcer characteristics on suitability for surgical reconstruction.<br><br>LIMITATIONS: Surveys only considered factors one by one. Analyses of the Hospital Episode Statistics cohort depended on coding accuracy. For the comparison of surgical reconstruction and no surgical reconstruction, the no surgical reconstruction group had to be admitted. Routine data do not record wound healing outcomes. Primary care data underestimated pressure ulcer incidence; pressure ulcer care episodes could not be identified. The consensus meeting did not include surgeons. The COVID-19 pandemic caused delays, made team members unavailable and restricted face-to-face meetings.<br><br>CONCLUSIONS: There is insufficient evidence to determine the effectiveness of surgical reconstruction on health-related quality of life or wound healing for severe pressure ulcers. Too few procedures are carried out to enable a randomised controlled trial to be feasible.<br><br>FUTURE WORK: We identified three areas: qualitative research on the acceptability of surgical reconstruction and the impact of a SPU on a patient's quality-of-life; a core outcome set for interventions to treat pressure ulcers; and economic modelling of surgical reconstruction cost-effectiveness.<br><br>STUDY REGISTRATION: This study is registered as PROSPERO 2019 CRD42019156436, 2019 CRD42019156450; ISRCTN13292620.<br><br>FUNDING: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR127850) and is published in full in Health Technology Assessment; Vol. 29, No. 47. See the NIHR Funding and Awards website for further award information.}, }
@article {pmid41014378, year = {2025}, author = {Upadhyay, A and Khandelwal, V}, title = {Endophytes in Medicinal Plants: A Sustainable Solution for Coping with Environmental Stresses.}, journal = {Current microbiology}, volume = {82}, number = {11}, pages = {529}, pmid = {41014378}, issn = {1432-0991}, mesh = {*Endophytes/physiology ; *Plants, Medicinal/microbiology/physiology ; *Stress, Physiological ; Humans ; COVID-19 ; Symbiosis ; SARS-CoV-2 ; }, abstract = {The increasing need for integrative and alternative medical therapies, especially in the aftermath of the COVID-19 epidemic, has emphasized the importance of medicinal plants in worldwide healthcare. These plants, which contain abundant bioactive secondary metabolites, provide a sustainable and cost-effective option for medicinal, adaptogenic, and immune-boosting purposes. Blooming medicinal plants that exist are at risk of becoming extinct because of excessive harvesting, deforestation, and wildfires. Medicinal plants have complex physiological defenses against stress, which are strengthened by their symbiotic relationship with endophytes. Endophytes are microbial colonies that live within plant tissues without causing harm and play a vital role in maintaining the health of plants by helping them to tolerate stress, promoting development, acquiring nutrients, synthesizing phytohormones, breaking down toxic substances, and improving plant resistance to environmental pressures such as high salt levels, lack of water, and exposure to heavy metals. In addition, endophytes have a role in managing biotic stress by engaging in antibiosis, synthesizing lytic enzymes, producing secondary metabolites, and regulating hormones. Their function in preserving the health and well-being of the host, ensuring proper nutrition intake, and enhancing resistance against pathogens highlights their potential as agents for biological control and biofertilization, providing a safer option compared to chemical pesticides. Endophytic inoculants have the potential to significantly transform crop yield in agriculture by reducing the impact of abiotic problems and improving soil health. This review critically evaluates causal studies and recent omics-based advances, highlighting their crucial significance for sustainable bioinoculant development and practical applications in climate-resilient agriculture.}, }
@article {pmid41014014, year = {2025}, author = {Malamitsi-Puchner, A and Briana, DD and Di Renzo, GC}, title = {Vaccinations During Pregnancy Protect the Mother-Infant Dyad and Are Generally Safe.}, journal = {Acta paediatrica (Oslo, Norway : 1992)}, volume = {}, number = {}, pages = {}, doi = {10.1111/apa.70301}, pmid = {41014014}, issn = {1651-2227}, abstract = {AIM: Vaccination in pregnancy has a critical impact on mothers, foetuses and infants. The aim of this paper was to summarise key points presented by experts attending the 12th Maria Delivoria-Papadopoulos Perinatal Symposium in March 2025 and further expand and update them.<br><br>METHODS: We discuss the benefits and potential side effects of vaccines for tetanus-diphtheria-acellular pertussis, influenza, COVID-19, respiratory syncytial virus and monkeypox. The future use of cytomegalovirus and group B streptococcus vaccines is also covered. Vaccine hesitancy, mainly due to fears of harming the foetus, including preterm delivery, is addressed. The use of evidence-based information to allay fears is explored. Ethical issues about the potential side effects of vaccinating mothers, primarily for the good of the infant, are discussed.<br><br>RESULTS: The vaccines we looked at were generally effective and safe, with no considerable adverse effects for the mother-infant dyad. Vaccination hesitancy was predominately based on fears about the adverse effects on the foetus. These can mainly be combated by health professionals providing clear information on the impact on both the mother and her offspring.<br><br>CONCLUSION: The vaccines discussed in the paper were generally effective and safe for the mother, foetus and infant.}, }
@article {pmid41013291, year = {2025}, author = {Dhayfule, D and Wu, YH and Ashyani, A and Li, MC and Tsai, CS and Chen, PL and Nordling, TEM}, title = {A meta-analysis of vaccine efficacy from phase III clinical trials of approved vaccines against SARS-CoV-2 and variants.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {1169}, pmid = {41013291}, issn = {1471-2334}, support = {105-2218-E-006-016-MY2//Ministry of Science and Technology, Taiwan/ ; 105-2218-E-006-016-MY2//Ministry of Science and Technology, Taiwan/ ; 105-2218-E-006-016-MY2//Ministry of Science and Technology, Taiwan/ ; 111-2221-E-006-186//National Science and Technology Council/ ; 111-2221-E-006-186//National Science and Technology Council/ ; }, mesh = {Humans ; *COVID-19/prevention &amp; control/virology/immunology ; *COVID-19 Vaccines/immunology ; *SARS-CoV-2/immunology/genetics ; Clinical Trials, Phase III as Topic ; *Vaccine Efficacy ; }, abstract = {BACKGROUND: As we emerge from the COVID-19 pandemic and transition to a post-pandemic era, it is crucial to reflect on our experiences and prepare for future pandemics. Here we evaluate the impact of different methods for calculating the vaccine efficacy of COVID-19 vaccines, which has not been done previously.<br><br>METHODS: We conducted a meta-analysis of 38 approved COVID-19 vaccines using data from phase III clinical trials between May 4, 2020, and June 10, 2022. We analyze vaccine efficacy against multiple SARS-CoV-2 variants including the original strain, Alpha, Beta, Delta, and Kappa using multiple endpoints. Clinical endpoints are categorized into a tree structure including asymptomatic infection, symptomatic infection, mild to critical illness, and death. We employ re-estimated vaccine efficacies, including relative risk and Poisson regression with robust error variance, for equitable cross-vaccine comparisons.<br><br>RESULTS: We re-estimated 63 vaccine efficacies, revealing a 3% to 6% difference in five efficacies compared to the original study. Four efficacies exhibited lower bounds below the critical 50% threshold for the endpoint asymptomatic, symptomatic, moderate, and severe, contrary to the initial reports. However, efficacy consistently surpasses the 50% threshold against symptomatic COVID-19. Overall efficacies range from 34.2% to 100%, 50.3% to 100% against symptomatic, and 66.8% to 100% against severe, and 65% to 95% against variants.<br><br>CONCLUSIONS: Our systematic classification of vaccine endpoints enables more statistically rigorous meta-analyses across studies. Beyond the quantitative results, our study emphasizes the need to standardize the estimation method for robust assessments of vaccine efficacy. We highlight the incompleteness of the knowledge about different vaccine efficacy in the middle of the pandemic, in particular the need to identify variants during the trials and report on multiple endpoints. We encourage all authors to publicly share their data, fostering additional impartial investigations. This data collection enables comparisons with real-world effectiveness data, enabling future studies of the predictive power of efficacy.}, }
@article {pmid41013029, year = {2025}, author = {Zhang, D and Lv, X and Jiang, H and Fan, Y and Liu, K and Wang, H and Deng, Y}, title = {AI-Enabled Microfluidics for Respiratory Pathogen Detection.}, journal = {Sensors (Basel, Switzerland)}, volume = {25}, number = {18}, pages = {}, pmid = {41013029}, issn = {1424-8220}, mesh = {Humans ; *Artificial Intelligence ; COVID-19/diagnosis/virology ; SARS-CoV-2/isolation &amp; purification ; *Microfluidics/methods ; Lab-On-A-Chip Devices ; Machine Learning ; Point-of-Care Systems ; *Microfluidic Analytical Techniques/methods ; *Respiratory Tract Infections/diagnosis ; Biosensing Techniques ; }, abstract = {Respiratory infectious diseases, such as COVID-19, influenza, and tuberculosis, continue to impose a significant global health burden, underscoring the urgent demand for rapid, sensitive, and cost-effective diagnostic technologies. Integrated microfluidic platforms offer compelling advantages through miniaturization, automation, and high-throughput processing, enabling "sample-in, answer-out" workflows suitable for point-of-care applications. However, their clinical deployment faces challenges, including the complexity of sample matrices, low-abundance target detection, and the need for reliable multiplexing. The convergence of artificial intelligence (AI) with microfluidic systems has emerged as a transformative paradigm, addressing these limitations by optimizing chip design, automating sample pre-processing, enhancing signal interpretation, and enabling real-time feedback control. This critical review surveys AI-enabled strategies across each functional layer of respiratory pathogen diagnostics: from chip architecture and fluidic control to amplification analysis, signal prediction, and smartphone/IoT-linked decision support. We highlight key areas where AI offers measurable benefits over conventional methods. To transition from research prototypes to clinical tools, future systems must become more adaptive, data-efficient, and clinically insightful. Advances such as sensor-integrated chips, privacy-preserving machine learning, and multimodal data fusion will be essential to ensure robust performance and meaningful outputs across diverse scenarios. This review outlines recent progress, current limitations, and future directions. The rapid development of AI and microfluidics presents exciting opportunities for next-generation pathogen diagnostics, and we hope this work contributes to the advancement of intelligent, point-of-care testing (POCT) solutions.}, }
@article {pmid41012647, year = {2025}, author = {Winter, M and Boecker, D and Posch, W}, title = {Hypochlorous Acid (HOCl) as a Promising Respiratory Antiseptic.}, journal = {Viruses}, volume = {17}, number = {9}, pages = {}, pmid = {41012647}, issn = {1999-4915}, mesh = {*Hypochlorous Acid/pharmacology/therapeutic use ; Humans ; *Anti-Infective Agents, Local/pharmacology/therapeutic use ; SARS-CoV-2/drug effects ; COVID-19 ; *COVID-19 Drug Treatment ; Animals ; }, abstract = {The COVID-19 pandemic has inflicted unprecedented pressure on communities and healthcare systems around the world. An outstandingly broad and intensive investigation of possible therapeutic interventions is currently taking place to prevent similar future threats to the global population. Investigating the related mechanisms of action is often complex and time consuming. Moreover, research on biochemical interactions of new drugs involves a considerable amount of effort, consequently bearing inherent financial and operational risks for pharmaceutical companies. An interesting approach to counteract colonization and infection is the concept of antiseptic treatment in vivo. Antiseptics are cost-effective and globally accessible, due to their ease of production, transportation and handling. A broad spectrum of active agents with different properties is readily available. One of these substances is hypochlorous acid (HOCl), which is also a naturally occurring biocidal agent and as such part of the innate immune system. Its successful history of medical use in wound treatment, combined with low cytotoxicity and documented efficacy against various pathogens, suggests that HOCl might be an effective agent for treating the respiratory mucosa. This could potentially enable therapeutic inhalation for combating bacterial infections and viral pathogens such as human respiratory syncytial, influenza, and SARS-CoV-2 viruses, which will be discussed in the present article.}, }
@article {pmid41012635, year = {2025}, author = {Batista, VL and Martins, JR and Queiroz-Junior, CM and Hottz, ED and Teixeira, MM and Costa, VV}, title = {Mechanisms of Thromboinflammation in Viral Infections-A Narrative Review.}, journal = {Viruses}, volume = {17}, number = {9}, pages = {}, pmid = {41012635}, issn = {1999-4915}, support = {465425/2014-3//Brazilian National Science Council (CNPq)/ ; 25036/2014-3//Minas Gerais Foundation for Science (FAPEMIG)/ ; RED-00202-22" 29568-1//FAPEMIG/ ; APQ-04650-23//FAPEMIG/ ; APQ-02618-23.//FAPEMIG/ ; 163937/2022-2//CNPq/ ; }, mesh = {Humans ; *Virus Diseases/complications/virology/immunology ; *Thromboinflammation/virology/immunology ; Animals ; Platelet Activation ; COVID-19 ; Inflammation ; }, abstract = {The circulatory and immune systems function in close coordination to maintain homeostasis and act as a frontline defense against infections. However, under certain conditions, this interaction becomes dysregulated, leading to thromboinflammation, a pathological process marked by the concurrent and excessive activation of coagulation, inflammation, and endothelial dysfunction. During viral infections, this phenomenon can markedly worsen clinical outcomes. Evidence indicates that viruses such as dengue, chikungunya, influenza, and SARS-CoV can trigger thromboinflammatory responses involving platelet activation, the release of procoagulant and pro-inflammatory mediators, and the formation of thrombi within blood vessels. While this response may initially help contain viral dissemination, in cases of high viremia it can progress to disseminated intravascular coagulation (DIC), hemorrhage, and multiple organ failure. This review compiles current evidence on thromboinflammatory mechanisms induced by arboviral and respiratory viruses and examines how these processes contribute to diseases' pathogenesis and clinical severity.}, }
@article {pmid41012623, year = {2025}, author = {Alsaadawe, M and Radman, BA and Hu, L and Long, J and Luo, Q and Tan, C and Amirat, HS and Alsaadawi, M and Lyu, X}, title = {From Viral Infection to Malignancy: The Dual Threat of EBV and COVID-19 in Cancer Development.}, journal = {Viruses}, volume = {17}, number = {9}, pages = {}, pmid = {41012623}, issn = {1999-4915}, mesh = {Humans ; *COVID-19/complications/virology/immunology ; *Epstein-Barr Virus Infections/complications/virology/immunology ; *Herpesvirus 4, Human/physiology/pathogenicity ; *SARS-CoV-2/physiology ; *Neoplasms/virology/etiology/immunology ; Animals ; }, abstract = {This narrative review consolidates existing evidence about the interaction between Epstein-Barr virus (EBV) and SARS-CoV-2 in cancer development. EBV is a recognized oncogenic driver, whereas COVID-19 may heighten cancer risk by immunological dysregulation, persistent inflammation, and reactivation of latent viruses. We underscore molecular similarities (e.g., NF-κB activation, T-cell exhaustion) and clinical ramifications for high-risk individuals, stressing the necessity for interdisciplinary research to alleviate dual viral risks. EBV, a well-known oncogenic virus, has been linked to numerous malignancies, including lymphomas, nasopharyngeal carcinoma, and gastric cancer. Through the production of viral proteins that interfere with immune evasion, cellular signaling, and genomic integrity, it encourages malignant transformation and ultimately results in unchecked cell proliferation. Because of its capacity to induce tissue damage, immunological dysregulation, and chronic inflammation, COVID-19, which is brought on by the SARS-CoV-2 virus, has become a possible carcinogen. The virus's influence on cellular pathways and its long-term effects on the immune system may raise the chance of malignancy, particularly in people with pre-existing vulnerabilities, even if direct correlations to cancer are still being investigated. When two viruses co-infect a host, the review highlights the possibility of synergistic effects that could hasten the development of cancer. It describes how overlapping mechanisms like inflammation, immune suppression, and viral reactivation may be used by a combined EBV and COVID-19 infection to exacerbate carcinogenic processes. Gaining an understanding of these relationships is essential for creating tailored treatment plans and enhancing cancer prevention in high-risk groups.}, }
@article {pmid41012587, year = {2025}, author = {Zhou, X and Huang, Y and Zhang, X and Guan, W and Zhang, F and Hao, H}, title = {Epitranscriptomic Regulation of Hepatitis B Virus by RNA 5-Methylcytosine: Functions, Mechanisms, and Therapeutic Potential.}, journal = {Viruses}, volume = {17}, number = {9}, pages = {}, pmid = {41012587}, issn = {1999-4915}, support = {2024AFB1065//Natural Science Foundation of Hubei Province/ ; JXBS013//Hubei Jiangxia Laboratory Biosafety Key R&amp;D Project/ ; E3ZFJX0101//Hubei Jiangxia Laboratory Research Startup Funding Project/ ; 2024YFC2309400//National Key Research and Development Program/ ; XDB0490000//Strategic Priority Research Program of the Chinese Academy of Sciences/ ; }, mesh = {*Hepatitis B virus/genetics ; Humans ; *5-Methylcytosine/metabolism ; *RNA, Viral/genetics/metabolism ; Antiviral Agents/pharmacology/therapeutic use ; *Transcriptome ; *Gene Expression Regulation, Viral ; *Epigenesis, Genetic ; Hepatitis B/virology ; RNA Stability ; }, abstract = {Hepatitis B virus (HBV) remains a major global health challenge, with over 296 million people chronically infected worldwide. Despite the availability of antiviral therapies, a functional cure is rarely achieved, highlighting the need for novel therapeutic strategies. RNA 5-methylcytosine (m[5]C) is a pivotal epitranscriptomic mark implicated in RNA stability, transport, and translation. Emerging evidence shows that m[5]C is conserved within HBV RNA and plays critical roles in the viral life cycle. This review provides a comprehensive overview of the molecular mechanisms governing m[5]C deposition and recognition, summarizes recent advances in m[5]C biology, and highlights the emerging role of epitranscriptomic m[5]C regulation in HBV infection. We discuss the identification of HBV-specific m[5]C sites, the functions of key regulatory enzymes, and their interplay in viral RNA stabilization and evasion of innate immune responses. Interplay between m[5]C and other RNA modifications-particularly N6-methyladenosine (m[6]A)-is examined alongside virus-specific m[5]C regulation in EV71, HIV, HCV, EBV, and SARS-CoV-2. Potential links between m[5]C dysregulation and HBV-induced hepatocarcinogenesis are outlined, and emerging therapeutic strategies targeting the m[5]C machinery are highlighted. Together, these insights position the epitranscriptomic landscape as a promising avenue for innovative antiviral strategies.}, }
@article {pmid41012509, year = {2025}, author = {Dahan, A and Yarmolinsky, L and Nakonechny, F and Semenova, O and Khalfin, B and Fleisher-Berkovich, S and Ben-Shabat, S}, title = {Etrog Citron (Citrus medica) as a Novel Source of Antiviral Agents: Overview of Its Bioactive Phytochemicals and Delivery Approaches.}, journal = {Pharmaceutics}, volume = {17}, number = {9}, pages = {}, pmid = {41012509}, issn = {1999-4923}, abstract = {The recent COVID-19 pandemic highlighted the significant challenge of insufficient antiviral pharmacological options. Edible plants offer a promising avenue for developing novel antiviral drugs. Etrog citron (Citrus medica L.), which is a valuable edible and medicinal plant, contains various antiviral phytochemicals, mainly flavonoids, coumarins, and terpenes. However, the therapeutic application of these compounds remains limited by factors such as poor solubility, limited bioavailability, and unclear mechanisms of action. The aim of the present article is to offer a comprehensive analysis of the antiviral phytochemicals extracted from various parts of Citrus medica, emphasizing their mode of action and delivery strategies that may allow turning these compounds into new antiviral drugs.}, }
@article {pmid41012182, year = {2025}, author = {Yuan, F and Bluth, MH}, title = {Novel Strategies for Developing Next-Generation Vaccines to Combat Infectious Viral Diseases.}, journal = {Vaccines}, volume = {13}, number = {9}, pages = {}, pmid = {41012182}, issn = {2076-393X}, support = {2024-67012-42721//National Institute of Food and Agriculture/ ; }, abstract = {The development of viral vaccines faces persistent scientific and logistical challenges, particularly in the wake of the COVID-19 pandemic. This review critically examines emerging strategies to overcome key barriers in viral vaccine design and deployment. We focus on four major areas: (1) structure-guided antigen engineering to stabilize conformations; (2) the mRNA platform and its delivery system; (3) advanced adjuvant systems that enhance cellular and humoral immunity; and (4) approaches to mitigate immune imprinting and antigenic variability, such as chimeric antigens and glycan shielding. We also explore anti-idiotypic vaccination strategies and the limitations of current animal models in predicting human immune responses. In addition, to address vaccine hesitancy and inequitable access, we advocate for global collaboration in manufacturing, distribution, and public education to ensure inclusive immunization strategies. By integrating molecular insights with platform technologies, we aim to inform the rational design of future vaccines with improved efficacy and public acceptance.}, }
@article {pmid41012179, year = {2025}, author = {Moseman, JE and Shim, D and Jeon, D and Rastogi, I and Schneider, KM and McNeel, DG}, title = {Messenger RNA and Plasmid DNA Vaccines for the Treatment of Cancer.}, journal = {Vaccines}, volume = {13}, number = {9}, pages = {}, pmid = {41012179}, issn = {2076-393X}, support = {P30 CA014520/CA/NCI NIH HHS/United States ; P50 CA269011/CA/NCI NIH HHS/United States ; 5P30CA014520-25/NH/NIH HHS/United States ; 5P50CA269011-03/NH/NIH HHS/United States ; }, abstract = {Immunotherapy is now an established therapy for nearly a third of patients with cancer. Most therapies, typically using cytokines or checkpoint blockade therapy, rely on global activation of immune effector cells. The ability of vaccines to activate specific populations of cells has led to a renewed interest in their ability to treat cancers, either alone or with other immune therapies or other conventional therapies. The COVID-19 pandemic sparked a new interest in nucleic acid vaccines with the development of new technologies and the short manufacturing time for vaccine implementation. Nucleic acid-based cancer vaccines have been studied for decades, but have shown modest anti-tumor efficacy as monotherapies, as many of these vaccines encode for shared tumor-associated antigens (TAAs) and must overcome immune tolerance. New developments, technologies, routes of delivery, and combination therapies have paved the way for new approaches and clinical trials involving nucleic acid vaccines for the treatment of cancer. Here we review mRNA and pDNA vaccines for the treatment of cancer, including similarities and differences in their mechanisms of action, an overview of these treatment modalities in preclinical and clinical studies, methods to improve these vaccine strategies, and exciting new combination approaches in development.}, }
@article {pmid41012167, year = {2025}, author = {Lo Moro, G and Golzio, F and Calabrese, SC and Scaioli, G and Basile, A and Siliquini, R and Bert, F}, title = {Strategies to Increase Vaccinations in Adult Cancer Patients: A Systematic Review.}, journal = {Vaccines}, volume = {13}, number = {9}, pages = {}, pmid = {41012167}, issn = {2076-393X}, abstract = {BACKGROUND/OBJECTIVES: Although vaccinations are a priority for patients with cancer, achieving high coverage remains challenging. Evidence on effective strategies in oncology settings is still limited. This systematic review aimed to identify interventions to improve vaccination uptake or reduce hesitancy among cancer patients.<br><br>METHODS: A systematic search was conducted in PubMed, Embase, and Scopus, including studies published up to the end of 2023. The protocol was registered in PROSPERO (CRD42024511008).<br><br>RESULTS: Out of 10,927 non-duplicate records, 15 studies describing unique interventions were included. All studies were published between 2011 and 2022, primarily conducted in Europe/UK (40%) and in North America (40%). The most common study design was pre-post (60%), and 33.3% included a control group. Most interventions were multi-component (60%) and were classified into three main categories: educational materials/campaigns (46.7%), reminders (40%), and patient counselling (33.3%). Additional components included guideline development in two studies. Some studies also highlighted the importance of specific key figures, such as dedicated professionals, general practitioners, and pharmacists. Interventions mainly targeted patients (40%), with 33.3% addressing both healthcare professionals and patients and 26.7% professionals only. They most frequently concerned vaccinations against influenza and pneumococcal disease (26.7%), pneumococcal disease alone (26.7%), or Coronavirus Disease 2019 (COVID-19) (26.7%). Vaccination uptake was the primary outcome in 86.7% of studies, with 66.7% reporting significant improvements.<br><br>CONCLUSIONS: This review identified a variety of strategies, with education, reminders, and counselling as key components. Multicomponent interventions and those involving both patients and providers were most promising. However, methodological limitations and limited generalizability highlighted the need for more rigorous research.}, }
@article {pmid41012117, year = {2025}, author = {Ng, CS}, title = {Immunotherapy of Oncovirus-Induced Cancers: A Review on the Development and Efficacy of Targeted Vaccines.}, journal = {Vaccines}, volume = {13}, number = {9}, pages = {}, pmid = {41012117}, issn = {2076-393X}, abstract = {BACKGROUND: A number of viruses are oncogenic. These include the human papilloma virus (HPV), Epstein-Barr virus (EBV), Kaposi sarcoma human herpes virus 2/human herpes virus 8 (KSHHV/HHV8), hepatitis B virus, (HBV), hepatitis C virus (HCV), Merkel cell polyoma virus (McPyV), and the human T-cell leukemia virus type 1 (HTLV-1). These viruses cause malignancies ranging from carcinomas, sarcomas, lymphomas, to leukemias. This review aims to study the effects and efficacy of vaccines against these viruses and the cancers they cause in their prevention and treatment.<br><br>METHODS: The literature in the past 30 years was searched employing Scopus and Google Scholar using the keywords "oncogenic viruses, HPV, EBV, KSHHV, HHV8, Polyoma virus, HTLV-1, COVID-19, carcinoma, sarcoma, lymphoma, leukemia, anti-virus vaccines".<br><br>RESULTS: Prophylactic vaccines against the HPV and HBV are highly effective in preventing and reducing the incidence of uterine cervical and hepatocellular carcinomas. Prophylactic vaccines against other oncogenic viruses have been less successful, though efficacious in some experimental animals. Therapeutic vaccines are still mostly under evaluation and development.<br><br>CONCLUSIONS: Identification of oncogenic viruses has rendered anti-viral vaccines conspicuous tools for preventing and treating cancers they cause. Many endeavors for the development of such vaccines have been met with limited success, apart from the very effective anti-HPV and anti-HBV vaccines in universal vaccination programs. With the development of new vaccine technologies, it is hoped that effective vaccines against other oncogenic viruses will be developed in the future.}, }
@article {pmid41012096, year = {2025}, author = {Parvez, S and Pathrathota, A and Uppar, AL and Yadagiri, G and Mudavath, SL}, title = {Influenza Virus: Global Health Impact, Strategies, Challenges, Role of Nanotechnolgy in Influenza Vaccine Development.}, journal = {Vaccines}, volume = {13}, number = {9}, pages = {}, pmid = {41012096}, issn = {2076-393X}, support = {IIRP-2023- 3052//Indian Council of Medical Research/ ; }, abstract = {Influenza is a serious and global health issue, and it is a major cause of morbidity, fatality, and economic loss every year. Seasonal vaccines exist but are not very effective due to strain mismatches, delays in production, and antigenic drift. This comprehensive overview discusses the current situation of influenza vaccination, including the numerous types of vaccines-inactivated, live attenuated, and recombinant vaccines-and their effectiveness, efficacy, and associated challenges. It highlights the effects of the COVID-19 pandemic on the trends of influenza vaccination and the level to which innovation should be practiced. In the future universal influenza vaccines will be developed that target conserved viral antigens to provide long-term protection to people. In the meantime, novel vaccine delivery platforms, such as mRNA technology, virus-like particle (VLP), and nanoparticle-based systems, and less cumbersome and invasive administration routes, as well as immune responses are also under development to increase access and production capacity. Collectively, these innovations have the potential to not only reduce the global influenza epidemic but also to change the way influenza is prevented and prepare the world for a pandemic.}, }
@article {pmid41012094, year = {2025}, author = {Gasana, P and Gahamanyi, N and Nzitakera, A and Farnir, F and Desmecht, D and Mutesa, L}, title = {A Review of Insights on Vaccination Against Respiratory Viral Infections in Africa: Challenges, Efforts, Impacts, and Opportunities for the Future.}, journal = {Vaccines}, volume = {13}, number = {9}, pages = {}, pmid = {41012094}, issn = {2076-393X}, support = {ARES-COOP-CONV-22-099//University of Rwanda-Academie de Recherche et d'Enseignement Superieur UR-ARES/ ; }, abstract = {Background: Respiratory viral infections such as influenza, COVID-19, and respiratory syncytial virus (RSV) are considered as major public health threats in Africa. Despite global advancements in vaccine development, persistent inequities in access, delivery infrastructure, and public trust limit the continent's capacity to control these diseases effectively. This review aimed at providing insights on challenges, efforts, impacts, and opportunities for the future related to vaccination against respiratory viral infections in Africa. Methods: This narrative review synthesizes the peer-reviewed literature and global health reports to examine vaccination efforts against respiratory viruses in Africa. The analysis focuses on disease burden, vaccine coverage, barriers to uptake, enabling factors, progress in local vaccine production, and strategies for integrating vaccines into national immunization programs (NIPs). Results: Respiratory vaccines have significantly reduced hospitalizations and mortality among high-risk groups in African countries. Nonetheless, key challenges, including limited cold chain capacity, vaccine hesitancy, donor-reliant supply chains, and under-resourced health systems, continue to undermine vaccine delivery. Successful interventions include community mobilization, use of mobile health technologies, and leveraging existing immunization platforms. Emerging initiatives in local vaccine manufacturing, including Rwanda's modular mRNA facility and Senegal's Institut Pasteur, signal a shift toward regional self-reliance. Conclusions: Maximizing the impact of respiratory vaccines in Africa requires a multifaceted strategy: integrating vaccines into NIPs, strengthening domestic production, expanding cold chain and digital infrastructure, and addressing sociocultural barriers through community-driven communication. These efforts are essential to achieving vaccine equity, health resilience, and pandemic preparedness across the continent.}, }
@article {pmid41011838, year = {2025}, author = {Alotaibi, M and Al-Khalaifah, H and Bouhoudan, A}, title = {Global Research Trends on Major Pathogenic Enteric Viruses (1990-2024): A Bibliometric Analysis of Epidemiology, Transmission, and Public Health Impact.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {9}, pages = {}, pmid = {41011838}, issn = {2076-0817}, mesh = {Humans ; Bibliometrics ; Public Health ; Global Health ; *Gastroenteritis/virology/epidemiology ; *Enterovirus Infections/epidemiology/transmission/virology ; Enterovirus/pathogenicity ; }, abstract = {Pathogenic enteric viruses are a leading cause of gastroenteritis-related mortality worldwide. However, the architecture of this research field remains poorly quantified. This bibliometric analysis provides a comprehensive overview of 35 years of global scientific output on major enteric viruses, such as rotavirus, norovirus, astrovirus, sapovirus, and non-polio enteroviruses, to map trends, methodological developments, and geographic disparities. We conducted a systematic search of PubMed and Scopus (1990-2024), identifying 10,017 records. After deduplication and eligibility screening, a final corpus of 8320 publications was analyzed using Bibliometrix (Biblioshiny 5.0) in R (version 4.3.0) and VOSviewer (Version 1.6.20). We found that scientific production grew steadily (CAGR = 5.84%), reaching its peak in 2021. The field is characterized by profound thematic and geographic disparity: rotavirus dominated the literature (56.3% of publications), followed by norovirus (30.8%), while other viruses were severely underrepresented (<9% each). Geographically, output was highly concentrated, with the top five countries (the USA, China, Japan, India, and Brazil) producing 92.4% of the publications. In contrast, high-burden regions, such as sub-Saharan Africa and Latin America, contributed only 7.6%. Genomic sequencing gained prominence, being cited in over 26.2% of publications from 2020 to 2024, reflecting a methodological shift accelerated by the application of wastewater-based epidemiology during the COVID-19 pandemic. In conclusion, while genomic tools and environmental monitoring are transforming enteric virus research, its progress is hampered by deep and persistent inequalities. These include a narrow focus on rotavirus and a significant disparity between regions with high disease burdens and those with high research outputs. Closing this gap requires targeted investments in equitable collaboration, local genomic capacity, and integrated public health interventions combining vaccination, WASH, and One Health strategies.}, }
@article {pmid41011777, year = {2025}, author = {Corbin, J and Cerles, A and Tebon, P and Haverkate, M and Campbell, S and Hurst, J and Woodul, R and Hunzeker, J and Schwartz-Watjen, K and Owens, A and Wu, A}, title = {A Flurry of Infectious Disease Modeling Tools During the COVID-19 Pandemic, Considerations for Future Selection.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {9}, pages = {}, pmid = {41011777}, issn = {2076-0817}, support = {prime contract HDTRA1-19-D-0007//Defense Threat Reduction Agency (DTRA)/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; *Epidemiological Models ; *Communicable Diseases/epidemiology ; }, abstract = {Infectious disease modeling surged during the COVID-19 pandemic, with numerous epidemiological models developed to shape both research and public policy. The abundance of available models-developed with diverse characteristics and modeling objectives-gave users plenty of model selection options; however, little guidance was available for selecting an appropriate epidemiological model. In recognition of this need for guidance, this work describes the development of a decision framework for appropriate model selection. To serve as both an example and a starting point for model users, we walk through the creation and use of a decision framework to evaluate key considerations for selecting a forward-looking epidemiological model intended to inform policy. Our assessment includes 43 models and modeling platforms that have been or could be used to model infectious disease. The framework developed for this assessment focused on assessing each model's strengths and weaknesses in terms of flexibility and customization, the ability to implement pharmaceutical and non-pharmaceutical mitigations, and visualization capabilities. By providing a decision framework and demonstrating its use, we aim to support better decision-making and stronger trust between public health institutions and the constituents they serve.}, }
@article {pmid41011521, year = {2025}, author = {Georgakopoulou, VE and Dodos, K and Pitiriga, VC}, title = {Role of Lipidomics in Respiratory Tract Infections: A Systematic Review of Emerging Evidence.}, journal = {Microorganisms}, volume = {13}, number = {9}, pages = {}, pmid = {41011521}, issn = {2076-2607}, abstract = {Lower respiratory tract infections (LRTIs) remain a major cause of global morbidity and mortality, yet accurate pathogen identification and risk stratification continue to pose clinical challenges. Lipidomics-the comprehensive analysis of lipid species within biological systems-has emerged as a promising tool to unravel host-pathogen interactions and reveal novel diagnostic and prognostic biomarkers. This systematic review synthesizes evidence from nine original studies applying mass spectrometry-based lipidomic profiling in human LRTIs, including community-acquired pneumonia (CAP), ventilator-associated pneumonia (VAP), and coronavirus disease 2019 (COVID-19). Across diverse study designs, sample types, and analytical platforms, consistent alterations in lipid metabolism were observed. Perturbations in phospholipid classes, particularly phosphatidylcholines (PCs) and lysophosphatidylcholines (LPCs), were frequently associated with disease severity and immune activation. The ratios of PC to LPC and phosphatidylethanolamine (PE) to lysophosphatidylethanolamine (LPE) emerged as markers of inflammatory remodeling. Sphingolipids-including sphingomyelins (SMs) and sphingosine-1-phosphate (S1P)-were identified as key modulators of monocyte and neutrophil activation. Fatty acid-derived lipid mediators such as oxylipins (e.g., 12,13-epoxyoctadecenoic acid and 15-hydroxyeicosatetraenoic acid) and acylcarnitines reflected pathogen-specific immune responses and mitochondrial dysfunction. Several lipid-based classifiers demonstrated superior diagnostic and prognostic performance compared to conventional clinical scores, including the CURB-65 and pneumonia severity index. However, significant heterogeneity in experimental design, lipid identification workflows, and reporting standards limits inter-study comparability. While preliminary findings support the integration of lipidomics into infectious disease research, larger multi-omic and longitudinal studies are required. This review provides the first comprehensive synthesis of lipidomic alterations in human LRTIs and highlights their emerging translational relevance.}, }
@article {pmid41011507, year = {2025}, author = {Maddaloni, L and Bugani, G and Fracella, M and Bitossi, C and D'Auria, A and Aloisi, F and Azri, A and Santinelli, L and Ben M'Hadheb, M and Pierangeli, A and Frasca, F and Scagnolari, C}, title = {Pattern Recognition Receptors (PRRs) Expression and Activation in COVID-19 and Long COVID: From SARS-CoV-2 Escape Mechanisms to Emerging PRR-Targeted Immunotherapies.}, journal = {Microorganisms}, volume = {13}, number = {9}, pages = {}, pmid = {41011507}, issn = {2076-2607}, support = {RM124190A260C1F0//Sapienza University of Rome/ ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is recognized by pattern recognition receptors (PRRs), which play a vital role in triggering innate immune responses such as the production of type I and III interferons (IFNs). While modest PRR activation helps to defend against SARS-CoV-2, excessive or sustained activation can cause harmful inflammation and contribute to severe Coronavirus Disease 2019 (COVID-19). Altered expression of Toll-like receptors (TLRs), which are among the most important members of the PRR family members, particularly TLRs 2, 3, 4, 7, 8 and 9, has been strongly linked to COVID-19 severity. Furthermore, retinoic acid-inducible gene I (RIG-I) and melanoma differentiation-associated protein 5 (MDA5), collectively known as RLRs (RIG-I-like receptors), act as sensors that detect SARS-CoV-2 RNA. The expression of these receptors, as well as that of different DNA sensors, varies in patients infected with SARS-CoV-2. Changes in PRR expression, particularly that of TLRs, cyclic GMP-AMP synthase (cGAS), and the stimulator of interferon genes (STING), have also been shown to play a role in the development and persistence of long COVID (LC). However, SARS-CoV-2 has evolved strategies to evade PRR recognition and subsequent signaling pathway activation, contributing to the IFN response dysregulation observed in SARS-CoV-2-infected patients. Nevertheless, PRR agonists and antagonists remain promising therapeutic targets for SARS-CoV-2 infection. This review aims to describe the PRRs involved in recognizing SARS-CoV-2, explore their expression during SARS-CoV-2 infection, and examine their role in determining the severity of both COVID-19 and long-term manifestations of the disease. It also describes the strategies developed by SARS-CoV-2 to evade PRR recognition and activation. Moreover, given the considerable interest in modulating PRR activity as a novel immunotherapy approach, this review will provide a description of PRR agonists and antagonists that have been investigated as antiviral strategies against SARS-CoV-2. This review aims to explore the complex interplay between PRRs and SARS-CoV-2 in depth, considering its implications for prognostic biomarkers, targeted therapeutic strategies and the mechanistic understanding of long LC. Additionally, it outlines future perspectives that could help to address knowledge gaps in PRR-mediated responses during SARS-CoV-2 infection.}, }
@article {pmid41011460, year = {2025}, author = {Liakou, AI and Routsi, E and Plisioti, K and Tziona, E and Koumaki, D and Kalamata, M and Bompou, EK and Sokou, R and Ioannou, P and Bonovas, S and Samonis, G and Tsantes, AG and Stratigos, A}, title = {Autoimmune Skin Diseases in the Era of COVID-19: Pathophysiological Insights and Clinical Implications.}, journal = {Microorganisms}, volume = {13}, number = {9}, pages = {}, pmid = {41011460}, issn = {2076-2607}, abstract = {The COVID-19 pandemic has highlighted intricate associations between SARS-CoV-2 infection and autoimmune skin diseases (ASDs). This review examines the bidirectional relationship between COVID-19 and ASDs including hidradenitis suppurativa, psoriasis, atopic dermatitis, alopecia areata, autoimmune bullous diseases, cutaneous and systemic lupus erythematosus, systemic sclerosis, dermatomyositis, and lichen planus. Current evidence indicates that SARS-CoV-2 may precipitate or worsen ASDs via mechanisms such as molecular mimicry, dysregulated cytokine signaling, and enhanced Th1/Th17 immune responses, leading to loss of self-tolerance and autoantibody production. Epidemiological studies have identified increased incidence and flares of psoriasis, hidradenitis suppurativa, and other ASDs following both COVID-19 infection and vaccination, with mRNA vaccines associated with a higher risk of flare in hidradenitis suppurativa compared with non-mRNA vaccines. Notably, severe COVID-19 is associated with a greater risk of new-onset autoimmune disease, and patients with pre-existing inflammatory skin conditions may have increased susceptibility to SARS-CoV-2 infection but experience less severe COVID-19 courses. These findings underscore the need for ongoing surveillance and mechanistic studies to clarify the immunopathogenic links between SARS-CoV-2 and ASDs and inform management strategies for affected patients in the context of both infection and vaccination.}, }
@article {pmid41011440, year = {2025}, author = {Lin, R and Porto, BN}, title = {Pyroptosis in Respiratory Virus Infections: A Narrative Review of Mechanisms, Pathophysiology, and Potential Therapeutic Interventions.}, journal = {Microorganisms}, volume = {13}, number = {9}, pages = {}, pmid = {41011440}, issn = {2076-2607}, support = {324636//University of Manitoba/ ; }, abstract = {Pyroptosis is a mode of inflammatory cell death, characterized by cell membrane rupture and the release of pro-inflammatory cytokines and damage-associated molecular patterns (DAMPs). Pyroptosis is a critical part of the innate immune response and acts as a defense mechanism against different types of pathogens, including viruses. Several respiratory viruses, including influenza virus, respiratory syncytial virus (RSV), human metapneumovirus, and SARS-CoV-2, have been shown to trigger pyroptosis through distinct mechanisms. While pyroptosis is beneficial to the host by controlling virus replication and eliminating infected cells, the exaggerated induction of pyroptosis can be harmful and cause significant tissue damage, such as that to the lung tissue during infection with respiratory viruses. Therefore, understanding the mechanisms and the role pyroptosis plays during respiratory virus infections could lead to the development of novel therapeutic approaches to reduce the morbidity caused by these infections. In this review, we discuss the recent knowledge obtained on the pathophysiological role of pyroptosis during different respiratory viral infections as well as some experimental approaches to regulating its detrimental effects to the host.}, }
@article {pmid41011341, year = {2025}, author = {Wu, L and Tao, Y and Wu, X and Li, S and Yang, R and Li, C and Yao, Y and Xu, S and Shu, J and He, Y and Feng, H}, title = {Current Advances and Applications of Animal Models in SARS-CoV-2 Pathogenesis and Vaccine Development.}, journal = {Microorganisms}, volume = {13}, number = {9}, pages = {}, pmid = {41011341}, issn = {2076-2607}, support = {LQ22C180003; 32302904; 32172893//by the Zhejiang Provincial Natural Science Foundation of China under Grant No. LQ22C180003, and by the National Natural Science Foundation of China under Grant Nos. 32302904 (For L.W.) and 32172893 (For H.F.),/ ; }, abstract = {COVID-19 is the most widespread emerging infectious disease in humans, recently caused by the SARS-CoV-2 virus. Understanding the pathogenesis and development of efficient vaccines is crucial for the prevention and control of this emerging disease. SARS-CoV-2 viruses have widespread hosts, including humans, domesticated/companion animals (cats, dogs), specific farmed animals (minks), specific wildlife (white-tailed deer), and laboratory animal models. Bats are considered the original reservoir, and pangolins may be important intermediate hosts. Suitable animal models play an important role in studying the pathogenicity and evaluation of vaccines and antiviral drugs during the preclinical stage. In this review, we summarized the animal models and potential animal models for the research of SARS-CoV-2 pathogenesis, vaccine and antiviral drugs development, including transgenic mice, cats, hamsters, nonhuman primates, ferrets, and so on. Our summary provides the important information to select the animals used for a specific purpose and facilitates the development of novel vaccines and antivirals to prevent and control COVID-19.}, }
@article {pmid41011200, year = {2025}, author = {Li, X and Fu, Y and Yu, T and Song, R and Nie, H and Ding, Y}, title = {Anti-Oxidant, Anti-Inflammatory and Antiviral Properties of Luteolin Against SARS-CoV-2: Based on Network Pharmacology.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {9}, pages = {}, pmid = {41011200}, issn = {1424-8247}, support = {82170093//National Natural Science Foundation of China/ ; 2023JH2/20200072//Liaoning Province Science and Technology Plan Project/ ; }, abstract = {Luteolin is a natural flavonoid compound with multifaceted pharmacological properties, including anti-oxidant, anti-inflammatory, antiviral, and anti-tumor activities. Network pharmacology analysis has been utilized to decipher the underlying mechanisms and multitargets of luteolin against coronavirus disease 2019 (COVID-19). This review aims to provide a systematic and comprehensive summary of luteolin, as a potential novel remedy with anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) activity, as well as its anti-oxidant mechanisms. We systematically delineate the epidemiological profile, genomic architecture, and replicative dynamics of SARS-CoV-2, thereby constructing a multiscale framework to decode its pathogenic mechanisms. Employing a multi-level network pharmacology analytical strategy, we identify 46 core targets through protein interaction network construction, followed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Molecular investigations reveal luteolin's dual antiviral mechanisms, including direct targeting of SARS-CoV-2 proteins and host-directed intervention through suppression of angiotensin-converting enzyme 2 receptor engagement/transmembrane protease serine 2-mediated viral priming. The polypharmacological profile of luteolin demonstrates synergistic effects in blocking viral entry, replication, and host inflammatory cascades. This phytochemical repurposing study of luteolin provides a novel mechanistic paradigm for developing multitarget antiviral agents, highlighting the translational value of natural compounds in combating emerging viral variants.}, }
@article {pmid41011141, year = {2025}, author = {Niazi, SK}, title = {Artificial Intelligence in Small-Molecule Drug Discovery: A Critical Review of Methods, Applications, and Real-World Outcomes.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {9}, pages = {}, pmid = {41011141}, issn = {1424-8247}, abstract = {Artificial intelligence (AI) is emerging as a valuable complementary tool in small-molecule drug discovery, augmenting traditional methodologies rather than replacing them. This review examines the evolution of AI from early rule-based systems to advanced deep learning, generative models, diffusion models, and autonomous agentic AI systems, highlighting their applications in target identification, hit discovery, lead optimization, and safety prediction. We present both successes and failures to provide a balanced perspective. Notable achievements include baricitinib (BenevolentAI/Eli Lilly, an existing drug repurposed through AI-assisted analysis for COVID-19 and rheumatoid arthritis), halicin (MIT, preclinical antibiotic), DSP-1181 (Exscientia, discontinued after Phase I), and ISM001-055/rentosertib (Insilico Medicine, positive Phase IIa results). However, several AI-assisted compounds have also faced challenges in clinical development. DSP-1181 was discontinued after Phase I, despite a favorable safety profile, highlighting that the acceleration of discovery timelines by AI does not guarantee clinical success. Despite progress, challenges such as data quality, model interpretability, regulatory hurdles, and ethical concerns persist. We provide practical insights for integrating AI into drug discovery workflows, emphasizing hybrid human-AI approaches and the emergence of agentic AI systems that can autonomously navigate discovery pipelines. A critical evaluation of current limitations and future opportunities reveals that while AI offers significant potential as a complementary technology, realistic expectations and careful implementation are crucial for delivering innovative therapeutics.}, }
@article {pmid41010904, year = {2025}, author = {Szamosfalvi, M and Pino, CJ and Humes, HD}, title = {Selective Cytopheretic Device Therapy in the Context of Extracorporeal Membrane Oxygenation.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {9}, pages = {}, pmid = {41010904}, issn = {1648-9144}, mesh = {Humans ; *Extracorporeal Membrane Oxygenation/instrumentation/methods/adverse effects ; *COVID-19/therapy ; *Inflammation/therapy/etiology/prevention &amp; control ; Acute Kidney Injury/therapy ; SARS-CoV-2 ; }, abstract = {This review examines the clinical data and basic science research to evaluate the potential of the Selective Cytopheretic Device (SCD) in mitigating Extracorporeal Membrane Oxygenation (ECMO)-associated inflammation. In brief, SCD is an immunomodulatory device used within extracorporeal blood circuits along with the use of citrate anticoagulation. SCD has been shown to be a novel, first-in-its-class device (being marketed as QUELimmune by SeaStar Medical), which is capable of the autologous processing of hyper-inflamed leukocytes to reduce systemic inflammation. Strong preclinical data gathered for SCD in the context of both Cardio-Pulmonary Bypass (CPB) as well as ECMO set the stage for SCD to be used in these life support circuits. ECMO played a crucial role during the COVID-19 pandemic, during a time period when SCD therapy was being evaluated in clinical trials, generating initial clinical data in this setting. SCD has also been utilized in the setting of pediatric acute kidney injury (AKI) and multiorgan dysfunction (MOD), where ECMO can be common.}, }
@article {pmid41010858, year = {2025}, author = {Voinea, C and Mocanu, E and Opariuc-Dan, C and Dantes, E and Gache, AC and Rugina, S}, title = {Global Lessons from COVID-19: Regional Variations in the Management of Hospital-Acquired Infections During and Post-Pandemic.}, journal = {Journal of clinical medicine}, volume = {14}, number = {18}, pages = {}, pmid = {41010858}, issn = {2077-0383}, abstract = {Background/Objectives: The COVID-19 pandemic has significantly disrupted healthcare systems worldwide, exposing longstanding weaknesses, particularly in the prevention and control of healthcare-associated infections (HAIs). Regional disparities in infection prevention and control (IPC) strategies offered valuable lessons for improving public health preparedness. This systematic review aims to identify and compare regional IPC approaches adopted during and after the pandemic, highlighting best practices to strengthen healthcare resilience. Methods: The review was conducted in line with PRISMA guidelines and registered in the PROSPERO database (CRD420251032525). Articles published between 1 January 2020 and 31 March 2025, were retrieved from PubMed, Scopus, and Web of Science. Only full-text studies in English were included. The risk of bias was assessed using the ROBINS-I tool. Results: Of the 63 articles initially identified, 8 met the inclusion criteria. The selected studies demonstrated substantial variability in the implementation of IPC. The availability of infrastructure, funding, coordination capacity, and training of medical staff had a significant impact on outcomes. In regions with well-defined protocols and a solid infrastructure, there was a significant decrease in HAIs, while in resource-poor areas, there was a significant increase. Effective measures included continuous monitoring, regular staff training, provision of adequate equipment, expansion of testing capacity, reorganisation of hospitals, and introduction of technological innovations in healthcare. Conclusions: COVID-19 emphasised the importance of adaptable IPC frameworks. Strengthening health systems requires context-specific standards, sustained investment in infrastructure, continuous training, and increased international cooperation to better prepare for future health emergencies.}, }
@article {pmid41010778, year = {2025}, author = {Asseri, AA and Aldukain, M and Aldukain, A and Alzuhairi, A}, title = {Olfactory Training for Post-COVID-19 Olfactory Dysfunction: A Meta-Analysis of Efficacy and Combination Therapies.}, journal = {Journal of clinical medicine}, volume = {14}, number = {18}, pages = {}, pmid = {41010778}, issn = {2077-0383}, support = {RGP2/488/46//Deanship of Research and Graduate Studies at King Khalid University/ ; }, abstract = {Background/Objectives: This systematic review and meta-analysis evaluated the effectiveness of olfactory training (OT) using standardized protocols in patients with post-COVID-19 olfactory dysfunction. The objective was to assess whether OT, compared to no treatment, placebo, or alternative therapies, improved olfactory function as measured using validated smell tests, including UPSIT, Sniffin' Sticks (TDI score), CCCRC, and B-SIT. Methods: A systematic search of PubMed, Web of Science, and Ovid Medline was conducted through February 2025 in accordance with PRISMA guidelines. Eight randomized controlled trials (RCTs) met the inclusion criteria. Data were extracted on study characteristics (author, year, country, design, sample size), population details (age, sex, post-COVID-19 cause), intervention type (training method, frequency, duration), comparators, outcome measures (baseline and post-intervention olfactory scores), follow-up duration, and reported adverse effects. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. Meta-analyses were performed using RevMan and Open Meta-Analyst. Results: Olfactory training significantly improved the olfactory scores compared to those of the controls. The greatest improvement was observed when OT was combined with PEA-luteolin (MD = 4.62, 95% CI: 2.17-7.06, p = 0.0002), followed by EDTA (MD = 2.33, 95% CI: 0.58-4.08, p = 0.009). Corticosteroids showed a borderline benefit (MD = 1.34, 95% CI: 0.01-2.67, p = 0.05), while alpha-lipoic acid had no significant effect. Combination therapies were associated with higher recovery rates (RR = 1.65, 95% CI: 1.13-2.42, p = 0.01). Conclusions: Olfactory training is an effective treatment for post-COVID-19 smell dysfunction. When paired with specific adjunct therapies, particularly PEA-luteolin, it may yield superior recovery outcomes. Further large-scale, standardized RCTs are needed to define optimal treatment protocols.}, }
@article {pmid41010747, year = {2025}, author = {Turcato, G and Zaboli, A and Cipriano, A and Montagnani, A and Vannucchi, V and Pieralli, F and Belfiore, A and Valbusa, F and Marchetti, M and Ferretto, P and Filippi, L and Voza, A and Ghiadoni, L and Ageno, W and Wiedermann, CJ}, title = {Intermediate Care Units in Europe and Italy: A Review of Structure, Outcomes, and Policy Implications for Internal Medicine.}, journal = {Journal of clinical medicine}, volume = {14}, number = {18}, pages = {}, pmid = {41010747}, issn = {2077-0383}, abstract = {Background/Objectives: Intermediate Care Units (IMCUs) provide a level of care between general wards and Intensive Care Units (ICUs). While widely implemented across Europe, their use in the Italian internal medicine remains limited. To review the clinical effectiveness, organizational benefits, and policy relevance of IMCUs in Europe and assess opportunities and barriers to their implementation in the Italian hospital system. Methods: A narrative review of international and Italian literature from the origin of intermediate care models in 2025, with emphasis on patient outcomes, ICU utilization, cost-effectiveness, and governance models for IMCUs. Results: European studies consistently show that IMCUs improve patient flow, reduce ICU burden, and may reduce mortality among selected high-acuity patients. In Italy, respiratory and cardiac IMCUs have demonstrated similar benefits. However, general internal medicine IMCUs remain underdeveloped. The COVID-19 pandemic exposed structural gaps in the capacity for intermediate care. Recent legislative efforts (e.g., Decree-Law 34/2020) have aimed to expand sub-intensive care, but implementation is still heterogeneous. Conclusions: IMCUs are a cost-effective and clinically valuable strategy for managing non-ICU high-acuity patients. Structured integration of IMCUs into internal medicine in Italy could improve care quality and system efficiency. Clear triage protocols, adequate staffing, and strong organizational leadership are essential for success.}, }
@article {pmid41009895, year = {2025}, author = {Sakagianni, A and Koufopoulou, C and Koufopoulos, P and Feretzakis, G and Koumaki, V}, title = {The Impact of COVID-19 on the Epidemiology of Carbapenem Resistance.}, journal = {Antibiotics (Basel, Switzerland)}, volume = {14}, number = {9}, pages = {}, pmid = {41009895}, issn = {2079-6382}, abstract = {Background: The global COVID-19 pandemic has significantly disrupted healthcare systems, inadvertently influencing the epidemiology of antimicrobial resistance (AMR). Among the most critical AMR threats are carbapenem-resistant organisms (CROs), which include carbapenem-resistant Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa. This review explores the pandemic's impact on carbapenem resistance patterns worldwide. Objectives: This study aimed to assess the effects of the COVID-19 pandemic on carbapenem resistance trends, identify key drivers, and discuss implications for clinical practice and public health policy. Methods: A comprehensive review of peer-reviewed literature, national surveillance reports, and WHO/ECDC data from 2019 to 2025 was conducted, with emphasis on hospital-acquired infections, antimicrobial use, and infection control practices during the pandemic. Results: The pandemic has led to increased use of broad-spectrum antibiotics, including carbapenems, often in the absence of confirmed bacterial co-infections. Overwhelmed healthcare systems and disruptions in infection prevention and control (IPC) measures have facilitated the spread of carbapenem-resistant organisms, particularly in intensive care settings. Surveillance data from multiple countries show a measurable increase in CRO prevalence during the pandemic period, with regional variations depending on healthcare capacity and stewardship infrastructure. Conclusions: COVID-19 has accelerated the emergence and dissemination of carbapenem resistance, underscoring the need for resilient antimicrobial stewardship and IPC programs even during public health emergencies. Integrating pandemic preparedness with AMR mitigation strategies is critical for preventing further escalation of resistance.}, }
@article {pmid41009829, year = {2025}, author = {Filev, R and Bogov, B and Lyubomirova, M and Rostaing, L}, title = {From Pandemic to Resistance: Addressing Multidrug-Resistant Urinary Tract Infections in the Balkans.}, journal = {Antibiotics (Basel, Switzerland)}, volume = {14}, number = {9}, pages = {}, pmid = {41009829}, issn = {2079-6382}, abstract = {Background/Objectives: The rise in urinary tract infections caused by multidrug-resistant (MDR) bacteria presents a serious public health challenge across the Balkans, a region already burdened by aging populations, healthcare resource limitations, and fragmented antimicrobial surveillance systems. Methods: This review explores the epidemiology, risk factors, and consequences of MDR UTIs, particularly in the context of the COVID-19 pandemic, which significantly accelerated antimicrobial resistance (AMR) due to widespread, inappropriate antibiotic use. Results: The paper discusses region-specific data on resistance trends, highlights the gaps in diagnostic infrastructure, and evaluates emerging clinical strategies including antimicrobial stewardship (AMS), rapid diagnostic technologies, novel antibiotics, and non-antibiotic alternatives such as bacteriophage therapy and vaccines. Conclusions: Policy recommendations are provided to strengthen surveillance, promote evidence-based treatment, and ensure equitable access to diagnostic and therapeutic tools. A multidimensional and regionally coordinated response is essential to curb the MDR UTI burden and safeguard public health across the Balkans.}, }
@article {pmid41009608, year = {2025}, author = {Mantle, D and Domingo, JC and Golomb, BA and Castro-Marrero, J}, title = {Gulf War Illness, Fibromyalgia, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Overlap in Common Symptoms and Underlying Biological Mechanisms: Implications for Future Therapeutic Strategies.}, journal = {International journal of molecular sciences}, volume = {26}, number = {18}, pages = {}, pmid = {41009608}, issn = {1422-0067}, mesh = {Humans ; *Fatigue Syndrome, Chronic/therapy/metabolism/pathology/drug therapy ; *Persian Gulf Syndrome/therapy/pathology/metabolism ; Ubiquinone/analogs &amp; derivatives/therapeutic use ; *Fibromyalgia/therapy/metabolism/pathology/drug therapy ; *COVID-19/complications/metabolism/therapy ; Oxidative Stress ; SARS-CoV-2 ; }, abstract = {Although Gulf War Illness (GWI), fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID have distinct origins, in this article we have reviewed evidence that these disorders comprise a group of so-called low-energy associated disorders with overlapping common symptoms underlying pathology. In particular, evidence for mitochondrial dysfunction, oxidative stress, inflammation, immune dysregulation, neuroendocrine dysfunction, disrupted brain-gut-microbiome axis, apoptosis/ferroptosis and telomere shortening as common features in the pathogenesis of these disorders has been identified. Given the role of coenzyme Q10 (CoQ10) in promoting normal mitochondrial function, as an antioxidant, antiinflammatory and antiapoptotic and antiferroptotic agent, there is a rationale for supplementary CoQ10 in the management of these disorders. The reported benefits of supplementary CoQ10 administration in GWI, FM, ME/CFS and long COVID have been reviewed; the potential benefit of supplementary CoQ10 in reducing telomere shortening and improving the efficiency of stem cell transfer relevant has also been identified as promising therapeutic strategies in these disorders. This review advances beyond previous systematic reviews and consensus statements on overlapping similar symptoms and underlying biological pathomechanisms in these complex disorders.}, }
@article {pmid41009326, year = {2025}, author = {Muñoz-Carrillo, JL and Gutiérrez-Coronado, O and Villalobos-Gutiérrez, PT and Villacis-Valencia, MS and Chávez-Ruvalcaba, F and Vázquez-Alcaraz, SJ and Rivera-Lozada, O and Barboza, JJ}, title = {Current Landscape of the Interrelationship Between Periodontitis, Type 2 Diabetes Mellitus, and COVID-19.}, journal = {International journal of molecular sciences}, volume = {26}, number = {18}, pages = {}, pmid = {41009326}, issn = {1422-0067}, mesh = {Humans ; *Diabetes Mellitus, Type 2/complications/metabolism ; *COVID-19/complications/epidemiology/metabolism ; *Periodontitis/complications/metabolism ; SARS-CoV-2 ; Inflammation ; Angiotensin-Converting Enzyme 2/metabolism ; }, abstract = {The inflammatory response plays a central role in the pathophysiology of various chronic diseases such as periodontitis, type 2 diabetes mellitus (T2DM), and coronavirus disease 2019 (COVID-19), whose coexistence is associated with an increase in clinical complications and a more severe and serious course of these diseases. Current evidence on the interrelationship between periodontitis, T2DM, and COVID-19 remains insufficient, highlighting the need for further research to elucidate these associations. The main aim of this narrative review is to provide the current landscape of the most relevant aspects of the interrelationship between periodontitis, T2DM, and COVID-19. This narrative review was carried out through a specialized, exhaustive, and structured search of published studies indexed in the electronic databases PubMed and LILACS, for the inclusion of studies in English and Spanish, respectively, without date restriction. A search strategy was performed using the Boolean operators AND, OR, and NOT, with the following DeCS/MeSH terms: "periodontal disease", "periodontitis", "type 2 diabetes mellitus", "SARS-CoV-2", and "COVID-19". A variety of articles were included, focusing on the most relevant aspects of the interrelationship between periodontitis, T2DM, and COVID-19. Findings suggest that inflammation is a unifying mechanism, which leads to the severity of these conditions through four shared axes: (1) a clinicopathological axis involving systemic manifestations; (2) an axis associated with metabolic alterations linked to glycemic dysregulation; (3) an axis related to enzyme overexpression linked to altered angiotensin-converting enzyme (ACE)-2 expression and glucose metabolism; and (4) an inflammatory axis. These synergistic interactions can cause these three diseases to mutually enhance each other, creating a vicious cycle, worsening the patient's health.}, }
@article {pmid41009245, year = {2025}, author = {Agyapong-Opoku, F and Agyapong-Opoku, N and Agyapong, B and Greenshaw, A}, title = {Suicidal Behaviors Among Medical Students: A Scoping Review of Systematic Reviews and Meta-Analyses.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {9}, pages = {}, pmid = {41009245}, issn = {2076-328X}, support = {N/A//Alberta Innovates/ ; }, abstract = {BACKGROUND: Suicidal ideation and attempts are major public health concerns among young adults, particularly those in demanding academic settings. Medical students exhibit disproportionately high rates compared to peers in the general population and other fields of study, highlighting the urgent need to understand and address mental health challenges in medical education.<br><br>OBJECTIVE: This scoping review summarizes evidence from systematic reviews and meta-analyses on the prevalence and risk factors of suicidal ideation and suicide attempts among medical students worldwide.<br><br>METHODS: Following PRISMA-ScR guidelines, six databases were searched for peer-reviewed reviews published in the last ten years. Studies focused exclusively on medical students and reporting prevalence or risk factors of suicidal ideation or attempts were included. Data were charted on prevalence, risk factors, study characteristics, and recommendations.<br><br>RESULTS: Twelve reviews comprising 378,081 medical students were included. Lifetime prevalence of suicidal ideation ranged from 2.9% to 53.6% among the systematic reviews, with pooled estimates from meta-analyses ranging from 11% and 25%. Attempted suicide pooled prevalences ranged from 1.64% to 8%. Depression was frequently reported as the most significant risk factor for both suicidal ideation and attempts. Other significant risk factors for suicidal ideation included anxiety, burnout, female gender, financial strain, and academic stress. Suicidal ideation was higher during the COVID-19 pandemic and among clinical-phase students. Gender differences in suicide attempts were inconsistent. Medical students' rates of suicidal behavior exceeded those of other university students.<br><br>CONCLUSION: Suicidal behavior remains a critical mental health issue for medical students globally. Despite known risk factors, targeted interventions are limited. Future research should emphasize longitudinal studies, post-pandemic effects, regional gaps, and intervention development. Implications are discussed.}, }
@article {pmid41009217, year = {2025}, author = {Glozah, FN and Tia, RS}, title = {Preparing for the Next Pandemic: Lessons from COVID-19's Impact on Child and Adolescent Health Inequities in Ghana.}, journal = {Behavioral sciences (Basel, Switzerland)}, volume = {15}, number = {9}, pages = {}, pmid = {41009217}, issn = {2076-328X}, abstract = {The pandemic spared most children and adolescents in Ghana from severe clinical disease, but it exposed long-standing gaps in services and protection methods. Methods: We conducted a desk-based narrative review of peer-reviewed studies, national and international reports, and grey literature from January 2020 to May 2025. The evidence was organised across eight domains of child and adolescent well-being. Across mental health, gambling and other risky behaviours, access to health services, economic hardship and child labour, nutrition, education, early childhood development, and WASH, the pandemic disrupted essential services and social safety nets. Examples include declines in routine care and immunisation, wider digital exclusion during remote learning, a rise in child labour linked to income loss, and persistent hygiene constraints. Preparedness in Ghana should focus on mental health, digital inclusion, early childhood services, and strong social protection. Ghana's specific empirical data are uneven, so we triangulate peer-reviewed evidence with official reports, appraised the grey literature, and calibrated claims to the strength of sources.}, }
@article {pmid41008646, year = {2025}, author = {Lee, E and Ozigbo, AA and Varon, J and Halma, M and Laezzo, M and Ang, SP and Iglesias, J}, title = {Mitochondrial Reactive Oxygen Species: A Unifying Mechanism in Long COVID and Spike Protein-Associated Injury: A Narrative Review.}, journal = {Biomolecules}, volume = {15}, number = {9}, pages = {}, pmid = {41008646}, issn = {2218-273X}, mesh = {Humans ; *COVID-19/metabolism/complications/pathology ; *Mitochondria/metabolism/pathology ; *Reactive Oxygen Species/metabolism ; SARS-CoV-2/metabolism ; *Spike Glycoprotein, Coronavirus/metabolism ; Post-Acute COVID-19 Syndrome ; Oxidative Stress ; }, abstract = {Post-acute sequelae of SARS-CoV-2 infection (long COVID) present with persistent fatigue, cognitive impairment, and autonomic and multisystem dysfunctions that often go unnoticed by standard diagnostic tests. Increasing evidence suggests that mitochondrial dysfunction and oxidative stress are central drivers of these post-viral sequelae. Viral infections, particularly SARS-CoV-2, disrupt mitochondrial bioenergetics by altering membrane integrity, increasing mitochondrial reactive oxygen species (mtROS), and impairing mitophagy, leading to sustained immune activation and metabolic imbalance. This review synthesizes an understanding of how mitochondrial redox signaling and impaired clearance of damaged mitochondria contribute to chronic inflammation and multisystem organ symptoms in both long COVID and post-vaccine injury. We discuss translational biomarkers and non-invasive techniques, exploring therapeutic strategies that include pharmacological, non-pharmacological, and nutritional approaches, as well as imaging modalities aimed at assessing and restoring mitochondrial health. Recognizing long COVID as a mitochondrial disorder that stems from redox imbalance will open new options for personalized treatment and management guided by biomarkers. Future clinical trials are essential to validate these approaches and translate mitochondrial resuscitation into effective care for patients suffering from long COVID and related post-viral syndromes.}, }
@article {pmid41007801, year = {2025}, author = {Sáez-Leyva, J and Lennol, MP and Avilés-Granados, C and García-Ayllón, MS and Sáez-Valero, J}, title = {Risk for COVID-19 Vulnerability in Patients with Inflammatory Bowel Disease: Assessing Alterations in ACE2 and TMPRSS2.}, journal = {Biomedicines}, volume = {13}, number = {9}, pages = {}, pmid = {41007801}, issn = {2227-9059}, support = {PI22/01329//Fondo de Investigaciones Sanitarias/ ; AICO/2021/308//Direcci&#xf3; General de Ci&#xe8;ncia i Investigaci&#xf3;, Generalitat Valenciana/ ; CEX2021-001165-S//Severo Ochoa" Program for Centers of Excellence in R&amp;D/ ; }, abstract = {Chronic inflammatory conditions often involve the dysregulation of key enzymes, including serine proteases such as transmembrane serine protease 2 (TMPRSS2) and the angiotensin converting enzyme 2 (ACE2), which are key proteins implicated in the cellular entry mechanism of SARS-CoV-2. It remains uncertain whether the gastrointestinal symptoms observed in COVID-19 patients result from direct viral infection of the gastrointestinal tract, a process that may be exacerbated by altered expression of ACE2 or TMPRSS2. In this review, we explore the interplay among ACE2 and TMPRSS2 in the context of inflammatory bowel disease (IBD), including their roles in disease pathology and response to therapy. We also examine methodological approaches for assessing whether protease alterations contribute to increased susceptibility to infection, considering that TMPRSS2 exists in inactive (zymogen) and active forms. Furthermore, while membrane-bound ACE2 facilitates viral entry, soluble ACE2 fragments may act as decoys, preventing virus-receptor interaction. Therefore, the interpretation of changes in full-length versus cleaved forms of ACE2 and related enzymes is critical for understanding vulnerability to SARS-CoV-2 infection.}, }
@article {pmid41007602, year = {2025}, author = {Zayed, DK and Al-Smadi, RA and Almaayteh, M and Al-Hjouj, T and Hamdan, O and Ghalyoun, AA and Alsaleh, O and Abu Touk, T and Almaseidin, SN and Madi, T and Hassan, SK and Horabi, M and Belbiesi, A and Mukattash, TL and Al-Tammemi, AB}, title = {Strengthening Jordan's Laboratory Capacity for Communicable Diseases: A Comprehensive Multi-Method Mapping Toward Harmonized National Laboratories and Evidence-Informed Public Health Planning.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {9}, pages = {}, pmid = {41007602}, issn = {1660-4601}, mesh = {Jordan ; *Laboratories/standards/organization &amp; administration ; Humans ; *Communicable Diseases/diagnosis/epidemiology ; *Public Health ; Capacity Building ; *Health Planning ; }, abstract = {Infectious diseases remain a global threat, with low- and middle-income countries disproportionately affected due to socio-economic and demographic vulnerabilities. Robust laboratory systems are critical for early detection, outbreak containment, and guiding effective interventions. This study aimed to map and evaluate Jordan's laboratory diagnostic network for communicable diseases, identify gaps, and recommend strategies to strengthen capacity, harmonization, and alignment with international standards. A multi-method approach was employed in 2023 through collaboration between the Jordan Center for Disease Control and the Health Care Accreditation Council. Data were collected via (i) a desktop review of 226 national and international documents; (ii) 20 key informant interviews with stakeholders from the public, private, military, veterinary, and academic sectors; and (iii) 23 field visits across 27 laboratories in four Jordanian governorates. Data were analyzed thematically and synthesized using the LABNET framework, which outlined ten core laboratory capacities. Findings were validated through a multi-sectoral national workshop with 90 participants. The mapping revealed the absence of a unified national laboratory strategic plan, with governance dispersed across multiple authorities and limited inter-sectoral coordination. Standard operating protocols (SOPs) existed for high-priority diseases such as T.B, HIV, influenza, and COVID-19 but were lacking or outdated for other notifiable diseases, particularly zoonoses. Quality management was inconsistent, with limited participation in external quality assurance programs and minimal accreditation uptake. Biosafety and biosecurity frameworks were fragmented and insufficiently enforced, while workforce shortages, high turnover, and limited specialized training constrained laboratory performance. Despite these challenges, Jordan demonstrated strengths including skilled laboratory staff, established reference centers, and international collaborations, which provide a platform for improvement. Jordan's laboratory network has foundational strengths but faces systemic challenges in policy coherence, standardization, quality assurance, and workforce capacity. Addressing these gaps requires the development of a national laboratory strategic plan, strengthened legal and regulatory frameworks, enhanced quality management and accreditation, and integrated One Health coordination across human, animal, and environmental health sectors. These measures will improve diagnostic reliability, preparedness, and alignment with the global health security agenda.}, }
@article {pmid41007561, year = {2025}, author = {Muñoz-Nieves, C and Greaves, L and Huber, E and Brabete, AC and Wolfson, L and Poole, N}, title = {Sex and Gender Influences on the Impacts of Disasters: A Rapid Review of Evidence.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {9}, pages = {}, pmid = {41007561}, issn = {1660-4601}, support = {520671/CAPMC/CIHR/Canada ; }, mesh = {Humans ; *Disasters ; COVID-19/epidemiology ; Female ; Sex Factors ; Male ; SARS-CoV-2 ; New Zealand ; Australia ; }, abstract = {Both sex-related factors and gender-related factors affect the immediate and long term mental and physical health impacts of disasters, including those resulting from public health emergencies, climate-related events, and naturally occurring phenomena. These include sex-specific biological, physiological and genetic processes, mechanisms underlying reproduction, disease outcomes, and stress, immune, and trauma responses. Gendered factors such as roles, relations, identity, and institutional policies that have an impact on caregiving, occupation, gender-based violence, and access to healthcare, also influence the impacts of disasters and emergencies. Sex/gender factors interact with a range of social determinants to affect the equitability of impacts. A rapid review was conducted to examine evidence from Australia, Canada, countries from the European Union, New Zealand, the United Kingdom (UK), and the United States of America (USA) on the influence of sex- and gender-related factors in the context of disasters, such as COVID-19, earthquakes, floods, hurricanes, and wildfires. This article describes and categorizes this evidence with attention to real-world impacts of the interactions between sex, gender, and other equity related factors. Broad considerations for improving research and practices to support more sex and gender research in this area and ultimately, to improve emergency and disaster management, are discussed.}, }
@article {pmid41007506, year = {2025}, author = {Kachroo, P and Boivin, G and Cowling, BJ and Shannon, W and Mallefet, P and Kalita, P and Georgescu, AM}, title = {Long COVID Symptom Management Through Self-Care and Nonprescription Treatment Options: A Narrative Review.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {9}, pages = {}, pmid = {41007506}, issn = {1660-4601}, mesh = {Humans ; *COVID-19/therapy/complications ; *Self Care ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {Many patients experience unique or persistent symptoms several months following the onset of infection with severe acute respiratory syndrome coronavirus 2, the causative agent of COVID-19. While this condition is commonly referred to as long COVID, no universally accepted definition exists; therefore, many patients go underrecognized and underreported. Long COVID can involve almost any major organ system and is characterized by widely heterogeneous persistent or recurrent symptoms including fatigue, headache, cough, dyspnea, chest pain, cognitive dysfunction, anxiety, and depression. In line with the wide array of symptoms, numerous potential underlying pathophysiologic pathways, including viral persistence, prolonged inflammation, autoimmune reactions, endothelial dysfunction, and dysbiosis of the microbiome of the gut, may contribute to the symptomology of long COVID. Therapy is directed at symptomatic control; however, no pharmacologic treatments are specifically approved for the management of symptoms associated with long COVID. Several common symptoms of long COVID may be managed with nonprescription treatments (pharmacologic and nonpharmacologic). The goal of this review is to provide clinicians with a better understanding of long COVID and review the latest recommendations for managing common mild-to-moderate symptoms with nonprescription treatment options.}, }
@article {pmid41007425, year = {2025}, author = {Carista, A and Gratie, MI and Cappello, F and Burgio, S}, title = {HSP60 and SARS-CoV-2: Les Liaisons Dangereuses.}, journal = {Biology}, volume = {14}, number = {9}, pages = {}, pmid = {41007425}, issn = {2079-7737}, abstract = {Heat shock protein 60 (Hsp60) plays a crucial role in cellular homeostasis and stress responses. Recent evidence highlights its involvement in COVID-19 pathophysiology, particularly in immune modulation, inflammation, and endothelial dysfunction. Extracellular Hsp60 can interact with Toll-like receptors, amplifying inflammatory responses and contributing to cytokine storm and tissue damage. Additionally, since the presence of several common epitopes with SARS-CoV-2 proteins, its role in molecular mimicry suggests a potential link also to post-infectious autoimmune disorders. Hsp60 has also been implicated in endothelial damage and thromboembolic complications observed in severe COVID-19 cases. Beyond its pathogenic roles, Hsp60 could emerge as a potential biomarker for disease severity as well as a target for therapeutic strategies aimed at modulating immune responses. Finally, the structural similarity with SARS-CoV-2 proteins raises important considerations regarding both vaccine safety and the unexpected potential for anti-tumor immunity. This review critically examines the multifaceted roles of Hsp60 in COVID-19, specifically from a morpho-functional point of view, highlighting its implications in disease progression, post-viral complications, and therapeutic opportunities.}, }
@article {pmid41006970, year = {2025}, author = {Matsubara, D and Kotani, K and Osaka, H}, title = {School Refusal Behavior in Japan: The Impact of COVID-19 on Children.}, journal = {Children (Basel, Switzerland)}, volume = {12}, number = {9}, pages = {}, pmid = {41006970}, issn = {2227-9067}, abstract = {School refusal behavior, defined as a child's prolonged voluntary absence from school for reasons unrelated to illness and/or economic hardship, is a growing concern in Japan. The COVID-19 pandemic has worsened this issue by disrupting children's lives. This review summarizes the prevalence, contributing factors, and health implications of school refusal, particularly in the context of COVID-19. A literature review of government reports and PubMed-indexed studies indicates that school refusal in Japan has been rising for eleven years, reaching a record 340,000 cases in 2023. Middle school students (6.7%) were the most affected, followed by elementary school students (2.1%). The pandemic intensified school-related, family-related, and child-related risk factors. School closures disrupted routines, reduced peer interactions, and increased social isolation, contributing to higher rates of anxiety and depression. Reports of suicides and mental health disorders among children have also surged. Family stressors, including economic hardship and parental mental health struggles, further exacerbate school refusal. Additionally, remote learning has widened socioeconomic disparities in access to education, leaving vulnerable children at greater risk. Addressing school refusal requires a multifaceted approach involving schools, families, healthcare providers, and policymakers. School-based interventions, mental health approach, and flexible educational programs would be essential. The Japanese government's "COCOLO Plan" represents progress toward a more inclusive education system, and a comprehensive, interdisciplinary strategy is needed. Ensuring all children receive the necessary support to reengage with education is critical to overcoming the long-term challenges posed by school refusal.}, }
@article {pmid41005811, year = {2025}, author = {Rahman-Shepherd, A and Cutter, J and Hinjoy, S and Ho, ZJM and Huimin, JC and Miranda, I and Moideen, MA and Pang, T and Razavi, A and Rollet, V and Hsu, LY}, title = {ASEAN and the COVID-19 pandemic: a scoping review on the role and response of a regional organisation in a global health emergency.}, journal = {BMJ global health}, volume = {10}, number = {9}, pages = {}, pmid = {41005811}, issn = {2059-7908}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Global Health ; Asia, Southeastern/epidemiology ; SARS-CoV-2 ; *Pandemics ; Emergencies ; }, abstract = {The Association of Southeast Asian Nations (ASEAN) is a state-based membership organisation that facilitates cooperation in Southeast Asia. Over the past two decades, ASEAN has strengthened its cooperation efforts in health, particularly in managing infectious diseases. This scoping review explores the role and response of ASEAN in the COVID-19 pandemic, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We searched five databases using terminology related to 'ASEAN', 'COVID-19' and 'health emergencies', and extracted data on the role of ASEAN, its response efforts, critiques of either its role or response efforts, and any recommendations. We conducted a thematic synthesis of the evidence. From 17 studies, we characterised a normative, functional and diplomatic role that ASEAN played in managing the pandemic, and identified a total of 46 discrete mechanisms that ASEAN leveraged during. We synthesised both positive and negative critique of ASEAN's role and response efforts, and identified six themes of recommendations for ASEAN moving forward. Our review reveals the need for further research to understand where Member States' interests in managing health emergencies converge; and to define and measure the effectiveness of regional organisations to better establish their role and responsibilities.}, }
@article {pmid41005678, year = {2025}, author = {Corrêa, EM and da Silva Mendonça, S and Rocha, RSB and da Costa Cunha, K and Falcão, LFM and Normando, VMF}, title = {The effects of inspiratory muscle training on exercise tolerance in patients with post-covid-19 syndrome: a systematic review.}, journal = {Respiratory medicine}, volume = {248}, number = {}, pages = {108375}, doi = {10.1016/j.rmed.2025.108375}, pmid = {41005678}, issn = {1532-3064}, mesh = {Adult ; Humans ; Male ; *Breathing Exercises/methods ; *COVID-19/physiopathology/rehabilitation/complications ; *Exercise Tolerance/physiology ; Muscle Strength/physiology ; Randomized Controlled Trials as Topic ; *Respiratory Muscles/physiopathology ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: This systematic review aimed to evaluate the effects of Inspiratory Muscle Training (IMT), either performed in isolation or combined with aerobic and resistance exercises, on exercise tolerance and respiratory function in patients with post-COVID-19 syndrome.<br><br>METHODS: The review was conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO. Randomized controlled trials (RCTs) published in peer-reviewed journals investigating IMT in adults with post-COVID-19 syndrome were included. A comprehensive search was carried out in international electronic databases. Data extraction and risk of bias assessment (RoB 2.0) were performed independently by two reviewers.<br><br>RESULTS: Six randomized controlled trials encompassing a total of 451 participants were included. The overall quality of evidence was considered moderate, mainly due to small sample sizes and heterogeneous protocols. Compared with control groups, IMT demonstrated significant improvements in inspiratory muscle strength, diaphragmatic thickness, and distance covered in the 6-min walk test (6MWT). However, no consistent differences were observed in maximal oxygen uptake (VO2max) or autonomic modulation.<br><br>CONCLUSION: The findings suggest that IMT may enhance exercise tolerance and respiratory parameters in post-COVID-19 patients. Nevertheless, the available evidence remains limited and heterogeneous, underscoring the need for multicenter RCTs with standardized protocols and long-term follow-up to establish definitive clinical recommendations.}, }
@article {pmid41004951, year = {2025}, author = {Asai, K}, title = {Impact of physical activity on respiratory disease: Current status and therapeutic implications.}, journal = {Respiratory investigation}, volume = {63}, number = {6}, pages = {1187-1193}, doi = {10.1016/j.resinv.2025.09.020}, pmid = {41004951}, issn = {2212-5353}, mesh = {Humans ; *Exercise/physiology ; Pulmonary Disease, Chronic Obstructive/physiopathology/therapy ; Asthma/physiopathology/therapy ; Quality of Life ; COVID-19/complications ; Lung Diseases, Interstitial/physiopathology ; Exercise Therapy ; }, abstract = {Regular physical activity (PA) modulates key pathophysiological mechanisms underlying the onset, progression, and symptoms of major respiratory diseases. Notably, low daily PA and high sedentary time independently predict faster lung function decline, poorer quality of life, and premature mortality in asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILDs), and post-coronavirus disease lung sequelae. Conversely, structured exercise training-and the increasingly popular, lifestyle-integrated "move-more-sit-less" programs-improve dyspnea, exercise capacity, airway and systemic inflammation, and healthcare utilization. Large cohort analyses corroborate a clear dose-response relationship: attaining ≥7500 steps/day or ≥150 min/week of moderate-to-vigorous activity yields the greatest clinical benefit, even in individuals with impaired pulmonary function. Mechanistic studies also revealed that exercise dampens type-2 airway inflammation in asthma, enhances the skeletal muscle oxidative phenotype in COPD, and counteracts ILD-related deconditioning. Recent randomized trials have shown that pulmonary rehabilitation can improve 5-year survival in fibrotic ILD, while telerehabilitation and gamified smartphone coaching can close access gaps without compromising efficacy. Additionally, major international guidelines such as the Global Initiative for Asthma 2024 and Global Initiative for Chronic Obstructive Lung Disease 2025 now explicitly recognize PA as a "treatable trait." Nevertheless, PA uptake in routine care remains limited by behavioral, environmental, and policy barriers. Future work must refine personalized PA prescriptions, integrate wearable-derived metrics into decision-support algorithms, and test the synergistic effects with emerging biologics and anti-fibrotic agents. This review synthesizes contemporary evidence, highlights unanswered questions, and offers pragmatic recommendations for clinicians aiming to embed PA promotion in comprehensive respiratory care pathways.}, }
@article {pmid41004948, year = {2025}, author = {Breznik, JA and Miller, MS and Bowdish, DME}, title = {Rationalizing recommendations for influenza and COVID-19 vaccines.}, journal = {Vaccine}, volume = {65}, number = {}, pages = {127775}, doi = {10.1016/j.vaccine.2025.127775}, pmid = {41004948}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; *Influenza Vaccines/administration &amp; dosage/immunology ; *COVID-19 Vaccines/administration &amp; dosage/immunology ; *Influenza, Human/prevention &amp; control ; SARS-CoV-2/immunology ; Vaccination ; Vaccine Efficacy ; Health Policy ; }, abstract = {Influenza vaccination saves lives, reduces short-term and long-term health consequences, decreases healthcare utilization, and improves pregnancy outcomes and infant health. Consequently, many, although not all, high-income countries have influenza vaccination policies that recognize both the direct (prevention of infection) and indirect (e.g., reduction in transmission and absenteeism, exacerbations of other health conditions) benefits of vaccination. Vaccination policies for COVID-19 are less consistent, even though COVID-19 continues to cause more infections than influenza. Indeed, some countries recommend COVID-19 vaccination only for older adults and individuals who are severely immunocompromised. Herein we compare influenza and COVID-19 vaccination effectiveness against both acute infection and indirect effects of infection. We find that COVID-19 vaccines are equivalent to, or outperform, influenza vaccines when comparing protection from symptomatic infection, reduction in severe disease, safety profiles, and real-world effectiveness. We propose that expansion of COVID-19 vaccination policies would reduce disruptions to school, work, and healthcare systems, in addition to preventing hospitalizations and severe disease.}, }
@article {pmid41004357, year = {2025}, author = {Chau, CHH and Stefler, D and Szeto, MMS}, title = {Effectiveness of probiotics on COVID-19 prevention and treatment against mild COVID-19 in outpatient care: A systematic review.}, journal = {Nutrition and health}, volume = {}, number = {}, pages = {2601060251378200}, doi = {10.1177/02601060251378200}, pmid = {41004357}, issn = {2047-945X}, abstract = {BackgroundIn previous research, probiotics have shown to be beneficial in preventing and limiting the progress of upper respiratory infections. Their effectiveness in relation to coronavirus disease 2019 (COVID-19) has been investigated mainly in hospitalized patients, and less so among outpatients who constitute majority of COVID-19 cases.AimThis systematic review evaluates the available evidence regarding the effectiveness of probiotic use on prevention and treatment of COVID-19 among patients with mild symptoms in outpatient settings.MethodsPubMed, Embase and Cochrane Library were searched for studies from their inception to May 2024, restricting to randomized controlled trials and before-and-after studies. The primary outcomes were infection incidence and complete remission rate. Cochrane risk-of-bias tool (RoB 2.0) and risk of bias in non-randomized studies of interventions tool (ROBINS-I) were used to assess the risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluations approach was performed to assess the certainty of the evidence.ResultsEight randomized controlled trials and one pre-post study on 1235 participants were included. Four studies had low risk of bias. Probiotics were effective in reducing the incidence of COVID-19 upon exposure and accelerating the symptomatic remission of mild COVID-19 with less systemic symptoms. Overall, the certainty of evidence on both primary outcomes was moderate. Comorbidities and old ages were found to be significant confounders. Probiotics demonstrated significant immunomodulatory and humoral effects in the nasopharyngeal cavity.ConclusionThese results suggest that probiotics are effective at preventing COVID-19 and support faster recovery from mild COVID-19 among individuals seeking for outpatient care. People with comorbidities, that is, metabolic disorder and elderly benefit the most from probiotics supplements.}, }
@article {pmid41003823, year = {2025}, author = {Mansuri, R and Raj, A and Monika,  and Diwan, A and Shorog, E and Yasmin, S and Ashique, S and Ansari, MY}, title = {Revolutionizing vaccination: the marvel of nanovaccination technology.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {949}, pmid = {41003823}, issn = {1573-4978}, support = {RGP1/233/46//Deanship of Scientific Research, King Khalid University/ ; RGP1/233/46//Deanship of Scientific Research, King Khalid University/ ; }, mesh = {Humans ; *Vaccination/methods ; *Nanotechnology/methods ; *Vaccines/immunology/administration &amp; dosage ; COVID-19/prevention &amp; control/immunology ; Vaccine Development/methods ; Nanoparticles/chemistry ; Animals ; Drug Carriers/chemistry ; Adjuvants, Immunologic ; }, abstract = {Seasonal outbreaks of infectious diseases emphasise the critical need for the development of effective vaccines to address global healthcare challenges. Vaccines traditionally evolved using live attenuated organisms, killed organisms, and inactivated toxins. Despite the progression of traditional vaccines, improvement is needed due to toxicity and partial immunogenicity chances after multiple doses. Nanotechnology-based vaccines are now overcoming the gaps in traditional vaccines by enhancing their immunogenicity and reducing levels of toxicity. Nanocarrier-based vaccines reduce dosing frequency by enabling sustained antigen release, thereby minimising the need for booster doses required in conventional vaccines to achieve long-term immunity. The surface of nanocarriers can also be modified by phagocytic cells to increase their uptake for better antigen presentation and recognition and boost antibody production. As a result of better antigen recognition, the antibody production rate of nanocarrier-based vaccines is faster than that of traditional vaccines. Nanocarriers have a distinguished variety of sizes, shapes and compositions. They can also be used for the co-delivery of antigens and adjuvants. These advantageous nanocarriers are classified into various types based on their nature, like polymeric-based, lipid, and inorganic. In the case of solid nanocarriers, they protect against the degradation of the vaccine and improve its facilitation through gut related lymphoid tissues also mucosa linked lymphoid tissue. This review discussed the evolved platform of nanotechnology in vaccine development and its advantages over traditional vaccines. This paper also includes the classification of various nanocarriers, primarily focusing on nanovaccines developed for diseases such as hepatitis, malaria, COVID-19, influenza, human immunodeficiency virus, and cancer.}, }
@article {pmid41003635, year = {2025}, author = {Presta, V and Guarnieri, A and Laurenti, F and Mazzei, S and di Martino, O and Vitale, M and Condello, G}, title = {Post-Acute COVID-19 Syndrome (PACS) and Exercise Interventions: A Systematic Review of Randomized Controlled Trials.}, journal = {Sports (Basel, Switzerland)}, volume = {13}, number = {9}, pages = {}, pmid = {41003635}, issn = {2075-4663}, support = {MUR_DM737_2022_FIL_PROGETTI_B_CONDELLO_COFIN//Bando di Ateneo per la Ricerca 2022 - Azione B/ ; }, abstract = {The aim of this systematic review (PROSPERO registration number CRD42024517069) was to investigate the effectiveness of exercise interventions in Post-Acute COVID-19 Syndrome (PACS). We searched on several databases and followed the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). We included randomized controlled trials that evaluate exercise interventions in adults (40-60 years old) diagnosed with PACS. The outcomes of interest were health-related quality of life (HRQoL) and functional fitness. Twenty studies were included after screening. Thirteen and fourteen studies were rated as "low" risk for HRQoL and functional fitness outcomes, respectively. Based on the evidence, an 8-week exercise protocol of aerobic training in combination with strength-based and breathing exercises was found to be safe and feasible while improving quality of life and functional fitness in people with PACS. Telerehabilitation can also be an option to avoid contagion and physical contact with the same beneficial effects. Future research should expand the knowledge about other types of exercise (i.e., water-based exercises) with high-quality trials and consider whether findings could be potentially transferable to recovery from a wider spectrum of viral infections.}, }
@article {pmid41003163, year = {2025}, author = {Bocci, MG and Cascarano, L and Capecchi, G and Lesci, A and Sabatini, V and Rubino, D and Stazi, GV and Garotto, G and Carrara, S and Vulcano, A and Gori, C and Del Nonno, F and Colombo, D and Falasca, L and Caraffa, E and Cicalini, S and Fontana, C}, title = {Pulmonary Aspergillosis in Immunocompromised Critically Ill Patients: Prevalence, Risk Factors, Clinical Features and Diagnosis-A Narrative Review.}, journal = {Journal of fungi (Basel, Switzerland)}, volume = {11}, number = {9}, pages = {}, pmid = {41003163}, issn = {2309-608X}, abstract = {Aspergillosis in immunocompromised individuals is a serious and potentially life-threatening infection, as the weakened immune system cannot effectively fight the Aspergillus fungus. This review provides an in-depth examination of aspergillosis in patients with various conditions that compromise immunity, including hematological disorders, HIV, SARS-CoV-2 pneumonia, influenza, and those who have undergone solid organ transplants. The clinical manifestations of aspergillosis are influenced by factors such as the host's underlying comorbidities, immune response, and immune suppression due to medications or treatments. The review delves into the epidemiology of aspergillosis, exploring various risk factors that predispose individuals to infection. It also discusses the wide range of clinical symptoms, highlighting the challenges in diagnosis and the importance of early detection. The review contrasts traditional diagnostic approaches with emerging molecular techniques, emphasizing the role of advanced diagnostics in improving outcomes. A proposed clinical decision-making flowchart is provided to assist healthcare professionals in managing suspected cases of aspergillosis. In addition to diagnostic challenges, the review addresses antifungal prophylaxis, pre-emptive therapy, and the growing concern of pharmacological resistance to antifungal agents. It concludes with a discussion of future research directions, underscoring the need for improved therapeutic strategies and preventative measures in immunocompromised patients to reduce the burden of this severe fungal infection.}, }
@article {pmid41002881, year = {2025}, author = {Duru, EE and Kissi-Twum, K and Ben-Umeh, KC and Mattingly, TJ}, title = {Advancing Federal Coordination to Address Drug Shortages.}, journal = {Cancer journal (Sudbury, Mass.)}, volume = {31}, number = {5}, pages = {}, pmid = {41002881}, issn = {1540-336X}, mesh = {Humans ; United States/epidemiology ; COVID-19/epidemiology ; *Antineoplastic Agents/supply &amp; distribution ; *Drugs, Essential/supply &amp; distribution ; SARS-CoV-2 ; Drugs, Generic/supply &amp; distribution ; *Neoplasms/drug therapy ; Cisplatin/supply &amp; distribution ; Methotrexate/supply &amp; distribution ; Vincristine/supply &amp; distribution ; }, abstract = {Persistent shortages of essential medicines in the United States, especially generic oncology drugs, continue to compromise timely cancer care and patient safety. The presence of multiple high-level reports from federal agencies and industry experts has outlined similar recommendations, including the creation of a unified essential medicines list, transparent supply chain monitoring, domestic manufacturing incentives, and centralized federal coordination, among others, giving an optimistic direction. This manuscript synthesizes key findings from these reports and highlights misalignment across agency roles and priorities as a barrier to sustained progress. Case studies of cisplatin, vincristine, and methotrexate shortages underscore the high stakes of inaction. Drawing on recent coordination successes during the COVID-19 response, we propose a practical path forward: establishing a central federal coordinating body, legislating an essential medicines list developed using an established criticality-reach-vulnerability framework, reforming procurement incentives, and expanding the Strategic National Stockpile.}, }
@article {pmid41002604, year = {2025}, author = {Kounis, NG and Stefanidis, A and Hung, MY and Özkan, U and de Gregorio, C and Ceasovschih, A and Mplani, V and Gogos, C and Assimakopoulos, SF and Chatzigrigoriadis, C and Plotas, P and Dousdampanis, P and Kouni, SN and Tsigkas, G and Patsouras, N and Calogiuri, G and Pourmasumi, S and Koniari, I}, title = {From Acute Carditis, Rheumatic Carditis, and Morphologic Cardiac Reactions to Allergic Angina, Allergic Myocardial Infarction, and Kounis Syndrome: A Multidisciplinary and Multisystem Disease.}, journal = {Journal of cardiovascular development and disease}, volume = {12}, number = {9}, pages = {}, pmid = {41002604}, issn = {2308-3425}, abstract = {This narrative review explains the history of anaphylactic or hypersensitivity reactions, their connection to the cardiovascular system, and Kounis syndrome, which is linked to hypersensitivity. Additional subjects discussed include immunoglobulin E and serum tryptase, common pathways of allergic and nonallergic cardiovascular events, current perspectives on Kounis syndrome, allergic myocardial infarction, allergic angina, and the impact of COVID-19 and its vaccination on Kounis syndrome. Kounis syndrome is a distinct kind of acute vascular disease that affects the coronary, cerebral, mesenteric, peripheral, and venous systems. Kounis syndrome is currently used to describe coronary symptoms linked to disorders involving mast cell activation and inflammatory cell interactions, such as those involving T-lymphocytes and macrophages, which further induce allergic, hypersensitive, anaphylactic, or anaphylactic insults. Platelet activating factor, histamine, neutral proteases like tryptase and chymase, arachidonic acid products, and a range of cytokines and chemokines released during the activation process are among the inflammatory mediators that cause it. Proinflammatory cytokines are primarily produced by mast cells in COVID-19 infections. Mast cell-derived proteases and eosinophil-associated mediators are also more prevalent in the lung tissues and sera of COVID-19 patients. As a modern global threat to civilization, COVID-19 is linked to chemical patterns that can activate mast cells; therefore, allergic stimuli are usually the reason. Virus-associated molecular patterns can activate mast cells, but allergic triggers are typically the cause. By activating SARS-CoV-2 and other toll-like receptors, a variety of proinflammatory mediators, including IL-6 and IL-1β, are released, potentially contributing to the pathology of COVID-19.}, }
@article {pmid41001327, year = {2025}, author = {Le, KDR}, title = {Promoting Health System Resilience Through Health Policy Reform for the Ageing Population of Japan: A Rapid Literature Review.}, journal = {Cureus}, volume = {17}, number = {8}, pages = {e90931}, pmid = {41001327}, issn = {2168-8184}, abstract = {Health system resilience encapsulates the ability of a health system to maintain appropriate standards of healthcare service delivery despite stressors to the system. Insults to the system can come through various forms, including natural disasters and, more recently, the influence of the coronavirus pandemic. Additionally, Japan faces a more insidious health system challenge through its rapidly developing ageing population, coupled with a lower funding base in light of this. Healthcare costs in Japan continue to rise disproportionately and are anticipated to do so due to care and costs related to ageing-related diseases. This rapid review explores the opportunity for health policy reform with respect to the financial and service delivery vulnerabilities of the Japanese health system to improve the capacity of the system to maintain health system resilience. This review does this through synthesising evidence on the current Japanese health finance system and payment models, and evaluates these in the context of current epidemiological and healthcare financing data. In doing so, the review identifies potential reform opportunities, particularly related to restructuring access to healthcare, promoting the use of generic pharmaceuticals, consolidating insurance, and adopting value-based payment models to improve health system resilience.}, }
@article {pmid41000376, year = {2025}, author = {Rotolo, A and Mason, NJ and Exley, MA}, title = {Innate iNKT cells: from biological insight to clinical impact.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1653183}, pmid = {41000376}, issn = {1664-3224}, mesh = {Humans ; *Natural Killer T-Cells/immunology/metabolism ; Animals ; *Immunity, Innate ; Antigens, CD1d/immunology/metabolism ; Receptors, Antigen, T-Cell/immunology ; }, abstract = {Over the past 30 years, work of immunologists worldwide has phenotypically and functionally defined "Natural Killer T cells" (NKT) and their subsets, including "invariant Natural Killer T cells" (iNKT). NKT cells make up a substantial fraction of T cells that express NK cell markers and have TCRs restricted to either conventional MHC molecules or the monomorphic CD1d molecule. Among these, iNKT cells are CD1d-restricted and more common within NKT cells than T cells without NK markers. While the definition of NKT cells, whether based on phenotype, function, or both, remains a topic of debate, iNKT cells represent a distinct T cell population characterized by a recurrent, conserved TCR rearrangement (TRAV10-TRAJ18 in humans) paired with a limited Vβ repertoire (mostly encoded by TRBV25-1 in humans). iNKT cells are restricted by CD1d, which, unlike CD1a-c molecules, is expressed not only on professional antigen-presenting cells and thymocytes but also on certain non-hematopoietic somatic tissues, both normal and neoplastic. Like all CD1 family members, CD1d presents various lipid antigens by accommodating their long hydrophobic tails in deep binding pockets, in contrast to the shallow peptide grooves of conventional MHC molecules. However, the ligand repertoire of CD1d is distinct from that of CD1a-c. This review focuses on CD1d-restricted iNKT cells. Activation of iNKT cells via their semi-invariant TCR, often in synergy with NK receptors and other co-stimulatory molecules, triggers a rapid, polyfunctional response. Unlike conventional MHC-restricted T cells, individual iNKT cells can simultaneously produce both Th1- and Th2-type cytokines and exert cytotoxic activity in an immune synapse-directed fashion. Through this combination of direct cytotoxicity and cytokine-mediated immunomodulation, iNKTs can eliminate target cells while activating myeloid and other lymphoid populations to amplify immune responses. Their versatility has fueled growing interest in harnessing iNKT cells across inflammatory, infectious, and oncological diseases, where early-phase studies have demonstrated their safety and preliminary efficacy. Moreover, because they are restricted by the non-polymorphic CD1d molecule and possess immune-regulatory properties, iNKT cells lack graft-versus-host potential, making them ideal candidates for allogeneic, off-the-shelf therapies. This review summarizes how iNKT cells are being reimagined as innovative tools for immune intervention across a range of clinical settings.}, }
@article {pmid41000340, year = {2025}, author = {Larsson, M and Ho, DM and Kirschner, M and Seifritz, E and Manoliu, A}, title = {Digital resilience interventions for healthcare workers: a systematic review.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1519670}, pmid = {41000340}, issn = {1664-0640}, abstract = {INTRODUCTION: Burnout among healthcare professionals is rising, exacerbated by increased workloads and the Covid-19 pandemic. Affected individuals face stress, depression, and anxiety, adversely impacting both personal well-being and patient care. Resilience has emerged as a key focus for targeted interventions, with online delivery gaining relevance due to the digital transformation and the need for flexibility in busy healthcare schedules.<br><br>METHODS: A systematic review was conducted by searching PubMed, Embase, and Web of Science for eligible studies from April 2014 to April 2024, using search terms related to resilience, online/blended interventions, and healthcare professionals. A total of 7,619 records were identified and screened by two independent reviewers (ML, AM). Final inclusion was based on predefined criteria for online or blended interventions aimed at enhancing resilience in healthcare professionals. The Effective Public Health Practice Project (EPHPP) assessed risk of bias. PRISMA guidelines were followed.<br><br>RESULTS: Fifty-five studies were selected, employing various interventions such as psychoeducation, meditation, mindfulness, and elements of cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Interventions were delivered online through websites, apps, audio files, etc. or in blended formats complementing in-person sessions. Most studies reported significant improvements in resilience, alongside reductions in stress, burnout, depression, and anxiety. However, only three studies in the online group involving mindfulness or CBT interventions received a strong global rating in the risk of bias assessment by fulfilling the methodological quality criteria. Among these, mindfulness, compared to a waitlist control or a psychoeducational brochure, significantly improved resilience and reduced burnout, while the CBT intervention, compared to bibliotherapy, led to a significant reduction in stress. Compared to the other studies, these three stood out due to minimal selection bias, low attrition rates, a robust study design, and at least partial blinding.<br><br>DISCUSSION: This review indicates that digital interventions may enhance resilience and associated factors in healthcare personnel. However, caution is advised due to the heterogeneity of interventions and varied measurement methods. Only three studies met methodological quality criteria, limiting the reliability of other findings. Future research should standardize resilience concepts and adhere to methodological criteria to ensure valid conclusions.<br><br>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024542758 PROSPERO, identifier CRD42024542758.}, }
@article {pmid41000059, year = {2025}, author = {Diedericks, C and Crossley, KJ and Davies, IM and Blank, DA and Cramer, SJE and Wallace, MJ and Te Pas, AB and Kitchen, MJ and Hooper, SB}, title = {Role of the Chest Wall in Newborn Respiratory Function at Birth.}, journal = {FASEB journal : official publication of the Federation of American Societies for Experimental Biology}, volume = {39}, number = {19}, pages = {e71064}, pmid = {41000059}, issn = {1530-6860}, support = {2012443//Federal Government | DHAC | National Health and Medical Research Council (NHMRC)/ ; 2021055//Federal Government | DHAC | National Health and Medical Research Council (NHMRC)/ ; APP20262322//Federal Government | DHAC | National Health and Medical Research Council (NHMRC)/ ; //Australian Government Research Training Program/ ; }, mesh = {Humans ; *Thoracic Wall/physiology ; Infant, Newborn ; Respiratory Mechanics/physiology ; *Respiration ; Lung/physiology ; Respiratory Muscles/physiology ; COVID-19 ; }, abstract = {The chest wall significantly impacts respiratory function after birth, but its role in the newborn remains poorly understood as it is structurally and functionally different from adults. In neonates, the chest wall is highly compliant, which allows it to expand to accommodate the incoming air and the lung liquid cleared into the pulmonary interstitium during lung aeration. However, the high neonatal chest wall compliance predisposes it to distortion, which reduces breathing efficiency and necessitates respiratory muscle activation to stabilize it. This increases the work of breathing and, when combined with fewer fatigue-resistant Type I muscle fibers (slow twitch, high oxidative capacity) in the diaphragm muscle, the risk of respiratory fatigue is increased. Nevertheless, as the chest wall is highly compliant in the newborn, recent studies have demonstrated that extra-thoracic pressures can influence chest wall mechanics. Positive extra-thoracic pressures (such as those applied with tight swaddling) limit chest wall expansion, whereas a small constant negative extra-thoracic pressure stabilizes the chest wall and improves oxygenation in neonates. In this review, we aim to summarize the current evidence on chest wall function in fetuses and neonates, particularly during lung liquid clearance, lung aeration, and breathing after birth. Furthermore, we will explore how knowledge from newborn respiratory physiology may inform our understanding of the respiratory consequences of pulmonary oedema in adults, such as occurred during the initial stages of the COVID-19 pandemic.}, }
@article {pmid40999389, year = {2025}, author = {Li, Y and Lu, Y and Tang, H and Spector, EA and Wen, X and Germinal, K and Milfort, A and Guo, Y and Bost, S and Shenkman, E and Bian, J and Hu, H and Guo, J}, title = {Neonatal outcomes among pregnant women with COVID-19: a systematic scoping review and meta-analysis.}, journal = {BMC pregnancy and childbirth}, volume = {25}, number = {1}, pages = {948}, pmid = {40999389}, issn = {1471-2393}, support = {CDRN-1501-26692/PCORI/Patient-Centered Outcomes Research Institute/United States ; R21 ES032762/ES/NIEHS NIH HHS/United States ; R21ES032762/ES/NIEHS NIH HHS/United States ; UL1 TR001427/TR/NCATS NIH HHS/United States ; UL1TR001427/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; Pregnancy ; Female ; *COVID-19/epidemiology/transmission ; *Pregnancy Complications, Infectious/epidemiology/virology ; Infant, Newborn ; *Infectious Disease Transmission, Vertical/statistics &amp; numerical data ; *Pregnancy Outcome/epidemiology ; SARS-CoV-2 ; Intensive Care Units, Neonatal/statistics &amp; numerical data ; }, abstract = {BACKGROUND: Current findings on the neonatal outcomes among pregnant women infected with COVID-19 remain inconclusive. The purpose of this systematic scoping review and meta-analysis was to summarize the literature regarding this topic and provide an overview of the methodologies and results present in current research.<br><br>METHODS: PubMed was searched up to December 2022 to identify observational studies that reported neonatal outcomes among children delivered by mothers diagnosed with COVID-19 during pregnancy. Outcomes of interest included vertical transmission to neonates, neonatal intensive care unit (NICU) admission, and neonatal death. Qualitative analysis and meta-analysis were applied to summarize and synthesize the results.<br><br>RESULTS: Out of an initial selection of 13,387 studies, 187 were included in this systematic scoping review. There was high heterogeneity in the epidemiologic study design, sample size, and outcomes of interest. Most studies focused on neonatal outcomes from birth to day 14 rather than the full neonatal period. Conflicting conclusions were drawn regarding outcomes among neonates delivered by COVID-19-positive mothers. Results of meta-analysis revealed that maternal COVID-19 infection was moderately associated with the risk of vertical transmission to neonates (Incidence Rate [IR], 2.66%; 95%CI, 2.11-3.35%), neonatal intensive care unit admission (IR, 16.43%; 95%CI, 14.59-18.45%), and neonatal death (IR, 1.29%; 95%CI, 0.95-1.74%), and these risks seemed to be increased with the severity of maternal COVID-19.<br><br>CONCLUSIONS: This review identified heterogeneity in the epidemiologic studies. Maternal COVID-19 infection was associated with the risk of adverse neonatal outcomes and these risks seemed to be increased with the severity of maternal COVID-19.}, }
@article {pmid40998072, year = {2025}, author = {Sheervalilou, M and Ghanei, M and Arabfard, M}, title = {Single-cell RNA sequencing in high-burden viral respiratory infections: Decoding immune cell subsets and immune-related differential gene expression.}, journal = {Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases}, volume = {135}, number = {}, pages = {105834}, doi = {10.1016/j.meegid.2025.105834}, pmid = {40998072}, issn = {1567-7257}, mesh = {Humans ; *Single-Cell Analysis/methods ; Animals ; *COVID-19/immunology/genetics/virology ; Sequence Analysis, RNA/methods ; *Respiratory Tract Infections/immunology/virology/genetics ; SARS-CoV-2/immunology ; *Influenza, Human/immunology/genetics/virology ; }, abstract = {Respiratory infections remain a major global health burden, ranking among the leading causes of mortality worldwide. Single-cell RNA sequencing (scRNA-seq) has emerged as a transformative technology for dissecting the cellular and molecular complexity of these infections. This review focuses on recent scRNA-seq studies investigating the immune landscape of high-burden viral respiratory infections, particularly COVID-19 and influenza, which are characterized by high transmissibility and clinical impact. We provide an overview of publicly available scRNA-seq datasets derived from human peripheral blood and bronchoalveolar lavage fluid (BALF), as well as lung tissues and explants from murine models, emphasizing their value in profiling immune heterogeneity. scRNA-seq has revealed significant remodeling of immune cell populations during infection, including the identification of novel subsets such as CD4[+] c13-MKI67[+] CCL5[low] T cells, CD8[+] CXCR3[high] GZMA[+] T cells, and CD56[high] CD16[-] GZMB[+] NK cells. These subsets are frequently associated with differential expression of cytokines, chemokines, and interferon-stimulated genes that reflect disease severity and progression. In addition, scRNA-seq has highlighted key pathogen-induced pathways, including type I interferon, NF-κB, and JAK/STAT signaling, and has identified emerging immune-related biomarkers-such as PTX3, MCEMP1, CXCR4, IFIT1, ISG15, and STAT1-with potential diagnostic and prognostic utility. While scRNA-seq applications in respiratory infections of other microbial origins are limited, its role in mapping immune responses and guiding biomarker discovery in viral infections is rapidly expanding. This review synthesizes these findings to inform future translational research and immunodiagnostic strategies.}, }
@article {pmid40997838, year = {2025}, author = {Frisoni, GB and Hansson, O and Nichols, E and Garibotto, V and Schindler, SE and van der Flier, WM and Jessen, F and Villain, N and Arenaza-Urquijo, EM and Crivelli, L and Fortea, J and Grinberg, LT and Ismail, Z and Minoshima, S and Ossenkoppele, R and Zetterberg, H and Petersen, RC and Dubois, B}, title = {New landscape of the diagnosis of Alzheimer's disease.}, journal = {Lancet (London, England)}, volume = {406}, number = {10510}, pages = {1389-1407}, doi = {10.1016/S0140-6736(25)01294-2}, pmid = {40997838}, issn = {1474-547X}, mesh = {Humans ; *Alzheimer Disease/diagnosis/cerebrospinal fluid ; Biomarkers/cerebrospinal fluid/blood ; Amyloid beta-Peptides/metabolism/cerebrospinal fluid ; tau Proteins/cerebrospinal fluid/metabolism ; Diagnosis, Differential ; Positron-Emission Tomography ; }, abstract = {Alzheimer's disease involves a drastic departure from the cognitive, functional, and behavioural trajectory of normal ageing, and is both a dreaded and highly prevalent cause of disability to individuals, and a leading source of health and social care expenditure for society. Before the advent of biomarkers, post-mortem examination was the only method available to establish a definitive diagnosis. In this first paper of the Series, we review state-of-the-art diagnostic practices and the typical patient journey in specialist settings, where clinicians engage in a differential diagnosis to establish whether Alzheimer's pathology (cerebral deposition of β-amyloid and hyperphosphorylated tau) is a contributor to cognitive impairment. Biomarkers indicating dysregulation of β-amyloid and tau homeostasis, measured with PET and cerebrospinal fluid analysis, allow a molecular-level diagnosis-a mandatory step in defining eligibility for the recently approved anti-amyloid treatments. We anticipate that easily accessible blood biomarkers, already available in some countries, will lead to a new diagnostic revolution and bring about major changes in health-care systems worldwide.}, }
@article {pmid40997530, year = {2025}, author = {Rees, GH and Willis, G and Scotter, C}, title = {Health workforce planning should be strategy or policy-driven: From linear forecasts to normative futures.}, journal = {Health policy (Amsterdam, Netherlands)}, volume = {161}, number = {}, pages = {105440}, doi = {10.1016/j.healthpol.2025.105440}, pmid = {40997530}, issn = {1872-6054}, mesh = {Humans ; *Health Workforce/organization &amp; administration/trends ; Forecasting/methods ; *Health Policy ; *Health Planning/organization &amp; administration ; COVID-19 ; Pandemics ; }, abstract = {Health workforce planning (HWP) remains persistently ineffective, a weakness that was starkly exposed during the pandemic and amplified in today's ongoing health permacrisis. Despite the development of increasingly sophisticated workforce models and planning techniques, outcomes continue to fall short. We argue that a central reason lies in how the HWP problem is framed: the dominant reliance on linear, forward-looking forecasting methods constrains both the scope of planning and the relevance of its outputs. We propose reframing HWP through the use of normative futures methods, which begin with a desired future and then work backwards to identify the steps needed to reach it. Such approaches are well established in other complex policy domains and are particularly suited to HWP's long-term horizon, multi-stakeholder setting, and inherent uncertainties. By aligning workforce planning with the strategic directions already articulated in national health strategies, normative backcasting offers three key advantages: (1) improved integration of drivers of change into workforce modelling, (2) more meaningful stakeholder engagement and ownership, and (3) stronger governance through clearer milestones, responsibilities, and monitoring. As a result, HWP is more likely to deliver actionable, timely, and resource-efficient plans. We therefore call on policymakers and planners to shift from linear forecasting toward normative futures approaches to enable more reliable decisions and achieve the health workforce needed for resilient health systems.}, }
@article {pmid40997476, year = {2025}, author = {Porcel, JM and Porcel, L and Campo-Linares, R}, title = {Point-of-care ultrasound in pulmonary and pleural infections.}, journal = {Medicina clinica}, volume = {165}, number = {5}, pages = {107191}, doi = {10.1016/j.medcli.2025.107191}, pmid = {40997476}, issn = {1578-8989}, mesh = {Humans ; Ultrasonography/methods ; *Point-of-Care Systems ; COVID-19/diagnostic imaging ; Pleural Effusion/diagnostic imaging ; *Pleural Diseases/diagnostic imaging ; *Pneumonia/diagnostic imaging ; }, abstract = {Point-of-care ultrasound (POCUS) is a rapid bedside imaging modality available to clinicians for the diagnosis of pleuropulmonary infections. Compared with chest radiography, POCUS is more sensitive in identifying pneumonia and its complications (parapneumonic pleural effusions, necrosis, and abscesses). The most common sonographic features of pneumonia are consolidation (with irregular margins and dynamic air bronchograms), B-lines, and pleural effusion. POCUS also has prognostic applications, for example, to determine the severity of COVID-19 pneumonia or to predict residual pleural thickening in a tuberculous effusion. Finally, the presence of a complex septated ultrasound pattern in the context of pleural infection is indicative of the need for drainage, which is performed using a thoracostomy tube and instillation of intrapleural enzyme therapy.}, }
@article {pmid40997395, year = {2025}, author = {Moisi, M and Bowers, C and Shah, S and Zoghi, S and Venero, C and Arora, S and Mirza, S and Haridas, A and Vahdat, N and Foroughi, M and Mahdavi, SB and Sourani, A}, title = {A systematic review on COVID-19 and spinal strokes, the end of an era.}, journal = {Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia}, volume = {142}, number = {}, pages = {111639}, doi = {10.1016/j.jocn.2025.111639}, pmid = {40997395}, issn = {1532-2653}, mesh = {Humans ; *COVID-19/complications ; *Ischemic Stroke ; *Spinal Cord Ischemia/etiology/diagnostic imaging ; }, abstract = {AIM: To investigate the association of the COVID-19 virus with hemorrhagic and ischemic spinal strokes.<br><br>, BACKGROUND: COVID-19 has extensive extrapulmonary manifestations. Myelitis, demyelinating syndromes, hemorrhagic and ischemic presentations have been reported. To date, there is no comprehensive study to delineate an evidence-based correlation between COVID-19 and spinal strokes comprehensively.<br><br>MATERIALS AND METHODS: A PRISMA-based systematic review.<br><br>RESULTS: In the final review, 8 data sets for ischemia and 11 for hemorrhagic lesions were included. The mean age for ischemia and hemorrhagic lesions was 52 and 47&#xa0;years old, respectively. Patients with cord ischemia had more severe COVID-19 pneumonia as compared to hemorrhagic (62&#xa0;% vs 27&#xa0;%). Lab results showed 75&#xa0;% coagulation abnormalities in cord ischemia patients while there was no coagulopathy in the hemorrhage group. Somatosensory deficits were the most prevalent neurological presentations in both groups. MRI showed that the anterior spinal artery and central ischemia were the most common patterns of COVID-19 spinal ischemia. MRI images also revealed epidural and intramedullary hematomas were the most common type of hemorrhagic lesions with cervical and thoracic preferences. The most common on-admission neurological status was American Spinal Injury Association (ASIA) impairment scale A-B(ischemia) and ASIA B-D(hemorrhage). All of the ischemic patients received conservative management. In hemorrhagic patients, there were 4 laminectomies, 6 conservative management, and 1 combined approach. Post-intervention clinical outcomes in ischemia were unfavorable but in the hemorrhagic spinal strokes, it had more promising results.<br><br>CONCLUSION: COVID-19 can cause both ischemia and hemorrhagic spinal strokes. Coagulopathy may be a precipitating factor in cord ischemia development while other neuropathogenesis mechanisms may precipitate spinal hemorrhage. Early surgical or conservative management is the key factor in determining long-term outcomes.}, }
@article {pmid40995868, year = {2025}, author = {Lindfors, O and Josefsson, A and Sjöström, C}, title = {[Time to modernise healthcare regarding functional disorders].}, journal = {Lakartidningen}, volume = {122}, number = {}, pages = {}, pmid = {40995868}, issn = {1652-7518}, mesh = {Humans ; *COVID-19/complications/psychology/therapy ; Sweden ; Denmark ; Practice Guidelines as Topic ; Post-Acute COVID-19 Syndrome ; }, abstract = {The Swedish guideline on post covid-19 and related syndromes classify six overlapping conditions. A functional perspective, as used in Denmark, distinguishes physiological reactions from diseases, aiding understanding and treatment. Functional symptoms arise from dysregulated adaptation systems reacting excessively. This dysregulation can persist, leading to various symptoms. Effective treatment focuses on stabilizing these systems through knowledge, behavioral changes and gradual exposure to discomfort. A biopsychosocial model addressing biological, psychological, and social factors is key. Denmark's structured approach has improved care, and similar competence-building efforts in Sweden could enhance treatment for post-infectious and long term functional conditions.}, }
@article {pmid40994755, year = {2025}, author = {Ducas, J and Daneau, C and Bouqartacha, S and Lecours, A and Abboud, J and Marchand, AA and Descarreaux, M}, title = {The impact of telework on absenteeism, presenteeism, and return to work among workers with health conditions: a scoping review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1655200}, pmid = {40994755}, issn = {2296-2565}, mesh = {Humans ; *Absenteeism ; *Presenteeism/statistics &amp; numerical data ; *Return to Work/statistics &amp; numerical data ; COVID-19/epidemiology ; *Teleworking/statistics &amp; numerical data ; Adult ; Workplace ; SARS-CoV-2 ; Health Status ; }, abstract = {INTRODUCTION: Telework has become increasingly prominent as a flexible work arrangement, particularly since the COVID-19 pandemic. For workers managing health conditions, it may support continued employment by influencing key work-related phenomena such as absenteeism, presenteeism and return to work (RTW) process. However, current evidence on the impact of telework on the work-related outcome to manage health condition in the workplace remains limited and fragmented.<br><br>OBJECTIVE: This scoping review aimed to map the existing literature on the impact of telework on absenteeism, presenteeism, and RTW outcomes among adult workers with health conditions.<br><br>METHODS: Included studies were either qualitative, quantitative, or mixed methods, published in English or French, including adults with any physical or psychological health conditions. At least one outcome domain (absenteeism, presenteeism, or RTW) was required. Eight databases were searched from inception to May 2025: Medline, CINAHL, APA PsycINFO, Academic Search Complete, Business Source Complete, Scopus, Sociological Abstracts, and ABI/INFORM Global. Data extraction focused on study design, objectives, variables/definitions, sample size, health status, demographic characteristics, individual characteristics, organizational factors and results. Data were synthesized by the outcome domain (absenteeism, presenteeism, RTW) and stratified by study type (quantitative vs. qualitative).<br><br>RESULTS: From 4,093 records, 21 studies were included. The majority of studies suggest that telework contributes to reduced absenteeism by increasing work flexibility. Telework is also consistently associated with facilitating RTW, particularly following surgery or in the context of chronic illness, by supporting work reintegration and shortening the duration of sick leave. In contrast, findings on presenteeism are conflicting: some studies report that telework increases the likelihood of working while sick, others suggest a decrease, and some report no significant impact or conflicting results. These outcomes appear to be influenced by contextual factors, including health status, demographic variables, individual characteristics, and organizational context.<br><br>CONCLUSION: Telework appears to offer flexibility that can reduce absenteeism and facilitate RTW. However, its impact on presenteeism is less consistent and may even encourage working while sick if not properly supervised. Future studies should examine which policies most effectively maximize the benefits of telework while minimizing potential drawbacks.}, }
@article {pmid40994423, year = {2025}, author = {Greenleaf, MN and Damhorst, GL and Vogel, EM and Martin, GS and Lam, WA}, title = {From startup to shutdown: the dramatic rise and fall of the first at-home combo test for flu and COVID-19.}, journal = {Lab on a chip}, volume = {25}, number = {20}, pages = {5115-5121}, pmid = {40994423}, issn = {1473-0189}, support = {U54 EB027690/EB/NIBIB NIH HHS/United States ; UL1 TR002378/TR/NCATS NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/diagnosis ; *Influenza, Human/diagnosis ; SARS-CoV-2/isolation &amp; purification ; United States ; *COVID-19 Testing/methods ; United States Food and Drug Administration ; }, abstract = {This article explores the development and commercialization of Lucira Health's innovative at-home molecular diagnostic test, which detects influenza A or B and SARS-CoV-2. Launched amidst the urgent demand for accessible testing solutions, Lucira's product represented a significant breakthrough, becoming the first over-the-counter combination test authorized by the US Food and Drug Administration (FDA). The narrative tracks Lucira's journey from its origins in microfluidics at the University of California-Berkeley, through development challenges, business success and failure. It also contrasts the distinct motivations and technical challenges of pre-pandemic versus pandemic era diagnostics, emphasizing test-to-treat strategies versus rapid results for containment. Despite early successes, Lucira faced insurmountable regulatory and financial hurdles, culminating in bankruptcy just days before FDA authorization. The case offers critical insights into diagnostics product development, regulatory navigation, product diversification, and strategic risk management in push towards home and point of care diagnostics.}, }
@article {pmid40992230, year = {2025}, author = {Ortega-Paz, L and Talasaz, AH and Sadeghipour, P and Rashedi, S and Connors, JM and Angiolillo, DJ and Cavallari, LH and Jimenez, D and Bastidas, G and Lorenzi, E and Berry, LR and Hills, T and McAuley, DF and Shah, T and Lansky, AJ and Deepti, S and Gaitán-Duarte, HG and Potpara, TS and Galli, M and Dixon, DL and Piazza, G and Lip, GYH and Mehran, R and Libby, P and Krumholz, HM and Bikdeli, B}, title = {Safety and effectiveness of statins in hospitalized patients with COVID-19: Systematic review and collaborative meta-analysis of randomized controlled trials.}, journal = {Thrombosis research}, volume = {255}, number = {}, pages = {109484}, doi = {10.1016/j.thromres.2025.109484}, pmid = {40992230}, issn = {1879-2472}, mesh = {Humans ; *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; *COVID-19/mortality ; Hospitalization ; SARS-CoV-2 ; Female ; Male ; Muscular Diseases/chemically induced ; Treatment Outcome ; }, abstract = {AIMS: Statins may impact COVID-19 outcomes through lipid-mediated and lipid-independent pathways. However, the clinical impact of statin therapy among hospitalized patients with COVID-19 remains unclear due to the limited power of existing randomized controlled trials (RCTs).<br><br>METHODS: A systematic search of PubMed, Embase, and clinicaltrials.gov was conducted through July 17th, 2024. RCTs were included if they compared statin therapy to control (placebo or standard care) in hospitalized COVID-19 patients and enrolled at least 250 randomized participants. Studies with co-treatment were considered in sensitivity analyses. The primary effectiveness outcome was 30-day all-cause death. The main safety outcomes were myopathy and rise in liver enzymes.<br><br>RESULTS: Three RCTs were included in the main analysis (3882 statin-naive patients, 33.7&#xa0;% female, average follow-up duration 37&#xa0;days). Compared with control, statin therapy was associated with reduced all-cause death (20.9&#xa0;% vs. 23.8&#xa0;%; odds ratio [OR]: 0.82, 95&#xa0;% confidence interval [CI] 0.70-0.96; P&#xa0;=&#xa0;0.01), with a small but significant increase in myopathy (0.6&#xa0;% vs. 0&#xa0;%; risk difference: 0.00, 95&#xa0;% CI -0.00; 0.01), and no significant difference in liver enzyme abnormalities (1.0&#xa0;% vs. 1.4&#xa0;%; OR 1.00, 95&#xa0;% CI: 0.25-3.99). A sensitivity analysis including two additional RCTs that included randomized co-treatments yielded similar findings. There were no significant interactions for effectiveness by disease severity (critically vs. non-critically ill, P&#xa0;=&#xa0;0.38) or sex (males vs. females, P&#xa0;=&#xa0;0.83).<br><br>CONCLUSION: Among hospitalized patients with COVID-19, statin therapy was associated with a significant reduction in 30-day all-cause death compared with control and exhibited an excellent safety profile.<br><br>STUDY REGISTRATION: This study is registered in PROSPERO (CRD42023478764).}, }
@article {pmid40991173, year = {2025}, author = {Zhang, X and Tong, X and Hou, R and Wang, P and Mo, Y and Zhang, L}, title = {Unveiling the secret of cellular metamorphosis: the crucial role of EndMT mechanisms in COVID-19-induced pulmonary fibrosis.}, journal = {Inflammopharmacology}, volume = {33}, number = {10}, pages = {6251-6260}, pmid = {40991173}, issn = {1568-5608}, support = {2022NSFSC1394//Natural Science Foundation of Sichuan province/ ; 2023-GH02-00092-HZ//International Science and Technology Cooperation Project of Chengdu/ ; Q21018//Youth Innovation Project of Sichuan Medical Association/ ; 2022516//Chengdu Medical Research Projects/ ; 2023666//Chengdu Medical Research Projects/ ; }, mesh = {Humans ; *COVID-19/complications/pathology ; *Pulmonary Fibrosis/virology/pathology/etiology/metabolism ; Animals ; *Epithelial-Mesenchymal Transition/physiology ; Endothelial Cells/pathology/metabolism ; SARS-CoV-2 ; Endothelial-Mesenchymal Transition ; }, abstract = {The COVID-19 pandemic has resulted in several long-term complications, with COVID-19-induced pulmonary fibrosis being a significant concern. Despite increasing recognition, the mechanisms underlying its development, effective treatment strategies, and long-term outcomes remain poorly understood. Emerging research highlights the direct impact of SARS-CoV-2 on vascular endothelial cells, identifying endothelial-mesenchymal transition (EndMT) as a key factor in the progression of COVID-19-induced pulmonary fibrosis. However, there is a notable lack of comprehensive reviews addressing the link between EndMT and COVID-19-induced pulmonary fibrosis. This review seeks to fill that gap by providing an in-depth analysis of the relationship between EndMT and fibrosis, examining relevant risk factors and molecular pathways. Our findings offer critical insights that could inform the development of targeted anti-fibrotic therapies aimed at mitigating COVID-19-related pulmonary fibrosis. Ultimately, this review aims to advance understanding of the role of EndMT in pulmonary fibrosis and to guide future research and treatment approaches.}, }
@article {pmid40991037, year = {2025}, author = {Fichtner, F and Kluge, S and Laudi, S and Moerer, O and Weber-Carstens, S and Sander, M}, title = {[Ten key messages of the German S3 guideline on invasive ventilation and use of extracorporeal techniques in patients with acute respiratory failure].}, journal = {Medizinische Klinik, Intensivmedizin und Notfallmedizin}, volume = {120}, number = {8}, pages = {677-679}, pmid = {40991037}, issn = {2193-6226}, }
@article {pmid40989868, year = {2025}, author = {Patel, JJ and Fine, KS and O'Shea, AW and Wirth, PJ and Shaffrey, EC and Attaluri, PK and Rao, VK}, title = {Gloving the Surgeon: A Practical Review of Surgical Glove Material Properties, Safety, and Waste.}, journal = {Annals of surgery open : perspectives of surgical history, education, and clinical approaches}, volume = {6}, number = {3}, pages = {e600}, pmid = {40989868}, issn = {2691-3593}, abstract = {Surgical gloves are a staple in every surgeon's daily routine, yet their full lifecycle is not always well understood. This paper outlines the journey of a surgical glove from manufacturing to disposal, with particular emphasis on clinically relevant properties such as durability, perforation rates, and allergy risk. It begins with a review of the historical context of sterile surgical gloves, followed by a detailed overview of the manufacturing process and the materials used, including latex and various synthetic alternatives. These various materials may differ in barrier protection, fit, tactile sensitivity, and allergenic potential. Data presented here suggests that synthetic alternatives to latex, while hypoallergenic, may be more prone to microperforations or decreased dexterity. The logistics of glove sourcing and inventory management are also examined, providing insights to help surgical teams and hospital administrators prepare for supply chain disruptions, such as those experienced during the COVID-19 pandemic. Finally, best practices for glove disposal and the environmental impact of surgical gloves are explored. By examining the clinical and logistical aspects of glove use, this article offers insights to optimize surgical safety, resource management, and sustainability.}, }
@article {pmid40989546, year = {2025}, author = {Cruz Neto, J and Fiuza Olivindo, CV and Guimarães Dos Santos, JA and Araujo da Silva, MA and de Oliveira Sales Junior, R}, title = {Cardiometabolic factors related to post-COVID-19 conditions: a scoping review.}, journal = {Revista Cuidarte}, volume = {16}, number = {2}, pages = {e4290}, pmid = {40989546}, issn = {2346-3414}, abstract = {INTRODUCTION: Post-COVID syndrome is a pathology that involves multiple sequelae. It is important to identify cardiometabolic risk factors as a way of preventing complications.<br><br>OBJECTIVE: To map the scientific evidence related to cardiometabolic factors in long post-COVID-19 conditions.<br><br>MATERIALS AND METHODS: Scoping review with the guiding question: What scientific evidence relates cardiometabolic factors to patients with long post-Covid-19 syndrome? The sources of information used were six databases via the CAPES journal portal. For the gray literature, we used the CAPES catalog of theses and dissertations, the Brazilian Digital Library of Theses and Dissertations, the Who Library Database and the medRxiv and OpenGrey repositories. The following descriptors were used: Adult, heart disease risk factors, Syndrome, SARS-CoV-2 and Covid 19 crossed using the Boolean operators AND and OR.<br><br>RESULTS: 14 studies were included. The cardiometabolic factors found were: abnormal levels of triglycerides, glycated hemoglobin, ferritin, inflammatory processes, decreased platelets, phospholipids and endothelial cells, oxidative stress, higher concentrations of monosaccharides and reduced polysaccharides, increased LDL, ALT, AST and bilirubin, with reduced GFR.<br><br>DISCUSSION: Patients with long-term COVID report persistent and debilitating symptoms that affect recovery, quality of life, economic and social activities. In addition to increased resting heart rate, tachycardia, palpitations, hypotension, syncope, orthostatic tachycardia, angina and heart attack.<br><br>CONCLUSION: Cardiometabolic factors expose the vulnerability of individuals affected by long Covid-19, so strategies are needed to reduce the systemic inflammatory impact of the disease and its clinical consequences.}, }
@article {pmid40988745, year = {2025}, author = {Montrucchio, G and Traversi, R and Arrigo, G and Bonetto, C and Sales, G and Busca, A and Fanelli, V and Filippini, C and Brazzi, L}, title = {Hemophagocytic Lymphohistiocytosis in the adult critically ill: a narrative review of case reports and case series.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1622770}, pmid = {40988745}, issn = {2296-858X}, abstract = {BACKGROUND: Hemophagocytic Lymphohistiocytosis (HLH) is a rare life-threatening syndrome characterized by hyperinflammation caused by abnormally activated macrophages and cytotoxic T cells overlapping with sepsis and multi-organ disfunction (MOD). Its frequency is probably underestimated.<br><br>METHODS: Patients' data were extracted from a literature search performed on PubMed (MEDLINE) and EMBASE using the following search terms: "Hemophagocyitic Lymphohistiocytosis" OR "HLH" OR "MACROPHAGE ACTIVATING SYNDROME" OR "MAS" AND "Intensive Care Unit" OR "Critical Care" OR "ICU." Search was limited to articles published after 2014, when HScore was proposed.<br><br>RESULTS: We found 126 case reports and case series for a total of 148 patients with an overall mortality of 47.5%. Main triggers were infections (111 patients; 88.1%) followed by dysimmune disorders (29 patients; 19.7%) and hematological malignancies (20 patients; 13.6%). The following factors were associated with increased ICU mortality: viral infection (76 patients; 52.8%) p&#x202f;=&#x202f;0.0071 and p&#x202f;=&#x202f;0.0086 at multivariate analysis for SARS-CoV-2, hematological malignancies (p&#x202f;=&#x202f;0.0035 at univariate analysis; p&#x202f;=&#x202f;0.0083 at multivariate analysis), invasive mechanical ventilation (116 patients; 83.3%) p&#x202f;=&#x202f;0.0060 at univariate analysis not confirmed in multivariate analysis (p&#x202f;=&#x202f;0.0599). Corticosteroids were associated with reduced ICU mortality at univariate analysis (86 patients; 59.7% p&#x202f;=&#x202f;0.0250) not confirmed at multivariate analysis (p&#x202f;=&#x202f;0.7196).<br><br>CONCLUSION: Evidence from our analysis confirms the severity and rapid evolution of HLH, suggesting the importance of prompt clinical suspicion. Since HLH can be found in different hospital settings, including ICU, we believe that this syndrome should be considered in differential diagnosis for all patients presenting with MOD with unclear etiology. Development of specific diagnostic and therapeutic schemes should be considered a priority.}, }
@article {pmid40988320, year = {2025}, author = {Yin, X and Hou, X and Feng, J}, title = {Role of Ferroptosis on Lung Epithelial Cells in Disease Progression and Treatment: A Review.}, journal = {Medical science monitor : international medical journal of experimental and clinical research}, volume = {31}, number = {}, pages = {e948226}, pmid = {40988320}, issn = {1643-3750}, mesh = {*Ferroptosis/physiology/drug effects ; Humans ; *Epithelial Cells/pathology/metabolism ; Disease Progression ; *Lung/pathology/metabolism ; Epithelial-Mesenchymal Transition ; Oxidative Stress ; *Lung Diseases/pathology ; COVID-19/pathology ; Animals ; Lung Neoplasms/pathology ; SARS-CoV-2 ; Pulmonary Disease, Chronic Obstructive/pathology ; Lipid Peroxidation ; }, abstract = {Lung epithelial cells, including bronchial and alveolar epithelial cells, serve as the frontline barrier of the respiratory tract and play essential roles in maintaining pulmonary homeostasis and immune defense. Dysfunction of these epithelial cells contributes significantly to the development and progression of various lung diseases. Ferroptosis, an iron-dependent form of regulated cell death characterized by lipid peroxidation and glutathione depletion, has emerged as a key mechanism in pulmonary pathology. It plays distinct roles in benign and malignant lung conditions. In chronic obstructive pulmonary disease and asthma, ferroptosis promotes bronchial epithelial damage, oxidative stress, and persistent inflammation. Pathogens, such as Pseudomonas aeruginosa and SARS-CoV-2, induce ferroptosis to exacerbate epithelial injury. In pulmonary fibrosis, ferroptosis of alveolar epithelial cells contributes to tissue remodeling through oxidative stress and epithelial-mesenchymal transition. In lung cancer, ferroptosis affects carcinogenesis, therapy resistance, and response to radiotherapy. Emerging therapeutic strategies target ferroptosis using inhibitors, such as ferrostatin-1 and deferoxamine, or inducers, such as erastin and sulfasalazine, to modulate cell fate in a disease-specific manner. Natural compounds, such as curcumin, resveratrol, and nanomaterials, further enhance ferroptosis-based treatment potential. Ferroptosis thus offers a novel perspective on lung disease mechanisms and treatment. This article aims to review the role of epithelial cell ferroptosis in benign and malignant lung diseases.}, }
@article {pmid40988261, year = {2025}, author = {Gao, Y and Wang, X and Su, X and Liu, W and Zhang, Q}, title = {Acupuncture for hiccups: Case reports and literature review.}, journal = {Medicine}, volume = {104}, number = {38}, pages = {e44036}, pmid = {40988261}, issn = {1536-5964}, support = {ZKYB2410//the Hospital-level Project of Zhejiang Rehabilitation Medical Center/ ; (2022)NO:239//The National Program For Talents In Traditional Chinese Medicine/ ; }, mesh = {Aged ; Aged, 80 and over ; Humans ; Male ; *Acupuncture Therapy/methods ; *Hiccup/therapy ; }, abstract = {RATIONALE: Persistent hiccups following a stroke are a common complication that can adversely affect the patient's condition and rehabilitation. Certain refractory cases fail to respond adequately to pharmacological treatment. We report 2 cases of successful treatment of persistent hiccups with acupuncture and a medical electromagnetic device (trade name, TDP, an abbreviation of the Chinese phrase "Te-ding Dian-ci-bo Pu").<br><br>PATIENT CONCERNS: The first patient was a 94-year-old male who had experienced continuous hiccups for 7 days. His comorbidities included Alzheimer disease, cardiac arrhythmia following pacemaker implantation, chronic kidney disease, glaucoma, and recent COVID-19 infection complicated by pneumonia. The second patient was a 70-year-old male who had experienced hiccups for 10 days. He had a history of cerebellar and brainstem infarction, hypertension, and hypopharyngeal carcinoma.<br><br>DIAGNOSES: Both patients were diagnosed with persistent hiccups.<br><br>INTERVENTIONS: Both patients received combined treatment with acupuncture and TDP.<br><br>OUTCOMES: Following treatment, hiccups were alleviated to different degrees, and no recurrence was observed at follow-up.<br><br>LESSONS: Neuroexcitatory imbalance and thoracoabdominal pressure asymmetry are considered underlying causes of persistent hiccups. Acupuncture combined with TDP may modulate periumbilical arteriovenous networks and abdominal pressure, thereby relieving hiccups. This case series suggests a novel, easily implemented, well-tolerated therapeutic option for the management of persistent hiccups.}, }
@article {pmid40987329, year = {2025}, author = {Shaw, KE and Peterson, JK and Jalali, N and Ratnavale, S and Alkuzweny, M and Barbera, C and Costello, A and Emerick, L and Espana, G and Meyer, A and Mowry, S and Poterek, M and de Souza Moreira, C and Morgan, EL and Moore, S and Perkins, A}, title = {Co-circulating pathogens of humans: a systematic review of mechanistic transmission models.}, journal = {Proceedings. Biological sciences}, volume = {292}, number = {2055}, pages = {20251453}, pmid = {40987329}, issn = {1471-2954}, support = {/GM/NIGMS NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/transmission/virology/epidemiology ; SARS-CoV-2/physiology ; HIV Infections/transmission ; *Coinfection/virology ; *Communicable Diseases/transmission/virology/epidemiology ; *Models, Biological ; Models, Theoretical ; }, abstract = {Historically, most mathematical models of infectious disease dynamics have focused on a single pathogen, despite the ubiquity of co-circulating pathogens in the real world. We conducted a systematic review of 326 published papers that included a mechanistic, population-level model of co-circulating human pathogens. We identified the types of pathogens represented in this literature, techniques used and motivations for conducting these studies. We also created an interaction index to quantify the degree to which co-circulating pathogen models include across scale and/or pathogen-pathogen interactions. We found that the emergence of new pathogens, such as HIV and SARS-CoV-2, precipitated modelling activity of the emerging pathogen with established pathogens. Pathogen characteristics also tended to drive modelling activity; for example, HIV suppresses the immune response, eliciting interesting dynamics when it is modelled with other pathogens. The motivations driving these studies were varied but could be divided into two major categories: exploration of dynamics and evaluation of interventions. Future potential avenues of research we identified include investigating the effects of misdiagnosis of clinically similar co-circulating pathogens and characterizing the impacts of one pathogen on public health resources available to curtail the spread of other pathogens.}, }
@article {pmid40987100, year = {2025}, author = {Verdoni, L and Mazza, A and Martelli, L and Gervasoni, A and Amoroso, A and Marcora, SA and Brambilla, P and Bonanomi, E and Carioli, G and D'Antiga, L}, title = {The outcome of severe MIS-C managed at the Italian epicenter of the SARS-CoV-2 epidemic: a follow-up study of 50 consecutive patients.}, journal = {Current opinion in immunology}, volume = {97}, number = {}, pages = {102659}, doi = {10.1016/j.coi.2025.102659}, pmid = {40987100}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/epidemiology/therapy/diagnosis/complications ; Female ; Male ; *SARS-CoV-2 ; Child ; Follow-Up Studies ; *Systemic Inflammatory Response Syndrome/therapy/diagnosis/epidemiology ; Italy/epidemiology ; Child, Preschool ; Prognosis ; Adolescent ; Severity of Illness Index ; Ferritins/blood ; }, abstract = {BACKGROUND: During the SARS-CoV-2 pandemic, we described a peak of a Kawasaki-like disease in children, later renamed multisystem inflammatory syndrome in children (MIS-C). We report the long-term outcomes of MIS-C patients who presented to our center.<br><br>METHODS: We recorded clinical features and outcomes in patients with MIS-C admitted to our institution (February 2020-February 2022), focusing on the&#xa0;long-term outcome of those with a severe course.<br><br>RESULTS: A total of 50 MIS-C patients (mean age 8.8 &#xb1; 4.3 years, 16 females) were admitted. In univariate analysis, the predictors of high-risk disease were older age; high CRP, neutrophils, ferritin, D-dimer, and transaminases; and&#xa0;low white blood cells, lymphocytes, platelets, albumin, and sodium. In multivariate analysis, a more severe course of the disease was associated with sodium &#x2264;133 or ferritin >684. In two months, the symptoms disappeared. No relapses occurred during four years&#xa0;of surveillance.<br><br>CONCLUSION: The prognosis of MIS-C is favorable, even in severe cases. MIS-C resolves completely as early as eight weeks from onset and is not associated with other events over four years&#xa0;of observation. In our experience, careful and correct stratification in the initial phases has proven essential in setting up the correct treatment, with full recovery in all cases.}, }
@article {pmid40987023, year = {2025}, author = {Yang, J and Zhong, W and Li, Q and Zhang, W and Lin, W and Fan, X and He, Y and Ma, N}, title = {Sphingosine-1-phosphate signaling in respiratory diseases: mechanisms and therapeutic perspectives.}, journal = {International immunopharmacology}, volume = {166}, number = {}, pages = {115578}, doi = {10.1016/j.intimp.2025.115578}, pmid = {40987023}, issn = {1878-1705}, mesh = {Humans ; *Lysophospholipids/metabolism ; *Sphingosine/analogs &amp; derivatives/metabolism ; Signal Transduction/drug effects ; Animals ; Sphingosine-1-Phosphate Receptors/metabolism ; COVID-19/metabolism ; Phosphotransferases (Alcohol Group Acceptor)/antagonists &amp; inhibitors/metabolism ; *Respiratory Tract Diseases/metabolism/drug therapy ; SARS-CoV-2 ; Aldehyde-Lyases/antagonists &amp; inhibitors/metabolism ; }, abstract = {Sphingosine-1-phosphate (S1P) is a pivotal bioactive sphingolipid functioning as both a structural membrane component and a signaling mediator. It orchestrates diverse physiological and pathological processes including cellular proliferation, migration, differentiation, and immune regulation. The biological efficacy of S1P is controlled by metabolic networks that coordinate its biosynthesis, transport, and degradation to maintain intra/extracellular homeostasis and to activate cell surface S1P receptors (S1PRs) to initiate downstream signaling. Contemporary research increasingly has increasingly revealed the multifaceted roles of S1P signaling in respiratory pathologies, including asthma, chronic obstructive pulmonary disease (COPD), pulmonary malignancies, and especially infectious lung diseases such as COVID-19 and influenza. Particularly, S1P levels are significantly correlated with the severity and prognosis of the disease. These findings indicate that pharmacological modulation of the S1P signaling axis, through sphingosine kinase (SPHK1/2) inhibition, S1P lyase (SPL) inhibition, or the S1PR modulation represents a promising therapeutic approach. However, incomplete understanding of the S1P signaling mechanisms presents significant challenges for clinical applications. This review systematically consolidates recent advances in S1P signaling research in respiratory medicine, with particular emphasis on delineating cellular and molecular mechanisms and evaluating the translational potential of targeted therapeutics.}, }
@article {pmid40986167, year = {2025}, author = {Vester, P and Boudouroglou-Walter, S and Schreyögg, J and Wieting, C and Blome, C}, title = {Burden of Disease in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A Scoping Review.}, journal = {Applied health economics and health policy}, volume = {}, number = {}, pages = {}, pmid = {40986167}, issn = {1179-1896}, support = {GRK 2805/1//German Academic Research Foundation (DFG),/ ; }, abstract = {OBJECTIVE: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a serious chronic and complex multi-system disease characterised by symptoms such as post-exertional malaise, fatigue, cognitive impairment and pain. Diagnosis is based on international consensus criteria, and no curative treatment is available. In the USA, its prevalence is estimated at 0.42% among adults, with women affected three times as often as men. Prevalence is expected to increase due to the COVID-19 pandemic. In addition to its severe symptoms, ME/CFS has a substantial economic impact. This scoping review aimed to systematically examine the global health, social and economic burden of ME/CFS.<br><br>METHODS: We conducted a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines in six databases and supplemented it with a citation search. We assessed study quality using a modified version of the Mixed Methods Appraisal Tool.<br><br>RESULTS: We included 20 studies that assessed costs (n&#x2009;=&#x2009;16), disability-adjusted life years (DALYs) (n&#x2009;=&#x2009;3), employment rates (n&#x2009;=&#x2009;1), and school attendance (n&#x2009;=&#x2009;1) as indicators of disease burden. Reported costs per patient ranged from USD 2,916 to USD 119,611, with indirect costs accounting for the largest proportion. DALYs reported for the USA ranged from 0.714 million in 2016 to 5.77 million in 2022.<br><br>CONCLUSION: ME/CFS imposes a substantial health, social and economic burden of disease. Discrepancies in estimates are probably due to differences in study samples, methodologies, cost components, and healthcare systems. Because ME/CFS is assumed to be underdiagnosed, its true burden may be even higher.}, }
@article {pmid40985351, year = {2025}, author = {Peters, LER and Charnley, GEC and Roberts, S and Kelman, I}, title = {Public health disinformation, conflict, and disease outbreaks: a global narrative integrative review to guide new directions for health diplomacy.}, journal = {Global health action}, volume = {18}, number = {1}, pages = {2562380}, pmid = {40985351}, issn = {1654-9880}, mesh = {Humans ; *Global Health ; *Disease Outbreaks ; *Public Health ; *COVID-19/epidemiology ; *Diplomacy ; Pandemics ; SARS-CoV-2 ; International Cooperation ; }, abstract = {The COVID-19 pandemic laid bare the unpreparedness of global and public health systems to respond to large-scale health crises, while simultaneously revealing the entangled nature of disinformation and poor global and public health outcomes. This research challenges the common treatment of public health disinformation - deliberately false information - as an emergent and technical threat, and instead situates it as a more systemic and nuanced challenge for global health governance to address. This article presents an integrative narrative literature review on the interlinkages between public health disinformation, conflict, and disease outbreaks, demonstrating mutually influencing connections between them. In doing so, the analysis raises critical questions around how reactive responses, such as doubling down on information authority, can paradoxically fuel the uptake of both disinformation especially amidst global trends towards increasing conflict and decreasing cooperation. In this evolving sociopolitical landscape for global health, the discussion explores the potential to harness health diplomacy to strengthen critical public engagement and deliberation. This reimagined approach to health diplomacy offers pathways to mitigate the harmful effects of disinformation rather than seeking to eliminate false information. This article contributes to deepening an understanding of this rapidly expanding topic for global and public health in two pathways. First, by investigating the root causes and impacts of public health disinformation that intersect with conflict. Second, by exploring how health diplomacy can foster cooperative global health governance through transparency and inclusion. This research offers a new direction to strengthen preparedness for future global and public health crises amidst disinformation.}, }
@article {pmid40984753, year = {2025}, author = {Denman, DS and Dalhaimer, P}, title = {The curious case of anti-PEG antibodies.}, journal = {Nanoscale}, volume = {17}, number = {39}, pages = {22594-22605}, doi = {10.1039/d5nr02301g}, pmid = {40984753}, issn = {2040-3372}, mesh = {*Polyethylene Glycols/chemistry ; Humans ; Animals ; *Nanoparticles/chemistry ; Immunoglobulin M/immunology ; Mice ; COVID-19/immunology/prevention &amp; control ; *Antibodies/immunology ; Immunoglobulin G/immunology ; SARS-CoV-2/immunology ; Doxorubicin/analogs &amp; derivatives/chemistry ; COVID-19 Vaccines/immunology/chemistry ; Liposomes/chemistry ; }, abstract = {The components of nanoparticles can trigger the production of antibodies in patients and in model mammals such as mice. We focus on antibodies made against poly-ethylene-glycol (PEG), the most common polymer component of nanoparticles. Humans are frequently exposed to free PEG in processed foods, cosmetics, and over-the-counter drugs. These PEG-containing products trigger varying amounts of anti-PEG antibody production in consumers. In addition to consumer product usage, human exposure to PEG was greatly increased when millions were vaccinated with SARS-CoV-2 vaccine nanoparticles, which contained a PEGylated lipid. Thus, the chances of humans having anti-PEG antibodies is high and the ramifications of the presence of such antibodies must be addressed. The resulting antibodies could bind and negatively affect PEG-containing nanoparticles that are subsequently administered to patients. For example, a patient administered the PEGylated liposome DOXIL could have "pre-existing" anti-PEG antibodies from cosmetic products. The anti-PEG antibodies could bind the PEG component of DOXIL and take it to professional phagocytes. This would greatly reduce its ability to localize to cancer cells. In this review, we discuss the possible mechanisms by which PEG could generate immunoglobulin M (IgM) and how PEG could trigger a stronger and more mechanistically complex immunoglobulin G (IgG) response. We assess PEG-antibody binding. We discuss the various mechanisms by which PEG-containing nanoparticles may bind immune cells. We address gaps in our knowledge of the mechanisms of anti-PEG antibody formation. We discuss strategies for determining whether PEG triggers antibody production and how strong the antibody will interact with the PEG.}, }
@article {pmid40984136, year = {2025}, author = {Francis, Y and Lantry, FJ and Echeverry, M and Siddiq, M}, title = {Effective Countermeasures to Health Misinformation and Disinformation for Global Health Engagement Practitioners: A Rapid Review.}, journal = {Military medicine}, volume = {190}, number = {Supplement_2}, pages = {478-482}, doi = {10.1093/milmed/usaf237}, pmid = {40984136}, issn = {1930-613X}, support = {HU00012420029//Assistant Secretary of Defense, Health Affairs/ ; }, mesh = {Humans ; *Global Health/education ; COVID-19/epidemiology/psychology/prevention &amp; control ; *Communication ; *Disinformation ; United States ; }, abstract = {INTRODUCTION: Awareness and education about the risks posed by health misinformation and disinformation (mis/dis) to the U.S. Department of Defense's (DoD) health-related activities are currently insufficient, highlighting the need for effective counterstrategies. This issue became particularly evident during the COVID-19 pandemic, affecting U.S. DoD Global Health Engagement (GHE) activities. It is also increasingly significant as Combatant Commands expand their DoD GHE and Global Health Security activities to align with strategic priorities.<br><br>MATERIALS AND METHODS: To address this gap, the Center for Global Health Engagement at the Uniformed Services University of the Health Sciences conducted a rapid systematic review of literature on countering health mis/dis. The review examined English-language papers indexed in PubMed, Web of Science, and Embase from 2013 to 2023.<br><br>RESULTS: The rapid review revealed that while much of the literature on health mis/dis focuses on major institutional actors, there is a growing body of research on countermeasures designed for individuals. The most frequently studied strategy was debunking, which involves directly correcting false or misleading information. Other effective, though context-specific, strategies highlighted included prebunking, fact-checking, and health literacy training. Additionally, the review found that most existing studies focused on COVID-19, followed by childhood vaccines and vaccine hesitancy.<br><br>CONCLUSION: Debunking, prebunking, and health literacy strategies were identified as effective tools for addressing health-related mis/dis in the context of DoD GHE. Global Health Engagement practitioners and planners should be aware of these techniques and integrate them into their engagements and activities. However, there is no one-size-fits-all solution; the effectiveness of countering mis/dis depends heavily on the context in which the information is propagated. Further research is needed to develop educational materials on mis/dis countermeasures and to improve communication about the threats posed by health mis/dis within the GHE landscape.}, }
@article {pmid40983473, year = {2025}, author = {Kass-Gergi, S and Holcomb, NP and Maiden, MM and Eisenlohr, LC and Vaughan, AE}, title = {Scar wars: the viral menace.}, journal = {American journal of physiology. Lung cellular and molecular physiology}, volume = {329}, number = {5}, pages = {L555-L569}, doi = {10.1152/ajplung.00189.2025}, pmid = {40983473}, issn = {1522-1504}, mesh = {Humans ; *COVID-19/complications/virology/pathology/immunology ; SARS-CoV-2 ; *Pulmonary Fibrosis/virology/pathology/etiology/immunology ; *Influenza, Human/complications/virology/pathology ; Respiratory Distress Syndrome/virology/pathology ; Lung/virology/pathology ; Animals ; }, abstract = {Pulmonary fibrosis (PF) is a severe consequence of respiratory infections, characterized by excessive extracellular matrix deposition and irreversible lung architectural damage. Once considered a rare condition, PF is now increasingly recognized in the wake of viral infections, particularly among survivors of viral-induced acute respiratory distress syndrome (ARDS). The COVID-19 pandemic has highlighted in bold relief the observation that many survivors of severe viral pneumonia do not recover fully but develop chronic fibrotic changes that impair lung function. This review examines the clinical evidence and underlying mechanisms linking viral infections-COVID-19, influenza, and other respiratory viruses-to the onset of pulmonary fibrosis. By probing the mechanisms of cellular injury, immune dysregulation, and aberrant repair mechanisms, we aim to illuminate the pathways that transform an acute viral insult into a chronic, fibrotic disease.}, }
@article {pmid40983056, year = {2025}, author = {Yin, H and Zhang, PS and Chen, Y and Kong, BB and Zhang, CG and Wu, S}, title = {Death caused by transdermal ivermectin poisoning: A case report and literature review.}, journal = {The Journal of international medical research}, volume = {53}, number = {9}, pages = {3000605251377690}, pmid = {40983056}, issn = {1473-2300}, mesh = {Humans ; Administration, Cutaneous ; *Antiparasitic Agents/poisoning/administration &amp; dosage ; COVID-19 ; *Drug Overdose ; Fatal Outcome ; *Ivermectin/poisoning/administration &amp; dosage ; }, abstract = {Ivermectin is a classic antiparasitic drug that is widely used around the world. After the outbreak of coronavirus disease 2019, many studies have reported the potential effectiveness of ivermectin against coronavirus disease 2019; however, it is not recommended by the World Health Organization because of insufficient evidence and significant adverse effects. Owing to the abovementioned findings, the number of reports of poisoning and other serious reactions caused by ivermectin abuse have increased in recent years. Notably, no previous cases of transdermal ivermectin poisoning with documented blood concentrations has been reported to date. We report a rare fatal case of ivermectin misuse with a review of recent literature. The patient suffered from ivermectin poisoning due to transdermal overdose. The patient's plasma concentration was 27 ng/mL. The main clinical manifestations were gastrointestinal symptoms in the early stage and diffuse cerebral edema and intracranial hypertension in the later stage. Despite active treatment, including hemoperfusion and cardiorespiratory support, the patient died. Many recent in vitro studies have shown that ivermectin has the potential to become a new anticancer drug. If clinical research proves its effectiveness against cancer, it may also lead to ivermectin overuse. This study aimed to raise awareness regarding ivermectin poisoning among clinicians and the public, thereby preventing drug abuse.}, }
@article {pmid40982878, year = {2025}, author = {Khairetdinov, O and Rubakova, L and Pavlova, M and Asatryan, E and Tavormina, G and Vlasov, A}, title = {APPLICATION OF TELEMEDICINE TECHNOLOGIES IN THE DIAGNOSIS OF AUTISM SPECTRUM DISORDERS IN CHILDREN: A NARRATIVE REVIEW.}, journal = {Psychiatria Danubina}, volume = {37}, number = {Suppl 1}, pages = {85-90}, pmid = {40982878}, issn = {0353-5053}, mesh = {Humans ; *Autism Spectrum Disorder/diagnosis ; *Telemedicine ; Child ; *COVID-19 ; }, abstract = {BACKGROUND: The application of telemedicine technologies in providing psychiatric care to children with autism spectrum disorders (ASD) became widespread during the COVID-19 pandemic. This review aims to describe the types, structure, and features of tools used for the remote diagnosis of ASDs in children, based on contemporary scientific literature and our own experience.<br><br>METHODS: We conducted a descriptive review of scientific studies published from January 2013 to December 2024. Works presented in the electronic databases PubMed, Web of Science, and eLibrary were analyzed. Descriptive analysis was used to summarize the obtained data.<br><br>RESULTS: The analysis convincingly demonstrates a sufficient representation of remote tools for screening, assessment scales, and structured diagnostic procedures for ASD across various countries, exhibiting high levels of specificity and sensitivity.<br><br>CONCLUSIONS: The use of telemedicine diagnostic methods in clinical practice contributes to the early detection of ASDs, potentially enhancing the timeliness and effectiveness of medical and correctional interventions.}, }
@article {pmid40982817, year = {2025}, author = {Litta, A and Vacca, A and Mino, MV and Franza, F and Pastore, F}, title = {PROMOTING ADOLESCENT MENTAL HEALTH THROUGH SCHOOL-BASED LITERACY INITIATIVES: BEYOND THE STIGMA.}, journal = {Psychiatria Danubina}, volume = {37}, number = {Suppl 1}, pages = {165-168}, pmid = {40982817}, issn = {0353-5053}, mesh = {Humans ; Adolescent ; *Health Literacy ; Male ; Female ; *Social Stigma ; Italy ; *Mental Health ; *COVID-19/psychology ; *Health Knowledge, Attitudes, Practice ; Pilot Projects ; Surveys and Questionnaires ; *School Health Services ; *Health Promotion/methods ; *Students/psychology ; }, abstract = {BACKGROUND: Adolescent mental health has become an increasingly urgent concern, particularly in the aftermath of the COVID-19 pandemic. Mental Health Literacy (MHL) is emerging as a critical construct to promote psychological well-being, reduce stigma, and encourage the early recognition of psychological distress.<br><br>METHODS: This study presents baseline data from a school-based pilot initiative conducted in a secondary school in Southern Italy. The aim was to assess students' knowledge beliefs, and attitudes toward mental health prior to implementing targeted educational interventions. A total of 85 fifth-year students (mean age = 17.7 years) completed the Italian version of the Mental Health Literacy Questionnaire - short form (MHLq-short), administered anonymously via an online platform. Statistical analyses included descriptive measures and non-parametric tests to explore the association between MHL scores and familiarity with mental health problems.<br><br>RESULTS: Students who reported knowing someone with mental health issues exhibited a trend toward higher mental health literacy scores. In contrast, those who reported no such exposure or expressed uncertainty demonstrated lower average ranks, possibly reflecting limited awareness or emotional disengagement.<br><br>CONCLUSIONS: These findings highlight the potential role of personal experience in shaping mental health literacy and reinforce the need for structured, school-based interventions. To our knowledge, this study represents the first application of the MHLq-short in Italy and supports its feasibility in identifying literacy gaps among adolescents. Future initiatives could aim to replicate and scale this model across diverse educational settings and inform national strategies to integrate MHL into school curricula.}, }
@article {pmid40981769, year = {2025}, author = {Choong, C and Dharma, M and Barmanray, RD}, title = {Not all hyperglycaemia in hospitalised pneumonia is created equal.}, journal = {Internal medicine journal}, volume = {55}, number = {11}, pages = {1955-1957}, doi = {10.1111/imj.70208}, pmid = {40981769}, issn = {1445-5994}, mesh = {Humans ; *Hyperglycemia/chemically induced ; COVID-19/mortality/complications ; Community-Acquired Infections/drug therapy/mortality/blood ; Hospitalization ; *Adrenal Cortex Hormones/adverse effects/therapeutic use ; *Pneumonia ; Blood Glucose/metabolism ; SARS-CoV-2 ; }, abstract = {Community-acquired pneumonia (CAP) remains a major cause of hospitalisation and mortality worldwide. Corticosteroid therapy reduces 30-day mortality in hospitalised patients with CAP but nearly doubles the risk of hyperglycaemia. It may appear that hyperglycaemia can arise from distinct mechanisms: "inflammation-mediated hyperglycaemia," which signals disease severity and predicts worse outcomes, and "corticosteroid-induced hyperglycaemia," a side effect of beneficial treatment that may appear not to increase mortality risk. Evidence from COVID-19 cohorts supports this distinction, showing that hyperglycaemia following corticosteroid use correlates with disease severity and longer hospital stays but not with increased mortality. Early glycaemic control reduces complications such as healthcare-associated infections in the context of hyperglycaemia due to inflammatory mediators and in the absence of corticosteroids, yet its role in corticosteroid-induced hyperglycaemia remains unclear. The lack of a standardised definition of hyperglycaemia further complicates research and clinical management. Understanding the differential impacts and optimal glucose targets for these potential hyperglycaemia subtypes is critical. Future research should focus on evaluating the effects of glucose control on outcomes in corticosteroid-associated hyperglycaemia, determining optimal glycaemic thresholds and evaluating suitable therapeutic management strategies in this clinical context.}, }
@article {pmid40981424, year = {2025}, author = {Westhoven, S and Bertzbach, LD and Kloehn, M and Mahncke, C and Heinen, N and Brown, RJP and Pfaender, S}, title = {From zoonotic spillover to endemicity: the broad determinants of human coronavirus tropism.}, journal = {mBio}, volume = {16}, number = {11}, pages = {e0243725}, pmid = {40981424}, issn = {2150-7511}, support = {524774169//Deutsche Forschungsgemeinschaft/ ; 101191666//HORIZON EUROPE Health/ ; VIRASCREEN (01KI2113)//Bundesministerium f&#xfc;r Bildung und Forschung/ ; }, mesh = {Humans ; *Viral Tropism ; Animals ; *Coronavirus/physiology ; *Zoonoses/virology/epidemiology ; *Coronavirus Infections/virology/epidemiology/transmission ; Host Specificity ; *Viral Zoonoses/virology/epidemiology/transmission ; }, abstract = {Given the recurring threat of coronavirus outbreaks, understanding the specificity of coronaviruses in terms of their host, tissue, and cell tropism is crucial. This review consolidates and critically assesses the current literature on the tropism of endemic, epidemic, and pandemic coronaviruses. We explore different levels of tropism, including species tropism (virus preference for specific host species), host cell tropism (virus specificity for particular cell types), and tissue tropism (specificity for certain tissues or organs). This review compiles extensive basic research, particularly from recent years, to provide critical insights into the viral mechanisms that are key to improving future pandemic preparedness.}, }
@article {pmid40980513, year = {2025}, author = {Pettemeridou, E and Loizidou, M and Trajkovic, J and Constantinou, M and De Smet, S and Baeken, C and Sack, AT and Williams, SCR and Constantinidou, F}, title = {Cognitive and Psychological Symptoms in Post-COVID-19 Condition: A Systematic Review of Structural and Functional Neuroimaging, Neurophysiology, and Intervention Studies.}, journal = {Archives of rehabilitation research and clinical translation}, volume = {7}, number = {3}, pages = {100461}, pmid = {40980513}, issn = {2590-1095}, abstract = {OBJECTIVE: To investigate the structural, functional, and neurophysiological brain changes associated with post-COVID-19 condition (PCC)-related cognitive and psychological issues and evaluate the efficacy of noninvasive brain stimulation (NIBS) and cognitive rehabilitation interventions.<br><br>DATA SOURCES: Electronic databases, including Web of Science, PubMed, and Embase, were systematically searched for articles published before February 1, 2025, using terms such as "post-COVID-19 condition," "cognitive dysfunction," "brain changes," "noninvasive brain stimulation," and "cognitive rehabilitation." Language was restricted to English, and only studies involving human participants were included.<br><br>STUDY SELECTION: Studies with human participants aged &#x2265;18 years diagnosed with PCC, employing magnetic resonance imaging, functional magnetic resonance imaging, positron emission tomography, and electroencephalography, and interventions such as NIBS and cognitive rehabilitation were included. Articles were selected through independent review by multiple authors, with consensus resolving discrepancies. Of the 123 studies initially identified, 78 met the inclusion criteria.<br><br>DATA EXTRACTION: Data on participant demographics, methodologies, neurophysiological changes, and intervention outcomes were extracted by 2 independent reviewers using predefined guidelines. Study quality was assessed using the Newcastle-Ottawa Scale and Critical Appraisal Skills Program tools.<br><br>DATA SYNTHESIS: Seventy-eight studies with over 5900 participants met the inclusion criteria. Significant cognitive impairments were observed in attention, executive function, and memory (N=78). Key findings included mixed evidence of gray matter (N=16) and white matter volume changes (N=20), cortical thickness alterations (N=9), variations in functional connectivity (N=14), electrophysiology (N=9), and blood flow (N=8). NIBS, including transcranial magnetic stimulation (N=8) and transcranial direct current stimulation (N=2), showed potential benefits for managing depression and cognitive impairments. Although cognitive rehabilitation (N=3) showed promise, it requires further investigation.<br><br>CONCLUSIONS: This review highlights the complex neurologic underpinnings of PCC and the potential of NIBS and cognitive rehabilitation as interventions. Further research is essential to refine these interventions and establish evidence-based strategies for addressing long-term cognitive and psychological effects of PCC.}, }
@article {pmid40980413, year = {2025}, author = {Ifeanyi, C and Okechukwu, E and Tosin, O and Hyacinth, I and Ataguba, JE and Muriithi, GN and Achala, DM and Adote, ENA and Mbachu, CO and Beshah, SA and Nwosu, CO and Tlhakanelo, JT and Akazili, J and Masuka, N}, title = {Assessing the determinants of uptake and hesitancy in accessing COVID 19 vaccines in Nigeria: a scoping review.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1609418}, pmid = {40980413}, issn = {2813-0146}, abstract = {The coronavirus disease (COVID-19) is one of the largest public health threats in recent times, with significant health, economic, and social consequences globally. The WHO reported that over 651 million cases and 6.6 million deaths were attributed to COVID-19 globally. The Nigeria Centre for Disease Control (NCDC) in 2022 revealed that 266,057 cases with 3,155 deaths were reported. All the thirty-six states and the Federal Capital Territory (FCT) of Nigeria were affected, but Lagos and the FCT reported the highest number of cases. However, it is possible that these numbers do not accurately reflect the severity of COVID-19 disease in Nigeria because the country had only tested 5,160,280 people as at 2022, despite a population of around 200 million. Nigeria did not meet its 2021 vaccination target, prompting the need to identify the contextual factors affecting vaccine access and uptake as well as vaccine hesitancy in Nigeria and document the approaches that can be deployed to reduce opposition to vaccination as well as improve advocacy for vaccine equity. This scoping review, conducted using Arksey and O'Malley's framework, aimed to explore the factors influencing COVID-19 vaccine hesitancy and uptake in Nigeria. A comprehensive literature search was conducted across electronic databases, including Google Scholar and PubMed, with studies from Nigeria published in English. The review included 25 studies on vaccine hesitancy, uptake, and willingness to accept COVID-19 vaccination, identifying barriers at the national, community, and individual levels. The results indicated that 90% of the studies showed low vaccine acceptance and uptake, with barriers related to vaccine availability, misinformation, cultural and religious influences, socioeconomic factors, and lack of trust in the health system. Socio-demographic factors such as gender, age, education, and income were identified as key influences. The findings highlight the need for targeted, evidence-based strategies to address vaccine hesitancy, improve vaccine distribution, and engage diverse population groups to enhance vaccination uptake across Nigeria.}, }
@article {pmid40980411, year = {2025}, author = {Beshah, SA and Adem, JB and Degefa, MB and Ayalew, M and Lakew, Y and Garoma, S and Adote, ENA and Achala, DM and Muriithi, GN and Mbachu, CO and Akazili, J and Ifeanyi, C and Zegeye, EA and Nwosu, CO and Ataguba, JE}, title = {COVID-19 vaccine hesitancy in Ethiopia: a scoping review for equitable vaccine access.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1609752}, pmid = {40980411}, issn = {2813-0146}, abstract = {INTRODUCTION: COVID-19 vaccines are crucial for preventing severe illness from the virus. Despite their effectiveness; vaccine hesitancy, unequal access, and economic disparities hinder vaccination programs across Africa, posing significant challenges in Ethiopia.<br><br>METHOD: This scoping review followed the methodological guidelines outlined in the Joanna Briggs Institute Reviewer's and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation to ensure transparency. To analyze the data, we developed tailored search strategies for key databases [HINARI, PubMed, Cochrane, African Journals Online (AJOL), and Science Direct] and gray literature sources. These strategies combined controlled vocabulary and relevant keywords. A descriptive thematic analysis was then employed to identify and categorize the various findings within the included studies. The results are presented in a narrative format, summarizing the key themes and providing a clear and comprehensive overview of the current evidence base.<br><br>RESULTS AND RECOMMENDATIONS: A review of 34 Ethiopian studies revealed significant COVID-19 vaccine hesitancy, with rates exceeding 50% in over 40% of the studies. The lowest hesitancy was found in adults from Addis Ababa (19.1%), while the highest rates were seen among healthcare workers in Oromia (69.7%) and pregnant women in Southwest Ethiopia (68.8%). Factors contributing to vaccine hesitancy in Ethiopia include being female, having only primary education, residing in rural areas, younger age, limited knowledge about the vaccine, reduced trust in authorities, and misperceptions about the risk of the virus. To address this challenge effectively, policymakers should prioritize interventions that build public trust, enhance awareness of the vaccine's benefits, and counter misinformation.}, }
@article {pmid40978734, year = {2025}, author = {Bravo, FJ and Mena, J and Mejía Reyes, &#xc1; and Schäfer, C and Núñez-Rojas, N and Blamey-Fredes, C and Acuña-Castillo, C and Barrera-Avalos, C}, title = {The impact of Panx1 on inflammation, immunity, and cancer: a comprehensive review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1572418}, pmid = {40978734}, issn = {2296-858X}, abstract = {Pannexin 1 (Panx1) is a widely expressed membrane channel that regulates ATP release and purinergic signaling, playing essential roles in inflammation, immunity, and tumor progression. This review provides a comprehensive analysis of its structure, activation mechanisms, and its functional relevance in both innate and adaptive immunity. Panx1 has been implicated in inflammasome activation, neutrophil and dendritic cell regulation, and modulation of immune responses against infections, including SARS-CoV-2. Additionally, Panx1 plays a dual role in tumor progression, acting either as a promoter or a suppressor depending on the cellular and microenvironmental context. Pharmacological inhibition of Panx1 has shown therapeutic benefits in preclinical models of inflammatory, cardiovascular, and neurodegenerative diseases, establishing it as a promising and versatile therapeutic target. This review underscores the need for further research into Panx1's molecular mechanisms and the development of targeted interventions to effectively address inflammatory and autoimmune diseases with precision and efficacy.}, }
@article {pmid40977695, year = {2025}, author = {Lee, SM and Kim, EH}, title = {The role of cell death pathways in respiratory viral infection and vaccination: two sides of the same coin.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1650960}, pmid = {40977695}, issn = {1664-3224}, mesh = {Humans ; *Cell Death/immunology ; *SARS-CoV-2/immunology ; *COVID-19/immunology/prevention &amp; control ; Immunity, Innate ; Vaccination ; Animals ; *Influenza, Human/immunology ; *COVID-19 Vaccines/immunology ; Alarmins/immunology ; *Respiratory Tract Infections/immunology ; Signal Transduction ; Virus Diseases/immunology ; }, abstract = {Cell death pathways play contrasting roles in physiological processes such as responses to viral infections and vaccinations, potentially exerting either detrimental or beneficial effects. On one hand, uncontrolled cell death accompanied by the release of damage-associated molecular patterns (DAMPs) can lead to excessive inflammation and tissue damage. On the other hand, when properly regulated, these processes help establish an immunocompetent environment by activating innate immunity, which in turn stimulate antiviral immune responses. These mechanisms have emerged as promising targets for the development of effective antiviral therapeutics, immunotherapies, and vaccines. Recent advances have elucidated key aspects of cell death and DAMP pathways, highlighting their association with upstream viral sensors, their capacity to regulate immune responses, and their potential as therapeutic targets in the context of respiratory viral infections such as influenza virus and SARS-CoV-2. In this review, we discuss the advantages and disadvantages of cell death and DAMP pathways, focusing on their roles in antiviral immunity and pathogenesis of respiratory viral infections, and vaccine immunogenicity.}, }
@article {pmid40977416, year = {2025}, author = {Liu, C and Song, Y and Niu, S and Jiang, Y and Zhu, T and Li, X and Cui, R and Deng, Q}, title = {COVID-19 Infection Confirmed by Bronchoalveolar Lavage Fluid Metagenomics -Next-Generation Sequencing Instead of Pharyngeal Swabs in Follicular Lymphoma: Three-Case Report and Literature Review.}, journal = {Journal of clinical laboratory analysis}, volume = {39}, number = {20}, pages = {e70103}, pmid = {40977416}, issn = {1098-2825}, support = {TJWJ2023ZD003//Tianjin Municipal Health Commission/ ; Y-NCJH202201-0027//Beijing Xisike Clinical Oncology Research Foundation/ ; Y-2022YMJN/MS-0001//Beijing Xisike Clinical Oncology Research Foundation/ ; }, mesh = {Humans ; *COVID-19/diagnosis/complications/virology ; *Lymphoma, Follicular/complications/virology ; *Bronchoalveolar Lavage Fluid/virology ; High-Throughput Nucleotide Sequencing/methods ; Male ; *SARS-CoV-2/genetics/isolation &amp; purification ; Middle Aged ; Female ; Aged ; Metagenomics/methods ; Pharynx/virology ; }, abstract = {BACKGROUND: Hematologic malignancy patients with B lymphocytopenia after anti-CD20 monoclonal antibody or anti-CD19 chimeric antigen receptor (CAR) T cell therapy often face prolonged SARS-CoV-2 positivity on pharyngeal swabs and persistent or recurrent COVID-19 infection, resulting in high mortality.<br><br>METHODS: Here, we describe three follicular lymphoma (FL) patients with persistent fever, cough, and hypoxemia, but they were ruled out for bacterial, viral, fungal, and other pathogen infections, and the throat swabs were consistently SARS-CoV-2 negative. These FL patients with B lymphocyte deficiency who were diagnosed with COVID-19 infection confirmed by bronchoalveolar lavage fluid (BALF) metagenomics next-generation sequencing (mNGS). Their COVID-19 infection was characterized by differences in viral load in the upper and lower respiratory tracts. When this particular COVID-19 infection occurred, although their percentages and absolute values of CD8[+] T cells and CD4[+] T cells were normal, they all had B lymphocyte deficiency and hypogammaglobulinemia. They all had low expression of interleukin (IL)-6 in peripheral blood inconsistent with clinical infection symptoms.<br><br>RESULTS: The patients received a combination therapy of molnupiravir and methylprednisolone; then their symptoms were relieved over the next 2&#x2009;weeks-2&#x2009;months.<br><br>CONCLUSION: Therefore, for immunocompromised patients, especially those with B lymphocyte deficiency, hypogammaglobulinemia, and low expression of IL-6 in peripheral blood inconsistent with clinical infection symptoms, mNGS for BALF should be performed as soon as possible in this particular condition to confirm the diagnosis of COVID-19 infection.}, }
@article {pmid40976713, year = {2025}, author = {Leon-Icaza, SA and Vergé, R and Mazars, R and Berry, L and Cougoule, C}, title = {Lung organoids as a human system for Mycobacteria infection modeling and drug testing.}, journal = {The FEBS journal}, volume = {}, number = {}, pages = {}, doi = {10.1111/febs.70265}, pmid = {40976713}, issn = {1742-4658}, support = {RF20210502852/1/1/48//Association Gr&#xe9;gory Lemarchal/ ; RF20230503250//Association Gr&#xe9;gory Lemarchal/ ; 101080462//HORIZON EUROPE Health/ ; 21402; AO 2021-2 CSS 11//Agence Nationale de Recherches sur le Sida et les H&#xe9;patites Virales/ ; RF20210502852/1/1/48//Association Vaincre la Mucoviscidose/ ; RF20230503250//Association Vaincre la Mucoviscidose/ ; }, abstract = {Mycobacterial infections remain a global public health challenge. Each year, high rates of morbidity and mortality worldwide are a consequence of chronic respiratory infections due to Mycobacteria. According to the World Health Organization (WHO), in 2023, 10.8 million individuals fell ill with Mycobacterium tuberculosis (Mtb), resulting in an estimated 1.25 million deaths. This positions tuberculosis (TB) as the leading cause of death from a single pathogen worldwide after the coronavirus disease (COVID-19) pandemic. On the other hand, the cases of people affected by nontuberculous mycobacteria (NTM) have risen globally, but the precise incidence and prevalence of both pulmonary and extrapulmonary disease remain unknown. In Europe, nontuberculous mycobacterial pulmonary diseases affect between 0.2 and 2.9 per 100 000 individuals, mainly patients with cystic fibrosis (CF) and non-CF bronchiectasis. The diagnosis and treatment of mycobacterial infections are challenging and complex, frequently requiring long-duration treatments with several antibiotics, which in most cases leads to poor patient outcomes. As the role of immune cells has been extensively assessed, in this Review, we summarize the current knowledge about the contribution of epithelial cells in the early steps of Mycobacteria infections. Additionally, we describe how human lung organoid technology provides new tools to better understand host-Mycobacteria interactions in the airways and test new therapeutic targets.}, }
@article {pmid40976415, year = {2025}, author = {Kang, J and Lee, KR and Choi, IY and Lee, D and Chang, H and Kim, M}, title = {A systematic review of knowledge assessment instruments for isolation precautions among health care personnel.}, journal = {American journal of infection control}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ajic.2025.09.010}, pmid = {40976415}, issn = {1527-3296}, abstract = {BACKGROUND: Health care personnel (HCP) knowledge of isolation precautions (IPs) is essential for preventing health care-associated infections. HCP adherence to IP guidelines remains suboptimal worldwide, often due to knowledge gaps. Post-COVID-19 challenges highlight the need for standardized tools. This study systematically reviews IP knowledge instruments.<br><br>METHODS: Following PRISMA guidelines, 5 databases were searched for studies published between 2007 and 2024. Eligible studies used instruments with more than 10 items covering Centers for Disease Control and Prevention-recommended domains. Instruments were evaluated for content coverage, psychometric properties, and methodological quality.<br><br>RESULTS: Twenty-seven studies met inclusion criteria. All instruments assessed standard precautions, while transmission-based precautions and fundamental elements were under-represented. A total of 608 items were identified, most focusing on personal protective equipment and hand hygiene. Response formats and scoring systems varied widely, with inconsistent benchmarks. Knowledge of transmission-based precautions was consistently lower than standard precautions. Only 14 studies (51.9%) reported both validity and reliability, indicating limited psychometric rigor. Few studies were high quality, though those published after 2020 showed modest improvement.<br><br>CONCLUSIONS: Current HCP IP knowledge instruments show significant variation, incomplete scope, and limited validation. Standardized tools with balanced coverage and stronger psychometric evaluation are needed to support education, enable comparability, and guide interventions in diverse health care settings.}, }
@article {pmid40976013, year = {2025}, author = {Vetrugno, L and D'Ardes, D and Deana, C and Biasucci, DG and Boccatonda, A}, title = {Lung ultrasound and community-acquired pneumonia: from complementary tool to clinical game-changer.}, journal = {Respiratory medicine and research}, volume = {88}, number = {}, pages = {101203}, doi = {10.1016/j.resmer.2025.101203}, pmid = {40976013}, issn = {2590-0412}, mesh = {Humans ; *Community-Acquired Infections/diagnostic imaging ; Ultrasonography/methods ; *Pneumonia/diagnostic imaging ; COVID-19/epidemiology/diagnostic imaging ; *Lung/diagnostic imaging ; SARS-CoV-2 ; Community-Acquired Pneumonia ; }, abstract = {Community-acquired pneumonia (CAP) remains a major global health concern, traditionally diagnosed through chest X-ray (CXR). However, lung ultrasound (LUS) is increasingly emerging as a transformative tool in both diagnosis and management. Evidence from recent meta-analyses reveals that LUS outperforms CXR in sensitivity and rivals it in specificity, with pooled diagnostic accuracies exceeding 90 %. Unlike CXR, LUS is radiation-free, cost-effective, and ideal for bedside use, making it particularly valuable in emergency departments, intensive care units, pediatric and geriatric populations, and resource-limited settings. In children, LUS spares radiation exposure, while in elderly patients, contrast-enhanced ultrasound improves diagnostic specificity. Beyond diagnosis, LUS enables dynamic monitoring, prognostic scoring (e.g., LUS score, CPIS-PLUS), and supports treatment decisions such as ventilator weaning and antibiotic stewardship. Recent applications during the COVID-19 pandemic have demonstrated its effectiveness in triage and outcome prediction. Despite challenges such as operator dependency and reduced penetration for deep lesions, technological advances-particularly artificial intelligence and handheld devices-are mitigating these limitations. Deep learning models now interpret LUS images with high accuracy, enhancing reproducibility and accessibility for general practitioners. In low- and middle-income countries, LUS serves as a crucial diagnostic bridge, improving access and reducing reliance on costly imaging modalities. As training programs and standardized scoring systems evolve, LUS is becoming a frontline tool rather than a supplementary option. Its integration into clinical practice promises to reshape pneumonia care through rapid, accurate, and scalable diagnostics. In light of these advancements, LUS is not just complementary to radiography-it is redefining the diagnostic landscape of pneumonia.}, }
@article {pmid40975587, year = {2025}, author = {Sinha, SS and Bari, S and Tripathi, P and Kant, S and Tripathi, SM}, title = {Neuropsychiatric manifestations of long COVID.}, journal = {The Indian journal of tuberculosis}, volume = {72}, number = {4}, pages = {532-536}, doi = {10.1016/j.ijtb.2025.02.020}, pmid = {40975587}, issn = {0019-5707}, mesh = {Humans ; *COVID-19/psychology/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; *Mental Disorders/etiology ; *Nervous System Diseases/etiology ; }, abstract = {In 2019 after the COVID-19 outbreak, a subset of patients was observed to be experiencing unusual symptoms and prolonged illness following SARS-CoV-2 infection and were labeled as "Long-haulers". Various terms like Long COVID, and Post-COVID-19 Conditions (PCC) were used to describe symptoms extending four weeks or more. Long COVID encompasses a range of persistent symptoms with a multisystemic nature, exhibiting a relapsing-remitting pattern. Various theories explaining Long COVID such as direct neuro-invasion, systemic effects of the virus, and neuroimmune dysregulation have been suggested. Clinical manifestations of Long COVID include diverse symptoms with fatigue, dyspnea, and cognitive impairment being common symptoms reported. Neurological manifestations are more prevalent in severe COVID-19 cases. Non-specific neurological manifestations include loss of taste and smell while specific neurological manifestations include hemiplegia and large artery ischemic stroke. COVID-19 medications may also cause neurological symptoms. Psychiatric manifestations include depression, anxiety, panic disorders, post-traumatic stress disorder (PTSD), psychosis, and cognitive symptoms such as attention and executive function deficits. Psychological symptoms vary among different social groups like frontline health workers, young individuals, and the elderly. Social isolation exerts a substantial impact on the psychological presentations of Long COVID through mechanisms such as Hypothalamic-Pituitary-Adrenal axis (HPA) hyperactivation, epigenetic modifications, increased steroid concentrations, immune system suppression, and reactivation of latent infections. Conclusively, neuroimmune dysregulation, social isolation and associated factors serve as the link between SARS-CoV-2 virus, long COVID and its neuropsychiatric manifestations.}, }
@article {pmid40974857, year = {2025}, author = {Gajecki, D and Kiczak, L and Majda, J and Banasiak, W and Doroszko, A}, title = {Unravelling Thymidine phosphorylase: Mechanisms and multifunctional impact on cardiovascular system - from bench to bedside.}, journal = {Biomedicine &amp; pharmacotherapy = Biomedecine &amp; pharmacotherapie}, volume = {192}, number = {}, pages = {118577}, doi = {10.1016/j.biopha.2025.118577}, pmid = {40974857}, issn = {1950-6007}, mesh = {Humans ; *Thymidine Phosphorylase/metabolism ; Animals ; *Cardiovascular System/enzymology ; *Cardiovascular Diseases/enzymology ; COVID-19/enzymology ; }, abstract = {Thymidine phosphorylase (TYMP) is a multifunctional enzyme responsible for pyrimidine metabolism. Interestingly, its impact extends beyond that function. This review aims at summarising the role of TYMP in different biological processes, with particular attention paid to the cardiovascular system. TYMP regulates platelet activation and, within the vascular wall, promotes cell migration by modulating focal adhesion. Moreover, it affects cellular defence mechanisms activated under oxidative stress, thereby preventing vascular injury. Additionally, by modulating several pivotal signalling cascades, TYMP promotes tumour growth, and exerts anti-apoptotic action. Furthermore, the TYMP activation status correlates with outcomes of pharmacological treatment during chemotherapy with microtubule-interfering agents. TYMP is also expressed in the central nervous system, where it regulates transmembrane proteins essential in maintaining the blood-brain barrier. The thoroughly described pathophysiological basis of TYMP activity corresponds with the pathological mechanisms of numerous disorders. Modulating its actions may serve as an attractive novel therapeutic target in: the COVID-19-associated thrombotic complications, resistance to myocardial infarction-associated cardiomyocyte damage, aneurysm development, atherosclerosis progression, and neurological diseases, including stroke.}, }
@article {pmid40973410, year = {2025}, author = {Mehra, R and Thakur, S}, title = {The structure-based approaches to computing viral fitness.}, journal = {Advances in protein chemistry and structural biology}, volume = {147}, number = {}, pages = {461-498}, doi = {10.1016/bs.apcsb.2024.11.004}, pmid = {40973410}, issn = {1876-1631}, mesh = {Humans ; *SARS-CoV-2/genetics/chemistry ; *Spike Glycoprotein, Coronavirus/chemistry/genetics/metabolism ; Mutation ; Angiotensin-Converting Enzyme 2/chemistry/metabolism/genetics ; }, abstract = {Viral fitness presents a complex challenge that requires a deep understanding of evolution and selection pressures. The swift emergence of mutations in viruses makes them ideal models for studying evolutionary dynamics. Recent advancements in biophysical methods and structural biology have facilitated insights into how these mutations influence evolutionary trajectories at the structural level. Computationally guided structural techniques are particularly valuable for analyzing the mutational landscape across all possible mutations in viral proteins under selection pressure. The virus often interacts via the receptor binding domain (RBD) of its surface protein with the receptor protein of the host cell. This binding is a key step for the viral entry in host cell and infection. In response, the host immune response or vaccines generate antibodies to neutralize the virus particles. This creates a competitive scenario where the viral surface protein competes for binding between host cell receptor and antibodies. The viral mutations supposedly evolve to effectively bind to host receptors while evading the antibody recognition. The differential binding affinity of the viral surface protein, preferably via RBD, between host receptor and antibodies may aid in defining the molecular level viral fitness function. The present chapter explores these dynamics through the lens of severe acute respiratory syndrome coronavirus 2 spike protein, binding to human angiotensin-converting enzyme 2 and circulating antibodies. Interestingly, this strategy utilized the wealth of protein structural data from cryo-electron microscopy and biochemical data on mutations.}, }
@article {pmid40972736, year = {2025}, author = {Kumar, R and Maji, S and Tiwari, S and Misra, J and Gupta, J and Kumar, N and Gupta, R and Jha, NK}, title = {Precision vaccine design targeting the prefusion state of viral glycoproteins: advances in structural vaccinology.}, journal = {Biochemical pharmacology}, volume = {242}, number = {Pt 2}, pages = {117349}, doi = {10.1016/j.bcp.2025.117349}, pmid = {40972736}, issn = {1873-2968}, mesh = {Humans ; *Vaccinology/methods/trends ; SARS-CoV-2/immunology ; *Glycoproteins/immunology/chemistry ; COVID-19/prevention &amp; control/immunology ; *Viral Vaccines/immunology/chemistry ; *Vaccine Development/methods ; *COVID-19 Vaccines/immunology/chemistry ; Animals ; Protein Conformation ; *Viral Proteins/immunology/chemistry ; *Precision Medicine/methods/trends ; Drug Design ; }, abstract = {The prefusion conformation of viral glycoproteins is a key target for vaccine development because it can induce strong neutralizing antibody responses. Nevertheless, these structures are frequently metastable and susceptible to conformational alterations that diminish immunogenic efficacy. Progress in structural vaccinology has facilitated the meticulous design of viral proteins to maintain their prefusion conformation, thus improving vaccination effectiveness. This study emphasizes essential methodologies in precision vaccine design focused on preserving the structural integrity, solubility, and immunogenicity of viral glycoproteins. Methods include cavity-filling mutations, proline insertions, and disulfide bond engineering have demonstrated efficacy in enhancing structural stiffness and inhibiting unwanted post-fusion rearrangements. Hydrophobic surface residues are frequently substituted with polar or charged residues to boost solubility and minimize aggregation, while the development of salt bridges and helix-stabilizing substitutions further augment heat stability. The removal of proteolytic cleavage sites and the enhancement of hydrophobic core packing facilitate sustained conformational integrity. Alterations to the fusion peptide, an essential conserved area for viral entry, can inhibit early conformational changes, whereas charge-balancing alterations mitigate electrostatic stress. Glycan shielding conceals non-neutralizing or immunodominant epitopes, steering immune reactions towards conserved, protective areas. Collectively, these structure-guided interventions constitute a thorough molecular toolset, facilitating the creation of prefusion-stabilized immunogens for advanced vaccines. Successfully implemented in vaccine candidates for Respiratory Syncytial Virus (RSV), Human Immunodeficiency Virus (HIV), and Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), these methodologies establish a solid basis for the swift and logical generation of vaccines against emerging viral threats.}, }
@article {pmid40971749, year = {2025}, author = {Juan Ribelles, A and Felix, A and Benavent, N and Escrivá-Fernández, J and Brahmi, M and Gaspar, N and Gatz, SA and Grünewald, TG and Linder-Stragliotto, C and Palmerini, E and Pantziarka, P and Strauss, S and Surdez, D and Berlanga, P and McCabe, MG}, title = {Recurrent and Refractory Ewing Sarcoma Phase I/II Trials: Current Perspective From the Euro-Ewing Consortium.}, journal = {JCO precision oncology}, volume = {9}, number = {}, pages = {e2500377}, doi = {10.1200/PO-25-00377}, pmid = {40971749}, issn = {2473-4284}, mesh = {Humans ; *Sarcoma, Ewing/therapy ; Clinical Trials, Phase I as Topic ; Clinical Trials, Phase II as Topic ; *Bone Neoplasms/therapy ; *Neoplasm Recurrence, Local/therapy ; Europe ; Immunotherapy ; }, abstract = {PURPOSE: Updated analysis of phase I/II trials in recurrent/refractory (R/R) Ewing sarcoma (EwS) over the past 11 years.<br><br>METHODS: A systematic review was performed to identify phase I/II trials for R/R EwS in three databases (WHO, US National Library of Medicine, and European Clinical Trials Database) and/or published in PubMed/ASCO/European Society for Medical Oncology websites from 2014 to 2024. The search criteria included EwS OR bone sarcoma OR sarcoma AND Phase-I OR Phase-II. Eligibility and data extraction were performed independently by three reviewers, with priority given to trials with EwS specified data. Trials were categorized by therapeutic intervention, including targeted therapies, immunotherapy, chemotherapy, and combined therapies.<br><br>RESULTS: One hundred eight trials met inclusion criteria, predominantly academic (70%) and multicenter (81.5%), with significant US and European collaboration. Trial designs were mainly single-arm, with an increase in multiarm trials in the recent years and increased focus on the pediatric population. Trial modalities emphasized targeted therapies with tyrosine kinase, poly-ADP ribose polymerase, EWSR1::FLI1, and cell cycle inhibitors. Immunotherapy with monoclonal antibodies and CAR-T cells as primary agents is also under investigation. The COVID-19 pandemic coincided with a marked reduction in trial initiation in 2020. Among evaluable data, disease control rates averaged 44% and response rates 8%.<br><br>CONCLUSION: This review highlights evolving therapeutic directions in R/R EwS, with increased emphasis on targeted therapies and immunotherapies. Despite pandemic-related delays, trials have progressed in exploring novel targets, including EWSR1::FLI1 oncogenic fusion and DNA repair pathways. These findings underscore ongoing global efforts to address critical unmet needs in EwS treatment, offering a foundation for future trial designs, especially international, randomized phase-II trials across all age ranges.}, }
@article {pmid40971535, year = {2025}, author = {Maeda, T and Komine, G and Noda, R and Komatsu, M and Sakai, M and Takeyama, Y and Soejima, S and Maruyama, A and Akahoshi, M and Koarada, S and Tada, Y}, title = {Adult-onset Still's disease following COVID-19: a case report and literature review.}, journal = {Modern rheumatology case reports}, volume = {9}, number = {2}, pages = {}, doi = {10.1093/mrcr/rxaf059}, pmid = {40971535}, issn = {2472-5625}, mesh = {Humans ; *Still's Disease, Adult-Onset/drug therapy/etiology/diagnosis ; *COVID-19/complications ; Middle Aged ; Male ; SARS-CoV-2 ; Female ; Methotrexate/therapeutic use ; Glucocorticoids/therapeutic use ; Adult ; Immunosuppressive Agents/therapeutic use ; Ferritins/blood ; }, abstract = {A 59-year-old man developed adult-onset Still's disease 11 days after contracting COVID-19. He presented with high fever, polyarthritis, erythema, sore throat, and high levels of C-reactive protein and ferritin; treatment with glucocorticoids and methotrexate led to disease remission. We reviewed the clinical characteristics of 12 cases (11 from the literature and the present case) of adult-onset Still's disease following COVID-19. Eight cases involved females, with a median age of 54 years (19-59 years), and the median time from COVID-19 to Still's disease onset was 12.5 days. Frequencies of high fever, arthralgia, typical skin lesion, sore throat, liver damage, and increased neutrophil count did not differ from cases of non-COVID-related adult-onset Still's disease. Serum ferritin levels were increased in all cases (median 6354 ng/ml). Complications were infrequent, with macrophage activation syndrome reported in one case. Immunosuppressive drugs and biologic agents were used in five and three cases, respectively, and all cases had good outcomes. Our review suggests that adult-onset Still's disease develops early after COVID-19, presenting with clinical findings similar to non-COVID-19-related cases, and has few severe complications and a good prognosis.}, }
@article {pmid40971252, year = {2025}, author = {Shahiwala, A}, title = {Integrating the design thinking approach into pharmaceutical product development: emphasizing nanomedicine innovation.}, journal = {Drug development and industrial pharmacy}, volume = {51}, number = {12}, pages = {1662-1672}, doi = {10.1080/03639045.2025.2563633}, pmid = {40971252}, issn = {1520-5762}, mesh = {Humans ; *Nanomedicine/methods/trends ; *Drug Development/methods ; *Drug Design ; }, abstract = {OBJECTIVE: To perform a narrative review that critically examines the application of design thinking (DT) in pharmaceutical product development, with emphasis on its role in advancing nanomedicine innovation and patient-centric drug design.<br><br>SIGNIFICANCE OF REVIEW: DT offers a human-centered, iterative alternative to the traditional linear R&amp;D model. Its integration into pharmaceutical development addresses challenges such as high attrition rates, limited patient input, regulatory complexity, and scalability, thereby improving translational success. This review adopts a conceptual and narrative approach, analyzing the five stages of DT, Empathize, Define, Ideate, Prototype, and Test, within the context of pharmaceutical development.<br><br>KEY FINDINGS: The application of DT fosters tangible benefits in pharmaceutical innovation, including empathy-driven product design, targeted problem framing, and iterative prototyping aligned with user and regulatory needs. Case studies such as Doxil[&#xae;], ABRAXANE[&#xae;], and mRNA-based COVID-19 vaccines illustrate established successes, while emerging examples, including CRISPR-based therapeutics and extracellular vesicle (EV) nanocarriers, underscore the forward-looking potential of this methodology. Together, these examples highlight how DT accelerates development timelines, mitigates risk, and enhances patient and regulatory alignment.<br><br>CONCLUSIONS: Integrating DT into pharmaceutical product development enhances innovation by fostering interdisciplinary collaboration, reducing costs, and increasing the likelihood of successful translation to market. Its strategic application in nanomedicine provides a transformative pathway for next-generation therapies that are safer, more effective, and aligned with patient expectations and evolving regulatory frameworks.}, }
@article {pmid40970676, year = {2025}, author = {Reilly, JJ and Glendenning, L and Govan, L}, title = {Impact of the COVID-19 pandemic on motor competence in children and adolescents: A systematic review.}, journal = {Journal of sports sciences}, volume = {}, number = {}, pages = {1-12}, doi = {10.1080/02640414.2025.2555122}, pmid = {40970676}, issn = {1466-447X}, abstract = {This systematic review aimed to investigate COVID-19 impacts on motor competence (MC) in children and adolescents. SportDiscus, APAPsycInfo, CINAHL, Scopus, PubMed, Web of Science, Medline were searched in November 2024. Studies were included if they were in English; from 2015; measured actual MC pre and post COVID-19; in apparently healthy 3- to 19-year olds. Risk of bias assessment used the Effective Public Health Practice Project instrument. Eligible studies were synthesised narratively due to heterogeneity, and with Vote Counting to assess pre-post COVID-19 trend. Of the 568 studies, 278,536 participants, mean ages 5-11 years, took part in 11 eligible studies (4 longitudinal, 7 cross sectional): from Europe (7), Asia (2) and South America (2). Ten studies found a reduction in MC following the pandemic (Sign Test p = 0.01) with declines in: stability (one study, effect size, ES -0.30), locomotor domain (6 studies, ES -0.10 to -0.53), object control (3 studies, ES -0.07 to -0.25), composite MC (one study ES -0.65 in boys to -0.88 in girls). Seven studies were rated weak for selection bias, 8 for attrition and 6 for data collection methods. MC declined post-pandemic but there is a need for more global evidence. Funding: Scottish Funding Council. PROSPERO CRD42023467766.}, }
@article {pmid40970030, year = {2025}, author = {Hughes, B and Mirza, S and Ponamala, M and Sagaser, J and Paredes, R and Hematillake, N and Tailor, C and Khan, R and Pemminati, S}, title = {Exploring the Therapeutic Potential of Ketamine and Psilocybin in Comparison to Current Treatment Regimens for Treatment-Resistant Depression, Mood Disorders, and Post-traumatic Stress Disorder in the Pediatric Population: A Narrative Review.}, journal = {Cureus}, volume = {17}, number = {8}, pages = {e90425}, pmid = {40970030}, issn = {2168-8184}, abstract = {The stresses of the Coronavirus Disease of 2019 (COVID-19) pandemic highlighted the burden of psychiatric disorders within the pediatric population, revealing a pre-existing need for rapid-onset therapies that have since driven efforts to expand effective therapeutic interventions. In this narrative review, we utilized the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines to direct our report and study selection. We explored the current-state efficacy and therapeutic potential of ketamine and psilocybin in comparison to current treatment regimens for pediatric non-psychotic disorders, including Treatment-Resistant Depression (TRD), mood disorders like anxiety and bipolar disorder, and Post-Traumatic Stress Disorder (PTSD). We chose these pediatric disorders to eliminate concerns regarding reality orientation and the use of dissociative and/or psychedelic medicines in patients who are experiencing symptoms of psychosis. Also, we briefly discuss ketamine's more widely accepted utilization by medical providers as a pediatric anesthetic, and how this gives credence to further evaluation of ketamine's multifaceted indications in pediatric psychiatry. Recent studies have shed light on the involvement of glutamate pathways in the pathophysiology of TRD, mood disorders, and PTSD, and both ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, and psilocybin, a 5-hydroxytryptamine receptor 2A (5-HT2A) agonist, have emerged as promising options due to their ability to augment glutamate release. Ketamine's use for pediatric TRD demonstrated rapid-onset relief for signs and symptoms of depression in children and adolescents, and psilocybin also decreased symptoms in patients with longstanding or refractory depression. Ketamine has been well tolerated and exhibited symptom improvements for youth with mood disorders such as anxiety and bipolar depression, while psilocybin showed promise in fostering emotional processing. In youth suffering from PTSD, ketamine-assisted psychotherapy (KAP) brought about decreases in PTSD symptom severity, though outcomes varied across populations. Psilocybin enhanced neural plasticity, allowing patients to revisit and reframe memories under therapeutic guidance, especially for those with complex or treatment-resistant PTSD. Ethical considerations are involved in the use of dissociative and hallucinogenic therapies like ketamine and psilocybin in the pediatric population, and we explore some ethical issues regarding their use. Further research exploring specific brain locations and mechanisms of action underlying glutamate modulation by ketamine and psilocybin, and the subsequent rapid-acting relief of psychiatric symptoms offered by these substances, could pave the way for innovative treatments targeting pediatric mental health disorders.}, }
@article {pmid40969915, year = {2025}, author = {Yuri, E and Chung, HY and Chen, FS}, title = {Reframing SpO2 tolerance as a physiological switch: implications for hypoxic adaptation and exercise regulation.}, journal = {Frontiers in physiology}, volume = {16}, number = {}, pages = {1667238}, pmid = {40969915}, issn = {1664-042X}, abstract = {Blood oxygen saturation (SpO2) is a widely used oxygenation index in clinical and physiological settings. However, recent phenomena, such as asymptomatic hypoxia in COVID-19 and the superior performance of athletes in high-altitude conditions under hypoxia, have highlighted the significant variability in individual tolerance to blood oxygen saturation. Age, health status, disease, and hypoxic adaptation influence it. This brief review introduces the concept of the SpO2 switch as a dynamic. We also proposed a physiological compensatory response of SpO2 switch to SpO2 criticality that triggers compensatory responses, including ventilatory, autonomic, cardiovascular, and metabolic adaptations. Furthermore, individuals can exhibit markedly different responses to hypoxia at the same SpO2 value. It reflects a "threshold switch mechanism" driven by an individual's internal physiological settings. This suggests that the SpO2 value demonstrates the onset of hypoxia symptoms and reacts to the body's difference in compensatory capacity. This reconceptualisation shifts the focus from static thresholds to dynamic response analysis, offering new perspectives for precision health, mountain medicine, and personalised risk assessment of hypoxia.}, }
@article {pmid40969755, year = {2025}, author = {Gupta, S and Hemeg, HA and Afrin, F}, title = {Immuno-epigenetic paradigms in coronavirus infection.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1596135}, pmid = {40969755}, issn = {1664-3224}, mesh = {Humans ; *Epigenesis, Genetic/immunology ; *SARS-CoV-2/immunology/physiology/genetics ; *COVID-19/immunology/genetics/virology ; Host-Pathogen Interactions/immunology/genetics ; Animals ; Virus Replication ; }, abstract = {Coronavirus Disease 2019 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a novel member of the Coronaviridae family. The viral genome encodes both structural proteins, such as spike, membrane, hemagglutinin, and envelope, as well as non-structural proteins that include auxiliary proteins and replicase essential for viral replication. While immunization campaigns have mitigated the spread of the virus, therapeutic interventions remain critical for managing outbreaks and preventing long-term health consequences. Despite extensive global research into the genome, structure, entry process, and replication mechanisms of SARS-CoV-2, key aspects such as the roles of membrane lipids in viral entry, packaging, and release, as well as the metabolic alterations in infected cells, remain poorly understood. Epigenetics, the study of heritable phenotypic changes driven by genetic and non-genetic factors, plays a pivotal role in shaping host responses to SARS-CoV-2 infection. Epigenetic modifications, such as histone methylation and acetylation, DNA and RNA methylation, chromatin remodeling, and non-coding RNA regulation, significantly influence gene expression in infected host cells. These reversible changes orchestrate the host's antiviral responses and potentially alter susceptibility to COVID-19. This review delves into the immuno-epigenetic modifications occurring in hosts infected with SARS-CoV-2, providing insights into how these changes trigger viral replication and infection processes. By examining the current state of research on the immune-epigenetic landscape of SARS-CoV-2 infections, we highlight the mechanisms by which these modifications affect the host-viral interplay. Furthermore, we propose potential therapeutic targets within the immune-epigenetic pathways that could enhance ongoing efforts to combat COVID-19. Understanding these mechanisms will not only provide a deeper perspective on the virus's pathogenic strategies but also offer innovative approaches to improve therapeutic interventions. By addressing the gaps in knowledge surrounding immune-epigenetic factors, this review aims to contribute to the development of novel strategies for preventing and managing coronavirus infections and its variants.}, }
@article {pmid40969583, year = {2025}, author = {Astete-Cornejo, J and Burgos-Flores, MA and Cruz-Ausejo, L and Cainamarks-Alejandro, JA and Ambrosio-Melgarejo, JI and Rosales-Rimache, J}, title = {Implementation of occupational safety and health services and telehealth in Peru: a narrative review.}, journal = {Revista brasileira de medicina do trabalho : publicacao oficial da Associacao Nacional de Medicina do Trabalho-ANAMT}, volume = {23}, number = {2}, pages = {e20251405}, pmid = {40969583}, issn = {1679-4435}, abstract = {Although occupational health aims to protect the well-being of workers, challenges persist in workplaces, such as the provision of occupational safety and health services and the availability of occupational telehealth. This study's objective was to examine the implementation of occupational safety and health services and telehealth in Peru. A review was conducted of technical documents and regulations related to occupational safety and health services and occupational telehealth applicable to the Peruvian context. Forty percent of Peruvian workplaces lack occupational safety and health services, reflecting a similar issue across Latin America and Europe. Barriers such as corporate commitment and financing were identified. Occupational telehealth was utilized during the COVID-19 pandemic, highlighting its potential to strengthen occupational safety and health services. The lack of occupational safety and health services and occupational telehealth can be overcome through regulatory support, enforcement, and incentives for employers.}, }
@article {pmid40968958, year = {2025}, author = {Muddaloor, P and Baraskar, B and Shah, H and Gopalakrishnan, K and Sood, D and Pasupuleti, PC and Singh, A and Mitra, D and Hoskote, SS and Iyer, VN and Helgeson, SA and Arunachalam, SP}, title = {The Human Voice as a Digital Health Solution Leveraging Artificial Intelligence.}, journal = {Sensors (Basel, Switzerland)}, volume = {25}, number = {11}, pages = {}, pmid = {40968958}, issn = {1424-8220}, mesh = {Humans ; *Artificial Intelligence ; *Voice/physiology ; COVID-19/diagnosis ; Machine Learning ; Neural Networks, Computer ; SARS-CoV-2 ; Digital Health ; }, abstract = {The human voice is an important medium of communication and expression of feelings or thoughts. Disruption in the regulatory systems of the human voice can be analyzed and used as a diagnostic tool, labeling voice as a potential "biomarker". Conversational artificial intelligence is at the core of voice-powered technologies, enabling intelligent interactions between machines. Due to its richness and availability, voice can be leveraged for predictive analytics and enhanced healthcare insights. Utilizing this idea, we reviewed artificial intelligence (AI) models that have executed vocal analysis and their outcomes. Recordings undergo extraction of useful vocal features to be analyzed by neural networks and machine learning models. Studies reveal machine learning models to be superior to spectral analysis in dynamically combining the huge amount of data of vocal features. Clinical applications of a vocal biomarker exist in neurological diseases such as Parkinson's, Alzheimer's, psychological disorders, DM, CHF, CAD, aspiration, GERD, and pulmonary diseases, including COVID-19. The primary ethical challenge when incorporating voice as a diagnostic tool is that of privacy and security. To eliminate this, encryption methods exist to convert patient-identifiable vocal data into a more secure, private nature. Advancements in AI have expanded the capabilities and future potential of voice as a digital health solution.}, }
@article {pmid40968401, year = {2025}, author = {Reinhardt, J and Linde, K and Kersting, A}, title = {Prevalence of posttraumatic stress symptoms among physicians - A meta-analysis.}, journal = {European psychiatry : the journal of the Association of European Psychiatrists}, volume = {68}, number = {1}, pages = {e132}, pmid = {40968401}, issn = {1778-3585}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Occupational Stress/epidemiology ; *Physicians/psychology/statistics &amp; numerical data ; Prevalence ; *Stress Disorders, Post-Traumatic/epidemiology ; }, abstract = {BACKGROUND: The medical profession is associated with high demands and occupational stressors - including confrontation with illness and death, extended work hours, and high workload - which may increase the risk of traumatization and posttraumatic stress disorder (PTSD). This systematic review aimed to synthesize evidence on prevalence of PTSD among physicians and examine potential moderators, including the COVID-19 pandemic, specialties, and geographic regions.<br><br>METHODS: A systematic search was conducted in PubMed, Web of Science, PsychINFO, and PubPsych up to April 2025. Included studies were English-language, peer-reviewed, observational studies, reporting PTSD prevalence in physicians, using validated instruments. Studies focusing on preselected PTSD cases or mixed healthcare samples were excluded. Data extraction included study methodology, measurement tools, geographic region, specialty, and survey timing (pre-/"post"-COVID). Risk of bias was assessed using the JBI critical appraisal checklist for prevalence studies. Quantitative synthesis and moderator analyses were performed. The review was registered with PROSPERO (ID CRD42023401984).<br><br>RESULTS: Based on 81 studies (N&#xa0;=&#xa0;41,051), the pooled PTSD prevalence using a random-effects model was 14.9% (95% CI [0.132-0.168]). Prevalence estimates were lower in high-income (13.6%) compared to middle-income countries (21.1%) (p&#xa0;<&#xa0;0.036). Studies employing brief screening tools (&#x2264;10 items) yielded significantly lower prevalence estimates (10.2%) than those using longer instruments (16.4%) (p&#xa0;<&#xa0;0.027). No other significant moderators were identified.<br><br>CONCLUSION: PTSD prevalence among physicians is elevated relative to the general population, with notable variation across regions and measurement approaches. Future research should address gaps in representativeness and geographic coverage to improve prevalence estimates and guide prevention strategies.}, }
@article {pmid40967971, year = {2025}, author = {Odoom, A and Obeng, EM and Dzuvor, CKO}, title = {Multivalent decoy receptor therapeutics to combat viral pandemics and evolution.}, journal = {Trends in pharmacological sciences}, volume = {46}, number = {10}, pages = {935-939}, doi = {10.1016/j.tips.2025.08.010}, pmid = {40967971}, issn = {1873-3735}, mesh = {Humans ; Pandemics/prevention &amp; control ; Animals ; *Antiviral Agents/therapeutic use/pharmacology ; SARS-CoV-2 ; *Virus Diseases/drug therapy ; }, abstract = {Viruses are likely to cause future pandemics due to their inherent ability to evolve and spread rapidly, with limited treatment options. Engineered multivalent decoy receptors (EMDRs) offer a broad-spectrum alternative treatment option. We propose and evaluate EMDRs and their delivery methods to guide future efforts toward pandemic preparedness.}, }
@article {pmid40967275, year = {2026}, author = {Renard, M and Bell, Z and Jamshidvand, M and Mai, Z and McCloat, A and Mooney, E and Hollywood, L and Lavelle, F}, title = {Domestic cooking and food behaviours during the COVID-19 pandemic and the cost-of-living crisis: A scoping review.}, journal = {Appetite}, volume = {216}, number = {}, pages = {108311}, doi = {10.1016/j.appet.2025.108311}, pmid = {40967275}, issn = {1095-8304}, mesh = {Humans ; *COVID-19/economics/epidemiology ; *Cooking/economics ; SARS-CoV-2 ; Pandemics ; Family Characteristics ; *Feeding Behavior ; Consumer Behavior ; United Kingdom ; }, abstract = {This scoping review examined how the COVID-19 pandemic and cost-of-living crisis have influenced domestic cooking and food-related behaviours. Following PRISMA-ScR, a systematic search across five databases and grey literature sources identified 4955 records. After screening, 98 studies published between 2020 and 2024 were included. Most studies were conducted in the UK (22.4 %) and USA (18.4 %) and employed cross-sectional (94.9 %) and quantitative (73.5 %) methods. The review identified widespread increases in home cooking, with 50-78 % of participants reporting greater cooking frequency. Changes in food shopping were also prominent, including reduced in-person visits (reported by 40-74 % of participants) and increased online grocery use (25-61.8 %). Budgeting behaviours adapted to financial constraints, with many households reducing the quality and quantity of food purchased, substituting fresh with shelf-stable options. Improvements in hand hygiene were widely reported (74-90 %); however, unsafe practices such as consuming expired foods or mishandling leftovers, remained common. Only 4.1 % of studies received a positive quality rating, with frequent use of non-validated tools and self-reported measures. Future research should employ longitudinal designs to assess the sustainability of these behaviours. Structural policy actions are needed to ensure access to affordable, nutritious foods and support sustainable food practices during ongoing economic challenges.}, }
@article {pmid40966832, year = {2025}, author = {Gochicoa-Rangel, L and Torre-Bouscoulet, L and Salles Rojas, A and Guzmán-Valderrábano, C and Esperanza Benítez-Pérez, R and Salas Escamilla, I and Monráz-Pérez, S and Manuel Grosso-Espinosa, J and , }, title = {Functional respiratory evaluation in the coronavirus disease-19 era: The role of pulmonary function test laboratories.}, journal = {Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion}, volume = {77}, number = {4}, pages = {100011}, doi = {10.24875/RIC.20000250}, pmid = {40966832}, issn = {0034-8376}, mesh = {Humans ; *COVID-19/physiopathology ; *Respiratory Function Tests/standards/methods ; *Laboratories/standards ; Adult ; Quality Control ; Child ; }, abstract = {The pandemic character of coronavirus disease-19 (COVID-19) requires strategy changes designed to guarantee the safety of patients and health-care professionals. We are greatly concerned by the limitations in the operation of pulmonary function test (PFT) laboratories, since there is a high risk of disease progression in patients with chronic pulmonary diseases, and we are now faced by the influx of a new group of individuals in the recovery phase of post-COVID-19-syndrome that requires evaluation and follow-up of their respiratory function. To reestablish the operation of PFT laboratories limiting the risk of cross-contamination, we herein present the consensus reached by a group of experts in respiratory physiology, most of whom work in PFT laboratories in several Latin-American countries, on the applicable recommendations for severe acute respiratory syndrome coronavirus 2 pneumonia survivors when undergoing PFT. We present the safety and hygiene measures that must be adopted in laboratories or centers where PFT is conducted in adults and/or children. These recommendations answer the following questions: which PFT is most recommended in subjects that have recovered from COVID-19; what quality control and safety measures should PFT laboratories implement during this pandemic? And how should we approach non-COVID-19 patients requiring PFT?}, }
@article {pmid40966450, year = {2025}, author = {Bell, M and Krasnodembskaya, AD}, title = {Distal lung organoids derived from adult stem cells as novel tools in deciphering mechanisms of lung regeneration, infection, and cancer.}, journal = {Stem cells translational medicine}, volume = {14}, number = {9}, pages = {}, pmid = {40966450}, issn = {2157-6580}, mesh = {*Organoids/cytology/physiology/pathology ; Humans ; *Regeneration ; *Lung/physiology/pathology/cytology ; COVID-19/pathology ; *Adult Stem Cells/cytology ; SARS-CoV-2 ; *Lung Neoplasms/pathology ; Animals ; }, abstract = {While lung research has made great strides in understanding lung physiology, lung pathology still presents a major burden to patients and healthcare systems globally. To develop new effective therapeutics to improve lung regeneration, prevent spread of infections, or treat lung cancers, obscured fundamental processes of the lung must be dissected. Current understanding of lung cell cross talk has been limited due to a lack of accessible and representative models. Since the COVID-19 pandemic, many new foundational methodologies for distal organoid formation have been published, which eliminate difficulty in distal organoid longevity and donor cell extraction efficiency. This review describes how recent advances within distal lung organoid technology have been used to investigate lung regeneration, fibrosis, infection trafficking, personalized medicine, and mechanism of chronic lung pathology using donor cells. Additionally, the applicability of distal lung organoids to investigation of the roles of endothelium and previously unknown distal epithelial and mesenchymal cell populations is discussed. Finally, new techniques and methods for tackling current challenges within the field, such as integration of immune cells and vascularization of organoids are highlighted. This overview will therefore illustrate the potential of distal lung organoids to be tissue representative models, which will be crucial for evolving scientific knowledge of lung physiology.}, }
@article {pmid40966381, year = {2025}, author = {Espitia Angel, JM and Agudelo-Pérez, S and Olarte Bermúdez, LM and Chaparro Rojas, DDP and Bonilla Herrera, SD and Gómez Merchán, M}, title = {Characterization of Omics Components in Human Milk: A Systematic Review.}, journal = {Journal of mother and child}, volume = {29}, number = {1}, pages = {126-142}, pmid = {40966381}, issn = {2719-535X}, mesh = {Humans ; *Milk, Human/chemistry/metabolism ; Female ; Infant, Newborn ; Metabolomics ; Lactation/metabolism ; Proteomics ; Glycomics ; Metabolome ; COVID-19 ; Lipidomics ; }, abstract = {BACKGROUND/AIMS: The proteome, lipidome, glycome, and metabolome of human milk are critical for newborn nutrition and health, and offer personalised, non-pharmacological interventions. This systematic review aims to characterise the omics components of human milk according to maternal health and lactation phases, summarising current knowledge based on high-resolution analytical techniques.<br><br>METHODS: We conducted a systematic review according to the PRISMA 2020 guidelines. The search was performed between August and September 2022 using Medline, EMBASE, Scopus, LILACS, and Web of Science. Observational studies that analysed human milk at any lactation stage using mass spectrometry or nuclear magnetic resonance to characterise nutrients, biomolecules, or bioactive compounds were included. In total, 55 full-text articles were included in this study.<br><br>RESULTS: Glycomics is the most frequently studied omics, followed by proteomics, metabolomics, and lipidomics. Analyses revealed that maternal comorbidities and lactation phases influence the composition of human milk. Fucosylated HMOs showed a protective role against infectious diseases, while elevated levels of protease inhibitors were found in milk from allergic mothers and elevated immunoglobulins were present in milk from mothers with COVID-19. Endocannabinoid profile is associated with improved neonatal sucking ability, while fatty acid-derived metabolites are correlated with infant growth. Distinct omics patterns have also been identified in mothers with diabetes, hypothyroidism, and obesity.<br><br>CONCLUSION: Understanding the omics profile of human milk can guide precise nutrition and improve human milk substitutes. Further research integrating omics data with maternal and infant outcomes will be essential to advance knowledge and support infant health.}, }
@article {pmid40965740, year = {2025}, author = {Alhasan, MS and Alhasan, AS}, title = {Technical requirements and optimization strategies for home-based teleradiology workstations: a review article.}, journal = {Insights into imaging}, volume = {16}, number = {1}, pages = {198}, pmid = {40965740}, issn = {1869-4101}, abstract = {Teleradiology has advanced from an occasional modality to a cornerstone of modern radiology practice, with the COVID-19 pandemic catalyzing widespread adoption of home-based reading environments. This review synthesizes current literature and expert recommendations on hardware and software optimization for effective home-based teleradiology implementation. Available data indicate 65% of institutions established home workstations during the pandemic, with 74% transitioning routine daytime shifts to internal teleradiology. We reviewed key components of successful remote reading environments, including diagnostic display specifications, environmental controls, ergonomic considerations, computational infrastructure, and network architecture. Evidence suggests that properly configured remote workstations maintain diagnostic performance equivalent to hospital reading rooms while enhancing radiologist satisfaction and productivity. We found that 65% of radiologists reported reduced stress levels when working from home, and 96% observed similar or improved report turnaround times. Essential technical specifications include display luminance standards, ambient lighting levels between 25 and 75 lux, acoustic conditions below 40 decibels, and temperature control within 20-24 °C. Computational requirements include a minimum sustained bandwidth of 50-100 Mbps. We review multi-layered security architectures and workflow integration strategies supporting distributed reading environments. Our review concludes that properly implemented home-based teleradiology is a viable practice model extending specialized expertise across geographic boundaries while promoting radiologist well-being. However, knowledge gaps remain in technical standardization, regulatory harmonization, and long-term clinical outcomes, underscoring the need for further research to support confident, data-driven teleradiology implementation. CRITICAL RELEVANCE STATEMENT: This review critically evaluates the technical, ergonomic, and operational requirements for home-based teleradiology, offering evidence-based recommendations that address current practice gaps and support the development of sustainable, high-performance remote reading environments in modern clinical radiology. KEY POINTS: Home teleradiology maintains diagnostic quality while improving radiologist well-being; 65% report reduced stress and 96% show similar or improved report turnaround times. Optimal implementation requires medical-grade displays, a controlled environment (25-75 lux lighting), 50-100 Mbps bandwidth, and robust security measures. Standardization varies across jurisdictions; some countries have protocols, but gaps persist in cross-border teleradiology and long-term outcomes assessment.}, }
@article {pmid40964609, year = {2025}, author = {Ibarz Pavon, AB and Clemens, J and Craviotto, A and Crump, JA and Garrett, DO and Gordon, MA and John, J and Keddy, KH and Laurens, MB and Liu, X and Marks, F and Pollard, AJ and Saha, S and Wilder-Smith, A}, title = {WHO preferred product characteristics for bivalent Salmonella Typhi/Paratyphi A vaccine for comprehensive protection against enteric fever- key considerations and research gaps.}, journal = {Gates open research}, volume = {9}, number = {}, pages = {71}, pmid = {40964609}, issn = {2572-4754}, mesh = {Humans ; *Typhoid Fever/prevention &amp; control/epidemiology ; *Typhoid-Paratyphoid Vaccines/immunology ; *Paratyphoid Fever/prevention &amp; control/epidemiology ; *Salmonella paratyphi A/immunology ; *Salmonella typhi/immunology ; World Health Organization ; Child, Preschool ; Evidence Gaps ; }, abstract = {In 2021, Salmonella Paratyphi A caused >2 million illnesses, resulting in >14,000 deaths, most of which occurred among children under 5 years of age in socioeconomically deprived populations. Both typhoid fever and paratyphoid fever occur in such areas, but paratyphoid fever is currently concentrated in South Asia. Typhoid conjugate vaccines are recommended for the control of enteric fever in typhoid-endemic settings; however, there are increasing demands for the development of vaccines that can address enteric fever more broadly by including protection against paratyphoid fever. The WHO preferred product characteristics (PPC) and a research and development (R&amp;D) technology roadmap are normative documents developed with the guidance and contribution of a multidisciplinary expert group following a standard methodological framework. In this paper, we summarize the PPC and R&amp;D roadmap presenting the key attributes for a bivalent Salmonella enterica serovar Typhi and Paratyphi A vaccine, and discuss the identified key research and data gaps needed to optimize vaccine value and to inform public health and policy decisions, with a particular focus in paratyphoid and enteric fever endemic countries.}, }
@article {pmid40964194, year = {2025}, author = {Fetriani, U and Zakiawati, D}, title = {Viral Triggers Exposed: A Systematic Review of Virus-Induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.}, journal = {Journal of inflammation research}, volume = {18}, number = {}, pages = {12575-12588}, pmid = {40964194}, issn = {1178-7031}, abstract = {AIM: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe skin conditions characterized by widespread epidermal necrolysis and mucous membrane involvement. SJS affects less than 10% of the body surface area, while TEN involves over 30%, with cases between 10% and 30% classified as SJS/TEN overlap. Drug hypersensitivity reactions, especially to antibiotics, anticonvulsants, and non-steroidal anti-inflammatory medications, are the most common and well-established causes of SJS/TEN. In addition, infections, including viral ones like herpes simplex virus (HSV), influenza virus, varicella-zoster virus, and human immunodeficiency virus (HIV), have also been implicated as potential inducers, complicating management and requiring careful clinical vigilance.<br><br>PURPOSE: This review aims to investigate and compile information on reported cases of SJS/TEN potentially linked to virus infections.<br><br>METHODS: Literature from PubMed, NCBI, ScienceDirect, and Cochrane Library databases was searched. The inclusion criteria were studies reporting details of patients diagnosed with SJS, TEN, or SJS/TEN overlap, potentially induced by viral infections. Cases were included if the viral infection occurred within one week before the rash onset, emphasizing the association between these infections and severe skin reactions.<br><br>RESULTS: Ten studies were included in this systematic review, most of which demonstrated fair to good methodological quality. The review encompassed cases of virus-induced SJS/TEN, including herpes virus infection, influenza virus infection, varicella-zoster virus, HIV infection, COVID-19, and coxsackie infection, each with distinct manifestations.<br><br>CONCLUSION: The evidence strongly suggests that viral infections contribute to the development of SJS/TEN, yet the precise mechanisms remain unclear and warrant further research. Awareness of this risk is crucial, particularly in regions experiencing outbreaks of these viruses.}, }
@article {pmid40963624, year = {2025}, author = {Lattarulo, S and Centrone, F and Chironna, M}, title = {Anti-MDA5+ dermatomyositis following SARS-COV-2 infections: a systematic review.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1565803}, pmid = {40963624}, issn = {1664-3224}, mesh = {Humans ; *Interferon-Induced Helicase, IFIH1/immunology ; *COVID-19/immunology/complications ; *Dermatomyositis/immunology/etiology ; *SARS-CoV-2/immunology ; *Autoantibodies/blood/immunology ; }, abstract = {BACKGROUND: Anti-MDA5+ dermatomyositis (DM), also called anti-MDA5+ syndrome, or clinically amyopathic dermatomyositis (CADM), is characterized by extra-muscular DM manifestations such as skin rash, arthralgia, and rapid progressive-interstitial lung disease. Between 2020 and 2024, an increase in serum titer of anti-MDA5 autoantibodies (AABs) and MDA5+ DM cases was registered among the general population. Given the role of MDA5 as a viral-RNA sensor, it is considered a key molecule in rheumatological disorders, as studies show its activity is triggered by viral infection. Here, we conducted a systematic review of studies reporting an unambiguous temporal link between SARS-CoV-2 infections and development of MDA5+ DM. The aim was to clarify our understanding of this idiopathic rheumatic nature.<br><br>METHODS: This review meets Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA). The Google Scholar, PubMed, Scopus and ScienceDirect were searched using appropriate keywords to identify relevant studies published from 2020-2025. Twenty-nine studies concerning the development of MDA5+ DM in COVID-19 patients, as well as molecular pathogenetic mechanisms and pharmaceutical treatments were included.<br><br>RESULTS: Anti-MDA5 antibodies have been detected in patients with COVID-19, as well as in sera from post-COVID patients, and their presence correlates positively with disease severity. The onset of MDA5+ DM, in different phenotypic variants, increased during the COVID-19 pandemic, paralleled by an increase in the incidence of juvenile idiopathic inflammatory myopathies (JIIM). The literature here reported shows that MDA5+ DM arises after primary SARS-CoV-2 infection, which could stimulate an antiviral pathway overactivation, leading to innate and adaptive immune cells recruiting, cytokine storm, and synthesis of autoantibodies.<br><br>CONCLUSION: This review provides evidence for a link between primary SARS-CoV-2 infections, anti-MDA5 AABs synthesis and emergence of MDA5+ DM in phenotypically different variants such as MIP-C, driven by the virus's inclination to trigger type-I interferonopathy in genetically predisposed individuals.<br><br>https://www.crd.york.ac.uk/prospero/, identifier 1129317.}, }
@article {pmid40962401, year = {2025}, author = {Juarez-Martinez, EL and Araia, A and Prasad, D and Dhar, S and Nandoliya, K and Sherrington, IG and Zhao, C and Wescott, A and Pickens, CI and Wunderink, RG and Kimchi, EY}, title = {Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {177}, pages = {}, pmid = {40962401}, issn = {1600-0617}, support = {P01 HL154998/HL/NHLBI NIH HHS/United States ; T32 TR005124/TR/NCATS NIH HHS/United States ; U19 AI135964/AI/NIAID NIH HHS/United States ; U19 AI181102/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; COVID-19/mortality ; *Delirium/epidemiology/mortality/diagnosis ; *Pneumonia/mortality/diagnosis/epidemiology/complications ; Prevalence ; Prognosis ; Risk Assessment ; Risk Factors ; }, abstract = {BACKGROUND: Delirium can occur in patients with pneumonia, but its prevalence is inconsistent across studies. Unreliable estimates and uncertainty regarding the significance of patient-specific versus microbiological risk factors hinder delirium management and prognosis. Here, we provide robust estimates of delirium prevalence in patients with pneumonia, associated risk factors and association with mortality.<br><br>METHODS: We searched five databases (Medline, Cochrane Library, Embase, PsycINFO and Scopus), from inception to 6 August 2024. We included studies in adults hospitalised with pneumonia reporting delirium, encephalopathy or altered mental status. Two investigators extracted data and assessed risk of bias. Summary rates were calculated using random-effects models. We performed prespecified analyses for diagnostic methods, microbiologic factors, clinical factors and mortality, with sensitivity analysis among studies at low risk of bias. The review protocol was registered with PROSPERO: CRD42023385571.<br><br>RESULTS: Delirium prevalence across 126 studies was 22% (95% CI 18-26%) and higher in studies at low risk of bias (40%, 95% CI 24%-58%; n=11). Standardised assessments yielded higher rates than symptom- or International Classification of Diseases code-based assessments (p<0.05). Surprisingly, delirium rates did not differ by microbiological aetiology (p=0.63), including COVID-19, nor by pneumonia origin (p=0.14). Predisposing factors included older age and neurologic and systemic comorbidities. Delirium was associated with increased mortality (odds ratio 4.3, 95% CI 3.24-5.76; p<0.001), without change over five decades (p=0.32).<br><br>INTERPRETATION: Delirium is highly prevalent and enduring in pneumonia, with nearly double the estimated prevalence when standardised diagnostic methods for both pneumonia and delirium are used. Our results emphasise patient- and care-related factors over microbiological causes, including COVID-19. Delirium's entrenched association with mortality, even considering covariates, reinforces the need to manage delirium as a convergent syndrome in pneumonia.}, }
@article {pmid40962199, year = {2025}, author = {Butt, NU and Baytas, SN}, title = {Indole therapeutics: Latest FDA updates, ongoing trials, and future directions.}, journal = {Drug discovery today}, volume = {30}, number = {10}, pages = {104471}, doi = {10.1016/j.drudis.2025.104471}, pmid = {40962199}, issn = {1878-5832}, mesh = {Humans ; *Indoles/therapeutic use/pharmacology/chemistry ; United States ; United States Food and Drug Administration ; Drug Approval ; *COVID-19 Drug Treatment ; Antiviral Agents/therapeutic use/pharmacology ; Antineoplastic Agents/therapeutic use/pharmacology ; Clinical Trials as Topic ; Animals ; Drug Repositioning ; COVID-19 ; SARS-CoV-2 ; }, abstract = {Indole-based compounds serve as versatile pharmacophores across anticancer, antiviral, neurological, antimicrobial, and metabolic therapies. This review systematically analyses FDA-approved, withdrawn, and investigational indole-containing drugs over the past decade, focusing on evolving clinical outcomes, regulatory decisions, and therapeutic repositioning. It explores the shift from cytotoxic to targeted anticancer agents, the rise of indole-based antivirals in response to the COVID-19 pandemic, and the expanding interest in neuroactive indoles, particularly psychedelic compounds. Additionally, it highlights the underrepresentation of indole-based antibiotics and outlines progress in epigenetic and metabolic modulators. Through a detailed evaluation of pharmacological classes, clinical trial data, and structural characteristics, this review presents a comprehensive framework to guide future optimization and multi-target development of indole scaffolds.}, }
@article {pmid40961897, year = {2025}, author = {Tran, LB and Michita, RT and Kumar, D and Mysorekar, IU}, title = {Intercellular highways of viral spread: tunneling nanotubes and extracellular vesicles at the maternal-fetal interface.}, journal = {Current opinion in virology}, volume = {73}, number = {}, pages = {101490}, doi = {10.1016/j.coviro.2025.101490}, pmid = {40961897}, issn = {1879-6265}, mesh = {Humans ; *Extracellular Vesicles/virology ; Pregnancy ; Female ; *Placenta/virology/immunology ; Infectious Disease Transmission, Vertical ; *Maternal-Fetal Exchange ; *Virus Diseases/transmission/virology ; *Nanotubes/virology ; Animals ; *Pregnancy Complications, Infectious/virology ; Cell Communication ; SARS-CoV-2 ; Viruses ; Immune Evasion ; }, abstract = {The placenta serves as both a conduit and a barrier, facilitating nutrient exchange while shielding the fetus from pathogens. Despite these defenses, several viruses, including ZIKV, CMV, HSV, HIV, LCMV, and HBV, can breach the placental barrier, while others like SARS-CoV-2 and RSV infect placental cells without consistent vertical transmission. Emerging evidence highlights two underexplored intercellular communication mechanisms, tunneling nanotubes (TNTs) and extracellular vesicles (EVs), as critical pathways exploited by viruses to disseminate, modulate immunity, and disrupt placental homeostasis. This review discusses how virally hijacked TNTs and EVs facilitate transmission and immune evasion at the maternal-fetal interface, emphasizing the need to further understand these mechanisms in the context of pregnancy and fetal health.}, }
@article {pmid40961807, year = {2025}, author = {Coombs, LA and Kim, M}, title = {Effectiveness of web-based interventions on depression and anxiety in older adults: a systematic review and meta-analysis of randomized controlled trials.}, journal = {Archives of gerontology and geriatrics}, volume = {139}, number = {}, pages = {106025}, doi = {10.1016/j.archger.2025.106025}, pmid = {40961807}, issn = {1872-6976}, mesh = {Humans ; Randomized Controlled Trials as Topic ; Aged ; *Depression/therapy ; *Anxiety/therapy ; *Internet-Based Intervention ; Middle Aged ; COVID-19/psychology/epidemiology ; }, abstract = {OBJECTIVE: This study examined the effects of web-based interventions on depression and anxiety in older adults.<br><br>METHODS: We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I&#xb2; statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.<br><br>RESULTS: A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD = -0.48, 95 % CI = -0.72 to -0.24) and anxiety (SMD = -0.70, 95 % CI = -0.97 to -0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect.<br><br>CONCLUSION: This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.}, }
@article {pmid40960573, year = {2025}, author = {Urquiaga, M and Winthrop, KL and Curtis, JR}, title = {Vaccination Update and Specific Concerns for RA.}, journal = {Current rheumatology reports}, volume = {27}, number = {1}, pages = {37}, pmid = {40960573}, issn = {1534-6307}, support = {P30 AR072583/AR/NIAMS NIH HHS/United States ; P30AR072583//National Institute of Arthritis and Musculoskeletal and Skin Disease/ ; }, mesh = {Humans ; *Arthritis, Rheumatoid/drug therapy/immunology ; *Vaccination ; *Antirheumatic Agents/therapeutic use ; *COVID-19 Vaccines ; Pneumococcal Vaccines ; *COVID-19/prevention &amp; control ; Immunocompromised Host ; Practice Guidelines as Topic ; }, abstract = {PURPOSE OF REVIEW: We present information on the burden of vaccine-preventable diseases in people with rheumatoid arthritis (RA), the latest evidence on vaccine immunogenicity in disease-modifying antirheumatic drug (DMARD) users, and expert and guideline-based immunization recommendations. We focus on infections with the highest morbidity and mortality, and those relevant due to new developments or current outbreaks.<br><br>RECENT FINDINGS: Following the license expansion for two respiratory syncytial virus (RSV) vaccines, GSK's Arexvy and Pfizer's Abrysvo, the Advisory Committee for Immunization Practices (ACIP) expanded the recommendation for vaccination in adults at increased risk of severe RSV disease. In the spring of 2025, the Center for Disease Control lowered the cutoff for immunization in high-risk groups from &#x2265;&#x2009;60 to &#x2265;&#x2009;50 years. There are new 2024-2025 SARS-CoV-2 vaccines and updated ACIP recommendations for SARS-CoV-2 immunization that address new viral strains and the known waning immunity from vaccines. All individuals who are moderately to severely immunocompromised (including those with RA) should receive at least one additional vaccine dose compared to the general population. The ACIP has updated its recommendations for pneumococcal immunization, aiming to lower pneumococcal disease incidence in adults. Following the approval of the 21-valent pneumococcal conjugate vaccine, designed to target the serotypes commonly affecting adults, the cutoff for vaccination in the general population changed from &#x2265;&#x2009;65 to &#x2265;&#x2009;50 years. Recommendations for vaccination in RA patients (everyone age&#x2009;&#x2265;&#x2009;18 years) remain unchanged. Vaccine recommendations for RA patients constantly evolve as new DMARDs and vaccines are developed, and our understanding of their interaction with DMARDs vis a vis immunogenicity improves. It is essential to stay current with the latest recommendations from the ACIP and rheumatologic society guidelines.}, }
@article {pmid40959961, year = {2025}, author = {Kadam, Y and Dagli, N and Venugopal, R and Raj, S and Goel, S}, title = {Global Trends and Emerging Themes in Tele-Ophthalmology Research: A Bibliometric Analysis (1993 to 2024).}, journal = {Seminars in ophthalmology}, volume = {}, number = {}, pages = {1-11}, doi = {10.1080/08820538.2025.2559842}, pmid = {40959961}, issn = {1744-5205}, abstract = {BACKGROUND: Tele-ophthalmology is transforming eye care delivery, particularly in remote and underserved areas, where specialist shortages and geographic barriers prevent millions from receiving timely diagnosis and treatment for preventable blindness. Tele-ophthalmology has emerged as a critical solution to bridge these care gaps, with applications ranging from remote screening, diagnosis, and monitoring of conditions like diabetic retinopathy and glaucoma. Despite rapid technological advances and growing implementation, the research landscape lacks literature providing an overview of global trends, collaborative patterns, and emerging innovations in this field, hindering strategic research planning and evidence-based policy development for expanding digital eye care services. This study aims to analyse global trends and emerging themes in tele-ophthalmology research to fill this knowledge void and provide strategic insights for researchers, clinicians, and policymakers.<br><br>METHODS: A comprehensive online literature search was conducted using the Scopus database, retrieving English-language publications related to tele-ophthalmology up to 31st December 2024. Data were extracted and analysed using Biblioshiny in R Studio and VOSviewer. The study assessed annual publication trends, top journals' contributions, authors' contributions, authors' collaboration, keyword co-occurrence, and thematic evolution.<br><br>RESULTS: A total of 5,498 publications were identified, with an annual growth rate of 9.55%, and nearly 800 articles published in 2023 alone. The United States led in publication output and international collaborations. Dr. Michael F. Chiang published the highest number of articles, with the highest total link strength (174), followed by Dr. R.V. Paul Chan and Dr. J. Peter Campbell (122). Telemedicine and E-Health was the leading journal, followed by the Journal of Telemedicine and Telecare and the Indian Journal of Ophthalmology. Common keywords included "telemedicine," "diabetic retinopathy," "artificial intelligence," and "COVID-19," reflecting major research themes. Thematic analysis showed a shift toward AI integration and digital health solutions in ophthalmology.<br><br>CONCLUSION: The field of teleophthalmology has experienced significant and rapid growth in research activity. Recent trends indicate growing integration of artificial intelligence and digital health tools. This bibliometric study provides a comprehensive overview that can inform future research and policy efforts to enhance digital eye care delivery.}, }
@article {pmid40959931, year = {2025}, author = {Kondakova, O and Tsybina, A and Evtushenko, E and Ryabchevskaya, E and Granovskiy, D and Kovalenko, A and Arkhipenko, M and Nikitin, N and Karpova, O}, title = {Farm animal coronaviruses: the solution is in vaccines.}, journal = {The veterinary quarterly}, volume = {45}, number = {1}, pages = {1-29}, pmid = {40959931}, issn = {1875-5941}, mesh = {Animals ; *Viral Vaccines/immunology ; *Coronavirus Infections/prevention &amp; control/veterinary/transmission/epidemiology ; Livestock ; Animals, Domestic ; *Coronavirus/immunology ; Poultry ; Poultry Diseases/prevention &amp; control/virology ; Humans ; COVID-19 ; Vaccination/veterinary ; }, abstract = {RNA-containing coronaviruses are widespread in nature and can infect a number of vertebrates. Animals are potential sources of human coronaviruses diseases, and interspecies infection by animal coronaviruses has been recorded several times. Such a transmission may have caused the COVID-19 pandemic. The study and control of the spread of farm animals' coronavirus infections is very important, due to the constant close contact between humans and farm animals. Vaccination remains the key to preventing animal diseases and limiting the further spread and transmission of coronavirus infections among poultry and livestock. This review considers coronavirus infections in farm animals, which pose a serious challenge to animal husbandry, and their zoonotic potential and epidemiological features. The review also discusses current vaccines and their limitations, as well as the latest developments and trends in veterinary vaccines aimed at preventing coronavirus infections in poultry and livestock.}, }
@article {pmid40959656, year = {2025}, author = {Martínez-Líbano, J and Reyes, JMA and Passalacqua, AS and Molina, JAC and Bulnes, JG}, title = {Prevalence and post-pandemic consequences of body dysmorphic disorder: a systematic review with meta-analysis.}, journal = {Health psychology report}, volume = {13}, number = {3}, pages = {215-225}, pmid = {40959656}, issn = {2353-5571}, abstract = {Body dysmorphic disorder (BDD) has had a growing impact in Western cultures, manifesting itself in social pressures to achieve physical standards, affecting both men and women. Media influences have magnified these ideals, promoting a standardized body appearance, which has generated an increase in appearance-related disorders. The COVID-19 pandemic exacerbated body concerns. Therefore, we aimed to determine the post-pandemic prevalence and its consequences. For these purposes, a systematic review was carried out based on the PRISMA strategy to identify relevant studies between 2019 and 2023 in databases such as Web of Science and Scopus. Selection criteria were applied, including cross-sectional or longitudinal studies that focused on populations without a previous diagnosis of BDD and used clinical instruments. Of the 52 articles identified, 10 met the inclusion criteria and were selected. Four were used for the systematic review and 6 to carry out the meta-analysis. The prevalence of BDD was high, at 20.8% (6 studies, logOR = 0.208 [95% CI: 0.121-0.294], Z = 4.69, p < .001, I [2] = 98.51%). In conclusion, the restrictions caused by the COVID-19 pandemic such as remaining in isolation, the closure of beauty services, and the increase in the use of social networks and video calls increased anxiety and stress levels in patients diagnosed with BDD and also in people with symptoms related to BDD.}, }
@article {pmid40959555, year = {2025}, author = {Deng, Q and Liu, Y and Rong, H and Liu, Q and Yang, R}, title = {Association Between Gut Microbiota and Pneumonia Risk: A Systematic Review and Mendelian Randomization.}, journal = {International journal of medical sciences}, volume = {22}, number = {14}, pages = {3511-3527}, pmid = {40959555}, issn = {1449-1907}, mesh = {Humans ; *COVID-19/microbiology/genetics/epidemiology ; *Gastrointestinal Microbiome/genetics ; Mendelian Randomization Analysis ; *Pneumonia/microbiology ; Risk Factors ; SARS-CoV-2 ; }, abstract = {Background: The gut-lung axis represents a critical pathway potentially modulating COVID-19 pathogenesis. We employed meta-analysis to investigate the Mendelian randomization (MR) studies for the putative causal relationships between gut microbiota composition/metabolites and COVID-19 severity. Methods: Adhering to PRISMA 2020 guidelines, we conducted a systematic review of MR studies (PubMed/Web of Science/Embase/Scopus/Cochrane; inception to June 2024). Data from 11 studies (aggregating 32,748,274 participants; 1,487 SNPs) underwent meta-analysis across four COVID-19 severity strata including susceptibility, infection, hospitalization, and critical disease. Study quality was evaluated using a validated MR framework assessing 32 core assumptions. Results: Elevated COVID-19 susceptibility risk was associated with Actinobacteria (OR 1.16, 95% CI 1.06-1.26) and Negativicutes (1.06, 1.03-1.09), whereas protective effects emerged for Oxalobacter (0.84, 0.71-0.99) and Ruminococcaceae UCG014 (0.88, 0.78-0.99). For COVID-19 infection, Negativicutes conferred increased risk (1.13, 1.02-1.26), while the Ruminococcus torques group (0.54, 0.39-0.74) and Parasutterella (0.90, 0.83-0.97) demonstrated protection. Hospitalization risk elevated with MollicutesRF9 (1.13, 1.04-1.22) and Alloprevotella (1.25, 1.07-1.45), contrasting with butyrate (0.97, 0.94-0.99) and Ruminiclostridium6 (0.81, 0.69-0.94) showing protective associations. Severe COVID-19 risk increased with Actinobacteria (1.20, 1.01-1.42), Bifidobacterium (2.09, 1.15-3.81), and Alloprevotella (1.66, 1.36-2.01), while Oxalobacter (0.84, 0.76-0.92) and Subdoligranulum (0.82, 0.76-0.89) exhibited protection. Notably, Actinobacteria, Negativicutes, and Alloprevotella constituted consistent risk factors across severity strata, whereas Oxalobacter and Parasutterella showed trans-stage protective effects. Butyrate production specifically attenuated hospitalization risk, and Bifidobacterium demonstrated strikingly elevated critical disease risk, contrasting with typical probiotic associations. Conclusions: This meta-analysis of MR studies provides robust evidence for severity-specific causal effects of the gut microbiota on COVID-19 outcomes. The identified microbial taxa and metabolites provide potential biomarkers for clinical risk stratification and targets for novel adjuvant therapeutic strategies.}, }
@article {pmid40959313, year = {2025}, author = {Preetam, S and Lata, S and Aditi,  and Bora, J and Thapliyal, S and Mehta, S and Ramniwas, S and Deshwal, R and Rustagi, S and Talukdar, N and Malik, S}, title = {Exosome-driven biohybrid nanorobots: bridging nature and nanotechnology in biomedical innovation.}, journal = {RSC advances}, volume = {15}, number = {40}, pages = {33390-33409}, pmid = {40959313}, issn = {2046-2069}, abstract = {Exosome- and extracellular vesicle (EV)-based biohybrid nanorobots represent a cutting-edge approach in nanomedicine, combining the natural targeting, immune tolerance, and molecular transport capabilities of EVs with the functional versatility of engineered nanomaterials. These hybrid systems can be designed for guided or autonomous navigation, enabling site-specific drug delivery with minimal cytotoxicity. Recent advances have integrated magnetic, photothermal, or drug-loaded components into EVs, transforming them into innovative nanoscale delivery systems. As naturally secreted vesicles from most cell types, EVs facilitate intercellular communication and are increasingly recognized for their clinical potential in treating conditions like Crohn's disease, type 1 diabetes, and COVID-19. Biohybrid EV nanorobots offer enhanced biodistribution, stability, and cellular uptake compared to traditional nanoparticles. Key design challenges include ensuring reproducibility, size control, and functional stability. This next-generation drug delivery platform holds promise for overcoming limitations of conventional systems while advancing targeted therapy and personalized medicine.}, }
@article {pmid40959053, year = {2025}, author = {Saleem, M and Chang, CW and Qadeer, A and Asiri, M and Alzahrani, FM and Alzahrani, KJ and Alsharif, KF and Chen, CC and Hussain, S}, title = {The emerging role of extracellular vesicles in viral transmission and immune evasion.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1634758}, pmid = {40959053}, issn = {1664-3224}, mesh = {Humans ; *Extracellular Vesicles/immunology/virology ; *Immune Evasion ; *Virus Diseases/immunology/transmission/therapy/virology ; Animals ; SARS-CoV-2/immunology ; Host-Pathogen Interactions/immunology ; COVID-19/immunology ; }, abstract = {Extracellular vesicles (EVs) are membrane-bound structures that serve as major mediators of intercellular communication, playing a crucial role in various physiological and pathological processes. These membrane-bound vesicles are involved in several biological processes and are essential because they play a vital role in regulating viral infections. Given the global burden of viral diseases, understanding the interaction between EVs and viruses is crucial for the development of novel diagnostic tools and therapeutic strategies. This review provides a comprehensive examination of the structure and nature of EVs, as well as their biogenesis and molecular components, distinguishing between exosomes, microvesicles, and apoptotic bodies. We discuss the relationship between EVs and viral diseases, as well as their roles in viral pathogenesis and the dissemination of infections. Moreover, based on the ability of viruses to modulate host immune responses at both the innate and adaptive levels, the involvement of EVs in immune evasion is described. Additionally, the ability of EVs to diagnose viral illnesses and their therapeutic applications, such as using EVs for vaccines, immunotherapy, and the delivery of antiviral drugs, will also be discussed. Various viral diseases, including HIV, hepatitis B and C, and influenza, as well as emerging viruses such as SARS-CoV-2, are reviewed to capture the multifaceted functions of EVs in viral diseases. Finally, the review discusses the limitations of EV research, factors that affect the standardization of the technique, and the outlook for clinical applications. Based on a synthesis of current literature knowledge, this review aimed to identify and highlight the potential of EVs as diagnostic and therapeutic agents in the prevention and treatment of viral infections, thereby paving the way for further research and innovation.}, }
@article {pmid40958923, year = {2025}, author = {Feiz-Haddad, MH and Khorami, S}, title = {A Comprehensive Review of Epidemiology, Environmental Factors, and Control Strategies for Zoonotic Cutaneous Leishmaniasis in Iran: Challenges and Prospects.}, journal = {Advanced biomedical research}, volume = {14}, number = {}, pages = {90}, pmid = {40958923}, issn = {2277-9175}, abstract = {Zoonotic cutaneous leishmaniasis (ZCL) remains a significant public health challenge in Iran, which reported an incidence rate of 15.8 cases per 100,000 individuals in 2019. Among the countries of the Eastern Mediterranean region, Iran bears a disproportionate burden of this neglected tropical disease, with 18 out of its 31 provinces affected. ZCL is especially prevalent in rural and semiurban areas, where ecological and environmental factors create suitable conditions for disease transmission. Rodent reservoirs, particularly Meriones species, and specific vectors, such as Phlebotomus sandflies, play critical roles in the epidemiology of ZCL in Iran. Recent studies have highlighted dynamic changes in the distribution of ZCL in Iran, with newly identified hotspots in regions such as Beyza district (Fars province), Isfahan, and Razavi Khorasan. These shifts are attributed to climate change, urbanization, and altered land use patterns, which influence vector habitats and reservoir dynamics. Notably, the COVID-19 pandemic has exacerbated the spread of ZCL, redirecting health priorities and increasing the vulnerability of already high-risk areas. The interplay between these ecological factors underscores the importance of understanding localized transmission patterns. Despite the growing prevalence of ZCL, research remains limited in its focus on epidemiological aspects specific to Iran. This review aims to address this gap by examining the geographic distribution, reservoirs, vectors, and ecological drivers of ZCL within Iran. By identifying high-risk provinces and emerging trends, such as those in Fars, Isfahan, and Razavi Khorasan, this study provides a foundation for designing targeted control strategies. Effective interventions, informed by these findings, are crucial in mitigating the future burden of ZCL, particularly as vector habitats are expected to expand due to climatic changes.}, }
@article {pmid40958240, year = {2025}, author = {Jin, M and Zhu, Z and Zhou, P and Liu, S}, title = {Extensive deep neck abscess caused by middle ear cholesteatoma complicating Proteus vulgaris infection: A case report and literature review.}, journal = {Medicine}, volume = {104}, number = {37}, pages = {e44463}, pmid = {40958240}, issn = {1536-5964}, support = {SCU10370//the Reform Project of Higher Education Teaching at Sichuan University/ ; }, mesh = {Humans ; Male ; *Abscess/etiology/microbiology ; Adult ; *Neck ; COVID-19/complications ; *Proteus Infections/complications/diagnosis ; *Cholesteatoma, Middle Ear/complications ; Tomography, X-Ray Computed ; Drainage/methods ; SARS-CoV-2 ; }, abstract = {RATIONALE: Middle ear cholesteatoma (MEC) is a non-neoplastic cystic lesion that can cause severe complications if untreated. While subperiosteal abscesses, neck abscesses, and sigmoid sinus thrombophlebitis have been reported, an extensive deep neck abscess extending to the axillary fossa due to MEC has not been previously documented. This case highlights a deep neck abscess complicated by Proteus vulgaris infection during coronavirus disease 2019 (COVID-19) recovery, underscoring the importance of individualized management strategies based on pathogen characteristics.<br><br>PATIENT CONCERNS: A 27-year-old man with a history of left ear purulent otorrhea for&#x2005;>&#x2005;20 years presented with neck swelling for 5 days during COVID-19 recovery.<br><br>DIAGNOSES: Examination revealed: the left neck, up to the mastoid process, down to the ipsilateral armpit and lateral chest wall, and back to the trapezius muscle, was widely erythematous and swollen, with elevated skin temperature. Computed tomography revealed soft tissue density shadows in the left mastoid process, along with gas and pus accumulation in the left neck, pharynx, and axillary fossa. Culture results confirmed P vulgaris infection. The diagnosis was MEC complicated by a deep neck abscess and P vulgaris infection.<br><br>INTERVENTIONS: The patient underwent a modified radical mastoidectomy and incision and drainage of a left maxillofacial cervical multi-gap abscess. Postoperatively, the neck cavity was sutured, and negative pressure drainage tubes were placed. Due to subsequent parapharyngeal swelling and respiratory distress with a difficult airway, a tracheotomy was performed, followed by additional drainage of an abscess in the posterior oropharyngeal wall. Extensive necrosis of the cervical soft tissue necessitated reopening the neck incision and placement of Penrose drains for continued drainage.<br><br>OUTCOMES: The patient recovered well following surgical interventions and tailored wound management, with no further complications.<br><br>LESSONS: This case underscores the importance of timely and appropriate abscess drainage and wound management tailored to the causative organism's characteristics. It also highlights the need for aggressive treatment of the primary pathology (MEC) to prevent severe complications. Clinicians should be vigilant for unusual presentations of deep neck abscesses, especially in patients with recent infections such as COVID-19, which may complicate the clinical course.}, }
@article {pmid40957683, year = {2025}, author = {Caruso, BA and Snyder, JS and O'Brien, LA and LaFon, E and Files, K and Shoaib, DM and Prasad, SK and Rogers, HK and Cumming, O and Esteves Mills, J and Gordon, B and Wolfe, MK and Freeman, MC}, title = {Behavioural factors influencing hand hygiene practices across domestic, institutional and public community settings: a systematic review and qualitative meta-synthesis.}, journal = {BMJ global health}, volume = {10}, number = {Suppl 7}, pages = {}, pmid = {40957683}, issn = {2059-7908}, mesh = {Humans ; *Hand Hygiene ; Qualitative Research ; COVID-19/prevention &amp; control ; *Health Behavior ; }, abstract = {INTRODUCTION: This systematic review sought to understand barriers and enablers to hand hygiene in community settings.<br><br>METHODS: Eligible studies addressed hand hygiene in a community setting, included a qualitative component, and were published in English between 1 January 1980 and 29 March 2023. Studies were excluded if in healthcare settings or were animal research. We searched PubMed, Web of Science, EMBASE, CINAHL, Global Health, Cochrane Library, Global Index Medicus, Scopus, Public Affairs Information Service Index, WHO Institutional Repository for Information Sharing, UN Digital Library and World Bank eLibrary, manually searched relevant systematic reviews' reference lists, and consulted experts. We used MaxQDA software to code papers, using the COM-B (Capability, Opportunity, Motivation and Behaviour) framework to classify barriers and enablers. We used thematic analysis to describe each COM-B subtheme identified, GRADE-CERQual to assess confidence in evidence for thematic findings and the Mixed Method Appraisal Tool (MMAT) to assess risk of study bias.<br><br>RESULTS: 80 studies were included; most took place in Africa (31; 39%), South-East Asia (31; 39%) and domestic settings (54; 68%). The mean MMAT score was 4.86 (good quality). Barriers and/or enablers were reported across all COM-B constructs and subconstructs. The most reported barriers aligned with Physical Opportunity (eg, soap availability), Reflective Motivation (eg, hand hygiene not prioritised) and Automatic Motivation (eg, no habit). In contrast, the most reported enablers aligned with Automatic Motivation (ie, habit) and Reflective Motivation (ie, perception of health risk).<br><br>CONCLUSION: Findings confirm that a lack of necessary resources for hand hygiene hinders practice, even when people are motivated. Results may explain why hand hygiene increases when there are acute health risks (eg, COVID-19), but decreases when risks are perceived to fade. The qualitative methodology used among the studies may have revealed a broader array of barriers and enablers than what might have been found by quantitative, researcher-driven studies, but representativeness may be limited. Evidence was also limited on alcohol-based hand rubs. Findings can inform the design of future hand hygiene initiatives.<br><br>PROSPERO REGISTRATION NUMBER: CRD42023429145.}, }
@article {pmid40957223, year = {2025}, author = {Mohus, RM and Gustad, LT and Damås, JK and Drakesmith, H}, title = {Iron-sepsis associations in population health revealed by epidemiology.}, journal = {EBioMedicine}, volume = {120}, number = {}, pages = {105927}, pmid = {40957223}, issn = {2352-3964}, mesh = {Humans ; *Sepsis/epidemiology/metabolism/etiology ; *Iron/metabolism/blood ; *COVID-19/epidemiology/metabolism ; *Population Health ; Risk Factors ; SARS-CoV-2 ; Hepcidins/genetics/metabolism ; }, abstract = {Sepsis is a leading cause of death and disability worldwide, so identifying preventable risk factors is important. Iron is essential for immune function and microbial growth, and iron status varies substantially between individuals, across demographics, and is therapeutically modifiable. Here, we review the current understanding of iron status and associated risks of bloodstream infection, sepsis and severe COVID-19 highlighting relevant population-based studies and Mendelian randomisation studies. Both low and high iron status are associated with increased risk of sepsis. Low iron status is associated with sepsis, bloodstream infections and pneumonia. High iron status and mutations affecting hepcidin regulation are linked to increased risk of bloodstream infections, sepsis and COVID-19. Both iron status pathologies and sepsis are global health issues, and the epidemiological studies described indicate they may be linked. More population-scale investigations on iron status, infection and immunity, especially in areas of high iron deficiency and infectious burden are warranted.}, }
@article {pmid40957172, year = {2025}, author = {Barkat, MQ and Li, Q and Manzoor, M and Xu, C and Hussain, N and Salawi, A and Yang, H and Hussain, M}, title = {Sepsis-induced ALI/ARDS beyond supportive care: molecular mechanisms and cutting-edge therapies.}, journal = {International immunopharmacology}, volume = {166}, number = {}, pages = {115495}, doi = {10.1016/j.intimp.2025.115495}, pmid = {40957172}, issn = {1878-1705}, mesh = {Humans ; *COVID-19/complications/immunology/therapy ; *Sepsis/complications/therapy/immunology ; SARS-CoV-2 ; *Respiratory Distress Syndrome/therapy/etiology/immunology ; *Acute Lung Injury/therapy/etiology/immunology ; Animals ; Signal Transduction ; Cytokine Release Syndrome ; }, abstract = {Sepsis-induced ALI/ARDS are severe conditions driven by complex molecular and cellular mechanisms, including endothelial dysfunction, immunological dysregulation, epigenetic changes, and oxidative stress. These factors disrupt endothelial integrity and promote cell death, worsening lung injury and respiratory failure. COVID-19-related ARDS, similar to sepsis-induced ALI, is more severe, involving immune dysregulation, cytokine storms, and microthrombi. Despite extensive research, sepsis-induced ALI/ARDS has gained the status of the Bermuda Triangle, as no effective pharmacological treatments are currently available, and supportive therapies remain the mainstay of treatment. Consequently, a critical need exists to explore innovative treatment options. This review highlights the molecular and cellular mechanisms of sepsis-induced ALI/ARDS, key cellular signaling pathways in sepsis-induced ALI/ARDS, clinical insights into COVID-19-related ALI/ARDS, existing and emerging treatments, and the limitations of current therapies. It emphasizes the need for innovative approaches to improve patient outcomes and underscores the importance of advancing research to enhance understanding and treatment development.}, }
@article {pmid40957159, year = {2025}, author = {Siem, TT and Nguyen, HTT and Luc, PT}, title = {Work-life balance in higher education: A review based on bibliographic coupling analysis.}, journal = {Acta psychologica}, volume = {260}, number = {}, pages = {105567}, doi = {10.1016/j.actpsy.2025.105567}, pmid = {40957159}, issn = {1873-6297}, mesh = {Humans ; *Work-Life Balance ; *COVID-19/psychology ; Bibliometrics ; Universities ; }, abstract = {This study provides an overview of higher education's work-life balance (WLB) structure by employing bibliographic coupling analysis to explore key research clusters. Data was collected from the Web of Science database, resulting in 203 publications retained for analysis, with VOS viewer software used to construct and visualize the bibliographic coupling network. The bibliometric analysis revealed eight clusters, notably including "The Impact of COVID-19 on Work-Life Balance and Well-being in Higher Education", "Impact of Work-Life Balance on Work Outcomes", "The Career Paths of Academics", and "Institutional and Personal Pressures Affecting Academic WLB". Despite existing bibliographic analyses of WLB policy across multiple disciplines and WLB dynamics during the pandemic, a dedicated in-depth analysis mapping the WLB research landscape specifically within the higher education sector has been notably absent. Therefore, this study uniquely contributes by offering a comprehensive overview of the WLB structure in higher education, identifying key research groups, and suggesting future directions, which will primarily benefit academic institutions, policymakers, and educators. Future research on academic well-being and WLB should adopt longitudinal and intersectional approaches, exploring experiences across diverse populations defined by gender, race, and career stage. Key areas include examining technology's impact, developing tailored mental health interventions and robust institutional support mechanisms, and emphasizing comparative analyses across global contexts as well as exploring generational differences in perceptions of WLB. In addition, refining theoretical frameworks for emerging work models is essential to inform equitable and sustainable policies.}, }
@article {pmid40957014, year = {2025}, author = {Karve, Z and Calpey, J and Machado, C and Knecht, M and Mejia, MC}, title = {New Doc on the Block: Scoping Review of AI Systems Delivering Motivational Interviewing for Health Behavior Change.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e78417}, pmid = {40957014}, issn = {1438-8871}, mesh = {*Motivational Interviewing/methods ; Humans ; *Health Behavior ; *Artificial Intelligence ; COVID-19 ; }, abstract = {BACKGROUND: Artificial intelligence (AI) is increasingly used in digital health, particularly through large language models (LLMs), to support patient engagement and behavior change. One novel application is the delivery of motivational interviewing (MI), an evidence-based, patient-centered counseling technique designed to enhance motivation and resolve ambivalence around health behaviors. AI tools, including chatbots, mobile apps, and web-based agents, are being developed to simulate MI techniques at scale. While these innovations are promising, important questions remain about how faithfully AI systems can replicate MI principles or achieve meaningful behavioral impact.<br><br>OBJECTIVE: This scoping review aimed to summarize existing empirical studies evaluating AI-driven systems that apply MI techniques to support health behavior change. Specifically, we examined the feasibility of these systems; their fidelity to MI principles; and their reported behavioral, psychological, or engagement outcomes.<br><br>METHODS: We systematically searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library for empirical studies published between January 1, 2018, and February 25, 2025. Eligible studies involved AI-driven systems using natural language generation, understanding, or computational logic to deliver MI techniques to users targeting a specific health behavior. We excluded studies using AI solely for training clinicians in MI. Three independent reviewers screened and extracted data on study design, AI modality and type, MI components, health behavior focus, MI fidelity assessment, and outcome domains.<br><br>RESULTS: Of the 1001 records identified, 15 (1.5%) met the inclusion criteria. Of these 15 studies, 6 (40%) were exploratory feasibility or pilot studies, and 3 (20%) were randomized controlled trials. AI modalities included rule-based chatbots (9/15, 60%), LLM-based systems (4/15, 27%), and virtual or mobile agents (2/15, 13%). Targeted behaviors included smoking cessation (6/15, 40%), substance use (3/15, 20%), COVID-19 vaccine hesitancy, type 2 diabetes self-management, stress, mental health service use, and opioid use during pregnancy. Of the 15 studies, 13 (87%) reported positive findings on feasibility or user acceptability, while 6 (40%) assessed MI fidelity using expert review or structured coding, with moderate to high alignment reported. Several studies found that users perceived the AI systems as judgment free, supportive, and easier to engage with than human counselors, particularly in stigmatized contexts. However, limitations in empathy, safety transparency, and emotional nuance were commonly noted. Only 3 (20%) of the 15 studies reported substantially significant behavioral changes.<br><br>CONCLUSIONS: AI systems delivering MI show promise for enhancing patient engagement and scaling behavior change interventions. Early evidence supports their usability and partial fidelity to MI principles, especially in sensitive domains. However, most systems remain in early development, and few have been rigorously tested. Future research should prioritize randomized evaluations; standardized fidelity measures; and safeguards for LLM safety, empathy, and accuracy in health-related dialogue.<br><br>TRIAL REGISTRATION: OSF Registries 10.17605/OSF.IO/G9N7E; https://osf.io/g9n7e.}, }
@article {pmid40956864, year = {2025}, author = {Olagunju, A and Perazzolo, S and Stephen, ZR and Ryan, M and Xu, X and Venkatasubramanian, P and Atoyebi, S and Fratte, RD and Owen, A and Flexner, C and Ho, RJY}, title = {The Promises and Prospects of Long-Acting Therapeutics for Treatment and Prevention of Infectious Diseases.}, journal = {Annual review of pharmacology and toxicology}, volume = {}, number = {}, pages = {}, pmid = {40956864}, issn = {1545-4304}, support = {227288/WT_/Wellcome Trust/United Kingdom ; R01 AI134091/AI/NIAID NIH HHS/United States ; }, abstract = {Long-acting (LA) therapeutics have emerged as a key component of infectious disease treatment and prevention strategies, their uptake fueled by the need to bridge notable gaps with short-acting drug formulations. In this review, we present the key drivers and summarize the enabling technologies. Focusing on infections with significant global disease burden (HIV, hepatitis B and C, tuberculosis, malaria, and COVID-19), the current state of knowledge on approved LA therapeutics and promising innovations currently in development are summarized. The potential role of LA therapeutics as countermeasures for diseases of pandemic potential and new approaches using computational modeling to accelerate their development for pediatric and perinatal health are discussed. Due to complexities in manufacturing, and the diversity of patent-protected technologies, barriers exist for global access to LA products and in upscaling intricate LA formulations. A multipronged strategic framework, including acceleration of equitable access through generic product manufacture, is proposed to realize the full potential of LA therapeutics for global health.}, }
@article {pmid40956375, year = {2025}, author = {Naushad, Z and Malik, J and Mishra, AK and Singh, S and Shrivastav, D and Sharma, CK and Verma, VV and Pal, RK and Roy, B and Sharma, VK}, title = {Artificial Intelligence in Cardiovascular Health: Insights into Post-COVID Public Health Challenges.}, journal = {High blood pressure &amp; cardiovascular prevention : the official journal of the Italian Society of Hypertension}, volume = {32}, number = {5}, pages = {475-494}, pmid = {40956375}, issn = {1179-1985}, mesh = {Humans ; *COVID-19/epidemiology ; *Cardiovascular Diseases/diagnosis/epidemiology/therapy ; *Artificial Intelligence ; *Public Health ; Risk Assessment ; SARS-CoV-2/pathogenicity ; Risk Factors ; }, abstract = {Cardiovascular diseases (CVDs) continue to be the topmost cause of the worldwide morbidity and mortality. Risk factors such as diabetes, hypertension, obesity and smoking are significantly worsening the situation. The COVID-19 pandemic has powerfully highlighted the undeniable connection between viral infections and cardiovascular health. Current literature highlights that SARS-CoV-2 contributes to myocardial injury, endothelial dysfunction, thrombosis, and systemic inflammation, increasing the severity of CVD outcomes. Long COVID has also been associated with persistent cardiovascular complications, including myocarditis, arrhythmias, thromboembolic events, and accelerated atherosclerosis. Addressing these challenges requires continued research and public health strategies to mitigate long-term risks. Artificial intelligence (AI) is changing cardiovascular medicine and community health through progressive machine learning (ML) and deep learning (DL) applications. AI enhances risk prediction, facilitates biomarker discovery, and improves imaging techniques such as echocardiography, CT, and MRI for detecting coronary artery disease and myocardial injury on time. Remote monitoring and wearable devices powered by AI enable real-time cardiovascular assessment and personalized treatment. In public health, AI optimizes disease surveillance, epidemiological modeling, and healthcare resource allocation. AI-driven clinical decision support systems improve diagnostic accuracy and health equity by enabling targeted interventions. The integration of AI into cardiovascular medicine and public health offers data-driven, efficient, and patient-centered solutions to mitigate post-COVID cardiovascular complications.}, }
@article {pmid40956349, year = {2025}, author = {Corrêa-Dias, LC and Lopes-Ribeiro, &#xc1; and Mendes, GER and Marques-Ferreira, G and Wilker-Teixeira, C and Clarindo, FA and de Melo Rocha, V and Martuchele-Félix, ME and Retes, HM and Santos, TAP and Azevedo, GLA and Pereira, VEV and de Fátima Silva Moraes, T and de Sousa Reis, EV and Gomes-de-Pontes, L and Rabelo, LF and Dos Santos, EAS and Pereira, CLD and Coelho, FDS and Coelho, RP and Santos, RA and Coelho, GP and da Fonseca, FG and Coelho-Dos-Reis, JGA}, title = {A pain from the nose to the head: neurological commitment during long COVID.}, journal = {Inflammation research : official journal of the European Histamine Research Society ... [et al.]}, volume = {74}, number = {1}, pages = {127}, pmid = {40956349}, issn = {1420-908X}, mesh = {Humans ; *COVID-19/complications/immunology ; *Neuroinflammatory Diseases/immunology/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: Long COVID is a debilitating illness with multi-systemic symptoms that affects at least 10% of individuals who have had COVID-19. Symptoms include respiratory, dermatological, gastrointestinal, cardiovascular, and most frequently reported, neurological sequelae. The most common neurological manifestations include fatigue, brain fog, memory issues, attention disorder, and headaches.<br><br>METHODS: In this review, we explore the current literature and highlight key findings regarding not only the clinical presentations of neurological commitment during long COVID but mainly the mechanisms that culminate in neuroinflammation, such as autoimmunity, viral reservoirs, and lack of surveillance of T-cells.<br><br>RESULTS: Neuroinflammation is a complex multicellular response that directly impacts microglial cells and includes inflammasome activation, trafficking of immune cells, and increased circulating autoantibodies, cytokines, and chemokines in the central nervous system, directly impacting the tissue homeostasis. This review provides important information beyond the clinical manifestations of long COVID. Here, we highlight multifactorial neuroinflammation as the main mechanism involved in long COVID, bringing together several studies that address the different mechanisms that culminate in inflammation of the central nervous system, and highlight possible biomarkers involved in this syndrome and potential therapeutic approaches that have been studied.<br><br>CONCLUSION: Thus, this review strengthens research into long COVID and provides new possibilities for future studies.}, }
@article {pmid40956318, year = {2026}, author = {Starcevic, V and Janca, A}, title = {Conspiracy theories, personality dimensions and personality disorders.}, journal = {Current opinion in psychiatry}, volume = {39}, number = {1}, pages = {42-46}, doi = {10.1097/YCO.0000000000001037}, pmid = {40956318}, issn = {1473-6578}, mesh = {Humans ; *Personality Disorders/psychology ; *Personality ; *COVID-19/psychology ; *Deception ; }, abstract = {PURPOSE OF REVIEW: Conspiracy theories are not a recent phenomenon, but their dissemination has been facilitated by the internet and modern means of communication such as social media. This article reviews personality-based factors that increase the likelihood of endorsing conspiracy theories.<br><br>RECENT FINDINGS: Most studies used a correlational approach and examined personality traits and dimensions rather than personality disorders. The strongest and most consistent relationships were found between endorsement of conspiracy theories and suspiciousness and paranoid ideation, pseudoscientific tendencies and beliefs, schizotypal personality traits and narcissism. Similar personality characteristics were identified as correlates of the endorsement of the specific COVID-19 conspiracy theories, but antisocial personality traits have also been reported in this context. Epistemic mistrust has emerged as arguably the key factor that facilitates endorsement of conspiracy theories. Schizotypal, paranoid, antisocial, borderline, and narcissistic personality disorders were more likely to accompany endorsement of conspiracy theories than other types of personality disorders.<br><br>SUMMARY: Although correlation does not imply causation, recent work has identified personality-related characteristics that confer an increased risk of espousing conspiracy theories. Further research is necessary to ascertain how this vulnerability could be decreased, thus minimizing the harms of conspiracy theories that are inflicted on their adherents and broader society.}, }
@article {pmid40956089, year = {2025}, author = {Williams, T and McCaw, JM and Osborne, JM}, title = {Spatially structured models of viral dynamics: a scoping review.}, journal = {Microbiology and molecular biology reviews : MMBR}, volume = {}, number = {}, pages = {e0028324}, doi = {10.1128/mmbr.00283-24}, pmid = {40956089}, issn = {1098-5557}, abstract = {SUMMARYThere is growing recognition in both the experimental and modeling literature of the importance of spatial structure to the dynamics of viral infections within the host. Aided by the evolution of computing power and motivated by recent biological insights, there has been an explosion of new, spatially explicit models for within-host viral dynamics in recent years. This development has only been accelerated in the wake of the COVID-19 pandemic. Spatially structured models offer improved biological realism and can account for dynamics that cannot be well-described by conventional, mean-field approaches. However, despite their growing popularity, spatially structured models of viral dynamics are underused in biological applications. One major obstacle to the wider application of such models is the huge variety in approaches taken, with little consensus as to which features should be included and how they should be implemented for a given biological context. Previous reviews of the field have focused on specific modeling frameworks or on models for particular viral species. Here, we instead apply a scoping review approach to the literature of spatially structured viral dynamics models as a whole to provide an exhaustive update of the state of the field. Our analysis is structured along two axes, methodology and viral species, in order to examine the breadth of techniques used and the requirements of different biological applications. We then discuss the contributions of mathematical and computational modeling to our understanding of key spatially structured aspects of viral dynamics and suggest key themes for future model development to improve robustness and biological utility.}, }
@article {pmid40955938, year = {2025}, author = {Rastogi, A and Sahoo, JP and Sivasubramanian, S and Mukhopadhyay, S and Shukla, R and Ramakrishnan, S and Shaikh, S and Abhyankar, M and Prasad, A and Kale, S}, title = {Evaluation of Deficiency of Vitamin D and Advantages of Supplementation of Vitamin D in COVID-19 Infections: A Narrative Review.}, journal = {The Journal of the Association of Physicians of India}, volume = {73}, number = {9}, pages = {e38-e47}, doi = {10.59556/japi.73.1169}, pmid = {40955938}, issn = {0004-5772}, mesh = {Humans ; *Vitamin D Deficiency/complications/drug therapy/epidemiology ; *Vitamin D/therapeutic use/administration &amp; dosage ; *COVID-19/mortality/complications ; *Dietary Supplements ; *Vitamins/therapeutic use ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Severity of Illness Index ; }, abstract = {Continuously evolving literature has helped to understand the vitamin D contribution to the coronavirus disease 2019 (COVID-19) manifestations and the associated clinical outcomes in different patient populations. Evidence suggests a widespread occurrence of deficiency of vitamin D among patients presenting COVID-19 and a possible link between vitamin D insufficiency and disease progression or mortality. Furthermore, studies worldwide have reported that supplements of vitamin D have a beneficial effect on COVID-19 outcomes. Contradictory data, however, suggest that there is no association between levels of vitamin D and the likelihood of COVID-19 infections. Therefore, a comprehensive search of the published literature is conducted to better understand any harmful effects of vitamin D deficiency (VDD), advantages of vitamin D supplementation, and the relationship between status of vitamin D and risk, severity, and mortality in patients with COVID-19. The information was gathered from the PubMed database published between January 2020 and July 2022 regarding the function of vitamin D in the immune system, the link between deficiency of vitamin D and COVID-19 infection, severity, risk of mortality of COVID-19, and the impact of vitamin D treatment on outcomes of COVID-19. Vitamin D modulates the immune system by elevating the levels of cathelicidins and β-defensin in the body. Deficiency of vitamin D is markedly attributed to the risk of acute respiratory distress syndrome (ARDS), which determines the severity of disease in patients with COVID-19. Levels of vitamin D below 20 ng/mL in patients with COVID-19 are linked to an increased mortality and morbidity. Vitamin D concentration of >30 ng/mL can diminish the COVID-19 severity and risk of mortality. Supplementation with vitamin D to maintain a serum concentration of 30 ng/mL would mitigate the incidence of COVID-19 and poor prognostic outcomes.}, }
@article {pmid40955521, year = {2025}, author = {Shang, W and Wang, G and Han, D}, title = {Benefits of Nanocurcumin on Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.}, journal = {Journal of integrative and complementary medicine}, volume = {}, number = {}, pages = {}, doi = {10.1177/27683605251379004}, pmid = {40955521}, issn = {2768-3613}, abstract = {Background: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. This systematic review and meta-analysis aimed to determine the efficacy of nanocurcumin on mortality in patients with COVID-19. Methods: A systematic search was performed in PubMed, Embase, Cochrane Library, and clinicaltrials.gov up to November 2024, without language restrictions. Inclusion criteria: (1) inclusion of hospitalized patients with COVID-19 who are 18 years or older; (2) polymerase chain reaction positive for severe acute respiratory syndrome coronavirus-2; and (3) use of a randomized controlled design to make a comparison of nanocurcumin with placebo. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. Studies were pooled to risk ratios (RRs) and standardized mean differences (SMDs), with 95% confidence intervals (CIs). Results: Six trials (enrolling 333 participants) met the inclusion criteria. Nanocurcumin therapy showed significant improvements on mortality (RR 0.47, 95% CI 0.25-0.88; p = 0.02), interleukin-6 (IL-6) (SMD -0.30, 95% CI -0.56 to -0.04; p = 0.02), tumor necrosis factor-α (TNF-α) (SMD -0.63, 95% CI -1.16 to -0.10; p = 0.02), and IL-1β (SMD -0.88, 95% CI -1.37 to -0.39; p = 0.0004). Conclusions: Nanocurcumin significantly reduced mortality, IL-6, TNF-α, and IL-1β in hospitalized patients with COVID-19. Given the lack of safety data and concerns about the risk of bias, the use of nanocurcumin in COVID-19 requires further research.}, }
@article {pmid40954187, year = {2025}, author = {van der Bie, J and Coleon, A and Visser, D and Bogers, WM and den Dunnen, J and Spronk, HMH and Langermans, JAM and Willemen, HLDM and De Melo, GD and Middeldorp, J and Stammes, MA}, title = {Post Pandemic Problem, is there an animal model suitable to investigate PASC.}, journal = {Npj imaging}, volume = {3}, number = {1}, pages = {41}, pmid = {40954187}, issn = {2948-197X}, support = {11080012310002/ZONMW_/ZonMw/Netherlands ; }, abstract = {Although the COVID-19 pandemic is no longer a global health emergency, many patients still suffer from long-term effects, known as post-acute sequelae of COVID-19 (PASC) or long COVID. Understanding its complex pathophysiology requires animal models replicating the post-acute phase, which may aid in developing, the urgently needed, therapeutics. Our review assessed and summarized 81 studies from 1979 manuscripts. In addition, a second table summarizing the imaging findings of 26 studies related to this topic was added, based on a separate literature search of 797 manuscripts. In humans a SARS-CoV-2 infection, the sequelae and possible development of PASC is heterogenic. The same holds true for experimental animal models. While several models are suitable to address different research questions, no single model can fully replicate all aspects of PASC. Imaging plays a crucial role in visualizing these aspects, especially since questionnaires, the primary diagnostic tool in humans, cannot be used in animals. Thus, imaging allows the investigation of pathophysiology in a controlled setting, offering valuable insights. This review summarizes the available animal models and imaging modalities used in PASC research. Our aim is to provide researchers with guidance on selecting the most appropriate model and imaging technique to address their specific research questions.}, }
@article {pmid40953098, year = {2025}, author = {Hassani, M and Karanikas, N}, title = {Scoping review of studies on work-related musculoskeletal disorders: Quality of evidence, coverage of risk factors and types of risk assessment tools used.}, journal = {Work (Reading, Mass.)}, volume = {}, number = {}, pages = {10519815251374641}, doi = {10.1177/10519815251374641}, pmid = {40953098}, issn = {1875-9270}, abstract = {BackgroundDespite continual efforts globally in preventing work-related musculoskeletal disorders (WMSDs), they remain one of the most common occupational injuries with individual, organisational and societal impacts.ObjectiveThis scoping review analysed 265 studies on WMSDs published between January 2013 and December 2024, aiming to assess the quality of evidence, identify risk factors, and examine risk assessment tools used.MethodsA systematic search in Embase, PubMed, Web of Science, EBSCO, and Scopus, including subscription-based and open-access journals identified relevant studies. Inclusion criteria focused on WMSD risk assessment in occupational settings. Data extraction covered study characteristics, risk factors, assessment tools, and methodological quality.ResultsThe review revealed a significant increase in WMSD research in recent years, particularly from 2021 to 2024, possibly influenced by the COVID-19 pandemic's impact on work tasks and conditions. Lower back, neck, and shoulder pain were the most prevalent WMSDs reported. The review identified 79 risk factors across five categories. Physical task factors were most frequently investigated, while psychosocial and environmental factors were underrepresented. Self-report tools, particularly the Nordic Questionnaire, were the most commonly used assessment methods. Our review also highlights the need for more comprehensive risk assessment approaches that consider the interconnected nature of WMSD risk factors. Additionally, about 28% of the reviewed studies did not meet adequate quality of evidence criteria, indicating a need for improved research methodologies.ConclusionsThis review provides valuable insights for researchers and practitioners in occupational health and safety, emphasising the importance of holistic approaches to WMSD risk assessment and management.}, }
@article {pmid40952530, year = {2025}, author = {Bulygin, AA and Kuznetsov, NA}, title = {Prospects for the structure‒function evolution of SARS-CoV-2 main protease inhibitors.}, journal = {Journal of computer-aided molecular design}, volume = {39}, number = {1}, pages = {78}, pmid = {40952530}, issn = {1573-4951}, support = {#121112900214-2//Russian state/ ; #121112900214-2//Russian state/ ; }, mesh = {*SARS-CoV-2/enzymology/drug effects ; Humans ; Molecular Dynamics Simulation ; *Coronavirus 3C Proteases/antagonists &amp; inhibitors/chemistry/metabolism ; *Protease Inhibitors/chemistry/pharmacology ; *COVID-19 Drug Treatment ; Structure-Activity Relationship ; *Antiviral Agents/chemistry/pharmacology ; COVID-19/virology ; Lactams ; Leucine ; Nitriles ; Proline ; }, abstract = {The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the third case of widespread coronavirus infection. Together with the other two viruses, the SARS-CoV-2 virus is highly pathogenic, and some strains have a mortality rate of more than 1%. Moreover, it has become clear that coronaviruses mutate quite often, which reduces the effectiveness of available vaccines and forces the regular creation of new ones. The main viral protease M[pro] is a suitable target for direct-acting drugs. Currently, there is only one recommended anticoronavirus drug, nirmatrelvir, which, however, does not have all the properties necessary for widespread and effective use. Thus, the development of a highly selective and effective protease inhibitor that can be taken orally still remains relevant. In this work, we performed an in-depth literature review of M[pro] inhibitor studies and conducted extensive molecular dynamics simulations of M[pro]-inhibitor complexes with computational prediction of binding ability and ADME (absorption, distribution, metabolism and excretion) properties of new compounds. On the basis of the literature review we composed a set of criteria that a potent inhibitor must meet. Then we created a set of possible inhibitors and their parts, which presumably allows all the necessary properties, namely, high affinity for the viral enzyme, selectivity, bioavailability and solubility, to be achieved.}, }
@article {pmid40951905, year = {2025}, author = {Khumbudzo, M and Duah, E and Grobler, E and Maluleke, K}, title = {The Role of Mathematical Modelling in Predicting and Controlling Infectious Disease Outbreaks in Underserved Settings: A Systematic Review and Meta-Analysis.}, journal = {Public health challenges}, volume = {4}, number = {3}, pages = {e70116}, pmid = {40951905}, issn = {2769-2450}, abstract = {BACKGROUND AND AIM: Mathematical modelling plays an important role in public health by enabling the prediction of disease outbreaks, assessment of transmission dynamics and evaluation of intervention strategies. Although widely applied in high-resource settings, its use in underserved contexts remains underexplored. This review aimed to examine and synthesize current evidence on the application of mathematical modelling for predicting and controlling infectious diseases in underserved settings.<br><br>METHODS: A comprehensive and reproducible search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and population, intervention, comparison and outcome (PICO) frameworks across databases, including PubMed, Scopus, Medline, ScienceDirect and EBSCOhost. Keywords and Medical Subject Headings (MeSH) terms related to mathematical modelling and infectious disease control were applied. Two reviewers independently screened titles, abstracts and full texts, with a third resolving discrepancies. Thematic analysis and meta-analysis were used for synthesis.<br><br>RESULTS: Out of 838 studies screened, 27 (3.2%) met inclusion criteria. Deterministic models were most used, followed by stochastic and agent-based models. Diseases modelled included COVID-19, malaria, tuberculosis (TB), Ebola, Zika, chikungunya, dengue, diphtheria, respiratory infections, visceral leishmaniasis (VL) and Mpox. Modelling predicted the impact of interventions on transmission, with pooled effect size (Ro) of 1.32 (&#x3b8;&#xa0;=&#xa0;1.3, p&#xa0;<&#xa0;0.0001). However, challenges, such as data underreporting, gaps and inconsistencies, were common, potentially affecting model accuracy and real-world applicability.<br><br>CONCLUSION: Mathematical modelling has demonstrated value in supporting infectious disease control in underserved settings. However, the predominance of deterministic models limits adaptability across diverse contexts. Poor data quality further constrains reliability. Future work should focus on expanding modelling approaches, strengthening data infrastructure and addressing a broader range of diseases. These findings can guide public health policy by supporting data-driven decision-making, improving resource allocation and integrating modelling into outbreak preparedness and response strategies in underserved settings.}, }
@article {pmid40951570, year = {2025}, author = {A Razzak Mahmood, A and Rani, VI and Yadav, P and Patil, SS}, title = {Advanced Therapeutic Interventions Targeting Mycobacterium Tuberculosis.}, journal = {Archives of Razi Institute}, volume = {80}, number = {1}, pages = {19-35}, pmid = {40951570}, issn = {2008-9872}, mesh = {Humans ; *COVID-19/epidemiology ; *Mycobacterium tuberculosis ; *Tuberculosis/epidemiology/drug therapy/diagnosis/prevention &amp; control ; Artificial Intelligence ; *Antitubercular Agents/therapeutic use ; }, abstract = {Tuberculosis infection (TBI), caused by Mycobacterium tuberculosis (M.tb), presents with or without clinical signs of active TB and is a persistent global threat despite efforts to eradicate it. The emergence of HIV/AIDS is one of the problems to complete eradication. Recent research has focused on vaccines, diagnostics, and treatment. This review examines vulnerable populations, high-risk groups, and socio-economic factors influencing TBI prevalence. It also explores the intersection of TBI and the COVID-19 pandemic, including healthcare disruptions and transmission dynamics. Advances in TBI diagnosis, biomarkers, prophylactic therapies, and combination treatments are discussed, along with the integration of artificial intelligence (AI) in TBI therapy to optimize treatment and personalize care. Vulnerability to TBI varies based on age, socio-economic status, and immune status. High-risk groups include those with compromised immune systems, the elderly, and those in crowded or poorly ventilated settings. Socioeconomic factors such as poverty and limited healthcare access also contribute to TBI prevalence. The COVID-19 pandemic has disrupted TBI diagnosis and treatment, with limited healthcare access impacting outcomes. Changes in healthcare delivery, like telemedicine, may have long-term impacts on TBI care. Improved biomarkers, like interferon-gamma release assays (IGRAs), offer faster TBI diagnosis. Prophylactic therapies, such as isoniazid preventive therapy (IPT), reduce active TB risk in high-risk groups. Combination treatments are being evaluated for drug-resistant strains. AI integration in TBI therapy could lead to better outcomes by analyzing patient data for personalized treatment plans. In conclusion, TBI remains a global health threat requiring ongoing research and innovative approaches for diagnosis and treatment. Advances in diagnosis, prophylactic therapies, and combination treatments, along with AI integration, offer hope for improved outcomes and better patient care, In conclusion, traumatic brain injury (TBI) persists as a significant global health concern, necessitating sustained research efforts and the development of innovative diagnostic and therapeutic approaches. Advancements in diagnostic methods, prophylactic therapies, combination treatments, and the integration of artificial intelligence hold promise for enhancing outcomes and enhancing patient care.}, }
@article {pmid40951566, year = {2025}, author = {Rashki Ghalenoo, S and Azhdari, K and Khosravi, F and Hamzeh, S and Bayat, Z and Talebi Mehrdar, M and Dahmardeh, N and Hassanshahian, M}, title = {Manufacturing Technology and Effectiveness of Corona Vaccines: A Bibliometric Review.}, journal = {Archives of Razi Institute}, volume = {80}, number = {1}, pages = {11-18}, pmid = {40951566}, issn = {2008-9872}, mesh = {*COVID-19 Vaccines/standards/immunology ; Humans ; *COVID-19/prevention &amp; control ; *Bibliometrics ; SARS-CoV-2/immunology ; *Vaccine Efficacy ; }, abstract = {The etiology of "Covid-19," a respiratory illness, was first identified in late 2019 as the causative agent of the novel coronavirus. The conclusion of the pandemic was declared in 2023, and during this interval, a range of vaccines employing diverse strategies were developed. The effectiveness and other immunological characteristics of these vaccines have been thoroughly evaluated. The publication of documents related to the vaccines has persisted even after the conclusion of the pandemic. This study was conducted to investigate the research process and published documents related to the manufacturing technology and effectiveness of the vaccines. The documents published in the Scopus database in early 2024 were collected using restrictions in four subject areas and the English language. The bibliographic analysis was conducted using the Bibliometrix package in Rstudio and VOSviewer. A total of 2,810 documents were reviewed. The majority of these documents were articles and reviews, with 2,320 and 394 documents falling into these categories, respectively. Peptides and capillary electrophoresis emerged as prominent subjects in 2024. Furthermore, elasomeran, covilo, and tozinameran emerged as more recent than other keywords based on their temporal distribution. This study examines the documents published in one of the most reliable databases of vaccines against the novel strain of severe acute respiratory syndrome (SARS-CoV-2) from a bibliometric perspective. The findings of this study are expected to provide valuable insights and direction for future research initiatives, opportunities, and challenges in this field.}, }
@article {pmid40950999, year = {2025}, author = {Zhuang, Z and Bo, Y}, title = {Self-management and role of nurses of diabetic patients: a critical narrative literature review during COVID-19 pandemic.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1626447}, pmid = {40950999}, issn = {2296-858X}, abstract = {BACKGROUND: During COVID-19 and the postepidemic phase, the concept of a frontline emergency response team was gradually expanded [based on a previous clinical trial, https://clinicaltrials.gov/, identifier (ChiCTR2500103976)]. The professional scope of nurses gradually expanded towards the digital. We selected the digital interventions implemented by nurses during the COVID-19 pandemic and self-management by diabetes patients as the research context.<br><br>AIMS: To synthesise a framework for the module-intensity-outcome of digitalised care during COVID-19.<br><br>METHODS: We searched the PubMed database for literature related to the role of nurses and self-management of diabetes patients during the COVID-19 pandemic, and then used these literature as 'seed literature' for a snowball search. We synthesised all the evidence using a directional evidence synthesis method, a narrative description method, and a visual presentation method.<br><br>RESULTS: A total of 10 publications were retrieved from the PubMed database, involving a cumulative total of 5,834 adults. This indicates that using these 10 'seed literature' for secondary literature retrieval enhances the persuasiveness of this method. Using these 'seed literature', an additional 28 literature were retrieved using the snowball method. Digital nursing has developed rapidly during the COVID-19 pandemic due to challenges in patient self-management. During the COVID-19 pandemic, patients sought digital nursing services from nurses due to disrupted healthcare services, surging mental health issues, and unhealthy lifestyles. In this model, nurses serve as a bridge between digital nursing services, the healthcare system, and patients. Digital nursing services not only bridge the gap in nursing services during healthcare crises but also expand the scope of nurses' professional roles.<br><br>CONCLUSION: Nurse-led digital care with a clear mix of "modules and intensity" may have directional benefits for diabetes self-management and metabolic outcomes.}, }
@article {pmid40950566, year = {2025}, author = {Carvajal-Tello, N and Segura-Ordóñez, A and García-Muñoz, H and Sánchez-Montoya, LJ and Cambindo-Larrahondo, LM and Muñoz-Chaux, V and Barahona-Guzmán, JP and Caballero-Lozada, AF}, title = {Systematic review of the effects of neuromuscular electrical stimulation in post-coronavirus disease.}, journal = {The South African journal of physiotherapy}, volume = {81}, number = {1}, pages = {2132}, pmid = {40950566}, issn = {2410-8219}, abstract = {BACKGROUND: Neuromuscular electrical stimulation (NMES) has demonstrated its efficacy in improving strength, muscle development, optimising microcirculation, reducing frailty and mortality risk. A better understanding of its prescription and effects in patients with coronavirus syndrome post (COVID-19) could favour its use.<br><br>OBJECTIVES: To find evidence that compares the effectiveness of NMES in the increasing muscle mass, muscle strength and functional independence of patients in post-intensive care unit (ICU) with COVID-19 syndrome.<br><br>METHOD: A systematic search was carried out in electronic databases: PubMed, Science Direct, Scopus, Ovid and Cochrane from 22 May 2022 to 30 April 2023, without language restriction, including clinical controlled trials (CCTs) and prospective longitudinal studies (PLS). Prospero registration (CRD42022332036).<br><br>RESULTS: A total of 1718 scientific articles were found; four articles met the inclusion criteria. For NMES dosing, intervention time ranged from 9 days to 30 days, the stimulus frequency was between 20 Hz and 121 Hz and the pulse width was between 350 &#xb5;s and 1400 &#xb5;s. The application time ranged from 30 min to 60 min, the intensity was between 20 mA and 250 mA and the stimulated muscle groups were quadriceps, tibialis anterior, hamstrings and gluteus.<br><br>CONCLUSION: The use of NMES after COVID-19 such as integral complementary strategy improves muscle mass, strength and functionality of the patients optimising recovery results.<br><br>CLINICAL IMPLICATIONS: The addition of NMES to standard physical therapy might have a positive impact on the recovery of individuals who have survived COVID-19.}, }
@article {pmid40949166, year = {2025}, author = {Albazah, NIJ and Tiong, JS and Yoshana, M and Aishath, A and Yeo, YT and Elhariri, S}, title = {Prognosis of patients with coronavirus disease with or without anosmia: A systematic review.}, journal = {Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia}, volume = {20}, number = {}, pages = {54}, pmid = {40949166}, issn = {1985-207X}, abstract = {INTRODUCTION: According to numerous research, anosmia has been reported more frequently as one of coronavirus disease (COVID-19) symptoms. However, whether anosmia is a relevant prognostic factor of COVID-19 outcomes is still unknown. A systematic review and meta-analysis were conducted to evaluate the relationship between anosmia and COVID-19 prognosis.<br><br>METHODS: PubMed, PubMed Central, Google Scholar and the WHO COVID-19 Research Database were scanned for published literature from September 2021 to December 2022 about the prognosis of patients positive for COVID-19 with anosmia. 'COVID-19' and 'prognosis' were among the search terms used. Pooled estimates of odds ratios (ORs) were then calculated by comparing patients with and without anosmia in terms of intensive care unit (ICU) admission and death.<br><br>RESULTS: A total of 16 full-text articles were included in this systematic review. There were a total of 40 deaths among the patients with olfactory dysfunction and 1681 deaths among those without olfactory dysfunction, with an OR of 0.19 (95% confidence interval: 0.10, 0.34; P<0.0001), indicating that the patients with COVID-19 with olfactory dysfunction had a decreased mortality rate.<br><br>CONCLUSION: The good prognosis of patients with COVID-19 with anosmia is demonstrated in our study by the low mortality rate in those with anosmia. However, there is no association between the prognosis and ICU admission among patients with COVID-19 with anosmia.}, }
@article {pmid40949164, year = {2025}, author = {Roczkowsky, A and Rachubinski, RA and Hobman, TC and Power, C}, title = {Peroxisomes as emerging clinical targets in neuroinflammatory diseases.}, journal = {Frontiers in molecular neuroscience}, volume = {18}, number = {}, pages = {1642590}, pmid = {40949164}, issn = {1662-5099}, abstract = {Peroxisomes are membrane-bounded organelles that contribute to a range of physiological functions in eukaryotic cells. In the central nervous system (CNS), peroxisomes are implicated in several vital homeostatic functions including, but not limited to, reactive oxygen species signaling and homeostasis; generation of critical myelin sheath components (including ether phospholipids); biosynthesis of neuroprotective docosahexaenoic acid; breakdown of neurotoxic metabolites (such as very-long chain fatty acids); and, intriguingly, glial activation and response to inflammatory stimuli. Indeed, peroxisomes play a critical role in modulating inflammatory responses and are key regulators of the mitochondrial antiviral signaling (MAVS) protein-mediated response to infections. The importance of peroxisomes in CNS physiology is exemplified by the peroxisome biogenesis disorders (PBDs), a spectrum of inherited disorders of peroxisome assembly and/or abundance, that are characterized in part by neurological manifestations ranging from severe cerebral malformations to vision and hearing loss, depending on the individual disorder. Recently, peroxisome dysfunction has been implicated in neurological diseases associated with neuroinflammation including Alzheimer's disease, amyotrophic lateral sclerosis, multiple sclerosis, and Parkinson's disease while also contributing to the pathogenesis of neurotropic viruses including SARS-CoV-2, Human Pegivirus, HIV-1 and Zika virus. In the present review, we examine the diverse roles that peroxisomes serve in CNS health before reviewing more recent studies investigating peroxisome dysfunction in inflammatory brain disorders and also highlight potential peroxisomal targets for diagnostic biomarkers and therapeutic interventions.}, }
@article {pmid40949107, year = {2025}, author = {Mbambara, S and Modipane, N and Serite, T and Sathekge, M and Kgatle, M}, title = {The role of aryl hydrocarbon receptor signalling in COVID-19 pathology and its therapeutic potential.}, journal = {Frontiers in molecular medicine}, volume = {5}, number = {}, pages = {1599785}, pmid = {40949107}, issn = {2674-0095}, abstract = {Coronavirus disease 2019 (COVID-19), caused by the betacoronavirus SARS-CoV-2, emerged in Wuhan, China, and rapidly evolved into a global health crisis. Recent evidence highlights the activation of the aryl hydrocarbon receptor (AHR) pathway following SARS-CoV-2 infection, implicating AHR in facilitating viral replication and impairing antiviral immunity. As a ligand-dependent transcription factor, AHR regulates immune responses, cellular differentiation, and proliferation, and is frequently exploited by viruses to evade host defences. In relation to COVID-19, AHR activation drives immune suppression, systemic inflammation, and metabolic disturbances, intensifying disease severity. Notably, in individuals with comorbidities such as obesity and diabetes, AHR overactivity exacerbates insulin resistance, oxidative stress, endothelial dysfunction, and thrombotic risk, contributing to cardiovascular complications. AHR also promotes airway remodelling and mucus hypersecretion, fostering respiratory dysfunction and fibrotic progression. This review synthesizes current insights into the mechanistic role of AHR signalling in SARS-CoV-2 pathogenesis and discusses its potential as a target for host-directed therapeutic interventions.}, }
@article {pmid40948783, year = {2025}, author = {Tabakov, DV and Maznina, AA and Astakhova, EA and Egorova, AE and Zakharova, EN and Glushkova, OV and Petriaikina, ES and Svetlichnyy, DV and Krupinova, JA and Bogdanov, VP and Yudin, VS and Keskinov, AA and Yudin, SM and Woroncow, M and Skvortsova, VI and Volchkov, PY}, title = {Diagnosis of cancer, autoimmune and infectious diseases and prediction of the therapy effectiveness based on the individual's immunotype.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1658970}, pmid = {40948783}, issn = {1664-3224}, mesh = {Humans ; *Neoplasms/diagnosis/immunology/therapy ; *Autoimmune Diseases/diagnosis/immunology/therapy ; COVID-19/immunology/diagnosis ; *Communicable Diseases/diagnosis/immunology/therapy ; SARS-CoV-2/immunology ; Biomarkers ; Prognosis ; Treatment Outcome ; Immunotherapy ; }, abstract = {Immune system plays a central role in the pathogenesis of cancer and autoimmune diseases. An entire field has emerged to identify separate minor cell subpopulations carrying potential molecular targets or activation markers to study their prognostic role in disease progression and severity or predictive potential to use immunotherapy. However, the biomarker potential of minor populations is limited, as it does not take into account systemic interactions between populations of the immune system. A number of studies in the COVID era have shown that the certain balance between immune cell populations in donor's blood, called 'immunotype', can predict the outcome of treatment and the onset of a cytokine storm. This observation was extended to other diseases, including cancer and autoimmunity. It was shown that the immunotype can be used to diagnose both the presence of the disease itself, as well as its form or progression, to stratify patients in the risk groups and to predict the effectiveness of therapy. The most important advantages of immunotype-based diagnostics are its low invasiveness, the possibility of multiple biomaterial sampling, and the complexity of the analysis by the simultaneous assessment of blood cell composition and their functional activity. In this review, we summarize currently available studies of immunotypes and defined key subpopulations, their possible impact in diagnostics and personalization of the therapy in clinical routine practice in various diseases.}, }
@article {pmid40948395, year = {2025}, author = {González Corralejo, C and Culebras López, E and Martínez Rodríguez, M and Delgado-Iribarren García-Campero, A}, title = {Analysis of Respiratory Syncytial Virus cases at Hospital Clínico San Carlos in Madrid during 2018-2025.}, journal = {Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia}, volume = {38}, number = {5}, pages = {426-430}, pmid = {40948395}, issn = {1988-9518}, mesh = {Humans ; *Respiratory Syncytial Virus Infections/epidemiology/prevention &amp; control ; Spain/epidemiology ; Infant ; Incidence ; Child, Preschool ; COVID-19/epidemiology ; Seasons ; Child ; Aged, 80 and over ; Aged ; Respiratory Syncytial Virus, Human ; Infant, Newborn ; Adolescent ; Middle Aged ; Male ; Female ; Adult ; }, abstract = {Respiratory syncytial virus (RSV) infection is one of the main causes of morbidity and mortality in infants under 6 months of age; however, it can cause respiratory infection at other stages of life. In the period 2018-2025, the number of cases has risen considerably, with positivity mainly concentrated in children under 24 months of age. The SARS-CoV2 pandemic caused modifications in affected population groups and seasonality. The percentage of RSV in children under 6 months of age in the period 2024-2025 was significantly lower than in the 2023-2024 season. In contrast, in the elderly population, especially those over 86 years of age, the percentage of positive cases has increased significantly. From 2022 onwards, the incidence of virus positivity shows a more stable and sustained pattern from October to April compared to previous years. The aim of this review is to assess the evolution of the type of patient diagnosed with RSV infection and to determine early whether the beginning of the vaccination campaign has reduced the incidence in the susceptible population. The availability of epidemiological information to guide decision-making is of great importance for evaluating the effectiveness of these measures and adopting changes in the use of vaccination in the general population.}, }
@article {pmid40947624, year = {2025}, author = {Liu, S and Shao, C and Ding, Y and Wang, Y and Jin, L and Tan, DA and Li, S and Deng, X and Zhou, Y and Xia, Z}, title = {Ubiquitination: A Double-Edged Mechanism in Coronavirus Infections.}, journal = {Journal of medical virology}, volume = {97}, number = {9}, pages = {e70589}, doi = {10.1002/jmv.70589}, pmid = {40947624}, issn = {1096-9071}, support = {//This study was supported by the National Natural Science Foundation of China (U21A20384), the Science and Technology Innovation Program of Hunan Province (2024WZ9001), China Tobacco Hunan Indtstrial Co. Ltd. (KY2024JC0008), Beijing Life Science Academy (BLSA) (2024100CB0170), and the Central South University Graduate Research Innovation Project (2023ZZTS0944, 2025ZZTS0927)./ ; }, mesh = {Humans ; *Ubiquitination ; *SARS-CoV-2/pathogenicity ; *COVID-19/virology/metabolism ; Host-Pathogen Interactions ; Ubiquitin/metabolism ; Virus Replication ; Proteasome Endopeptidase Complex/metabolism ; *Coronavirus Infections/virology/metabolism ; Animals ; Immunity, Innate ; Protein Processing, Post-Translational ; Viral Proteins/metabolism ; Antiviral Agents/pharmacology/therapeutic use ; }, abstract = {The emergence of SARS-CoV-2 in late 2019 had a profound impact on public health, leading to the global COVID-19 pandemic. This viral outbreak has significantly heightened interest in coronaviruses, accelerating research into their pathogenesis. Ubiquitination, a common Posttranslational protein modification, plays a crucial role in processes such as protein localization, metabolism, and degradation. During coronavirus invasion and disease progression, complex interactions involving ubiquitination are at play. On one hand, the host utilizes ubiquitination to activate innate immune signaling pathway or degrade crucial viral proteins via the ubiquitin-proteasome pathway, thereby inhibiting viral replication. On the other hand, coronaviruses manipulate ubiquitination to suppress the activation of key antiviral molecules or promote their degradation. Thus, both the host and virus leverage ubiquitination to their advantage. Thus, investigating the role of ubiquitination in coronavirus infection provides crucial insights into viral infection mechanisms and pathogenesis, potentially facilitating the development of novel antiviral drugs, particularly those targeting ubiquitination regulation, such as PROTAC. This paper offers a comprehensive examination of the regulatory function of ubiquitination in coronavirus infection, with the potential to advance research in the field and open new avenues for the effective control of coronaviruses, especially SARS-CoV-2.}, }
@article {pmid40947117, year = {2025}, author = {Weber, SB}, title = {Grappling with Judicial Discretion in Complex Times.}, journal = {The Journal of law, medicine &amp; ethics : a journal of the American Society of Law, Medicine &amp; Ethics}, volume = {53}, number = {3}, pages = {433-434}, doi = {10.1017/jme.2025.10152}, pmid = {40947117}, issn = {1748-720X}, mesh = {Humans ; *COVID-19/epidemiology ; United States/epidemiology ; SARS-CoV-2 ; Pandemics ; *Judicial Role ; }, abstract = {When areas of the law are ambiguous or untested, such as in the compassionate release cases that proliferated during the height of the COVID-19 pandemic, district judges must rely on their discretion to fill in legal gaps. Discretion can be beneficial, because it means that it allows district judges to consider factors that may lead to potentially harmful outcomes for litigants or their communities. But discretion is imperfect, particularly in the face of ethically or factually complex problems. Perhaps a place to start with addressing this difficulty is greater transparency about the benefits and limitations of discretion.}, }
@article {pmid40946682, year = {2025}, author = {de Castro, AA and Assis, LC and Appel, RJC and da Cunha, EFF and Nepovimova, E and Kuca, K and Ramalho, TC and La Porta, FA}, title = {Nanoparticles and bioactive materials against COVID-19 and its variants: Hints from a computational-materials design perspective.}, journal = {Computers in biology and medicine}, volume = {197}, number = {Pt B}, pages = {111046}, doi = {10.1016/j.compbiomed.2025.111046}, pmid = {40946682}, issn = {1879-0534}, mesh = {Humans ; *COVID-19/virology ; *SARS-CoV-2/drug effects ; Pandemics ; *Nanoparticles/chemistry/therapeutic use ; *Antiviral Agents/therapeutic use/chemistry ; *COVID-19 Drug Treatment ; *Pneumonia, Viral/drug therapy/virology ; *Coronavirus Infections/drug therapy ; Drug Design ; *Betacoronavirus/drug effects ; }, abstract = {Society currently faces many challenges caused by the coronavirus outbreak, known as SARS-CoV-2, and in addition, its variant strains tend to be still more aggressive. Therefore, there is an enormous need to accelerate the development of novel remediation techniques against SARS-CoV-2. A literature review focusing on key terms such as 'COVID-19', 'SARS-CoV-2', 'pharmacotherapy', 'pandemic', 'nanotechnology' and 'computational-materials design', accentuates the increased role played by in silico models in developing prevention, diagnosis, and the treatment strategies. In an attempt to help in the front line, computational repositioning of drugs has intensively been explored as a well-established strategy in preclinical research in order to discover an effective therapy for SARS-CoV-2 infection. Furthermore, computational-materials design-which integrates principles of materials science, physics, chemistry, and computer science-has emerged as an indispensable approach in the fight against COVID-19, accelerating the development of novel nanomaterials and bioactive compounds, and optimizing existing drugs for enhanced efficacy against the virus and its variants. Overall, in this review, we have demonstrated the vital role of computational-materials design strategies in diverse applications (such as diagnostics, vaccines, and treatments, as well as in understanding the fundamental mechanisms of the virus and its interactions with various advanced materials) to handle the current pandemic and pave the way toward future preparedness against emerging infectious disease outbreaks.}, }
@article {pmid40945593, year = {2026}, author = {Cao, Z and Soleimani Samarkhazan, H}, title = {Immature platelet fraction in cardiology.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {579}, number = {}, pages = {120600}, doi = {10.1016/j.cca.2025.120600}, pmid = {40945593}, issn = {1873-3492}, mesh = {Humans ; *Blood Platelets/metabolism/cytology ; *Cardiovascular Diseases/blood/diagnosis ; COVID-19/blood ; *Cardiology ; Biomarkers/blood ; }, abstract = {Cardiovascular diseases (CVDs) remain a leading global cause of mortality, necessitating biomarkers that enhance risk stratification and therapeutic personalization. The Immature Platelet Fraction (IPF), representing young, RNA-rich platelets (also known as reticulated platelets, RP) released from bone marrow, has emerged as a dynamic biomarker linking platelet turnover to cardiovascular pathophysiology. Clinically, elevated IPF is associated with adverse outcomes in acute coronary syndromes (ACS), myocardial infarction, and post-cardiac surgery, particularly when measured 24-72 hours after the event or post-operatively. It correlates with infarct size, recurrent thrombosis, and major adverse cardiovascular events (MACE), though its predictive value is inconsistent at the initial clinical encounter. Its rise reflects compensatory thrombopoiesis in hypercoagulable states like diabetes, COVID-19, and malignancy. IPF also informs antiplatelet therapy, high IPF correlates with clopidogrel resistance but not ticagrelor, guiding agent selection and dual antiplatelet therapy (DAPT) duration. Despite standardization challenges across measurement platforms (flow cytometry vs. automated analyzers), IPF outperforms mean platelet volume (MPV) in tracking platelet activity. Future directions include point-of-care IPF devices, multi-marker panels, and novel therapies targeting thrombopoiesis. Integrating IPF into clinical practice promises refined risk assessment, personalized treatment, and improved prognostic precision in cardiology, bridging translational innovation to patient care. This review synthesizes current evidence on IPF's role in CVDs, highlighting its molecular characteristics, elevated prothrombotic mediators (e.g., thromboxane A2, P-selectin), heightened reactivity, and rapid response to inflammatory stimuli.}, }
@article {pmid40945384, year = {2025}, author = {Muzaffar, U and Fakiruddin, KS and Talebiashtiany, Y and Abdullah, S}, title = {Delving deeper in the eye of the hurricane: Immunopathogenesis &amp; molecular characterization of cytokine storm in COVID-19, association with disease severity &amp; the therapeutic regimens.}, journal = {Cytokine}, volume = {195}, number = {}, pages = {157025}, doi = {10.1016/j.cyto.2025.157025}, pmid = {40945384}, issn = {1096-0023}, mesh = {Humans ; *COVID-19/immunology/complications/pathology/therapy ; *Cytokine Release Syndrome/immunology/therapy/pathology ; *SARS-CoV-2/immunology ; Cytokines/immunology/metabolism ; Severity of Illness Index ; Immunity, Innate ; }, abstract = {The COVID-19 pandemic elicited by SARS-CoV-2 has led to a world-wide crisis, affecting a substantial percentage of the entire global population, and has engendered profound morbidity and fatalities. SARS-CoV-2 mediates its entry into human respiratory epithelial cells via interaction between viral Spike protein (S) and ACE2 receptor and enacts the host cell tropism by numerous molecular factors and inflammatory signaling pathways. The complex molecular immunopathogenesis involves loss of regulatory control of the generation &amp; release of proinflammatory cytokines at both local as well as systemic levels. Excessive secretion of pro-inflammatory cytokines and chemokines leads to the dysregulation of the innate immune system leading to the cytokine storm. Owing to the enormous release of inflammatory factors and active mediators, cytokine storm induces severe damage to secondary tissues, leading to Acute Respiratory Distress Syndrome (ARDS) or multiple-organ failure, which evokes aggravation of the disease and eventually death. Comparisons amid COVID-19 cytokine storm and several other types of cytokine storm associated diseases, gives proper insights about the etiology of cytokine storm in COVID-19. Various genetic and physiological factors contribute to severe disease progression and aggravation of the disease. In that view, several immunoregulatory therapies have been tailored to curb the cytokine storm, which might be crucial in improving the success rates of various treatment strategies as well as in lowering the mortality rate in COVID-19 patients. This review elucidates the hallmarks of COVID-19 cytokine storm, immunopathogenesis, disease progression, biomarkers, and therapeutic interventions.}, }
@article {pmid40945038, year = {2025}, author = {Li, Y and Fan, G and He, H}, title = {Urogenital manifestations of SARS-CoV-2, MPXV and Zika virus: A comprehensive review.}, journal = {Molecular aspects of medicine}, volume = {106}, number = {}, pages = {101399}, doi = {10.1016/j.mam.2025.101399}, pmid = {40945038}, issn = {1872-9452}, abstract = {The current century has been associated with the outbreaks of emerging and re-emerging viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), monkeypox virus (MPXV), and Zika virus (ZIKV). Although their common clinical manifestations are currently well-known, the urogenital system is gaining attention as a significant, though often underappreciated, anatomical site for emerging and re-emerging viral infections, disease development, and transmission. The present review aims to comprehensively discuss the urogenital complications linked to the infections caused by these viruses, with a primary focus on describing their suggested and established roles in the development of urogenital sequelae. It reviews various molecular and cellular mechanisms, such as direct viral pathogen cytopathic activity, virally-mediated inflammation, and the nephrotoxic side effects of specific medications, by which SARS-CoV-2, MPXV, and ZIKV may affect various parts of the urogenital system. In this context, SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) for cell entry, which is frequently present in the urogenital tissues, resulting in urogenital injuries. Zika virus exhibits a distinct tropism for the male reproductive tract, demonstrating prolonged viral persistence in semen that facilitates sexual transmission and is linked to testicular damage and adverse congenital outcomes. The present study also addresses diagnostic considerations and therapeutic strategies in the context of urogenital sequelae associated with these viruses. Understanding the intricate molecular basis of these viral-caused sequelae is crucial for improving differential diagnosis and introducing targeted therapeutic strategies.}, }
@article {pmid40944962, year = {2025}, author = {Yong, SJ and Kenny, TA and Halim, A and Munipalli, B and Alhashem, YN and AlSaihati, H and Al-Subaie, MF and Al Kaabi, NA and Al Fares, MA and Garout, M and Sabour, AA and Alshiekheid, MA and Almansour, ZH and Alotaibi, J and Alrasheed, HA and Alamri, AA and Albayat, H and Alamodi, AS and Tombuloglu, H and Mohapatra, RK and Hazazi, A and Rabaan, AA}, title = {Post-COVID-19 Vaccination (or Long Vax) Syndrome: Putative Manifestation, Pathophysiology, and Therapeutic Options.}, journal = {Reviews in medical virology}, volume = {35}, number = {5}, pages = {e70070}, doi = {10.1002/rmv.70070}, pmid = {40944962}, issn = {1099-1654}, mesh = {Humans ; *COVID-19 Vaccines/adverse effects ; *COVID-19/prevention &amp; control/immunology ; *Vaccination/adverse effects ; SARS-CoV-2/immunology ; Fatigue Syndrome, Chronic ; Syndrome ; }, abstract = {With the global rollout of COVID-19 vaccines, vaccine safety remains a priority. Emerging concerns have raised the potential risk of a long COVID-like syndrome following vaccination, informally called long Vax and provisionally termed post-COVID-19 vaccination syndrome (PCVS). Our narrative review describes the putative manifestation, pathophysiology, and therapeutic approaches of PCVS based on the available evidence, mostly from case reports/series and observational studies. Our review noted that PCVS typically manifests within days to weeks post-vaccination, with symptoms lasting months to years. PCVS may present as recognized diagnoses such as postural orthostatic tachycardia syndrome (POTS), small-fibre neuropathy (SFN), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), or as long-term sequelae of myocarditis, vaccine-induced thrombotic thrombocytopaenia (VITT), or immune thrombocytopaenia purpura (ITP). Symptomatically, PCVS overlaps with long COVID, such as fatigue and brain fog, but PCVS may involve more frequent paraesthesia and less dyspnoea. We also review pathophysiological hypotheses of PCVS, focussing on the vaccine-derived spike protein and related immune responses. Finally, we discuss potential therapies used to treat patients with PCVS or related conditions, primarily documented in case reports/series, which could guide future clinical research. Overall, PCVS remains a poorly understood condition that requires more research to elucidate its prevalence, prognosis, risk factors, and treatments.}, }
@article {pmid40943962, year = {2025}, author = {Păcurar, D and Dinulescu, A and Prejmereanu, A and Palcău, AC and Dijmărescu, I and Pavelescu, ML}, title = {Neurodevelopmental Outcomes in Children Born to Mothers Infected with SARS-CoV-2 During Pregnancy: A Narrative Review.}, journal = {Journal of clinical medicine}, volume = {14}, number = {17}, pages = {}, pmid = {40943962}, issn = {2077-0383}, abstract = {Background: The potential impact of maternal SARS-CoV-2 infection during pregnancy on the neurodevelopment of offspring has raised considerable concern. Emerging studies have evaluated various developmental domains in exposed infants, yet findings remain inconsistent. Objective: To synthesize current evidence regarding neurodevelopmental outcomes in infants born to mothers with confirmed SARS-CoV-2 infection during pregnancy. Methods: We conducted a narrative review following PRISMA guidelines. A literature search was performed in PubMed, Cochrane, and ScienceDirect using keywords including "COVID-19", "pregnancy", "neurodevelopment", and "SARS-CoV-2". Nineteen studies were included. Data were extracted regarding study design, sample size, timing of exposure, age at assessment, developmental tools used, and key findings. Study quality was assessed using the Newcastle-Ottawa Scale. Results: Among 19 included studies, 12 reported at least some neurodevelopmental delays, particularly in motor and language domains. However, these delays were generally mild, domain-specific, and often not statistically significant. Seven studies, most of which were high-quality and low-risk, reported no significant differences between exposed and unexposed groups. Assessment tools and follow-up durations varied widely, limiting comparability. Conclusions: Current evidence does not support a consistent association between in utero SARS-CoV-2 exposure and an unfavorable neurodevelopmental outcome up to 24 months. However, heterogeneity in methods and short-term follow-up warrant further high-quality longitudinal research.}, }
@article {pmid40943770, year = {2025}, author = {Var, SR and Maeser, N and Blake, J and Zahs, E and Deep, N and Vasilakos, Z and McKay, J and Johnson, S and Strell, P and Chang, A and Korthas, H and Krishna, V and Narayanan, M and Arju, T and Natera-Rodriguez, DE and Roman, A and Schulz, SJ and Shetty, A and Vernekar, M and Waldron, MA and Person, K and Cheeran, M and Li, L and Low, WC}, title = {Pulmonary and Immune Dysfunction in Pediatric Long COVID: A Case Study Evaluating the Utility of ChatGPT-4 for Analyzing Scientific Articles.}, journal = {Journal of clinical medicine}, volume = {14}, number = {17}, pages = {}, pmid = {40943770}, issn = {2077-0383}, support = {RF1 AG077772/AG/NIA NIH HHS/United States ; AG077772/NH/NIH HHS/United States ; }, abstract = {Coronavirus disease 2019 (COVID-19) in adults is well characterized and associated with multisystem dysfunction. A subset of patients develop post-acute sequelae of SARS-CoV-2 infection (PASC, or long COVID), marked by persistent and fluctuating organ system abnormalities. In children, distinct clinical and pathophysiological features of COVID-19 and long COVID are increasingly recognized, though knowledge remains limited relative to adults. The exponential expansion of the COVID-19 literature has made comprehensive appraisal by individual researchers increasingly unfeasible, highlighting the need for new approaches to evidence synthesis. Large language models (LLMs) such as the Generative Pre-trained Transformer (GPT) can process vast amounts of text, offering potential utility in this domain. Earlier versions of GPT, however, have been prone to generating fabricated references or misrepresentations of primary data. To evaluate the potential of more advanced models, we systematically applied GPT-4 to summarize studies on pediatric long COVID published between January 2022 and January 2025. Articles were identified in PubMed, and full-text PDFs were retrieved from publishers. GPT-4-generated summaries were cross-checked against the results sections of the original reports to ensure accuracy before incorporation into a structured review framework. This methodology demonstrates how LLMs may augment traditional literature review by improving efficiency and coverage in rapidly evolving fields, provided that outputs are subjected to rigorous human verification.}, }
@article {pmid40943488, year = {2025}, author = {Patel, S and Foster, C and Patel, K and Hunter, M and Isales, CM and Fulzele, S}, title = {Musculoskeletal Complications in COVID-19: Exploring the Role of Key Biomarkers.}, journal = {International journal of molecular sciences}, volume = {26}, number = {17}, pages = {}, pmid = {40943488}, issn = {1422-0067}, support = {P01 AG036675/AG/NIA NIH HHS/United States ; 3P01AG036675-03/NH/NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/complications/metabolism ; *Biomarkers/metabolism/blood ; *Musculoskeletal Diseases/etiology/metabolism/diagnosis ; SARS-CoV-2 ; Cartilage Oligomeric Matrix Protein/metabolism ; Hyaluronic Acid ; }, abstract = {The COVID-19 pandemic has revealed significant secondary complications affecting musculoskeletal (MSK) health, especially in patients with pre-existing conditions. This review synthesizes data from clinical and experimental studies on key MSK biomarkers, including cartilage oligomeric matrix protein (COMP), hyaluronic acid (HA), osteocalcin, alkaline phosphatase (ALP), procollagen type I N-terminal peptide (PINP), osteopontin (OPN), matrix metalloproteinases (MMP-3 and MMP-9), myostatin, IGF-1, follistatin, and creatine kinase. COVID-19 is associated with decreased COMP and osteocalcin levels, indicating cartilage degradation and impaired bone formation, alongside elevated HA, ALP, PINP, OPN, and MMPs, reflecting increased joint inflammation, bone remodeling, and tissue breakdown. Changes in myostatin, IGF-1, follistatin, and creatine kinase levels have been shown to be linked with COVID-19-related sarcopenia. These biomarker alterations provide insight into the underlying mechanisms of MSK damage in COVID-19 patients and highlight the potential for using these markers in early diagnosis and management of post-COVID musculoskeletal disorders. Further longitudinal research is essential to develop targeted therapies aimed at mitigating long-term MSK complications in affected individuals.}, }
@article {pmid40942842, year = {2025}, author = {Kinyua, DM and Memeu, DM and Mugo Mwenda, CN and Ventura, BD and Velotta, R}, title = {Advancements and Applications of Lateral Flow Assays (LFAs): A Comprehensive Review.}, journal = {Sensors (Basel, Switzerland)}, volume = {25}, number = {17}, pages = {}, pmid = {40942842}, issn = {1424-8220}, mesh = {Humans ; *COVID-19/diagnosis ; SARS-CoV-2/isolation &amp; purification ; Immunoassay/methods ; *Biosensing Techniques/methods ; Limit of Detection ; Nanoparticles/chemistry ; Pandemics ; Nanotechnology ; }, abstract = {Over a decade ago, WHO introduced the ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment-free, and Deliverable to end-users) criteria to guide diagnostic assay development. Today, lateral flow assays (LFAs) best meet these standards, evolving from simple rapid tests to advanced diagnostics integrating AI and nanotechnology for precise, quantitative results. Notably, nanoparticle-enhanced LFAs have achieved limits of detection (LOD) as low as 0.01 pg/mL (a 100-fold improvement over conventional methods), while AI algorithms have reduced interpretation errors by 40% in low-contrast conditions. The COVID-19 pandemic underscored the societal impact of LFAs, with over 3 billion antigen tests deployed globally, demonstrating 98% specificity in real-world surveillance. Beyond infectious diseases, LFAs are revolutionizing cancer screening through liquid biopsy, achieving a 92% concordance rate with gold-standard assays, food safety and environmental monitoring. Despite these advancements, challenges remain in scalability, reproducibility, sustainable manufacturing, and how to enhance the sensitivities and lower the LOD. However, innovations in biodegradable materials, roll-to-roll printing, CRISPR-integrated multiplexing, and efficient functionalization methods like photochemical immobilization technique offer promising solutions, with projected further cost reductions and scalability. This review highlights the technological evolution, diverse applications, and future trajectories of LFAs, highlighting their critical role in democratizing diagnostics.}, }
@article {pmid40941682, year = {2025}, author = {Cocuz, IG and Niculescu, R and Popelea, MC and Cocuz, ME and Sabău, AH and Tinca, AC and Cozac-Szoke, AR and Chiorean, DM and Budin, CE and Cotoi, OS}, title = {Current Trends and Future Directions of Digital Pathology and Artificial Intelligence in Dermatopathology: A Scientometric-Based Review.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {17}, pages = {}, pmid = {40941682}, issn = {2075-4418}, abstract = {Background: Digital Pathology (DP) and Artificial Intelligence (AI) have strongly developed in recent years, especially in pathology, with a high interest in dermatopathology. Accelerated by the COVID-19 pandemic, DP and AI are now integrated in pathology, research and education, bringing value to histopathological diagnoses, telepathology and personalized medicine. This narrative review presents a comprehensive literature review by defining three research directions, using scientometric analysis, of the current state of DP and AI in pathology and dermatopathology. Methods: The research was conducted through the Pubmed and Web of Science databases, within the research period of January 2019-July 2025: a two-phase methodology. Four independent pathologists selected the articles in accordance with the inclusion and exclusion criteria, and the synthesis of the articles was based on three research directions. Results: The research shows that CNN (Convolutional Neural Network), AI powered diagnostic platforms and telepathology strongly contribute to increasing the speed and accuracy of diagnostics, especially on cutaneous malignant skin tumors. There are still several challenges and limitations in terms of validation, interoperability, initial high implementation costs, ethics and transparency in AI and equity in healthcare. Conclusions: DP and AI are essential pillars of modern dermatopathology, with a high necessity of standardization, regulation and a multidisciplinary approach.}, }
@article {pmid40941488, year = {2025}, author = {Compañ-Gabucio, LM and Moreno-Morente, G and Company-Devesa, V and Torres-Collado, L and García-de-la-Hera, M}, title = {Occupational Therapy Interventions in Mental Health During Lockdown: A Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {17}, pages = {}, pmid = {40941488}, issn = {2227-9032}, abstract = {Lockdown derived from the COVID-19 pandemic posed significant challenges to mental health care, prompting the adaptation of therapeutic practices. The objective of this study was to describe the characteristics and objectives of occupational therapy (OT) interventions conducted in the field of mental health during the COVID-19 lockdown. A scoping review was conducted following PRISMA-ScR guidelines. A systematic search was carried out in the following databases: PubMed, Scopus, Embase, OTSeeker, PsycINFO, and Web of Science. We included randomized or non-randomized intervention studies, published in English or Spanish, that explored OT interventions in mental health during the COVID-19 period and/or lockdown. Data were extracted using pre-designed tables in accordance with the recommendations of the Cochrane Handbook. We included seven articles. OT interventions were conducted via video call (n = 4) and in person (n = 3). These were carried out with adults, adolescents, and children, lasting from 1 to 32 weeks, with the number of sessions ranging from 7 to 22 and lasting 20 to 90 min. The most frequently addressed outcomes were quality of life (n = 4), anxiety or depression (n = 4), and sleep (n = 4). During lockdown, OT interventions were mainly applied via telerehabilitation with the aim of increasing activity participation and addressing emotional issues. These results could help occupational therapists to implement mental health interventions when in-person application is compromised.}, }
@article {pmid40940092, year = {2025}, author = {Saadi, S and Nacer, NE and Boughellout, H and Benyahia, FA and Faiza, A and Anwar, F and Ariffin, AA and Boudjellal, A and Ghazali, HM and Saari, N and Mohammed, AS}, title = {Advances in microbial C-reactive peptides as pro-sensors for antibiotic release and membrane driving potentials.}, journal = {Advances in food and nutrition research}, volume = {116}, number = {}, pages = {409-500}, doi = {10.1016/bs.afnr.2025.04.012}, pmid = {40940092}, issn = {1043-4526}, mesh = {*Anti-Bacterial Agents/pharmacology/analysis ; Humans ; *C-Reactive Protein/metabolism ; Animals ; Biomarkers ; }, abstract = {The involvement of C-reactive proteins in triggering antibiotic release is important in figuring out the underlaying mechanisms of cellular biomarkers involving the immune reaction and inflammation. Thus, the existence of microbial C-reactive proteins or peptides are getting logical acceptance due to the presence of some homologue peptides into microbes capable in triggering same inflammatory response levels like to that happening into mammalian cells. The objective of this chapter is to study in depth the mechanization of microbial C-reactive proteins/peptides for allowing the release of de novo antibiotics capable in competing the penicillin mechanism of action. Therefore, series of plasmo-dynamic markers are beared in mind and studied including the role of anti-inflammatory peptides, peptide transporters, opioid peptides, cell penetrating peptides and other static membrane markers including Toll-like receptor, and G-protein coupled receptors. These cellular biomarkers are studied in light of their mechanizations toward the release of commonly known classes of antibiotics including antiviral, antifungal, and antimicrobial ones. The chapter is also covering the availability of antibiotics in foods, microbes, biological matrices and in animal cells and tissues as well as the methods of detection and quantification of antibiotics and also the commonly methods used in mitigating those antibiotics when they are present in excessive doses in food materials. In this regard, some engineered models have been developed in order to remove residual traces of antibiotics as mode for food safety purposes. The domain applications of antibiotics as putative cores and therapies used for preventing the burden diseases like Covid-19 pandemia and other complicated transient diseases are also covered. The chapter is shedding light on the mechanization of peptides like antibiotics, microbial resistance against antibiotics, mechanism of antibiotic sensing, peptides-antibiotic interaction, and antibiotic resistance, by projecting lights on some developed biosensors used in detecting these type of substances.}, }
@article {pmid40939863, year = {2025}, author = {Filipczak, N and Yalamarty, SSK and Li, X and Pathrikar, TV and Pinapati, R and Vanjara, B and Torchilin, V}, title = {Neutrophil extracellular traps: Formation, pathological roles, and nanoparticle-based therapeutic targeting strategies.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {387}, number = {}, pages = {114220}, doi = {10.1016/j.jconrel.2025.114220}, pmid = {40939863}, issn = {1873-4995}, mesh = {*Extracellular Traps/drug effects/immunology ; Humans ; Animals ; *Neutrophils/immunology/drug effects ; *Nanoparticles/administration &amp; dosage ; Inflammation/drug therapy/immunology ; Drug Delivery Systems ; }, abstract = {Neutrophil extracellular traps (NETs) are large, web-like DNA structures released by neutrophils, coated with histones and antimicrobial proteins. They serve as a crucial defense mechanism for neutrophils against microbial invasion, playing a significant role in eliminating microorganisms such as bacteria, fungi, and viruses. While NETs are primarily recognized for their role in microbial defense, growing evidence indicates that excessive NET formation, triggered by physical and chemical stimuli, pathogens, or pathological factors, can worsen inflammation and cause organ damage. Understanding NETs' presence in various tissues and body fluids is crucial for elucidating their contribution to disease etiopathogenesis. By designing nanoparticles that can either prevent NET formation or facilitate their degradation, researchers aim to mitigate the harmful effects of excessive NETs. These nanotechnological interventions can be tailored to specifically target the molecular components of NETs, enhancing treatment precision and efficacy. Furthermore, nanoparticles can deliver therapeutic agents directly to inflammation sites, reducing systemic side effects and improving patient outcomes. This review summarizes the role of NETs in various pathologies, focusing on strategies to inhibit NETosis, including mechanisms of pathogen evasion, and the use of nanodelivery systems to enhance the efficiency of NETs inhibition or removal.}, }
@article {pmid40939529, year = {2025}, author = {Saidoune, F and Yatim, A and Di Domizio, J and Gilliet, M}, title = {Skin manifestations of SARS-CoV-2 infection and its vaccination.}, journal = {Current opinion in immunology}, volume = {97}, number = {}, pages = {102656}, doi = {10.1016/j.coi.2025.102656}, pmid = {40939529}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/immunology/prevention &amp; control/complications ; *SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology/adverse effects ; Vaccination/adverse effects ; Interferon Type I/immunology/metabolism ; *Skin/immunology/pathology/virology ; Animals ; Dendritic Cells/immunology ; *Skin Diseases/immunology/etiology ; }, abstract = {SARS-CoV-2 infection and vaccination are associated with a broad range of skin manifestations, including chilblains, urticaria, morbilliform and papulovesicular rashes, purpuric-necrotic lesions, and autoimmune flares. These patterns reflect differences in the timing and nature of type I interferon (IFN-I) responses. Rapid TLR7-mediated IFN-I production by plasmacytoid dendritic cells (pDCs) in the upper airways restricts viral replication; hyperresponsive pDCs protect from severe infection but may cause chilblain-like lesions through exaggerated local inflammation. When early IFN-I responses are weak, viral spread to the lungs triggers endothelial cell death, mitochondrial DNA release, and cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) activation, producing a late IFN-I surge that amplifies inflammation, mirrored by morbilliform, vesicular, or necrotic skin lesions. mRNA and viral vector vaccines can similarly activate nucleic acid sensors, inducing IFN-I-driven rashes, and promote spike-specific T cells that cross-react with skin antigens. Recognizing these cutaneous signs offers insight into the balance between protective and pathogenic immunity in COVID-19.}, }
@article {pmid40939094, year = {2025}, author = {Wang, Y and Zhang, C and Zhang, Y and Zhang, Z}, title = {The Cerebral Haemorrhage and SARS-CoV-2: An Emerging Virus From a Meta-Analysis Perspective.}, journal = {Reviews in medical virology}, volume = {35}, number = {5}, pages = {e70069}, pmid = {40939094}, issn = {1099-1654}, mesh = {Humans ; *Cerebral Hemorrhage/epidemiology/virology/etiology ; *COVID-19/complications/virology/epidemiology ; Risk Factors ; *SARS-CoV-2/pathogenicity ; }, abstract = {The central nervous system is a potential target of the COVID-19 virus, and one of the devastating neurological consequences of this infection is cerebral haemorrhage (ICH). Cerebral haemorrhage is a leading cause of death worldwide. This study aimed to systematically review and analyse the existing literature on this topic and provide insights into the potential neurological consequences of COVID-19. A comprehensive search was conducted across the PubMed, Scopus, Web of Science, and Embase databases to extract relevant published data up to February 2025. This meta-analysis included 11 studies involving a total of 197,060 individuals. Subgroup analyses were performed based on the year of publication, hospital sampling wards, and study design. A critical appraisal was carried out using the Newcastle-Ottawa Scale (NOS) score. Risk was utilised as a measure of pooled effect size based on a random-effects model. In this analysis, we identified 11 articles that directly assessed the risk of cerebral haemorrhage. The reported risk of cerebral haemorrhage was five cases per 10,000 COVID-19 patients [0.005 (95% CI: 0.002-0.009), p < 0.001]. Notably, studies published in 2022 and 2023 indicated a significantly higher risk of cerebral haemorrhage compared to earlier years. COVID-19 patients admitted to the intensive care unit (ICU) faced an increased risk of cerebral haemorrhage compared to those admitted to general wards. Meta-regression analysis revealed a statistically significant association between the risk of cerebral haemorrhage and the type of wards in a hospital [0.0089 (95% CI: 0.0067-0.0112), p < 0.001], as well as the year of publication [0.0004 (95% CI: 0.0003-0.0008), p = 0.048]. Therefore, it is essential to evaluate COVID-19 patients admitted to the ICU in recent years for the potential occurrence of cerebral haemorrhage.}, }
@article {pmid40937306, year = {2025}, author = {Ucciferri, C and Chiappini, F and Vecchiet, J and Falasca, K}, title = {From Legacy to Innovation: Pidotimod's Expanding Therapeutic Horizon.}, journal = {Mediterranean journal of hematology and infectious diseases}, volume = {17}, number = {1}, pages = {e2025057}, pmid = {40937306}, issn = {2035-3006}, abstract = {Pidotimod, a synthetic dipeptide, has been utilized for over three decades as an immunomodulatory agent to prevent recurrent respiratory infections, particularly in immunocompromised populations such as children and the elderly. Originally developed for its ability to enhance innate and adaptive immune responses, pidotimod is now being revisited in light of new clinical insights and emerging therapeutic needs. Recent studies have expanded its potential beyond traditional indications, with evidence supporting its role in patients with chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD), allergic rhinitis, and even viral infections, including SARS-CoV-2. Pidotimod exerts its effects by stimulating dendritic cells, enhancing toll-like receptor (TLR) expression, and promoting cytokine production, including IL-2 and IFN-γ, thereby supporting both cellular and humoral immunity. This broad-spectrum immune modulation makes pidotimod a promising adjunct in managing immune-mediated diseases and infections in both immunocompetent and immunocompromised individuals. In this review, we examine pidotimod's pharmacodynamics, summarize clinical evidence from recent studies, and explore its evolving role in modern therapeutic strategies for infectious diseases. Given its safety profile and oral administration, pidotimod holds significant promise not only for preventing infections but also as part of a broader immunomodulatory approach in complex disease management.}, }
@article {pmid40936739, year = {2025}, author = {Rastogi, S and Gupta, S and Deepak, D and Mishra, BN and Gore, R and Singh, V}, title = {A Systematic Literature Review on Anxiety Among Undergraduate Students: Causes and Coping Strategies.}, journal = {Annals of neurosciences}, volume = {}, number = {}, pages = {09727531251366078}, pmid = {40936739}, issn = {0972-7531}, abstract = {BACKGROUND: Anxiety is a prevalent mental health concern among undergraduate students, adversely affecting academic performance, social functioning and emotional well-being. Its multifactorial causes and coping strategies, particularly in the context of global disruptions such as the COVID-19 pandemic, warrant a comprehensive synthesis.<br><br>PURPOSE: This systematic review aims to analyse empirical studies on the causes of anxiety and the effectiveness of coping strategies among undergraduate students from 2010 to 2025.<br><br>METHODS: A systematic review was conducted using Scispace.ai, selecting 40 empirical studies published between 2010 and 2025. Keywords used included 'anxiety', 'undergraduate students' and 'coping strategies'. Thematic analysis was performed to categorise findings into major focus areas.<br><br>RESULTS: Seven key themes emerged: Prevalence (16%), academic stress (18%), social anxiety (16%), emotional comorbidities (16%), demographic differences (12%), coping mechanisms (14%) and contextual stressors such as COVID-19 (8%). Social judgement, academic pressure and fear of failure were primary causes of anxiety, often co-occurring with depression and emotional dysregulation. Female students and first-year undergraduates were identified as more vulnerable groups. Effective coping strategies included mindfulness practices, yoga, peer support and biofeedback; however, utilisation was limited by stigma and inadequate mental health services. The COVID-19 pandemic further intensified anxiety levels due to social isolation and academic uncertainty.<br><br>CONCLUSION: This review underscores the urgent need for inclusive support systems, integration of digital mental health tools and culturally sensitive interventions within educational institutions. Future research should explore longitudinal trends and develop context-specific strategies to improve mental health outcomes among undergraduate students.}, }
@article {pmid40936649, year = {2025}, author = {Schumann, A and Di Giuliano, M and Schulz, S and de la Cruz, F and Kreuder, T and Seifert, G and Bär, KJ}, title = {Mapping the brain's fatigue network: a transdiagnostic systematic review and meta-analysis on functional correlates of mental fatigue.}, journal = {Brain communications}, volume = {7}, number = {5}, pages = {fcaf315}, pmid = {40936649}, issn = {2632-1297}, abstract = {Mental fatigue is a significant psychopathological symptom that has recently gained attention, particularly in chronic fatigue syndrome/myalgic encephalomyelitis and Post-COVID-19 condition. However, fatigue is a clinically relevant symptom across a wide range of mental and neurological disorders. To identify a transdiagnostic functional network associated with fatigue, we conducted an activation likelihood estimation meta-analysis of neuroimaging studies. The primary inclusion criterion was studies involving any medical condition where patients exhibited significantly higher levels of fatigue compared to healthy controls. A systematic literature review across three major scientific databases identified 46 eligible neuroimaging studies, including a total of 2603 individuals. The meta-analysis of these studies revealed a widespread cortical-subcortical network involving frontal, limbic, basal ganglia and parietal structures. Three main clusters were highlighted: a frontal-striatal-limbic cluster, a frontal-cingulate cluster and a parietal cluster, with regions implicated in cognitive, emotional and somatosensory symptoms associated with mental fatigue. Quality analysis indicated a moderate risk of bias in the majority of the included studies. Overall, our findings provide scientific evidence for a transdiagnostic mental fatigue network in the brain, with key nodes located in the lateral frontal cortex, cingulate cortex, insula, thalamus, precuneus and caudate. These results support the theory of thalamic-striatal-cortical dysfunction, which may impair compensatory mechanisms related to mental fatigue. Additionally, abnormal activation of limbic and parietal regions may contribute to cognitive, emotional and attentional impairments linked to fatigue.}, }
@article {pmid40935562, year = {2025}, author = {Wormser, J and Romanet, C and Cachanado, M and Youinou, M and Chatellier, G and Torres Sánchez, I and Philippart, F}, title = {Virtual reality in adults with respiratory diseases experiencing dyspnoea: a systematic review and meta-analysis.}, journal = {BMJ open respiratory research}, volume = {12}, number = {1}, pages = {}, pmid = {40935562}, issn = {2052-4439}, mesh = {Humans ; *Dyspnea/therapy/etiology/physiopathology ; Quality of Life ; *Virtual Reality ; Exercise Tolerance ; Adult ; }, abstract = {OBJECTIVES: Our aim was to evaluate virtual reality's effects in dyspnoea's management.<br><br>METHODS: Information sources: Trials were identified through a systematic search carried out on MEDLINE, Web of Science, Scopus and CINAHL until 17 March 2025.<br><br>ELIGIBILITY CRITERIA: Eligible studies were controlled trials including adults with dyspnoea associated with respiratory diseases, for whom virtual reality was implemented and compared with another intervention. Risk of bias: Risk of bias (ROB) was assessed using the ROB 2 tool.<br><br>SYNTHESIS OF RESULTS: The primary outcome was dyspnoea. Secondary outcomes included exercise capacity, health-related quality of life (HRQOL) and muscle function. Effect size was expressed using standardised mean difference (SMD) or MD for primary and secondary outcomes, respectively (random-effects model). We used the Grading of Recommendations Assessment, Development and Evaluation approach to judge the certainty of evidence.<br><br>RESULTS: Included studies: 13 studies were selected, including 483 adults and using non-immersive tools (n=7) or immersive tools (n=6). Risk of bias in these studies was low (n=1), some concerns (n=8) and high risk (n=4).<br><br>SYNTHESIS OF RESULTS: No difference was found in dyspnoea (8 studies, 224 participants; SMD 0.02, 95%&#x2009;CI -0.82 to 0.86, I[2]=88.2%), exercise capacity (5 studies, 183 participants; MD 3.62, 95%&#x2009;CI -19.39 to 26.63, I[2]=39.8%) and in HRQOL (4 studies, 127 participants; MD -11.81, 95%&#x2009;CI -42.95 to 19.33, I[2]=98.9%). The data available were insufficient to conduct a pooled analysis for muscle function.<br><br>CONCLUSIONS: Limitations of evidence: The evidence is very uncertain about virtual reality's effects on dyspnoea due to risk of bias, imprecision and heterogeneity.<br><br>INTERPRETATION: Further studies are needed and should explore various aspects of the application of immersive virtual reality.<br><br>PROSPERO REGISTRATION NUMBER: CRD42023443280.}, }
@article {pmid40935100, year = {2025}, author = {Chen, L and Zhao, S and Li, X and Wang, X and Yu, G}, title = {Synergistic effects of microplastics and bioaerosols: emerging trends in urban air pollution complexification and public health implications.}, journal = {Environmental research}, volume = {286}, number = {Pt 1}, pages = {122808}, doi = {10.1016/j.envres.2025.122808}, pmid = {40935100}, issn = {1096-0953}, mesh = {*Microplastics/analysis/adverse effects ; Humans ; Aerosols/analysis ; *Air Pollutants/analysis/adverse effects ; *Public Health ; *Air Pollution/adverse effects/analysis ; *Air Microbiology ; COVID-19 ; }, abstract = {Urban air is increasingly contaminated with complex mixtures of microplastics (MPs) and bioaerosols (BAs), whose co-exposure may pose unique health risks. This review highlights the synergistic interaction between MPs and BAs during atmospheric transport and human exposure. We summarized the sources and physicochemical characteristics of airborne MPs (fragments and fibers from urban waste and textiles) and BAs (bacteria, fungi, and viruses from soil, water, and human activity) and their shared dispersion pathways via wind and resuspension. Both pollutants deposit in the respiratory tract upon inhalation. Notably, MPs may function as potential microbial carriers. Laboratory and field data indicate that airborne plastics harbor distinct microbial biofilms (often with antibiotic-resistant bacteria/genes) and may prolong virus survival (e.g., SARS-CoV-2 on plastic surfaces). These MP-microbe aggregates can enhance pathogen persistence and increase host exposure. In lung models, inhaled MPs disrupt epithelial barriers and surfactant layers, inhibit cell proliferation, and trigger inflammation (tumor necrosis factor-alpha, interleukin-6, IL-1β, and tumor growth factor-beta) and oxidative stress (depleting SOD/CAT and generating reactive oxygen species). Assessing this co-pollution requires advanced methods. Standard spectroscopic tools (micro-Fourier-transform infrared spectroscopy and micro-Raman) and emerging methods such as laser direct infrared imaging enable polymer identification and MP sizing. Similarly, culture-independent high-throughput sequencing techniques (e.g., 16S/18S rRNA gene profiling) elucidate airborne microbial diversity. Novel real-time aerosol counters (e.g., UV-LIF optical sensors) and machine learning analytics are being applied to monitor BA load. Finally, we discussed implications for vulnerable subpopulations (children, the elderly, and individuals with chronic respiratory conditions) who may be more susceptible to combined MP/BA effects. The review proposes future directions, which include developing integrated toxicological models, multi-omics analyses of particle-microbe interactions, and establishing coordinated environmental health surveillance to track this emerging urban pollutant mixture.}, }
@article {pmid40934937, year = {2025}, author = {Wilhelm, F and Cadamuro, J and Mink, S}, title = {Autoantibodies in long COVID: a systematic review.}, journal = {The Lancet. Infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1473-3099(25)00411-6}, pmid = {40934937}, issn = {1474-4457}, abstract = {Post-COVID-19 condition (also known as long COVID) affects a substantial proportion of individuals who have been infected with SARS-CoV-2, profoundly affecting their daily lives and work. Diagnosis and prognosis of long COVID are complex and hindered by heterogeneous symptoms and the absence of validated biomarkers. This systematic review synthesises current evidence on the association between autoantibodies and long COVID, with the goal of evaluating their prognostic and diagnostic utility. Studies published in the PubMed and MEDLINE databases between Jan 1, 2020, and June 10, 2025, were considered. Study selection and quality assessment were done independently by two researchers. Of the 1113 publications screened, 44 studies met the inclusion criteria, with a total of 7571 participants, including 3372 individuals with long COVID. 31 (71%) studies reported an association between autoantibodies and long COVID; however, there was substantial heterogeneity in study design, type and timing of antibody measurements, and long COVID definitions. Several autoantibodies have been associated with long COVID occurrence, symptoms, and severity. Antinuclear antibodies, and autoantibodies targeting G protein-coupled receptors and chemokines, have emerged as potential biomarkers for aiding in the diagnosis, prognosis, and assessment of disease severity in long COVID. However, larger studies are needed to confirm the diagnostic and prognostic utility of these autoantibodies in the context of long COVID.}, }
@article {pmid40934489, year = {2025}, author = {Garcia Gonzalez-Moral, S and Pennock, E and Ewedairo, O and Green, E and Elgey, J and Mkwashi, A}, title = {Horizon Scanning Methods for Health Care Technology Innovation Identification: Rapid Scoping Review of Patent Research Studies.}, journal = {Interactive journal of medical research}, volume = {14}, number = {}, pages = {e70323}, pmid = {40934489}, issn = {1929-073X}, abstract = {BACKGROUND: Patents are an early sign of innovation, yet their role in horizon scanning for health care remains unclear.<br><br>OBJECTIVE: This study investigates the role of, and methods for, patent analysis in advancing health care technology innovation in a sector that is characterized by diverse health care technologies and significant research investment. Patents are critical early indicators of innovation, supporting horizon scanning and weak signal detection. The study aimed to identify intellectual property sources, evaluate methods for patent retrieval and analysis, and outline objectives for using patent data to anticipate trends and inform health care strategies.<br><br>METHODS: A rapid scoping review was conducted following Cochrane Rapid Review Methods recommendations and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a preregistered protocol on the Open Science Framework. Searches in Embase, IEEE Xplore, and Web of Science targeted records published 2020 onward to capture the most recent sources, methods, and tools. Three independent reviewers screened studies using Rayyan (Qatar Computing Research Institute). We included any study type published since 2020 that provided patent sources data, methods, and tools applied to the study of health care technologies. Our data extraction included bibliographic details, study characteristics, and methodological information. Risk of bias assessments were not undertaken. Narrative and tabular methods, supplemented by visual charts, were used to synthesize findings.<br><br>RESULTS: Our searches identified 1741 studies, of which 124 were included after title, abstract, and full-text screening, with 54% being original research, 43.5% reviews, and the remainder being conference abstracts (2.5%). Most studies (68%) relied solely on patent databases, while others searched the gray and published literature. Research objectives of the included studies were grouped into 10 themes, with trend analysis (50%) and the provision of recommendations for future research, policy, and strategy development (20%) being the most common. Our review identified up to 47 patent databases, with 27% of studies using multiple sources. Whenever time limits were reported, the mean time horizon for patent searches was 24.6 years, ranging from 1900 to 2019. Automated approaches, used in 33% (n=43) of studies, frequently used tools such as Gephi (Gephi Consortium) for network visualization. Disease mapping based on National Institute for Health and Care Excellence classification indicated that cancer (19%) and respiratory conditions (16%), particularly COVID-19, were key areas.<br><br>CONCLUSIONS: Patent data are valuable for identifying technological trends and informing policy and research strategies. While patents provide crucial insights into emerging technologies, inconsistent deduplication practices across studies pose the risk of data inflation, accentuating the need for transparency and rigor. Finally, this review emphasized the importance of data transformation and visualization in detecting emerging trends, with Python and R being the most commonly used programming languages for developing custom tools.}, }
@article {pmid40933738, year = {2025}, author = {Kemoun, G and Demoule, A}, title = {High-flow nasal oxygen is the reference treatment in acute hypoxemic respiratory failure: Con.}, journal = {Journal of intensive medicine}, volume = {5}, number = {3}, pages = {230-236}, pmid = {40933738}, issn = {2667-100X}, abstract = {Over the past decade and boosted by the coronavirus disease 2019 (COVID-19) pandemic, high-flow nasal oxygen (HFNO) has been increasingly used in the intensive care unit (ICU) to treat acute hypoxemic respiratory failure (AHRF). In this review, we show that despite this wide and rapid increase in the use of HFNO to treat AHRF, HFNO does not fulfill all the criteria of a "reference treatment". First, there are some inconsistencies between the studies that provided a positive signal toward the possible benefit of HFNO in AHRF. The two high-quality studies were negative in terms of primary outcome although they provided promising signals in favor of HFNO in terms of secondary outcomes or unplanned secondary analysis. The significance of the only positive study suffers from notable limitations and other trials, conducted in COVID-19 and in immunocompromised patients, are definitely negative and do not even provide promising signals in favor of HFNO. Of note, authors of some of the large randomized controlled trials (RCTs) on HFNO have received grants or personal fees from manufacturers of HFNO devices. Second, meta-analyses do not show positive results regarding the efficacy of HFNO on mortality and recent guidelines do not support its use to improve this outcome, although they recommend HFNO use to reduce intubation rate. Third, HFNO is associated with risks that should be accounted for. There are concerns that HFNO may delay intubation, which is in turn associated with higher mortality and prolonged length of stay. In addition, with HFNO, high inspiratory effort may generate high lung strain and overstretch, a phenomenon termed patient self-inflicted lung injury (P-SILI). Fourth, there are concerns regarding access to HFNO in resource-limited settings. Fifth, there are also concerns regarding the deleterious environmental impact of HFNO due to the high volume of consumables and high oxygen flow, which remain to be precisely quantified and balanced with the potential reduction in intubation rate. Considering all these limitations, HFNO is not yet the reference treatment for AHRF.}, }
@article {pmid40931272, year = {2025}, author = {Iodice, F and Cuffaro, L and Romoli, M and Bianchini, E and Sparaco, M and Arighi, A and Cerami, C and Salemme, S and Reale, G and Orologio, I and Lavorgna, L and Padovani, A}, title = {A comprehensive guide to digital neurology. An update on current development on digital neurology derived from the Digital Neuro Hub project.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {46}, number = {12}, pages = {6167-6179}, pmid = {40931272}, issn = {1590-3478}, mesh = {Humans ; *Neurology/methods/trends ; *Telemedicine/trends ; COVID-19 ; Artificial Intelligence ; Wearable Electronic Devices ; Italy ; }, abstract = {The rapid evolution of digital tools in recent years after COVID-19 pandemic has transformed diagnostic and therapeutic practice in neurology. This shift has highlighted the urgent need to integrate digital competencies into the training of future specialists. Key innovations such as telemedicine, artificial intelligence, and wearable health technologies have become central to improving healthcare delivery and accessibility. In response, the Digital Neurology group of the Italian Society of Neurology convened during the Italian Digital Neuro Hub meeting to define the essential digital skills and knowledge areas for tomorrow's neurologists. This paper outlines four primary domains of focus: wearable devices, telemedicine, AI applications, and the ethical implications of digital medicine in neurology.}, }
@article {pmid40930270, year = {2025}, author = {Walker, TA and Kohler, JZ and Haddad, MM}, title = {Long COVID: Current landscape of neurocognitive sequalae and opportunities to improve care management.}, journal = {Brain, behavior, and immunity}, volume = {130}, number = {}, pages = {106108}, doi = {10.1016/j.bbi.2025.106108}, pmid = {40930270}, issn = {1090-2139}, }
@article {pmid40930047, year = {2025}, author = {Sanftenberg, L and Kraeker, L and Walter, F and Tsiligianni, I and Bouloukaki, I and Roos, M and Gensichen, J}, title = {Associations between common mental disorders and vaccination readiness against seasonal influenza and Covid-19 of chronically ill adult patients in primary care - a systematic review.}, journal = {Vaccine}, volume = {64}, number = {}, pages = {127682}, doi = {10.1016/j.vaccine.2025.127682}, pmid = {40930047}, issn = {1873-2518}, mesh = {Adult ; Humans ; Chronic Disease/psychology ; *COVID-19/prevention &amp; control/psychology/epidemiology ; COVID-19 Vaccines/administration &amp; dosage ; *Influenza Vaccines/administration &amp; dosage ; *Influenza, Human/prevention &amp; control ; *Mental Disorders/epidemiology/psychology ; Primary Health Care ; SARS-CoV-2/immunology ; Seasons ; *Vaccination/psychology ; *Vaccination Hesitancy/psychology ; }, abstract = {BACKGROUND: Chronically ill are advised to receive annual vaccinations against Covid-19 and seasonal influenza. Furthermore, chronically ill show an increased prevalence of comorbid common mental disorders (CMDs), like depression, anxiety, and somatoform disorders. With vaccination rates remaining insufficient among these vulnerable patients, prior research assumes an association between CMDs and vaccination readiness. As diagnoses, treatment and vaccination of those patients are performed mainly in general practice, the aim of this review is to describe associations between CMDs and vaccination readiness against seasonal Influenza and Covid-19 in chronically ill adult patients in primary care.<br><br>METHODS: A systematic literature search was conducted in Medline, Embase, PsycINFO, the Cochrane Library and ERIC. Randomized controlled trials (RCTs), clustered RCTs and observational studies were considered. Two authors screened the studies and assessed the risk of bias independently (Cochrane Risk of Bias 2-Tool). We followed the PRISMA guideline. The study protocol was published in PROSPERO (CRD42024621413). The results were synthesized narratively.<br><br>RESULTS: Of 9820 identified studies, seven observational studies met the inclusion criteria. Regarding Covid-19, three studies could show, that CMDs might lead to decreased vaccination readiness in adults. Regarding seasonal influenza, no significant association between vaccination readiness and CMDs occurred. In terms of vaccination rates, no significant association between vaccinations against Covid-19 and CMDs could be identified. Two studies identified a significant association between decreasing vaccination rates against seasonal influenza and CMDs.<br><br>CONCLUSION: CMDs tend to be associated with decreased vaccination readiness, however vaccination rates were not automatically affected as well. This could indicate a potential intention-behavior gap.}, }
@article {pmid40929471, year = {2025}, author = {Schultz, MJ and Ball, L and Bernardi, M and Battaglini, D and Buiteman, LA and Ferreira, JC and Abreu, MG and Rosa, S and Hemmes, SN and Huhle, R and Mazzinari, G and Meenen, DMPV and Nasa, P and Serpa Neto, A and Pelosi, P and Paulus, F and Robba, C and Rocco, PRM and Scharffenberg, M and Tschernko, E and Wittenstein, J}, title = {The PROtective VEntilation (PROVE) Network - advancing research and collaboration in mechanical ventilation.}, journal = {Critical care science}, volume = {37}, number = {}, pages = {e20250399}, pmid = {40929471}, issn = {2965-2774}, mesh = {Humans ; *Respiration, Artificial/methods ; *COVID-19/therapy ; *Biomedical Research/organization &amp; administration ; SARS-CoV-2 ; }, abstract = {The PROtective VEntilation (PROVE) Network is a globally-recognized collaborative research group dedicated to advancing research, education, and collaboration in the field of mechanical ventilation. Established to address critical questions in intraoperative and intensive care ventilation, the network focuses on improving outcomes for patients undergoing mechanical ventilation in diverse settings, including operating rooms, intensive care units, burn units, and resource-limited environments in low- and middle-income countries. The PROVE Network is committed to generating high-quality evidence through a comprehensive portfolio of investigations, including randomized clinical trials, observational research, and meta-analyses. Its work has significantly contributed to understanding optimal ventilation strategies in critically ill patients, such as those with COVID-19, and in exploring innovative approaches like closed-loop ventilation systems. The network has spearheaded pioneering studies that have shaped clinical practice worldwide by integrating expertise from a wide range of disciplines. A defining feature of the PROVE Network is its emphasis on mentorship and collaboration. It fosters a supportive environment where junior researchers are guided by experienced mentors, ensuring the transfer of knowledge and promoting inclusivity. The network prioritizes gender balance and diversity, recognizing the value of varied perspectives in driving meaningful innovation and advancing research excellence. This paper reviews the history, key projects, and leadership of the PROVE Network, highlighting its impactful contributions to the field of mechanical ventilation. By uniting researchers globally, the PROVE Network exemplifies the power of collaboration in addressing complex clinical challenges, including personalized ventilation and the use of Artificial Intelligence, and improving patient care.}, }
@article {pmid40929000, year = {2025}, author = {Zhang, L and Srisawat, N and Lee, CC and Lee, DH and Lee, K and Liu, Z and Mohamad Nor, FS and Mustafar, RB and Peerapornratana, S and Pham, HM and Sewa, SDW and Tang, GKY and Yeh, YC and Zhu, M and Yao, Q and Wang, M and Bellomo, R}, title = {Extracorporeal Blood Purification with the oXiris® Filter for Patients with Sepsis and Hyperinflammatory Conditions: The Asia-Pacific oXiris Expert Meeting 2024 Consensus Statements.}, journal = {Blood purification}, volume = {54}, number = {11}, pages = {621-638}, pmid = {40929000}, issn = {1421-9735}, mesh = {Humans ; *Sepsis/therapy/blood ; *COVID-19/therapy/blood/complications ; *Hemofiltration/instrumentation/methods ; Acute Kidney Injury/therapy/blood/etiology ; Consensus ; SARS-CoV-2/isolation &amp; purification ; *Inflammation/therapy/blood ; Asia ; }, abstract = {Extracorporeal blood purification is a technique for reducing elevated levels of inflammatory mediators and/or endotoxins in critically ill patients with sepsis or other hyperinflammatory conditions. The oXiris filter combines endotoxin adsorption, cytokine adsorption, hemofiltration, and anti-thrombosis, and an emerging body of evidence demonstrates its use in critical care patients with hyperinflammatory conditions and acute kidney injury (AKI). A group of Asia-Pacific experts convened to formulate consensus statements for the use of the oXiris filter based on a comprehensive review of publications. After evaluation using a Delphi methodology, 17 statements achieved consensus (three recommendations and 14 practice points). These offer guidance on the initiation, monitoring, and evaluation of treatment with the oXiris filter in patients with sepsis, septic shock, severe COVID-19, or other hyperinflammatory states. We also recommend using the oXiris filter in patients undergoing cardiopulmonary bypass for cardiac surgery who are at risk for developing AKI. Other statements discuss modality, dosage, filter lifespan, anticoagulation, and combining the oXiris filter set with other extracorporeal therapies. Taken together, our statements offer targeted guidance for clinicians on the use of the oXiris filter across different patient populations. Additionally, we highlight the limitations of the current evidence base and identify key areas requiring further research.}, }
@article {pmid40928692, year = {2025}, author = {Wehbe, R and Khoshman, N and Ousseily, Z and Al-Tameemi, SA and Majzoub, RE and Najar, M and Merimi, M and Fayyad-Kazan, H and Badran, B and Fayyad-Kazan, M}, title = {Emerging SARS-CoV-2 variants: genomic shifts, immune evasion, and therapeutic perspectives.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {886}, pmid = {40928692}, issn = {1573-4978}, mesh = {Humans ; *SARS-CoV-2/genetics/immunology ; *COVID-19/immunology/virology/prevention &amp; control/therapy/epidemiology ; *Immune Evasion ; *COVID-19 Vaccines/immunology ; Antiviral Agents/therapeutic use ; Antibodies, Neutralizing/immunology/therapeutic use ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Viral/immunology ; COVID-19 Drug Treatment ; Genome, Viral ; Pandemics ; }, abstract = {The COVID-19 pandemic, caused by the continuously evolving SARS-CoV-2 virus, has presented persistent global health challenges. As novel variants emerge, many with enhanced transmissibility and immune evasion capabilities, concerns have intensified regarding the efficacy of existing vaccines and therapeutics. This review provides a comprehensive overview of the current landscape of COVID-19 vaccination, including the development and performance of monovalent and bivalent boosters, and examines their effectiveness against newly emerging variants of interest (VOIs) and variants under monitoring (VUMs), such as JN.1, KP.2, and XEC. We also explore real-world vaccine effectiveness, antibody neutralization studies, and the latest updates from WHO advisory groups. Beyond vaccines, we discuss evolving treatment approaches, including the use of monoclonal antibodies (mAbs), small-molecule antivirals, and host-targeted therapies. As resistance to antiviral agents and mAbs continues to emerge, combination therapies and next-generation broadly neutralizing antibodies offer promising avenues. This review underscores the importance of ongoing surveillance, rapid vaccine reformulation, and the development of adaptive treatment strategies to mitigate the impact of emerging SARS-CoV-2 variants and protect vulnerable populations.}, }
@article {pmid40927666, year = {2025}, author = {Natsir, RM and Halimah, E and Diantini, A and Levita, J}, title = {Clinical Outcomes and Complications of Basal, Bolus, and Combination Insulin Regimens in Type 2 Diabetes Mellitus: Evidence from Published Case Reports.}, journal = {Diabetes, metabolic syndrome and obesity : targets and therapy}, volume = {18}, number = {}, pages = {3215-3236}, pmid = {40927666}, issn = {1178-7007}, abstract = {Insulin therapy remains a cornerstone in the management of type 2 diabetes mellitus (T2DM), especially in patients experiencing progressive loss of pancreatic beta-cell function or those with inadequate glycemic control despite oral antidiabetic therapy. This review synthesized clinical outcomes from 44 peer-reviewed case reports published between 2019 and 2024, identified through systematic searches in PubMed and Scopus. The included cases involved 15 males and 29 females, with patient ages ranging from 11 to 91 years (mean 53 ± 20.85 years). Subcutaneous insulin was the most frequently used route of administration, while intravenous insulin was reserved for managing acute complications. The most commonly reported complication was diabetic ketoacidosis (DKA), especially in patients with delayed insulin initiation or in those receiving sodium-glucose cotransporter 2 (SGLT2) inhibitors, a class of oral glucose-lowering agents, one of whose side effects is known to elevate the risk of euglycemic DKA. Other triggers included COVID-19 infection and severe insulin resistance. Most patients received basal insulin regimens, whereas basal-bolus combinations were preferred in more complex or unstable cases. Insulin was frequently combined with oral agents, such as metformin, dipeptidyl peptidase IV (DPP-IV) inhibitors, glucagon-like peptide 1 (GLP-1) receptor agonists, or sodium-glucose cotransporter 2 (SGLT2) inhibitors, reflecting a trend toward individualized treatment strategies. Biomarkers such as glycated hemoglobin (HbA1c) and C-reactive protein (CRP) were routinely used to monitor glycemic control and systemic inflammation. These findings underscore the clinical importance of early insulin initiation, continuous monitoring, and personalized regimens to improve outcomes in advanced or complicated T2DM. Emerging therapies, such as once-weekly basal insulin formulations, show promise for enhancing adherence and glucose stability, although further research is needed to evaluate their long-term effectiveness and cost-efficiency.}, }
@article {pmid40927373, year = {2025}, author = {Lv, Y and Zhou, Y and Lu, H and Dong, H and He, Z}, title = {Determinants of piglet gut microbiome colonization: roles of genetics, nutrition, therapeutics, and the impact of enteric pathogens like PEDV.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1626239}, pmid = {40927373}, issn = {2235-2988}, mesh = {Animals ; Swine ; *Gastrointestinal Microbiome/drug effects ; *Swine Diseases/microbiology/virology/drug therapy/immunology ; *Porcine epidemic diarrhea virus/pathogenicity ; *Coronavirus Infections/veterinary/microbiology/virology/drug therapy ; Drugs, Chinese Herbal/therapeutic use/pharmacology ; Intestinal Mucosa/microbiology/immunology ; Immunity, Mucosal ; Diarrhea ; }, abstract = {The gut microbiota of piglets is crucial for intestinal health and immune function, yet highly susceptible to various factors. Multiple factors such as Genetic and Sow Factors, feeding environment, diet and pathogen combine to shape the gut microbiota of piglets. PEDV, a highly pathogenic and transmissible virus, disrupts the gut microbiota by damaging the intestinal epithelial barrier, leading to microbial imbalance, weakened gut immunity, and severe diarrhea. In this review, we systematically investigated the factors affecting microbial colonization in the gastrointestinal tract of piglets and the effects of PEDV infection on intestinal microecology, intestinal epithelial barrier and mucosal immunity. Meanwhile, the unique potential of Chinese herbal medicines compound represented by Qiwen Huangbai San in repairing the barrier, remodeling the flora and enhancing the immunity was discussed in depth. Through the above multidimensional perspectives, this review aims to provide a scientific basis and an effective preventive strategy for the construction of a comprehensive prevention and control program centered on Chinese herbs to alleviate the intestinal damage caused by PEDV in piglets.}, }
@article {pmid40926917, year = {2025}, author = {Ibrahim, ME and M Osman, HM and Mubarak Osman, AME and Mofareh Alanazi, NM and Mohamed Ali, BT and Adam Abdallah, II and Hussein Mohamed, MI}, title = {Comparing Telemedicine and In-Person Psychological Interventions for Anxiety: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {8}, pages = {e89594}, pmid = {40926917}, issn = {2168-8184}, abstract = {Barriers such as stigma and limited access to care continue to impede treatment for anxiety disorders. Telemedicine has emerged as a promising alternative to in-person psychological interventions, particularly after the COVID-19 pandemic. This systematic review compares the efficacy of telemedicine and in-person therapies for anxiety disorders, evaluating outcomes, patient engagement, and methodological rigor. Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Web of Science, and ClinicalTrials.gov, with the final search conducted in July 2025. Ten studies comparing telemedicine with in-person interventions were included. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized controlled trials and the Newcastle-Ottawa Scale for non-randomized studies. A narrative synthesis was conducted due to heterogeneity. Telemedicine demonstrated non-inferior efficacy to in-person therapy across diverse modalities and outperformed self-help programs. Patient satisfaction and adherence were high, with telehealth groups showing longer retention. Small effect size differences favored in-person therapy for generalized anxiety disorder, but most studies reported comparable outcomes. Risk of bias was low for nine out of ten studies. Telemedicine is a viable alternative to in-person therapy for anxiety disorders, with advantages in accessibility and therapist-guided formats. Future research should address long-term outcomes and equity in delivery.}, }
@article {pmid40926412, year = {2025}, author = {Tregoning, JS and Wang, Z and Sridhar, S and Shattock, RJ and DeRosa, F}, title = {Immunology of RNA-based vaccines: The critical interplay between inflammation and expression.}, journal = {Molecular therapy : the journal of the American Society of Gene Therapy}, volume = {33}, number = {12}, pages = {5945-5964}, doi = {10.1016/j.ymthe.2025.09.011}, pmid = {40926412}, issn = {1525-0024}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology ; *Inflammation/immunology ; SARS-CoV-2/immunology ; *COVID-19 Vaccines/immunology/genetics ; *mRNA Vaccines/immunology ; Animals ; }, abstract = {Since its use during the COVID-19 pandemic, mRNA has emerged as a leading candidate vaccine platform for pandemic infections. A critical difference between RNA-encoded antigen and protein vaccines is that RNA-based vaccines require the antigen to be translated in the body, adding an important variable. Much of the research focus in the field has been on ways to increase expression, but inflammation plays a critical role. The vaccine delivered is a combination of the RNA and the formulation, so both elements need to be considered. Formulated RNA can act as a form of adjuvant but can also activate cellular pathways that inhibit expression. Expression and inflammation are interlinked, but independent-a deeper understanding of the quality and quantity of immune induction will help to develop more efficient RNA vaccines. Here, we discuss factors that shape responses to RNA-based vaccines. These include the composition of the vaccine (the use of modified RNA bases, whether self-replicating or traditional mRNA and, critically, the formulation) and the type of cells that take up and translate the RNA. We then consider challenges presented by current generation RNA vaccines including clinical impact and how improved immunological understanding can inform the development of improved RNA vaccine platforms.}, }
@article {pmid40925784, year = {2025}, author = {Baskota, SU and Ahsan, M and Mohamed, S and Schukow, CP and Herman, MK and Nebbache, H and Punjabi, LS and Metcalf, BD and Upreti, D and Cima, L and Poombal, F and Ali Hashim, MM and Jiang, XS}, title = {Social media and cytopathology (#cytopath) education: developing a curated online resource index and exploring the evolution of e-learning.}, journal = {Journal of the American Society of Cytopathology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jasc.2025.08.002}, pmid = {40925784}, issn = {2213-2945}, abstract = {In recent years, social media (SoMe) has revolutionized medical education within the field of pathology; however, its performance in cytopathology has not been explored in detail. This systematic review aims to analyze SoMe trends, hashtag metrics, and online resources within cytopathology over the period of 7 years. A systematic review of 4 databases (PubMed, Medline, Embase, and Scopus) was conducted between January 1st, 2017, and December 22nd, 2022, in order to identify relevant English-language articles about SoMe and cytopathology. An index for online cytopathology (#cytopath) resources was created and posted on Knowledge In Knowledge Out on May 12, 2025. Sixteen studies were included for final analysis, dating from 2017 to 2023. The most commonly cited SoMe platforms used among cytopathologists were X (Twitter) (42%) and Facebook (26%) (P = 0.002). A variety of hashtags were used across posts: #Cytology (24%), #Cytopath (24%), #FNAFriday (24%), #Pathology (16%), and #Cytopathology (12%) (P = 0.865). Two studies discussed the use of SoMe in cytopathology during the COVID-19 pandemic, highlighting its role as a rapid communication tool in times of crisis. The most highly followed cytopathology accounts on X were @cytopathology (10,510), @IACytology (3639), and @britishcytology (3062). This systematic review shows how SoMe is enhancing networking, case discussion, and education in cytopathology. Although it could revolutionize professional communication, it still poses issues regarding privacy and possible misinformation. Future research and guidelines are necessary to optimize the use of SoMe in cytopathology.}, }
@article {pmid40925391, year = {2025}, author = {Frei-Stuber, L and Nowak, D}, title = {[Narrative review of clinical findings in patients with Post-COVID-19 and their relevance for occupational medical assessment].}, journal = {Deutsche medizinische Wochenschrift (1946)}, volume = {150}, number = {19}, pages = {1151-1157}, doi = {10.1055/a-2648-3362}, pmid = {40925391}, issn = {1439-4413}, mesh = {*Post-Acute COVID-19 Syndrome/complications/diagnosis/physiopathology ; *Occupational Diseases/complications/diagnosis/physiopathology ; Germany ; Practice Guidelines as Topic ; Occupational Medicine/methods/standards ; *Disability Evaluation ; Humans ; }, abstract = {The COVID-19 pandemic led to a sharp increase in the recognitions of COVID-19 as an occupational disease in Germany. The patients often report diverse symptoms, whereas causality and objectification remain difficult.A selective literature research in PubMed was carried out, assessment recommendations and guidelines were included, too.Long-term consequences of COVID-19 belong to various medical fields. Direct and indirect objectification are necessary. The latter requires concrete indications for the connection between COVID-19 and symptoms. An individual case assessment is also required regarding the reduction in earning capacity. Official recommendations for assessment were published shortly before this review in June 2025.Objectification is a crucial factor, whereas its implementation is complex. Effects on the degree of damage and the degree of disability should be taken into account.}, }
@article {pmid40925176, year = {2025}, author = {He, Z and Zhang, J and Kuang, S and Li, S and Wang, Y and Ding, J and Ma, Z and Zhang, B}, title = {Colloidal gold technology in viral diagnostics: Recent innovations, clinical applications, and future perspectives.}, journal = {Virology}, volume = {612}, number = {}, pages = {110686}, doi = {10.1016/j.virol.2025.110686}, pmid = {40925176}, issn = {1096-0341}, mesh = {Humans ; *Gold Colloid/chemistry ; Metal Nanoparticles/chemistry ; Biosensing Techniques/methods ; Immunoassay/methods ; COVID-19/diagnosis ; *Virus Diseases/diagnosis/virology ; SARS-CoV-2/isolation &amp; purification/immunology ; Point-of-Care Testing ; Surface Plasmon Resonance/methods ; Gold/chemistry ; }, abstract = {Colloidal gold technology has revolutionized viral diagnostics through its rapid, cost-effective, and user-friendly applications, particularly in point-of-care testing (POCT). This review synthesizes recent advancements, focusing on its role in detecting respiratory viruses, hepatitis viruses, and emerging pathogens. The technology leverages the unique optical and physicochemical properties of gold nanoparticles (AuNPs), including localized surface plasmon resonance (LSPR) and high surface-to-volume ratios, to achieve rapid antigen-antibody recognition with visual readouts within 15 min. Innovations such as CRISPR-Cas-integrated lateral flow immunoassays (LFIAs), dual-mode plasmonic biosensors, and nanomaterials like CeO2-colloidal gold composites have enhanced sensitivity and multiplex capability, enabling simultaneous identification of co-circulating pathogens. Case studies highlight its efficacy in dengue serotyping, SARS-CoV-2 neutralizing antibody quantification, and HBV/HCV co-detection, demonstrating high clinical specificity. However, challenges persist, including the need for improved sensitivity; interference of sample matrix with immunity; false positives caused by cross-reactions; and limitations of semi-quantitative analysis. Recent progress in hybrid nanomaterial synthesis, surface functionalization, and device-level multiplexing-coupled with AI-driven data interpretation- promises to address these gaps. Future trends emphasize integration with surface-enhanced Raman scattering (SERS), microfluidics, and portable sensors to achieve sub-zeptomolar sensitivity and scalable deployment. By bridging nanotechnology with precision diagnostics, colloidal gold platforms are poised to redefine global viral surveillance, particularly in resource-limited settings, underscoring their indispensable role in pandemic preparedness.}, }
@article {pmid40924127, year = {2025}, author = {McCartney, G and Walsh, D}, title = {Understanding changes to life expectancy and inequalities in the UK, Germany, and other high-income countries.}, journal = {Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz}, volume = {68}, number = {10}, pages = {1178-1184}, pmid = {40924127}, issn = {1437-1588}, mesh = {*Life Expectancy/trends ; Humans ; *COVID-19/mortality/epidemiology/economics ; United Kingdom/epidemiology ; Germany/epidemiology ; *Developed Countries/statistics &amp; numerical data/economics ; Pandemics/economics ; *Health Status Disparities ; Poverty/statistics &amp; numerical data ; Socioeconomic Factors ; Aged ; Female ; Male ; Middle Aged ; Mortality/trends ; SARS-CoV-2 ; Adult ; }, abstract = {The rate of improvement in life expectancy and mortality slowed considerably in a number of high-income countries from the early 2010s, predating the COVID-19 pandemic by almost a decade. Evidence for different countries, including the separate nations of the United Kingdom (e.g. Scotland and England), shows that this overall 'stalling' of improvement has been driven by markedly worsening mortality rates among poorer populations, thereby considerably widening spatial inequalities. Here we synthesise international data and evidence-with a particular focus on the United Kingdom and Germany-to highlight the common causes of these trends, most notably economic 'austerity' policies that were implemented in the aftermath of the 2007/2008 financial crash. These have demonstrably increased rates of poverty, reduced availability of required social services, and left public services more threadbare, all of which has negatively impacted mental and physical health and mortality. We conclude with a discussion of the economic policy responses required to address this multi-nation population health emergency.}, }
@article {pmid40923618, year = {2025}, author = {Susanna, BN and Marcellus, JM and Randleman, JB}, title = {Acute Accommodative Insufficiency After LASIK Due to COVID-19 Infection.}, journal = {Journal of refractive surgery (Thorofare, N.J. : 1995)}, volume = {41}, number = {9}, pages = {e1027-e1030}, doi = {10.3928/1081597X-20250801-01}, pmid = {40923618}, issn = {1938-2391}, mesh = {Adult ; Humans ; Male ; Accommodation, Ocular/physiology ; Acute Disease ; *COVID-19/complications ; *Hyperopia/surgery ; *Keratomileusis, Laser In Situ/adverse effects ; Lasers, Excimer/therapeutic use ; *Postoperative Complications/virology ; *SARS-CoV-2 ; Visual Acuity/physiology ; }, abstract = {PURPOSE: To report a case of acute and transient accommodative insufficiency after laser in situ keratomileusis (LASIK) due to coronavirus disease 2019 (COVID-19).<br><br>METHODS: Case report and literature review.<br><br>RESULTS: A 36-year-old man complained of acute blurred near vision 7 days after uneventful bilateral hyperopic LASIK, concurrent with the onset of COVID-19 infection. Examination revealed new-onset accommodative insufficiency, with binocular cross-cylinder test demonstrating an accommodative lag of +1.00 diopters (D) in both eyes. Pupillary and ocular motility findings were normal. The patient was prescribed low add multifocal contact lenses for temporary use. Six months postoperatively, accommodative lag resolved, accommodative function returned to baseline, and near vision returned to J1 uncorrected.<br><br>CONCLUSIONS: This report describes acute accommodative insufficiency as a complication of COVID-19, with spontaneous resolution over 6 months. Given the significant impact on refractive surgery outcomes, the authors recommend delaying elective procedures for at least 6 months after COVID-19, especially in patients presenting with unexplained postoperative near vision changes.}, }
@article {pmid40922939, year = {2025}, author = {Politis, M and Chatzichristodoulou, I and Mouchtouri, VA and Rachiotis, G}, title = {COVID-19 vaccination and use of antibiotics in COVID-19 patients: a systematic review and meta-analysis.}, journal = {Infection prevention in practice}, volume = {7}, number = {3}, pages = {100461}, pmid = {40922939}, issn = {2590-0889}, abstract = {BACKGROUND: Vaccinations are considered one of the most effective medical interventions. Among other benefits, certain vaccinations help reduce antimicrobial resistance by decreasing antibiotic use. Considering reports of increased antimicrobial resistance during the COVID-19 pandemic, this study aimed to explore the relationship between COVID-19 vaccination status and antibiotic use in COVID-19 patients.<br><br>METHODS: A systematic literature search was conducted in PubMed, Scopus, Web of Science, Embase, and Google Scholar between January 1, 2021, and November 6, 2024. The included studies were assessed for risk of bias using the Newcastle-Ottawa tool. Narrative synthesis and random-effects meta-analysis were employed to synthesize the evidence.<br><br>RESULTS: Eight studies were included in this systematic review and meta-analysis (134,022 participants). COVID-19 vaccination was significantly associated with a 34% reduction in the odds of antibiotic use (OR: 0.662; 95% CI: 0.540-0.811) in COVID-19 patients. These findings were supported by the sensitivity analyses. In the subgroup analysis, a significant negative association was observed between COVID-19 vaccination and antibiotic use among COVID-19 patients across all study designs. A major limitation of this study is that most of the included studies did not adjust for confounders.<br><br>CONCLUSIONS: COVID-19 vaccination was associated with a significant reduction in antibiotic use among COVID-19 patients. COVID-19 vaccination status may have influenced healthcare providers' decisions regarding antibiotic use in this group. Further large-scale cohort studies are needed to confirm these findings.<br><br>OTHER: The study protocol is registered with PROSPERO (ID: CRD42023449625). No funding was provided for this study. The APCs were covered by the Karolinska Institute.}, }
@article {pmid40922860, year = {2025}, author = {Potluri, S and Chittiprol, N and Varaganti, V and Avr, V and Vadakedath, S and Arvapally, D and Vemulapalli, C and Begum, GS and Madamsetti, N and Kandi, V}, title = {The Association of SARS-CoV-2 Infection and COVID-19 Vaccination With Sudden Death: An Explorative Review.}, journal = {Cureus}, volume = {17}, number = {8}, pages = {e89527}, pmid = {40922860}, issn = {2168-8184}, abstract = {Since its discovery, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has become the epicenter of public health concern. This was mainly attributed to the complexity of COVID-19 that resulted in variable disease progression with some developing asymptomatic infections, some suffering mild to moderate infections that resolved without the need for hospitalizations, and a few infected persons developing severe infections that required intensive care unit (ICU) admission and mechanical ventilation. The COVID-19 pandemic spread globally, affecting billions of people and killing millions. Most of the consequences were related to the novelty of the virus, poor understanding of its pathogenesis, and the lack of a specific antiviral drug and vaccine. The vaccines, although manufactured and made available to the public, were approved for emergency use before the completion of human clinical trials. Moreover, the continuous emergence of viruses following mutations resulted in the emergence of viral variants. This has led to doubts over the efficacy of vaccines. Vaccine inequity, represented by the disproportionate availability and distribution of vaccines among the rich and poor, concerns over long-term safety, and hesitancy, affected COVID-19 vaccination, thereby increasing the spread of SARS-CoV-2. Although the COVID-19 pandemic is no longer considered a public health emergency of international concern (PHEIC), the repercussions of the pandemic are still evident in the form of long COVID and post-COVID functional health status (PCFHS), wherein individuals who were previously infected continue to suffer organ dysfunction, primarily affecting the lungs and other organs of the body. During and after the pandemic, COVID-19 and probably vaccination were attributed to the death of many individuals, which were categorized as sudden death (SD) and sudden unnatural death (SUD). It is unclear if these deaths were a result of previous SARS-CoV-2 infection and prior COVID-19 vaccination or both. There are several instances of infected and recovered individuals who were healthy but suddenly developed complications and died. Through this explorative review, we aim to comprehend the role that SARS-CoV-2 infection and/or COVID-19 vaccination play in predisposing people to cardiovascular system (CVS) and central nervous system (CNS) disorders that can result in SD and SUD.}, }
@article {pmid40921936, year = {2025}, author = {Ojomo, O and Atibioke, O and Alesinloye-King, O and Erlandsson, K and Ängeby, K and Envall, N}, title = {A scoping study of postpartum mental health problems and associated factors: opportunities for research and practice.}, journal = {Discover mental health}, volume = {5}, number = {1}, pages = {136}, pmid = {40921936}, issn = {2731-4383}, abstract = {OBJECTIVE: To provide an overview of mental health problems throughout the postpartum period and to describe the screening instruments as well as associated factors related to the relevant population.<br><br>METHODS: The scoping study was guided by the framework outlined by Arksey and O'Malley and Levac et al. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline was used to report the findings including citation backtracking.<br><br>RESULTS: Of the 2828 studies screened, 43 met the inclusion criteria, and three key categories were identified: postpartum mental health problems, screening instruments, and associated factors, including support systems, previous mental and medical conditions, and other associated factors. Sub-categories in the support systems included partner, family, social, and work support, while subcategories in the other associated factors included socioeconomic and sociodemographic, pregnancy and birth, partner violence, mode of delivery, gender preference, COVID-19, and immigration status.<br><br>CONCLUSION: A comprehensive approach to postpartum mental health problems is necessary to understand protective factors needed at all levels. It is imperative to offer a spectrum of support services and ensure high availability of care to all relevant subgroups of mothers throughout pregnancy and up to one year postpartum. Inconsistent use of screening instruments at different periods indicates a need for harmonized use in clinical settings to mitigate the risk of women being undiagnosed. Training healthcare professionals in the area of assessment and management of postpartum mental health problems will significantly help in alleviating the challanges women face during this period.}, }
@article {pmid40921682, year = {2025}, author = {Yin, SY and He, MX}, title = {[Severe acute respiratory syndrome coronavirus 2 infection and post COVID-19 condition: the theory of immune pathology].}, journal = {Zhonghua bing li xue za zhi = Chinese journal of pathology}, volume = {54}, number = {9}, pages = {997-1002}, doi = {10.3760/cma.j.cn112151-20250227-00137}, pmid = {40921682}, issn = {0529-5807}, mesh = {Humans ; COVID-19 ; SARS-CoV-2 ; Pandemics ; *Coronavirus Infections/immunology/pathology/complications/virology ; *Pneumonia, Viral/immunology/pathology/complications/virology ; *Betacoronavirus/immunology ; *Cytokine Release Syndrome/immunology/pathology/virology ; RNA, Viral ; Multiple Organ Failure/immunology/pathology/virology ; B-Lymphocytes/immunology ; T-Lymphocytes/immunology ; Macrophages/immunology ; Lymph Nodes/pathology/virology/immunology ; Cytokines/metabolism ; }, }
@article {pmid40921133, year = {2025}, author = {Kole, E and Jadhav, K and Singh, R and Verma, RK and Chatterjee, A and Naik, J}, title = {Next-Generation Nanoparticle-Enabled mRNA Vaccines in the Treatment of COVID-19.}, journal = {Critical reviews in therapeutic drug carrier systems}, volume = {42}, number = {6}, pages = {83-123}, doi = {10.1615/CritRevTherDrugCarrierSyst.2025053265}, pmid = {40921133}, issn = {2162-660X}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology ; *COVID-19 Vaccines/administration &amp; dosage ; *Nanoparticles ; SARS-CoV-2/immunology ; *mRNA Vaccines/administration &amp; dosage ; Animals ; *RNA, Messenger/administration &amp; dosage/immunology ; 2019-nCoV Vaccine mRNA-1273 ; Vaccines, Synthetic/administration &amp; dosage/immunology ; BNT162 Vaccine ; Drug Delivery Systems ; }, abstract = {The emergence of messenger ribonucleic acid (mRNA) vaccines as an alternative platform to traditional vaccines has been accompanied by advances in nanobiotechnology, which have improved the stability and delivery of these vaccines through novel nanoparticles (NPs). Specifically, the development of NPs for mRNA delivery has facilitated the loading, protection and release of mRNA in the biological microenvironment, leading to the stimulation of mRNA translation for effective intervention strategies. Intriguingly, two mRNA vaccines, BNT162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna), have been permitted for emergency usage authorization to prevent COVID-19 infection by USFDA. Both mRNA vaccines utilized lipidic NPs (LNPs) as a delivery platform and demonstrated superior efficacy and safety profiles compared to traditional vaccines. This review article gives insight into ongoing pre-clinical and clinical developments of mRNA vaccine candidates, their efficacy against coronavirus variants, and analysis of NP-based approaches to recognize their potential for forthcoming growth. This review article highlights recent advances in delivery strategies, including LNPs, polymeric NPs, and exosomes, for effective immunization against COVID-19. The key challenges associated with mRNA NPs have been identified, and potential strategies to overcome these difficulties have been proposed. Production of nanomaterials for specific mRNA applications can offer new insights into next-generation nanomaterials, revolutionizing mRNA technology.}, }
@article {pmid40920753, year = {2025}, author = {Kelleher, AB and O'Donovan, M and O'Doherty, D and Lavery, R and Lehane, E and Saab, MM}, title = {The effect of exogenous melatonin and melatonin receptor agonists on intensive care unit and hospital length of stay: A systematic review and meta-analysis.}, journal = {PloS one}, volume = {20}, number = {9}, pages = {e0332031}, pmid = {40920753}, issn = {1932-6203}, mesh = {Humans ; *Melatonin/therapeutic use/pharmacology ; *Intensive Care Units ; *Length of Stay/statistics &amp; numerical data ; *Receptors, Melatonin/agonists ; Randomized Controlled Trials as Topic ; Delirium/drug therapy ; }, abstract = {INTRODUCTION: Melatonin supplements and melatonin receptor agonists are linked to reduced delirium in the Intensive Care Unit (ICU) which we hypothesised may affect the length of stay (LOS) in ICU or in hospital. In this review, we identified and critically appraised the literature on the effect of exogenous melatonin and melatonin receptor agonists on the ICU and/or hospital LOS among adults admitted to the ICU.<br><br>METHODS: Six electronic databases and three trial registries were searched for randomised controlled trials (RCTs). Screening, risk of bias assessment, quality appraisal, and level of evidence assessment were conducted and cross-checked by two reviewers independently. Meta-analyses with disease-specific subgroups were conducted to assess the mean difference in LOS for exogenous melatonin and melatonin receptor agonists compared with a placebo.<br><br>RESULTS: Twenty RCTs were reviewed with 14 having a low risk of bias. For ICU LOS (18 studies) there was significant statistical heterogeneity (I2&#x2009;=&#x2009;73%); compared with placebo the 95% prediction interval for the mean difference was -3.18 and 1.39 days. For hospital stay (12 studies, I2&#x2009;=&#x2009;79%) the 95% prediction interval ranged from -6.68 to 3.52. Removing two statistical outliers, and correcting for publication bias, there was no overall statistically significant difference in mean ICU LOS (p-value&#x2009;=&#x2009;0.298) or mean hospital LOS (p-value&#x2009;=&#x2009;0.456). The subgroup analysis found statistically significant improvements for those who underwent coronary artery bypass graft surgery (ICU LOS -0.47 days, 95% CI: -0.78 to -0.16, p-value&#x2009;=&#x2009;0.003); and patients with COVID-19 (hospital LOS -3.90 days, 95% CI: -6.28 to -1.51, p-value&#x2009;=&#x2009;0.001).<br><br>CONCLUSION: There was a very low certainty of evidence that melatonin and melatonin receptor agonists were associated with reductions in ICU and hospital LOS in ICU patients overall. However, further research is needed for surgical patients and those with pneumonia.}, }
@article {pmid40920390, year = {2025}, author = {Wang, H and Daizadeh, N and Shen, YL and Chen, J and Rockhold, FW and Pang, H and Lee, H}, title = {Decentralized Clinical Trials in the Era of Real-World Evidence: A Critical Assessment of Recent Experiences.}, journal = {Clinical and translational science}, volume = {18}, number = {9}, pages = {e70328}, pmid = {40920390}, issn = {1752-8062}, mesh = {Humans ; *COVID-19/epidemiology ; SARS-CoV-2 ; *Clinical Trials as Topic/methods ; Research Design ; Pandemics ; }, abstract = {Since the first decentralized clinical trial (DCT) was conducted in 2011, there has been an increased usage of DCT due to its benefits of patient-centricity and generalizability of findings. This trend was further expedited by the global COVID-19 pandemic. We identified 23 case studies across various therapeutic areas and grouped them into different categories according to their purposes-by necessity, for operational benefits, to address unique research questions, to validate innovative digital endpoints, or to validate decentralization as a clinical research platform. We leveraged the estimand framework from ICH E9(R1) including its five attributes (population, treatment, variable, intercurrent event, and summary measure) to critically assess their design and conduct. Common trends, opportunities, and challenges were reported along with recommendations for future DCT. Of note, intercurrent events and associated handling strategies are largely not present when reporting DCT. This is an area that can impact study conclusions and require more dedicated efforts when designing new DCTs.}, }
@article {pmid40919620, year = {2025}, author = {Ruqa, WA and Romeo, M and Cipolloni, G and Rosati, D and Laureti, C and Venarubea, S and Liberati, F and Santirocchi, A and Petrella, C and Cogoni, C and Cestari, V and Barbato, C and Minni, A}, title = {Nasal Cytology and Clinical Rhinology Support a Translational Integrative Neuroscience Perspective.}, journal = {Journal of integrative neuroscience}, volume = {24}, number = {8}, pages = {33392}, doi = {10.31083/JIN33392}, pmid = {40919620}, issn = {0219-6352}, support = {//Italian Ministry of University and Research (MUR)/ ; CUP B53D23018450006//European Union-NextGenerationEU-Project Title-Mapping NEUROCOVID via neurobiology and neurovolatilome in Post-COVID-19 patients/ ; }, mesh = {Humans ; *Translational Research, Biomedical ; *Nasal Mucosa/pathology/cytology ; *Neurosciences ; }, abstract = {Nasal cytology is evolving into a promising tool for diagnosing neurological and psychiatric disorders, especially those such as Alzheimer's and Parkinson's diseases. Moreover, recent research has indicated that biomarkers differ greatly between samples taken before and after death. Nasal cytology might help to identify the early stages of cognitive decline. The association of olfactory disturbances with a host of these neurological disorders is remarkable. This means that the nose, something we probably take for granted, could well be the best means of establishing important biomarkers for earlier diagnoses in these conditions. The nose is a source of epithelial and neuroepithelial cells that can be used in in vitro cultured models and nasal cytology provides new avenues for translational, integrative neuroscientific research. The future incorporation of artificial intelligence into cytological analyses would facilitate the acceptance of nasal cytology as a screening platform for neurodegenerative and psychiatric conditions, facilitating early diagnosis and better management for patients.}, }
@article {pmid40917828, year = {2025}, author = {Chen, L and Cai, Q and Zheng, P}, title = {Medical gases in respiratory diseases: ozone, argon, and nitric oxide as game-changers in therapeutics.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1598798}, pmid = {40917828}, issn = {2296-858X}, abstract = {Respiratory diseases pose a significant global health burden, prompting the exploration of novel therapeutic strategies. This narrative review consolidates existing knowledge and critically examines the evolving role of medical gases, ozone, argon, and nitric oxide (NO), in respiratory medicine. Based on recent literature, it highlights how these gases, originally used for their physicochemical properties, have now undergone a "functional crossover," revealing their broad therapeutic potential. Analysis of available evidence indicates Ozone exhibits dual mechanisms: redox balance regulation and antimicrobial effects, demonstrating efficacy in COVID-19 pneumonia and hospital disinfection. Argon, when delivered through cold atmospheric plasma jets (CAPPJ), provides broad-spectrum antibacterial effects and targeted treatment for bronchopleural fistulas. NO, beyond its vasodilatory role, is now a dynamic tool for airway inflammation monitoring and precision asthma management. However, challenges persist, including optimizing therapeutic windows, standardizing treatment protocols, and assessing long-term safety and efficacy. Future directions emphasize precision medicine, incorporating biomarkers, AI-driven diagnostics, and combination therapies to overcome current challenges and unlock the full potential of medical gases in treating respiratory diseases.}, }
@article {pmid40917792, year = {2025}, author = {Shadid, A and Hok, KD and Domozhirov, AY and Weng-Mills, T and Doursout, MF and Banda, NK and Restrepo, MI and Shivshankar, P}, title = {Enigmatic Roles of Complement Anaphylatoxin Signaling in Health and Disease.}, journal = {Immune network}, volume = {25}, number = {4}, pages = {e32}, pmid = {40917792}, issn = {1598-2629}, abstract = {Complement anaphylatoxins C3a and C5a are potent immunomodulators whose impact extends well beyond their traditional roles in innate immunity. Acting through G protein-coupled receptors C3aR, C5aR1, and C5aR2, these peptides take part in coordinating immune cell recruitment, vascular tone, and tissue remodeling. Yet their functions are deeply context-dependent: while they play essential roles in microbial clearance and immune coordination, their overactivation contributes to immunopathology in a wide range of diseases. The anaphylatoxins play key roles in early pathogen containment but can also drive cytokine storm and tissue damage, as in coronavirus disease 2019 (COVID-19) and bacterial sepsis. In autoimmune conditions, the anaphylatoxins promote leukocyte infiltration and complement-mediated tissue injury. In chronic diseases, they contribute to fibrosis in diabetic kidney disease and idiopathic pulmonary fibrosis, and anaphylatoxins disrupt neurovascular integrity in neurodegenerative diseases. In cancer, C3a and C5a shape the tumor microenvironment by facilitating immune evasion, angiogenesis, and metastasis. As complement-targeted therapies gain momentum in clinical settings-particularly in the treatment of genetic disorders, such as paroxysmal nocturnal hemoglobinuria, more recently COVID-19, and cancer-a deeper mechanistic understanding of C3a and C5a signaling is imperative as we advance closer toward precision medicine, and this review aims to inform future approaches for therapeutic complement modulation.}, }
@article {pmid40917430, year = {2025}, author = {Mao, W and Olson, K and Urli Hodges, E and Udayakumar, K}, title = {Progress, impacts and lessons from market shaping in the past decade: a systematic review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1614471}, pmid = {40917430}, issn = {2296-2565}, mesh = {Humans ; COVID-19/prevention &amp; control ; *Health Services Accessibility ; COVID-19 Vaccines/supply &amp; distribution/economics ; }, abstract = {UNLABELLED: Market shaping activities have been increasingly used to improve access to health products, such as the advance market commitments used to increase access to the pneumococcal vaccine and COVID-19 vaccines. This paper reviewed the progress and impacts, and identified enablers and barriers of market shaping activities in the past decade. We conducted a systematic review using a structured searching strategy across five academic databases and key actors' websites for gray and white literature published in English since 2012. Two researchers independently performed screening, data extraction, and analysis. Following independent screening, 97 out of 3,006 articles were eligible for analysis. The majority of the articles were qualitative studies and published within the past 5 years. Rapid access to new products, improved availability, and reduced product cost were the most reported impacts. Barriers of market shaping were the disconnection between market shaping interventions and downstream factors, fragmentation and lack of transparency in regulatory processes, and failure to incentivize manufacturers. Enablers included taking end-to-end approaches, coordination across different actors, particularly the national stakeholders and private sector, creating transparent and predictable demand, longer time span, and flexible funding. While market shaping interventions have contributed to the improvement of access to health products, future research should generate additional quantitative evidence, comprehensive impact evaluation, and in-depth studies on the negative impacts of market shaping. Market shaping actors need to adopt definitions and frameworks, apply an ecosystem-wide lens, engage with diverse stakeholders, consider service delivery, and strengthen key capabilities.<br><br>PROSPERO: CRD42023471098, https://www.crd.york.ac.uk/PROSPERO/view/CRD42023471098.}, }
@article {pmid40917342, year = {2025}, author = {Basu, S and Simerman, A and Hoffman, A}, title = {How is Engagement Defined Across Health Care Services and Technology Companies? A Systematic Review.}, journal = {Mayo Clinic proceedings. Digital health}, volume = {3}, number = {3}, pages = {100256}, pmid = {40917342}, issn = {2949-7612}, abstract = {OBJECTIVE: To systematically examine how digital health startups define and operationalize engagement in the post- coronavirus disease environment (2020-2025).<br><br>PATIENTS AND METHODS: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines adapted for web-based literature, we systematically reviewed publicly available information from digital health startups founded or significantly operating between 2020-2025. We extracted engagement definitions from company websites, white papers, blog posts, and press releases. Definitions were coded by type (explicit, implicit, or nondefinition) and dimensional focus (behavioral, cognitive, affective, and social). Inter-rater reliability was assessed using Cohen's &#x3ba; (&#x3ba;=0.82). We conducted this systematic review from April 20, 2025, to May 21, 2025.<br><br>RESULTS: We analyzed 64 engagement definitions from 30 digital health startups. Only 18.8% (n=12) were explicit definitions with clear measurement criteria, whereas 45.3% (n=29) were implicit definitions and 35.9% (n=23) were nondefinitions that mentioned engagement without defining it. The behavioral dimension dominated (64.1%, n=41), followed by social (28.1%, n=18), cognitive (21.9%, n=14), and affective dimensions (17.2%, n=11). Statistical analysis revealed significant associations between definition type and dimensional focus (P<.05). Based on our findings, we developed a taxonomy of engagement definitions and a 5-level engagement definition maturity model.<br><br>CONCLUSION: Digital health startups predominantly use implicit or undefined engagement concepts with a strong behavioral focus. The proposed taxonomy and maturity model provide frameworks for standardizing engagement definitions across the digital health ecosystem, potentially improving measurement consistency, facilitating more meaningful comparisons between solutions, and establishing a baseline for evaluating effectiveness.}, }
@article {pmid40916950, year = {2025}, author = {Martin, I and Ratjen, F and Flume, P}, title = {Evolving cystic fibrosis care models in the modulator era.}, journal = {Current opinion in pulmonary medicine}, volume = {31}, number = {6}, pages = {644-649}, pmid = {40916950}, issn = {1531-6971}, mesh = {Humans ; *Cystic Fibrosis/therapy/drug therapy ; Telemedicine ; *COVID-19/epidemiology ; SARS-CoV-2 ; Cystic Fibrosis Transmembrane Conductance Regulator ; Disease Progression ; }, abstract = {PURPOSE OF REVIEW: The advent of CFTR modulators and the adoption of telemedicine during the COVID-19 pandemic have prompted reconsideration of cystic fibrosis (CF) care models. This review explores how care delivery may evolve in response to these changes.<br><br>RECENT FINDINGS: Emerging evidence highlights the heterogeneity in response to CFTR modulators, with some patients continuing to experience disease progression. Preliminary trial data have explored therapy de-escalation, but long-term safety remains uncertain. Challenges in microbiological surveillance, particularly due to reduced sputum production, complicate monitoring. Early efforts to define "stability" have led to position statements advocating risk-stratified, hybrid care models.<br><br>SUMMARY: CF care models should shift toward individualized, flexible approaches that prioritize equity and safety. Clinical trials and registry analyses will be essential to validate such models. Until then, conservative implementation with continued multidisciplinary support and objective monitoring are advised.}, }
@article {pmid40916471, year = {2025}, author = {Peters, NE and Shields, AM and Hambleton, S and Richter, AG}, title = {Learning from inborn errors of immunity and secondary immune deficiencies about vaccine immunogenicity, efficacy, and safety.}, journal = {Clinical and experimental immunology}, volume = {219}, number = {1}, pages = {}, pmid = {40916471}, issn = {1365-2249}, mesh = {Humans ; *Immunologic Deficiency Syndromes/immunology ; *COVID-19 Vaccines/immunology ; *COVID-19/immunology/prevention &amp; control ; *SARS-CoV-2/immunology ; *Immunogenicity, Vaccine/immunology ; Vaccination ; Vaccine Efficacy ; }, abstract = {Since its discovery in the late 18th century, the role of vaccination in preventing death and disease has expanded across many infectious diseases and cancer. Key to our understanding of vaccine immunogenicity and efficacy is knowledge of the immune system itself. Inborn errors of immunity (IEI) represent a heterogeneous group of disorders characterized by impaired function of the immune system. Patients with IEI can have variable responses to vaccinations, depending on the nature and extent of the defect. Studies performed during the recent COVID-19 pandemic have brought unique insight into vaccine immunogenicity in individuals with IEI, knowledge that can be extended to the growing number of patients with secondary immunodeficiency arising from malignancy, organ transplantation, autoimmune conditions, and their treatments. In this review, we describe vaccine immunogenicity in IEI alongside their equivalent secondary immunodeficiencies and discuss what lessons can be learned about immunization strategies more broadly.}, }
@article {pmid40916093, year = {2025}, author = {Veltre, D and Joseph, R}, title = {Rapidly Upskilling Nurses During a Pandemic: An Integrative Review.}, journal = {Journal of Christian nursing : a quarterly publication of Nurses Christian Fellowship}, volume = {42}, number = {4}, pages = {206-213}, pmid = {40916093}, issn = {0743-2550}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; Pandemics ; *Nursing Staff, Hospital/psychology ; *Christianity ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic required healthcare organizations to rapidly upskill workers to care for critically ill patients. An integrative review focused on the upskilling of nurses during the pandemic identified themes of strategies, benefits, and challenges of rapid upskilling. Understanding the effectiveness, satisfaction, and challenges of upskilling efforts during COVID-19 can help healthcare organizations prepare for future emergencies by improving workforce readiness and response strategies. Biblical principles related to upskilling for best quality care are discussed.}, }
@article {pmid40915970, year = {2025}, author = {Too, EK and Wachira, P and Njenga, S and Odero, SA and Ndirangu-Mugo, E and Abubakar, A}, title = {Prevalence and factors associated with depression, anxiety and post-traumatic stress disorder among healthcare workers from sub-Saharan Africa: systematic review.}, journal = {BJPsych open}, volume = {11}, number = {5}, pages = {e192}, pmid = {40915970}, issn = {2056-4724}, abstract = {BACKGROUND: Depression, anxiety and post-traumatic stress disorder (PTSD) are prevalent among healthcare workers (HCWs), including those from sub-Saharan Africa (SSA). However, there are limited summary data on the burden and factors associated with these disorders in this region. We conducted this systematic review (registration no. CRD42022349136) to fill this gap.<br><br>AIMS: The aim of this review was to systematically summarise the available evidence on the prevalence and factors associated with depression, anxiety and PTSD, or their symptoms, among HCWs from SSA.<br><br>METHOD: We searched African Index Medicus, African Journals Online, CINAHL, PsycINFO and PubMed for articles published, from database inception to 15 February 2024. The keywords used in the search were 'depression/anxiety/PTSD', 'healthcare workers', 'SSA' and their variations.<br><br>RESULTS: Sixty-nine studies met our inclusion criteria, most of which (n = 55, 79.7%) focused on the burden of these disorders during the COVID-19 pandemic. Across studies, wide-ranging prevalence estimates of depressive (2.1-75.7%), anxiety (4.8-96.5%) and PTSD symptoms (11.7-78.3%) were reported. These disorders appear to have been heightened during the COVID-19 pandemic. Several sociodemographic, health-related, COVID-19-related and work-related factors were reported to either increase or lower the risk of these disorders among HCWs from SSA.<br><br>CONCLUSIONS: The burden of depression, anxiety and PTSD among HCWs from SSA is high and appears to have been worsened by the COVID-19 pandemic. The correlates of these disorders among HCWs from this region are multifactorial. A multi-component intervention could contribute to addressing the burden of mental disorders among HCWs from this region.}, }
@article {pmid40915399, year = {2025}, author = {Salim, NA and Taylor, J}, title = {Efficacy of Virtual Reality in Managing Pain for Patients in Palliative Care: A Systematic Review and Meta-Analysis.}, journal = {Journal of pain and symptom management}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jpainsymman.2025.08.030}, pmid = {40915399}, issn = {1873-6513}, abstract = {BACKGROUND: Pain management in palliative care, especially among cancer patients, remains a critical challenge that significantly affects patient quality of life. Virtual Reality (VR) has emerged as a promising nonpharmacological intervention that could revolutionize pain management strategies in this vulnerable population. This systematic review and meta-analysis evaluate the effectiveness of VR interventions, focusing exclusively on randomized controlled trials to provide a comprehensive assessment of VR as a therapeutic tool.<br><br>METHODS: This systematic review and meta-analysis followed the JBI methodology for randomized controlled trials (RCTs). English-language RCTs evaluating VR for pain management in adult palliative care cancer patients were included. Due to COVID-19-related publication delays, the search extended beyond the standard five-year scope. Keywords used included "virtual reality," "pain management," "palliative care," and "cancer patients," across databases such as PubMed, Scopus, Web of Science, and PsycINFO. Exclusions covered nonrandomized studies and those with methodological flaws. Study selection was conducted using Covidence. Data analysis was performed using STATA V. 17, calculating standardized mean differences (SMDs) for pain measurement scales.<br><br>RESULTS: The analysis of ten trials demonstrated VR's capability to significantly reduce pain intensity in palliative care. The pooled effect size showed a moderate to large reduction in pain, with enhanced effectiveness observed in longer VR sessions and with interactive content. Despite variability, the consistent findings support VR's potential as a flexible and adaptable approach to pain management.<br><br>CONCLUSIONS: Virtual reality offers a promising alternative for pain management in palliative care, highlighting the necessity for standardized protocols and further research into its long-term effects and economic viability. To gain a deeper understanding of how VR affects patient experiences and outcomes, future research should implement mixed-methods studies that combine quantitative data with qualitative insights. This approach will allow for a more comprehensive evaluation of VR's impact on the quality of life and pain management strategies, ensuring that interventions are tailored to meet the complex needs of palliative care patients.<br><br>STUDY REGISTRATION: The current study registered with the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number [CRD42024512961].}, }
@article {pmid40915301, year = {2025}, author = {Ribier, V and Hadjadj, J and Jachiet, V and Mekinian, A and Terrier, B and Georgin-Lavialle, S and Grayson, PC and Beck, DB and Savic, S and Dubée, V and Lacombe, V}, title = {Mapping the infectious burden in VEXAS syndrome: a systematic review and rationale for prevention.}, journal = {The Lancet. Rheumatology}, volume = {7}, number = {10}, pages = {e734-e744}, doi = {10.1016/S2665-9913(25)00225-5}, pmid = {40915301}, issn = {2665-9913}, mesh = {Humans ; *Opportunistic Infections/prevention &amp; control/epidemiology ; Myelodysplastic Syndromes ; Skin Diseases, Genetic ; }, abstract = {Infections are increasingly recognised as a major cause of morbidity and mortality in patients with vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome. We conducted a systematic review to characterise the infectious burden of VEXAS syndrome and propose preventive strategies. We included 57 studies (813 patients) showing that infections in patients with VEXAS syndrome were frequent, severe in 40-60% of cases, and fatal in 6-15% of cases. Pulmonary infections were most common, followed by cutaneous infections and bacteraemia. Opportunistic pathogens, such as Pneumocystis jirovecii, Legionella pneumophila, non-tuberculous mycobacteria, and varicella zoster virus, were frequently reported, even in patients not receiving immunosuppressive therapy, which suggests intrinsic immune dysfunction. Prophylaxis with co-trimoxazole (or other Pneumocystis prophylaxis, such as atovaquone or pentamidine) and valaciclovir should particularly be considered for patients at high risk of infection, including those receiving immunosuppressive therapy and those with lymphopenia, pMet41Val mutation, or previous severe or recurrent infections. Posaconazole might be appropriate in patients with neutropenia who are taking azacitidine. Vaccination against Streptococcus pneumoniae, varicella zoster virus, influenza, and SARS-CoV-2 is recommended. These data highlight the need to integrate infectious risk into VEXAS syndrome management and to evaluate preventive strategies in prospective studies.}, }
@article {pmid40915060, year = {2025}, author = {Zhou, Y and Feng, M and Zhang, L}, title = {Repurposing disulfiram: An innovative inhibitory approach against a broad spectrum of viruses.}, journal = {Biochemical and biophysical research communications}, volume = {782}, number = {}, pages = {152596}, doi = {10.1016/j.bbrc.2025.152596}, pmid = {40915060}, issn = {1090-2104}, mesh = {*Disulfiram/pharmacology/therapeutic use ; *Antiviral Agents/pharmacology/therapeutic use/chemistry ; *Drug Repositioning ; Humans ; SARS-CoV-2/drug effects ; *Virus Diseases/drug therapy/virology ; Virus Replication/drug effects ; *Viruses/drug effects ; Viral Proteins/metabolism/antagonists &amp; inhibitors/chemistry ; Zinc/metabolism ; COVID-19 Drug Treatment ; }, abstract = {Disulfiram (DSF), an FDA-approved therapeutic agent for alcohol dependence, has recently attracted considerable interest due to its broad-spectrum inhibitory effects against various viruses. Increasing evidence suggests that DSF can inhibit viral replication through two major mechanisms: the inhibition of viral protein catalytic activity and the ejection of Zn[2+] from viral proteins. This review comprehensively summarized the molecular mechanisms underlying DSF's antiviral activity against viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), hepatitis C virus (HCV), influenza virus, human immunodeficiency virus (HIV), and Kaposi sarcoma-associated herpes virus (KSHV), with a particular focus on its dual targeting of Cys residues and Zn[2+] coordination sites. By synthesizing current findings and emphasizing novel insights, this review aims to provide a foundation for the development of novel antiviral therapeutic strategies and to inspire further research into the repurposing of DSF for combating viral infections.}, }
@article {pmid40914991, year = {2025}, author = {Mathkor, DM and Tawil, S and Johargy, AK and Faidah, H and Babalghith, AO and Jalal, NA and Bantun, F and Ahmad, F and Haque, S}, title = {Respiratory and gastrointestinal infections among Hajj pilgrims during the 2012-2025 seasons: A systematic review.}, journal = {Journal of infection and public health}, volume = {18}, number = {11}, pages = {102951}, doi = {10.1016/j.jiph.2025.102951}, pmid = {40914991}, issn = {1876-035X}, mesh = {Humans ; *Respiratory Tract Infections/epidemiology/microbiology/virology ; *Islam ; *Gastrointestinal Diseases/epidemiology/microbiology ; Saudi Arabia/epidemiology ; Prevalence ; *Travel ; *Mass Gatherings ; Seasons ; COVID-19/epidemiology ; }, abstract = {INTRODUCTION: Hajj is the largest annual mass gathering in the world, attracting more than 2 million pilgrims from 184 countries. Adverse climatic conditions and close proximity of pilgrims during Hajj rituals create a facilitating environment for the transmission of infectious agents, including multi-drug resistant organisms. Although, several individual reports have been published on specific type of infections, there is a paucity of published work reflecting the overall picture of the prevalence of pathogenic infections during Hajj.<br><br>METHODS: A systematic review was conducted in PubMed, SCOPUS, ScienceDirect, and Google Scholar to examine the prevalence of Hajj-associated pathogenic respiratory and gastrointestinal (GI) infections during the pilgrimage sessions of 2012-2025.<br><br>RESULTS: A total of 56 studies involving Hajj pilgrims and healthcare workers in close contact with them were included. Most common respiratory viruses detected among pilgrims included influenza and rhinovirus. Bacterial pathogens Streptococcus pneumoniae and Hemophilus influenzae were also detected among the subjects. However, acquisition of the coronaviruses, MERS-CoV or SARS-CoV-2 remained very limited and systematic screening of pilgrims showed limited infections. Amongst the pilgrims with GI infections, Escherichia coli was found to be the commonest bacterial pathogen.<br><br>CONCLUSION: This study provides the most updated overview of the prevalence of pathogenic infections during Hajj. While it appears that well-conducted multinational follow-up and post-Hajj studies are necessary for further evaluation of the impact of the Hajj on the acquisition of these pathogens, pilgrims may be at high risk of infections and may carry and transfer them to their home countries. Preventive measures, including hygiene practices and vaccination for high-risk pilgrims should be mandated.}, }
@article {pmid40914773, year = {2025}, author = {Rodrigues, OMM and Lopes, IG and de Oliveira, MEF and Fragoso, MAC and de Oliveira, MRF and Silva, RS and de Castro E Caldo Lima, GR and Damazo, AS and Martins, WJ}, title = {The Use of Unmanned Aerial Vehicles (UAV) on Delivering Biological Samples for COVID-19 and Tuberculosis Diagnosis: A Scoping Review.}, journal = {Therapeutic innovation &amp; regulatory science}, volume = {}, number = {}, pages = {}, pmid = {40914773}, issn = {2168-4804}, support = {Convenio 04/2020 - FAP//Fiocruz Brasilia/ ; Convenio 04/2020 - FAP//Fiocruz Brasilia/ ; Convenio 04/2020 - FAP//Fiocruz Brasilia/ ; }, abstract = {PURPOSE: To identify and review scientific evidence from experimental studies utilizing unmanned aerial vehicles (UAVs) to transport samples for the diagnosis of COVID-19 and tuberculosis (TB). This exploratory study aims to support the future development of UAVs for transporting biological samples within the Brazilian Unified Health System (SUS).<br><br>METHODS: This scoping review defined its eligibility criteria using the PECO acronym, focusing on: Population: biological samples for diagnosing COVID-19 or TB; Exposure: UAV transportation; Comparator: land transportation; Outcomes: Cost, effectiveness, methods for sample preservation, flight parameters (time, altitude, speed, distance), and quality of transported samples. Eligible studies were identified through searches in Medline via PubMed, Scopus, Embase, and Web of Science. Grey literature was explored via Google Scholar.<br><br>RESULTS: Of the 2,052 articles initially found, 797 were duplicates, 1,247 were screened by title and abstract and excluded, eight were retrieved (and fully read) of which five met the eligibility criteria and were included in the review. These studies provided diverse evidence regarding cost, operational performance, safety, and sample integrity.<br><br>CONCLUSION: The reviewed studies demonstrate promising applications of UAVs in healthcare logistics. However, regulatory and legal frameworks require adaptation to ensure operational safety. Further experimental studies are necessary, particularly involving beyond visual line of sight (BVLOS) operations, to evaluate scalability and potential cost reductions.}, }
@article {pmid40914746, year = {2025}, author = {López-Labrador, FX and Blasco, A and Villamayor, LM and Gaume, G and Ros-Lis, JV}, title = {Use of Electrolysed Water as Disinfection Technology in Front of Various Microorganisms and SARS-COV-2.}, journal = {Food and environmental virology}, volume = {17}, number = {4}, pages = {49}, pmid = {40914746}, issn = {1867-0342}, mesh = {*SARS-CoV-2/drug effects ; *Disinfection/methods ; *Disinfectants/pharmacology/chemistry ; COVID-19/prevention &amp; control/virology ; Electrolysis ; *Water/chemistry/pharmacology ; Bacteria/drug effects ; Humans ; Hydrogen-Ion Concentration ; Fungi/drug effects ; Virus Inactivation/drug effects ; }, abstract = {The global emergence of SARS-CoV-2 has highlighted the urgent need for effective disinfection strategies to mitigate virus transmission. Electrolyzed water (EW), an eco-friendly and cost-effective biocidal agent, has garnered attention for its broad-spectrum antimicrobial activity. This study evaluates the virucidal, bactericidal, and fungicidal capacities of EW with diverse pH, with a focus on its effectiveness against SARS-CoV-2 and other pathogens. EW was generated under controlled conditions with adjustable pH (4.5 and 6.1) and free available chlorine (FAC) concentrations (300-1000 ppm). The biocidal activity was tested on surfaces and in solution following standardized protocols. Results demonstrated that oxidized EW at optimized concentrations achieved a ≥ 4 log reduction in bacterial populations and effectively inactivated enveloped and non-enveloped viruses, but this effect depends on FAC, pH, and contact time. Notably, EW reduced SARS-CoV-2 by > 4 log in solution and surfaces, in only 2 and 5 min, respectively. These findings highlight the potential of EW as a sustainable, multi-application disinfectant to combat emerging pathogens like SARS-CoV-2, ensuring public health safety.}, }
@article {pmid40913819, year = {2025}, author = {Mues, KE and Zhou, CK and Gerber, JE and van Hunsel, F and Klein, NP and Izurieta, HS and Chen, RT}, title = {A review of methodologic &amp; data considerations for vaccine safety surveillance in the wake of the COVID-19 pandemic.}, journal = {Vaccine}, volume = {64}, number = {}, pages = {127691}, doi = {10.1016/j.vaccine.2025.127691}, pmid = {40913819}, issn = {1873-2518}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; *COVID-19 Vaccines/adverse effects ; *Product Surveillance, Postmarketing/methods ; United States/epidemiology ; SARS-CoV-2/immunology ; Pandemics/prevention &amp; control ; Europe/epidemiology ; Adverse Drug Reaction Reporting Systems ; }, abstract = {Vaccine safety surveillance systems are vital for the post-market safety monitoring of novel and well-established vaccines, given the sample size, representativeness and follow-up time in clinical trials. The introduction of COVID-19 vaccines during the SARS-CoV-2 pandemic presented unprecedented challenges for safety surveillance. Here, we discuss methodologic considerations for epidemiologic study design and real world data for passive and active surveillance systems for COVID-19 vaccines in the United States (U.S.) and Europe, including standardized case definitions, quality of clinical reports, validity of coding algorithms, risk window misclassification, sample size considerations to detect safety signals within subgroups, time to signal identification, counterfactual including comparator selection, and confounding control in the context of a global pandemic. Throughout, we discuss techniques that may be applicable in vaccine surveillance activities, particularly those that occur within a global pandemic with rapid development and implementation of new vaccines to large portions of the population.}, }
@article {pmid40912879, year = {2025}, author = {Bolognesi, T and Schiavina, M and Felli, IC and Pierattelli, R}, title = {NMR insights on multidomain proteins: the case of the SARS-CoV-2 nucleoprotein.}, journal = {Progress in nuclear magnetic resonance spectroscopy}, volume = {148-149}, number = {}, pages = {101577}, doi = {10.1016/j.pnmrs.2025.101577}, pmid = {40912879}, issn = {1873-3301}, mesh = {*SARS-CoV-2/chemistry ; *Nuclear Magnetic Resonance, Biomolecular/methods ; *Coronavirus Nucleocapsid Proteins/chemistry ; Intrinsically Disordered Proteins/chemistry ; Protein Domains ; Humans ; Magnetic Resonance Spectroscopy/methods ; *Phosphoproteins/chemistry ; COVID-19/virology ; Protein Structure, Secondary ; }, abstract = {Studying multidomain proteins, especially those combining well-folded domains with intrinsically disordered regions (IDRs), requires specific Nuclear Magnetic Resonance (NMR) techniques to address their structural complexity. To illustrate this, we focus here on the nucleocapsid protein from SARS-CoV-2, which includes both structured and disordered regions. We applied a suite of NMR methods, combining ARTINA software for automatic assignment and structure modelling with multi-receiver experiments that simultaneously capture signals from different nuclear spins, increasing both data quality and acquisition efficiency. Studies of signal temperature-dependence, heteronuclear relaxation and secondary structure propensity (SSP) analysis, as well as experiments employing either [1]H or [13]C detection to achieve simultaneous snapshots of globular and disordered regions, were used to analyse both the isolated N-terminal domain (NTD) and a construct (NTR) comprising the NTD and two flanking highly disordered regions (IDR1, IDR2). This comprehensive approach allowed us to characterize the NTD's structure and to evaluate how the IDRs affect the overall conformation and dynamics, as well as the interaction with RNA. The findings underscore the importance of applying such a combination of tailored NMR techniques for effectively studying multidomain proteins with heterogeneous structural and dynamic properties.}, }
@article {pmid40910660, year = {2025}, author = {Medioli, F and Franceschini, E and Mussini, C and Meschiari, M}, title = {Update on infection prevention in the ICU.}, journal = {Current opinion in critical care}, volume = {31}, number = {5}, pages = {529-538}, pmid = {40910660}, issn = {1531-7072}, mesh = {Humans ; *Cross Infection/prevention &amp; control ; *Intensive Care Units/organization &amp; administration ; *Infection Control/methods/organization &amp; administration ; *COVID-19/epidemiology ; Hand Hygiene ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Healthcare-associated infections (HAIs) remain a critical challenge in intensive care units (ICUs) due to the high prevalence of invasive procedures, vulnerable patient populations, and the increasing threat of antimicrobial-resistant organisms (MDROs). This review synthesizes current evidence on infection prevention and control (IPC) strategies in the ICU setting, highlighting recent findings and innovations in this evolving field, particularly in light of the impact of the COVID-19 pandemic.<br><br>RECENT FINDINGS: The review outlines ten key IPC strategies for ICUs, categorizing them into horizontal (universal) and vertical (pathogen-specific) approaches. Recent literature emphasizes the importance of enhanced hand hygiene compliance through motivational interventions and feedback. The role of selective decontamination strategies remains debated, with evidence suggesting potential benefits in specific patient subgroups. Vertical strategies, including active screening for MDROs and per-pathogen bundles, are increasingly being tailored based on local epidemiology and pathogen characteristics. Studies suggest that de-escalating routine contact precautions for certain MDROs like Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococcus may be safe in settings with robust horizontal measures. Conversely, intensified "search and destroy" strategies show promise in controlling carbapenem-resistant Acinetobacter baumannii outbreaks.<br><br>SUMMARY: Effective IPC in the ICU requires a multifaceted and adaptable approach, integrating both universal precautions and targeted interventions against specific pathogens. While consistent implementation of horizontal strategies like hand hygiene is foundational, tailoring vertical strategies based on local MDRO epidemiology and patient risk profiles is crucial. Future research should focus on harmonizing IPC policies, optimizing screening methods, and evaluating the long-term impact of combined IPC and antimicrobial stewardship programs to improve patient outcomes and mitigate the spread of antimicrobial resistance in critical care settings.}, }
@article {pmid40910388, year = {2025}, author = {Elmgreen, SB and Nielsen, NK and Faurbye, JJ}, title = {[Force health protection as a strategic resource for military and civilian resilience].}, journal = {Ugeskrift for laeger}, volume = {187}, number = {35}, pages = {}, doi = {10.61409/V03250150}, pmid = {40910388}, issn = {1603-6824}, mesh = {Humans ; COVID-19/prevention &amp; control ; *Military Personnel ; *Military Health ; Military Medicine ; Risk Assessment ; }, abstract = {Force health protection (FHP) is a core component of NATO's health doctrine, aimed at safeguarding military personnel through prevention, risk assessment, and health surveillance. This review explores how FHP principles can enhance national health resilience by integrating military and civilian capacities, including in chemical, biological, radiological and nuclear response and tactical emergency care. International experiences and COVID-19 demonstrate the strategic value of such civil-military cooperation.}, }
@article {pmid40910064, year = {2025}, author = {Sorrentino, M and Mercogliano, M and Fiorilla, C and Stilo, I and Esposito, F and Moccia, M and Lavorgna, L and Affinito, G and Salvatore, E and Sormani, MP and Odone, A and Majeed, A and Rubba, F and Triassi, M and Palladino, R}, title = {The needs and unmet needs for people living with dementia, caregivers and care workers in dementia health care systems: a systematic review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1605993}, pmid = {40910064}, issn = {2296-2565}, mesh = {Humans ; *Dementia/therapy ; *Caregivers/psychology ; *Health Personnel/psychology ; *Health Services Needs and Demand ; Europe ; *Delivery of Health Care ; Health Services Accessibility ; }, abstract = {INTRODUCTION: The prevalence and costs of dementias are rising due to demographic changes. Dementia care depends largely on informal caregivers and fragmented healthcare systems that often fail to meet the needs of people with dementia.<br><br>OBJECTIVES: This systematic review aims to identify unmet needs and barriers in European dementia care, providing a framework to improve health strategies.<br><br>METHODS: Following PRISMA guidelines, articles from 2013 to 2023 were screened from Embase, PsycINFO, HTA Database, and Web of Science. The Mixed Methods Appraisal Tool was used for evaluation.<br><br>RESULTS: From 3,738 articles, 47 met the inclusion criteria. Through a narrative synthesis, the review identified unmet needs and barriers among People Living with Dementia, caregivers, and healthcare workers. Psychosocial and emotional support are essential for managing stress and ensuring quality of life. Caregivers demand education about dementia care, progression, and self-care, while healthcare workers need training, and interdisciplinary teams. Cultural sensitivity is critical for addressing stigma and facilitating inclusive care for ethnic minorities. Healthcare access remains fragmented, thereby decreasing continuity of care for families. High costs, bureaucratic complexity, and geographical inequalities, particularly in rural areas can be barrier to care for People Living with Dementia and their families. The COVID-19 pandemic disrupted social support services, increasing distress and uncertainty. About limitation, publication bias and geographical bias from focus on Europe were possible, potentially overlooking insights from other regions.<br><br>CONCLUSION: There is need for public policies to enhance education, community support, and dementia awareness, with a focus on culturally sensitive care.}, }
@article {pmid40910061, year = {2025}, author = {Huijghebaert, S and Fabbris, C and Baxter, AL and Parviz, S and Chatterjee, US and Rabago, D}, title = {Saline nasal irrigation and gargling in COVID-19: Part II. Outcomes in Omicron and risk-benefit for self-care.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1462286}, pmid = {40910061}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/therapy ; *Nasal Lavage/methods ; *Self Care/methods ; *Saline Solution/administration &amp; dosage/therapeutic use ; SARS-CoV-2 ; Risk Assessment ; }, abstract = {BACKGROUND: The World Health Organization recommends at-home management of mild COVID-19. While our preliminary evaluation provided evidence for saline nasal irrigation (SNI) and gargling in COVID-19, an update and risk-benefit assessment for self-care in Omicron infection is warranted, from treatment and preparedness perspectives, as new SARS-CoV-2 variants continuously emerge, while symptoms overlap with those of common colds and other upper respiratory tract infections.<br><br>METHODS: Systematic literature searches for preclinical and clinical studies involving Omicron infection and saline, bias assessment, and review of outcomes (benefits, risks).<br><br>RESULTS: A total of 14 studies met eligibility criteria: one experimental proof-of-concept study, eight randomized clinical trials (RCTs), two quasi-experimental, two matched case-control, and one controlled study (2,389 patients, 1,101 receiving saline). Study designs were highly heterogeneous, not allowing pooling of the data. In line with the pre-clinical findings, the clinical trials showed lower viral loads or faster viral clearance with SNI use; results were consistent, if SNI was started early in the infection. Individual studies supported reduced infectivity of saliva, inflammatory mediators and C-reactive protein, and increased lymphocytes. Symptoms resolved faster if severe at baseline, in line with the findings from pre-Omicron RCTs; the ability to perform daily activities was assessed in one RCT and improved significantly. Early initiation of daily SNI/gargling before the onset of smell/taste dysfunction prevented their development. Daily SNI hygiene was also associated with less frequent development of fever and a shorter duration of fever than observed among (non-irrigating) controls. Daily SNI modestly helped to reduce household transmission; a preliminary report suggests that reliable prophylaxis can be achieved, provided daily SNI is combined with strict use of personal protective measures. Hospitalization was virtually absent. Isotonic SNI was best tolerated.<br><br>CONCLUSION: This analysis is consistent with prior review findings: early initiation of SNI/gargling may help patients with mild COVID-19 feel better, irrespective of the variant. If clean water and irrigation materials are provided, SNI can reasonably be recommended as early self-care for COVID-19, as it is for the common cold. Larger prospective studies are required to determine optimal protocols and SNI's potential role in respiratory pathogen pandemic preparedness.}, }
@article {pmid40910058, year = {2025}, author = {Mazzali, C and Magnoni, P and Zucchi, A and Maifredi, G and Cavalieri d'Oro, L and Gambino, ML and Fanetti, AC and Perotti, PG and Villa, M and Valsecchi, MG and Vigani, D and Lucifora, C and Russo, AG}, title = {Strategies for population-level identification of post-acute sequelae of COVID-19 through health administrative data.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1637112}, pmid = {40910058}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/complications/epidemiology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Post-acute sequelae of COVID-19 (PASC) encompass several clinical outcomes, from new-onset symptoms to both acute and chronic diagnoses, including pulmonary and extrapulmonary manifestations. Health administrative data (HAD) from health information systems allow population-level analyses of such outcomes. Our primary aim was to identify clinical conditions potentially attributable to SARS-CoV-2 infection, and the types of HAD and "diagnostic criteria" used for their detection.<br><br>METHODS: We performed a literature review to identify HAD-based cohort studies assessing the association between SARS-CoV-2 infection and medium-/long-term outcomes in the general population. From each included study, we extracted data on design, algorithms used for outcome identification (sources, coding systems, codes, time criteria/thresholds), and whether significant associations with SARS-CoV-2 infection were reported.<br><br>RESULTS: We identified six studies investigating acute and chronic conditions grouped by clinical domain (cardiovascular, respiratory, neurologic, mental health, endocrine/metabolic, pediatric, miscellaneous). Two studies also addressed the onset of specific symptoms. Cardio/cerebrovascular conditions were most studied, with significant associations reported for deep vein thrombosis, heart failure, atrial fibrillation, and coronary artery disease. Conditions in other domains were less investigated, with inconsistent findings. Only three studies were designed as test-positive vs. test-negative comparisons.<br><br>DISCUSSION: Heterogeneity in data sources, study design, and outcome definitions hinder the comparability of studies and explain the inconsistencies in findings about associations with SARS-CoV-2 infection. Rigorously designed studies on large populations with wide availability of data from health information systems are needed for population-level analyses on PASC, and especially on its impact on chronic diseases and their future burden on healthcare systems.}, }
@article {pmid40909339, year = {2025}, author = {van Dorsten, RT and Breiman, RF}, title = {A landscape review with novel criteria to evaluate microbial drivers for cancer: priorities for innovative research targeting excessive cancer mortality in sub-Saharan Africa.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1625818}, pmid = {40909339}, issn = {2235-2988}, mesh = {Humans ; *Neoplasms/mortality/microbiology/epidemiology/etiology ; Africa South of the Sahara/epidemiology ; Microbiota ; Carcinogenesis ; }, abstract = {The escalating cancer burden in Sub-Saharan Africa (SSA), with projected doubling of incidence and mortality by 2040, necessitates innovative, cost-effective strategies for prevention, diagnosis, and treatment. While known infectious triggers like HPV, hepatitis viruses, and H. pylori account for an estimated 28.7% of cancers in SSA, the full scope of microbially-mediated oncogenesis remains underexplored. We examine existing data and formulate plausible hypotheses regarding the potential roles of additional infectious agents in cancer development within SSA. We explore mechanisms through which microbes may directly or indirectly contribute to oncogenesis, including the action of viral oncogenes, induction of chronic inflammation, mutational signatures, and the impact of immunosuppression, particularly in the context of HIV. Potential microbial triggers warrant further investigation, such as viruses (MMTV, CMV, polyomaviruses, SARS-CoV-2), bacteria (Fusobacterium nucleatum, Cutibacterium acnes, Salmonella Typhi), fungi (Candida, Aspergillus), parasites (Schistosoma japonicum and mansoni and Toxoplasma gondii) and the complex interplay with the microbiome. Given the significant challenges in establishing causation for microbial facilitators of cancer, with traditional postulates showing limited utility, we propose a refined set of criteria tailored to microbial oncogenesis, aiming to guide future research efforts. These criteria incorporate elements of both Koch's postulates and the Bradford Hill framework, adapted to address the unique characteristics of microbial interactions with human hosts. By leveraging existing knowledge and plausible causal relationships, and by implementing advanced experimental tools such as next-generation sequencing and multi-omics analyses, coupled with machine learning approaches and collaborative, multidisciplinary research, we propose to accelerate the identification of novel microbial links to cancer. This knowledge may pave the way for targeted interventions such as new approaches for screening and diagnosis, and strategies for prevention including vaccine development or modification of existing vaccines (or recommendations for immunization timing and population targets). While acknowledging the inherent complexities of studying polymicrobial interactions and the challenges of translating in vitro findings to human populations, this work aims to provide a framework for future research and intervention strategies to reduce the escalating cancer burden and address global inequities in SSA. The ultimate goal is to inform evidence-based public health policies and clinical practices that will improve cancer outcomes in this vulnerable region.}, }
@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 = {21}, number = {12}, pages = {833-845}, pmid = {40908304}, issn = {1759-507X}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Renal Insufficiency, Chronic/epidemiology/etiology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; COVID-19 Vaccines ; }, 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).<br><br>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).<br><br>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&#x2009;=&#x2009;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.<br><br>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.}, }
@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 = {160}, number = {}, pages = {108039}, doi = {10.1016/j.ijid.2025.108039}, pmid = {40907738}, issn = {1878-3511}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology/diagnosis ; Denmark/epidemiology ; SARS-CoV-2 ; Middle Aged ; COVID-19 Vaccines ; Pandemics/prevention &amp; control ; Adult ; Contact Tracing ; *Communicable Disease Control/methods ; Aged ; Male ; Female ; }, abstract = {When a new pandemic virus emerges in a naive population, the only control options are non-pharmaceutical interventions (NPIs) until vaccines or effective treatments become available. Here, we report on the Danish suppression strategy and use of a combination of NPIs with a notable absence of extremely strict measures (such as stay-at-home orders). Only 7% of Danes were infected (serological evidence) in the first year of the pandemic, compared with 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 an mRNA vaccine by summer. On February 1, 2022, while facing the Omicron variant and with the older adult newly boosted, Denmark became the first country to drop all NPIs. A few months later, 70% of the population had been infected with the Omicron variant, showing the SARS-CoV-2 transmission potential when unmitigated. Denmark was only close to intensive care unit capacity during the second wave in winter 2020-2021, when 5% of the population was infected. In conclusion, the effectiveness of the combined NPIs 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 a 50% attack rate and catastropic levels of severe 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 subphenotypes in biology and medicine. A growing body of literature has identified diverse phenotypic manifestations of SARS-CoV-2 influenced by host and viral factors.<br><br>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.<br><br>SOURCES: We conducted a comprehensive literature search of PubMed, Medline, and Embase databases from 1 October 2024 to 5 August 2025 to identify relevant literature regarding phenotypes observed in SARS-CoV-2 infection.<br><br>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 signalling pathways, and variations in white blood cell ratios, often reflecting a pattern of immune suppression. Molecular phenotypes reflect variations in host polymorphisms involving interleukin-18 secretion, inflammasome formation, and human leucocyte antigen-DR isotype 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.<br><br>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}, 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.<br><br>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.<br><br>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.<br><br>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.<br><br>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.<br><br>RR2-10.31219/osf.io/mfujb.}, }
@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 neurod&#xe9;g&#xe9;n&#xe9;rescence associ&#xe9;e 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.<br><br>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.<br><br>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.<br><br>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 {pmid40905952, year = {2025}, author = {Call, MJ and Call, ME and Wu, X}, title = {Insights from deep mutational scanning in the context of an emerging pathogen.}, journal = {Biochemical Society transactions}, volume = {53}, number = {5}, pages = {1169-1179}, pmid = {40905952}, issn = {1470-8752}, mesh = {*SARS-CoV-2/genetics ; Humans ; *COVID-19/virology ; Spike Glycoprotein, Coronavirus/genetics/metabolism/chemistry ; Angiotensin-Converting Enzyme 2/metabolism/genetics ; Mutation ; High-Throughput Nucleotide Sequencing/methods ; }, abstract = {Deep mutational scanning (DMS), a high-throughput method leveraging next-generation sequencing, has been crucial in mapping the functional landscapes of key severe acquired respiratory syndrome-coronavirus 2 (SARS-CoV-2) proteins. By systematically assessing thousands of amino acid changes, DMS provides a framework to understand Angiotensin-converting enzyme 2 (ACE2) binding and immune evasion by the spike protein, mechanisms and drug escape potential of the main and papain-like viral proteases and has highlighted areas of concern in the nucleocapsid protein that may affect most currently available rapid antigen testing kits. Each application has required the design of bespoke assays in eukaryotic (yeast and mammalian) cell models, providing an exemplar for the application of this technique to future pandemics. This minireview examines how DMS has predicted key evolutionary changes in SARS-CoV-2 and affected our understanding of SARS-CoV-2 biology, specifically highlighting their relevance for therapeutics development.}, }
@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.}, }
@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 = {41}, number = {8}, pages = {1417-1438}, doi = {10.1080/03007995.2025.2551227}, pmid = {40905188}, issn = {1473-4877}, mesh = {Humans ; *COVID-19 Drug Treatment ; *Hydroxylamines/therapeutic use ; *Cytidine/analogs &amp; derivatives/therapeutic use ; *Antiviral Agents/therapeutic use ; Observational Studies as Topic ; SARS-CoV-2/drug effects ; *COVID-19/mortality/virology ; Hospitalization/statistics &amp; numerical data ; Treatment Outcome ; }, 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.<br><br>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.<br><br>RESULTS: Twenty-one general and special population studies were included. General population studies (n&#x2009;=&#x2009;16) showed that MOV reduced the risk of death, hospitalization, and hospitalization/death. Special population studies (n&#x2009;=&#x2009;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 (&#x2265;60&#x2009;years). The wide range of risk reduction observed might be attributed to variability in COVID-19 hospitalization guidelines and vaccination status.<br><br>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.<br><br>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.<br><br>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 {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 &amp; social welfare}, volume = {84}, number = {7}, pages = {87-95}, pmid = {40904531}, issn = {2641-5224}, mesh = {Hawaii ; Humans ; *Public Health/methods/statistics &amp; numerical data/trends ; *Health Workforce/statistics &amp; 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.}, }
@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 &amp; 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.}, }
@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 &amp; immunology : official publication of the American College of Allergy, Asthma, &amp; 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.}, }
@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 &amp; 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.<br><br>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.<br><br>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.}, }
@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 &amp; 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.}, }
@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}, 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.<br><br>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.<br><br>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.<br><br>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.}, }
@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 = {20}, number = {20}, pages = {2545-2569}, pmid = {40901740}, issn = {1748-6963}, mesh = {Humans ; *Nanoparticles/chemistry ; *Lipids/chemistry ; COVID-19/prevention &amp; control ; COVID-19 Vaccines/administration &amp; dosage ; *RNA/administration &amp; dosage ; Injections, Intramuscular ; SARS-CoV-2/immunology ; Animals ; Drug Delivery Systems/methods ; Liposomes ; }, 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.}, }
@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 {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}, 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}, 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.<br><br>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.<br><br>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.<br><br>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}, 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 = {74}, number = {10}, pages = {665-674}, pmid = {40900166}, issn = {2731-6866}, mesh = {Humans ; *COVID-19/epidemiology ; *Surge Capacity/organization &amp; administration ; Germany/epidemiology ; *Volunteers ; *Emergency Service, Hospital/organization &amp; administration ; Pandemics ; SARS-CoV-2 ; *Disaster Planning/organization &amp; administration ; *Hospital Volunteers ; }, 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.<br><br>OBJECTIVE: We assessed whether non-medical helpers could be incorporated as surge capacity workforce in German hospitals.<br><br>METHODS: For this scoping review we performed an initial pilot search using GoogleScholar, followed by a&#xa0;systematic query of the Embase and Medline databases. The identified literature and the results of the pilot search were summarized in a&#xa0;narrative-descriptive way.<br><br>RESULTS: We identified 64&#xa0;relevant articles for the scoping review (4&#xa0;reports, 5&#xa0;reviews, 1&#xa0;book section, 13&#xa0;interventional and 4&#xa0;observational studies, 8&#xa0;cross-sectional surveys, 12&#xa0;expert articles, 13&#xa0;case reports, 4&#xa0;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&#xa0;requirement and can take place pre-emptively or at short notice (just in time).<br><br>CONCLUSION: An increasing body of evidence describes including volunteers in preparedness plans within the clinical setting. Especially medical students seem to be a&#xa0;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 {pmid40900154, year = {2025}, author = {Kuuwill, A and Kimengsi, JN and Giessen, L}, title = {Change in Formal and Informal Forest Management Institutions Induced by Health Shocks-A Global Systematic Review.}, journal = {Environmental management}, volume = {75}, number = {12}, pages = {3565-3585}, pmid = {40900154}, issn = {1432-1009}, support = {437116427//Forschungsgemeinschaft (DFG)/ ; }, mesh = {*Forestry ; *Forests ; Humans ; *Conservation of Natural Resources ; Africa ; }, abstract = {Studies on the impact of health shocks in (re)shaping forest management institutions exist, albeit fragmented. Similarly, significant knowledge gaps exist regarding conceptualizing health shocks, the mechanisms and outcomes of forest-linked institutional change, and the methods used so far. We review regional variations in conceptualizing forest management institutions and institutional change that are linked to health shocks. Further, we studied the mechanism of institutional change and outcome in the context of health shocks and evaluated the yet-to-be-filled methodological gaps. Using the critical eco-health approach and an institutional analysis framework, we systematically review 70 empirically conducted studies. Descriptive and directed content analysis was employed in the data analysis. First, we found that health shocks are predominantly conceptualized as pandemics in Asia and epidemic in Africa. Forest management institutions are viewed through the process dimension lens, with informal processes more prevalent in Africa and formal processes dominant in other regions. Second, health shocks have primarily induced new formal forest management institutions while eroding informal ones in Asia and Africa. Thirdly, these institutional changes are linked with negative ecological and economic outcomes in the developing subregions, particularly in Asia, followed by Africa and Latin America. Finally, most studies employed the qualitative and single case study approaches, potentially limiting the findings' generalizability. Our study establishes a gap in understanding the power dynamics and political process of institutional change in the context of health shocks. Future studies should use a multiple-case study approach, mixed methods, and actor-centred analysis of forest management institutional compliance during health shocks.}, }
@article {pmid40900040, year = {2025}, author = {Adin, ME and Nguyen, D and Shin, C and Pucar, D}, title = {COVID-19 vaccine-associated reactive axillary lymph nodes on FDG PET/CT: a systematic review and meta-analysis.}, journal = {Nuclear medicine communications}, volume = {46}, number = {12}, pages = {1232-1239}, doi = {10.1097/MNM.0000000000002041}, pmid = {40900040}, issn = {1473-5628}, mesh = {Humans ; *Positron Emission Tomography Computed Tomography ; *Fluorodeoxyglucose F18 ; *COVID-19 Vaccines/adverse effects ; *Lymph Nodes/diagnostic imaging ; Axilla/diagnostic imaging ; COVID-19/prevention &amp; control ; }, abstract = {PURPOSE: COVID-19 vaccine-induced reactive axillary lymph nodes (RAL) on fluorodeoxyglucose (FDG) PET/computed tomography (CT) imaging can mimic malignant lymphadenopathy, leading to diagnostic errors. Reported RAL prevalence varies widely in the literature, and factors contributing to its development remain poorly understood. This meta-analysis aims to evaluate vaccine-induced RAL observed on FDG PET/CT imaging and consolidate evidence from multiple studies to assess its prevalence, duration, and associations with vaccine-related factors and demographic characteristics.<br><br>METHOD: Using multiple databases, a systematic review and meta-analysis was conducted on studies reporting RAL on FDG PET/CT following COVID-19 vaccination. The primary outcome was RAL prevalence, while the secondary outcomes were maximum standardized uptake value (SUV max), vaccine-to-scan interval, and associations with vaccine type and demographics.<br><br>RESULTS: A total of 25 studies comprising of 5010 subjects were included. Mean SUV max of reactive nodes was 2.8&#x2005;&#xb1;&#x2005;1.2. Overall, RAL prevalence was 38.6%&#x2005;&#xb1;&#x2005;17.6, higher in females (58.1% versus 41.9%, P &#x2005;=&#x2005;0.02) and younger individuals (mean age 63.3 versus 70.7&#x2009;years, P &#x2005;=&#x2005;0.03). The RAL rate was not statistically different between mRNA (39.9%&#x2005;&#xb1;&#x2005;16.9) and non-mRNA vaccines (26.3%&#x2009;&#xb1;&#x2009;30.9). However, subanalysis showed about 40% RAL with Pfizer and Moderna mRNA vaccines and AstraZeneca non-mRNA vaccine, versus much lower, below 20%, RAL with Sinovac and Johnson &amp; Johnson non-mRNA vaccines. Stricter PET/CT interpretation criteria using blood pool threshold reduced RAL prevalence to <20%. RAL rate declined with time but was still present after 1&#x2009;month.<br><br>CONCLUSION: Low activity RAL is common on FDG PET/CT after COVID-19 vaccination, while higher activity RAL (above blood pool) that can lead to clinical errors is less frequent. The frequency of RAL is affected by expected factors, such as age, gender, vaccine type, and time after vaccination, which indirectly suggest the link between RAL and COVID-19 postvaccinal immunity.}, }
@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}, 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.}, }
@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.<br><br>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.<br><br>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.<br><br>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 {pmid41332911, year = {2024}, author = {Sim, JY and Chung, JH and Oh, JY and Yi, JE and Lee, YH and Choi, SW and Lee, JA and Jin, YW and Yoo, HS}, title = {[Global Measles Outbreaks].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {34}, pages = {1432-1448}, pmid = {41332911}, issn = {2586-0860}, abstract = {In 2023, as public health and social measures due to coronavirus disease 2019 (COVID-19) eased and overseas travel resumed, measles cases increased rapidly worldwide. According to the World Health Organization (WHO), approximately 320,000 measles cases were reported worldwide in 2023, 1.8 times higher than approximately 170,000 cases in 2022. Even in countries verified as measles-eradication countries, community epidemics have been observed mainly among unvaccinated and incompletely vaccinated people. The WHO indicated that low vaccination rates and increased international travel are the main causes of the rapid increase in measles outbreaks. During the COVID-19 pandemic, vaccination services were suspended or delayed in many countries, significantly decreasing vaccination rates. Simultaneously, as travel restrictions eased, population movement increased worldwide, creating an environment that made it easy for the measles virus to spread to various regions. The WHO has set the goal of eradicating measles by 2030, and important strategies include maintaining and strengthening vaccination rates, strengthening quarantine, patient surveillance, public health education, and information sharing through international cooperation. As of 2022, the Republic of Korea has maintained a relatively high vaccination rate by meeting the standards for maintaining herd immunity of over 95% recommended by the WHO, with a secondary vaccination rate of 95%. However, there is a risk of transmission through certain age groups and overseas inflows where vaccination rates are relatively low. Therefore, in areas with an active measles outbreak, it is essential to be vaccinated before traveling to areas where outbreaks are increasing, and careful monitoring is necessary to prevent domestic inflow.}, }
@article {pmid41341243, year = {2024}, author = {Kokorelias, KM and McMurray, J and Chu, C and Astell, A and Grigorovich, A and Kontos, P and Babineau, J and Bytautas, J and Ahuja, A and Iaboni, A}, title = {Technology-Enabled Recreation and Leisure Programs and Activities for Older Adults With Cognitive Impairment: Rapid Scoping Review.}, journal = {JMIR neurotechnology}, volume = {3}, number = {}, pages = {e53038}, pmid = {41341243}, issn = {2817-092X}, abstract = {BACKGROUND: Recreational and leisure activities significantly contribute to the well-being of older adults, positively impacting physical, cognitive, and mental health. However, limited mobility and cognitive decline often impede access to these activities, particularly for individuals living with dementia. With the increasing availability of digital technologies, there is a rising interest in using technology to deliver recreation and leisure activities for cognitively impaired individuals, acknowledging its potential to provide diverse experiences. The COVID-19 pandemic further highlighted the need for virtual program delivery, especially for individuals in long-term care settings, leading to the development of tools like the Dementia Isolation Toolkit aimed at supporting compassionate isolation. To better support future implementations of the DIT, our rapid scoping review explores evidence-based, technology-enabled recreation programs for older adults with cognitive impairments, which promote well-being.<br><br>OBJECTIVE: We conducted a rapid scoping review of published peer-reviewed literature to answer the following research question: What recreation and leisure programs or activities are being delivered using technology to adults living with dementia or another form of cognitive impairment?<br><br>METHODS: In total, 6 databases were searched by an Information Specialist. Single reviewers performed title or abstract review, full-text screening, data extraction, and study characteristic summarization.<br><br>RESULTS: A total of 92 documents representing 94 studies were identified. The review identified a variety of technology-enabled delivery methods, including robots, gaming consoles, tablets, televisions, and computers, used to engage participants in recreational and leisure activities. These technologies impacted mood, cognition, functional activity, and overall well-being among older adults with cognitive impairments. Activities for socializing were the most common, leveraging technologies such as social robots and virtual companions, while relaxation methods used virtual reality and digital reminiscence therapy. However, challenges included technological complexity and potential distress during reminiscing activities, prompting recommendations for diversified research settings, and increased sample sizes to comprehensively understand technology's impact on leisure among this demographic.<br><br>CONCLUSIONS: The findings suggest that technology-enabled recreational activities, such as socializing, relaxation and self-awareness activities, music and dance, exergaming, and art, can positively impact the mood and overall well-being of older adults with cognitive impairment. Future research should embrace a more inclusive approach, integrating design, diverse settings, and a broader sample of older adults to develop technology-driven leisure activities tailored to their unique needs and promote their effective use.}, }
@article {pmid41334148, year = {2024}, author = {Kim, SY and Bang, H and Kim, H and Kang, BH}, title = {[Distribution Status of National Culture Collection for Pathogens Pathogen Resources following Coronavirus Disease 2019 Occurrence from 2020 to 2023].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {27}, pages = {1186-1212}, pmid = {41334148}, issn = {2586-0860}, abstract = {Since the enforcement of the "Act on the Collection, Management, and Promotion of Utilization of Biological Resources" in 2017 and the establishment of the Korea Disease Control and Prevention Agency (KDCA) in September 2020, the KDCA has assumed supervisory authority over this law. The National Culture Collection for Pathogens (NCCP) serves as the depository responsible for pathogen resources. It secures and manages valuable pathogen resources on an annual basis, and distributes them for various purposes in the healthcare research and industry field. From 2020 to 2023, the NCCP has distributed a total of 15,312 samples: 3,047 in 2020; 3,988 in 2021; 4,925 in 2022; and 3,352 in 2023. Distribution was notably higher in March and April compared to other months. Private for-profit organizations requested significantly more responses (9,011) than national public research institutes (2,676) or university/nonprofit organizations (3,625). Samples for vaccine/therapeutics (2,509) and diagnostic technology research (10,591) were more prevalent than those for education (1,074) and quality control (674). The coronavirus disease 2019 pandemic, which began in 2020 and has persisted for an extended period, led to a sustained increase in the distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (31.3%) to support various healthcare industries and research fields until the end of 2023. Among the distributed derivatives, nucleic acid forms used for diagnostic purposes accounted for 57.5%. This study provides information on the distribution status of pathogen resources from 2020 to 2023. It demonstrates that domestic resources are widely utilized in the public health field as source materials to respond to emerging infectious diseases and as standard strains for food and pharmaceuticals.}, }
@article {pmid40927068, year = {2024}, author = {Obasuyi, OC and Obasuyi, VA}, title = {A systematic review on the effect of the COVID-19 pandemic on childhood immunisation programmes of West African countries.}, journal = {Ghana medical journal}, volume = {58}, number = {2}, pages = {165-177}, pmid = {40927068}, issn = {2616-163X}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Immunization Programs/statistics &amp; numerical data ; Africa, Western/epidemiology ; Child ; SARS-CoV-2 ; *Vaccination Coverage/statistics &amp; numerical data ; }, abstract = {OBJECTIVES: To investigate the effects of the COVID-19 pandemic on childhood immunisation programmes in West African Countries.<br><br>DESIGN: The study was a systematic review of available evidence of the impact of the COVID-19 pandemic on childhood immunisation programmes in West Africa.<br><br>SETTING: An online literature search was conducted using PubMed, Embase, Scopus and Web of Science for all peer-reviewed longitudinal, descriptive, observational, prospective and retrospective studies on childhood immunisation programmes in West Africa published between January 2020 and May 2022.<br><br>PARTICIPANTS: All West African childhood immunisation programmes.<br><br>INTERVENTIONS: None.<br><br>MAIN OUTCOME MEASURES: Change in immunisation volumes during the COVID-19 pandemic.<br><br>RESULTS: 353 studies were identified during the literature search, and eight were included in this review. The studies comprised six quantitative studies, one mixed-method (quantitative/qualitative) study and one qualitative study. Changes to immunisation services ranged between 53% and 52% for MCV and Penta3 vaccines in Guinea, lasting longer than August 2020, to 0.3% and 1% in Liberia for BCG and MCV vaccines lasting no longer than May 2020. Factors contributing to the observed disruptions in vaccine coverage during the pandemic included the fear of contracting the virus expressed by caregivers and healthcare workers and general misinformation about the COVID-19 virus.<br><br>CONCLUSION: While the changes were greater than 50% and lasted longer in some countries, they were brief and short-lived in others, emphasising that the COVID-19 pandemic's effect in each country differed.<br><br>FUNDING: This work did not receive any external funding and was entirely self-funded.}, }
@article {pmid41000578, year = {2024}, author = {Bugaighis, M and Milosh, B and Cervia, J}, title = {Safety of Monoclonal Antibodies as Treatment for Coronavirus Disease 2019 (COVID-19) During Pregnancy: A Systematic Review.}, journal = {O&amp;G open}, volume = {1}, number = {2}, pages = {7}, pmid = {41000578}, issn = {2994-9726}, abstract = {OBJECTIVE: Pregnant patients are at increased risk of severe illness, in-hospital mortality, and preterm birth in the setting of coronavirus disease 2019 (COVID-19); however, they often are excluded from clinical trials that analyze improved therapeutics for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Thus, there are relatively few available data that examine the safety of monoclonal antibodies (mAbs) in pregnant patients with COVID-19, which we aimed to explore in this systematic review.<br><br>DATA SOURCES: We searched PubMed, Cochrane, EMBASE, and Google Scholar on September 30, 2022. Included studies encompassed English-language case reports with at least five participants, cross-sectional studies, case-control studies, cohort studies, retrospective or prospective chart reviews, and randomized controlled trials that enrolled pregnant women who received SARS-CoV-2-targeted mAbs. Studies were screened for eligibility using Covidence according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines and were subsequently evaluated for risk of bias with the JBI critical appraisal checklist.<br><br>Initial search yielded 616 studies; 13 publications were ultimately eligible. Pregnant patients were treated with SARS-CoV-2-neutralizing mAbs casirivimab-imdevimab, bamlanivimab, or bamlanivimab-etesevimab. A total of 365 patients were treated with casirivimab-imdevimab, 13 were treated with bamlanivimab, and 11 were treated with bamlanivimab-etesevimab. There were no cases of maternal mortality. Eighteen of the 389 patients had adverse effects related to mAb administration-all resolved. Of the patients treated with casirivimab-imdevimab, there were 35 preterm deliveries, two fetal deaths, one neonatal death due to sepsis, five cases of preterm prelabor rupture of membranes (PROM), one case of PROM, and 24 neonatal intensive care unit (NICU) admissions. Of the patients treated with bamlanivimab, there was one case of preterm PROM and one preterm delivery. There were no NICU admissions in the bamlanivimab or bamlanivimab-etesevimab cohorts.<br><br>CONCLUSION: Preliminary data suggest that neutralizing mAb treatment for COVID-19 in pregnant patients is safe. However, treatment-associated events support the importance of clinical trials to determine the statistical significance of maternal and fetal outcomes in pregnant patients treated with SARS-CoV-2-targeted mAbs.}, }
@article {pmid41333312, year = {2024}, author = {Aum, J and Cho, S and Ha, JH and Koo, H and Choi, JH and Jang, EJ and Lee, SE and Cheun, HI and Shin, JK and Kwon, D and Lee, SE and Yu, M and Lee, J and Jeon, JH and Kim, JE and Choi, I and Kim, Y}, title = {[Preparedness and Responding for Infectious Disease for Mass Gathering of 「Winter Youth Olympic Games Gangwon 2024」].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {18}, pages = {739-771}, pmid = {41333312}, issn = {2586-0860}, abstract = {The importance of a public health strategy for mass gatherings has been consistently emphasized internationally in the past. In the Republic of Korea, the Korea Disease Control and Prevention Agency (KDCA) has established guidelines and standard operation procedures (SOPs) for preparations to address and respond to infectious disease outbreaks due to mass gathering events. The most recent example of the KDCA's response in line with these guidelines and SOPs was that for the 「Winter Youth Olympic Games Gangwon 2024」 (Gangwon 2024), for which a proactive response and cooperation system, quarantine measures, and an infectious disease surveillance system were implemented. During Gangwon 2024, 14 cases of infectious diseases were confirmed: 3 cases of norovirus infection (1 outbreak case), 1 case of chickenpox, 4 cases of coronavirus disease 2019, and 6 cases of influenza. There were no severe infectious disease outbreaks. We expect to provide a reference for responding to infectious disease outbreaks due to future mass gathering events by evaluating the experience of infectious disease prevention activities at Gangwon 2024.}, }
@article {pmid41333311, year = {2024}, author = {Ahn, E and Baek, SK and Lee, HJ and Park, HB and Choi, BY and Ahn, Y}, title = {[History and Achievement of Public Health Weekly Report].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {18}, pages = {772-786}, doi = {10.56786/PHWR.2024.17.18.3}, pmid = {41333311}, issn = {2586-0860}, abstract = {Korea Disease Control and Prevention Agency has been publishing Public Health Weekly Report (PHWR) to provide expeditiously and accurately scientific information related to health and disease. Accordingly, PHWR has been compiling and providing statistics related to communicable and non-communicable diseases. Additionally, PHWR has been providing weekly data and analyses regarding coronavirus disease 2019 from the early stage of the pandemic, displaying excellent capabilities for prevention and treatment to abroad. In the future, PHWR will be structured as an academic journal and will continue to serve as a journal that provides the fastest and easiest way to understand health and disease information based on timeliness and diversity.}, }
@article {pmid40949643, year = {2024}, author = {Ramathebane, MM and Maja, LJ and Lets'olo, M and Monts'i, S}, title = {Reviewing the availability and integration of community health information system for HIV/AIDS in Lesotho.}, journal = {Journal of the colleges of medicine of South Africa}, volume = {2}, number = {1}, pages = {3}, pmid = {40949643}, issn = {2960-110X}, abstract = {BACKGROUND: Universal Health Coverage (UHC) is an integral part of the Sustainable Development Goals, with community-based services playing a crucial role. Various stakeholders contribute to human immunodeficiency virus (HIV) interventions, which must be documented and shared with others for informed decision-making.<br><br>AIM: This study aims to review the availability of a community health information system (CHIS) in Lesotho and its integration between the Ministry of Health (MOH) and the National AIDS Commission (NAC).<br><br>SETTING: The study is based on the Ministry of Health and the National AIDS Commission in Maseru, Lesotho.<br><br>METHOD: A scoping review used peer-reviewed articles, documents from MOH and NAC, and other relevant reports from non-governmental organisations. The community information systems were examined for inclusion of clinical and non-clinical information. Possible linkages of information between MOH and NAC were reviewed.<br><br>RESULTS: Clinical information from CSOs is recorded in DHIS2 at the MOH facilities, while non-clinical information is reported in LOMSHA. However, clinical information from VHWs is currently not included in DHIS2 and formal reporting tools are being developed. There are no links between MOH and NAC, which limits information sharing.<br><br>CONCLUSION: Although a CHIS exists, it lacks the necessary linkages. Community-based information from VHWs is not reported through DHIS2. Therefore, the country does not benefit fully from community-based health information.<br><br>CONTRIBUTION: Community health information systems review has never been conducted in Lesotho before. Therefore, this review will raise awareness about its importance and use in decision-making.}, }
@article {pmid41059161, year = {2025}, author = {Giri, A and Tamgadge, S}, title = {Red Blood Cells in Health and Disease.}, journal = {Journal of microscopy and ultrastructure}, volume = {13}, number = {3}, pages = {130-136}, pmid = {41059161}, issn = {2213-8803}, abstract = {Red blood cells (RBCs) play a crucial role in the normal functioning of the human body, primarily through their ability to transport oxygen and carbon dioxide. Various diseases, including anemia and other hemolytic disorders, can arise when there is an abnormality in RBC structure or function. The pathophysiology of other conditions, such as cancer and cardiovascular disease can also involve changes in RBCs. Advances in RBC research have led to a better understanding of their structure, function, and pathophysiology. The COVID-19 pandemic has also highlighted the critical role of RBCs in disease pathology, with research suggesting that RBCs may be directly affected by the virus. This review provides a comprehensive overview of the current state of RBCs in health and disease, including recent advances in diagnosis, treatment, and the role of RBCs in disease pathology.}, }
@article {pmid41333519, year = {2024}, author = {Lee, J and Seo, H and Oh, S and Gim, H}, title = {[The Comparison of Coronavirus Disease 2019 Vaccine Adverse Events between Korea and the UK and Implications for Vaccine Adverse Event Management System].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {14}, pages = {587-613}, pmid = {41333519}, issn = {2586-0860}, abstract = {Coronavirus disease 2019 (COVID-19) vaccination programs in the Republic of Korea (ROK) and the United Kingdom (UK) have been successfully implemented by providing the most available vaccines in a timely manner. Both countries have collected post-vaccination adverse event (AE) data to continuously monitor evolving vaccine safety, and the cumulative number of individual case safety reports (ICSRs) obtained in the two countries has exceeded 0.48 million in total, respectively. The numbers of AEs per ICSR and AE types as well as the probability of having a serious AE per ICSR were lower in the ROK than in the UK. These findings could imply that the ROK might have adopted different standards and processes from those in the UK. For example, there were marked inter-country differences in acceptable reporter types, seriousness criteria, causality assessment criteria, and AE coding system, which could have resulted from the low level of acceptance of internationally recognized pharmacovigilance principles in the ROK. The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines are widely adopted by national regulatory authorities in many countries including the United States, European Union countries, and the UK, with research institutions and pharmaceutical companies being no exception. The ROK needs to improve the Adverse Event Following Immunization management system to practice more effective and sustainable vaccine safety monitoring by adopting ICH guidelines.}, }
@article {pmid41063671, year = {2024}, author = {Walsh, KA and O'Donnell, H and O'Loughlin, M and Eames, H and Jiang, J and O'Brien, KM and Broderick, N and O'Brien, KK and Carrigan, M and Comber, L and Cardwell, K and Quigley, J and Smith, SM and Ó Murchú, &#xc9; and Butler, K and Corcoran, B and Connolly, K and Harrington, P and Ryan, M and O'Neill, M}, title = {Duration of protective immunity following COVID-19 vaccination of individuals with underlying health conditions: A rapid review.}, journal = {Reviews in medical virology}, volume = {34}, number = {2}, pages = {e2504}, doi = {10.1002/rmv.2504}, pmid = {41063671}, issn = {1099-1654}, support = {/HRBI_/Health Research Board/Ireland ; }, abstract = {The World Health Organization has stated that the primary goal of immunisation in the COVID-19 pandemic remains to protect against hospitalisation, severe disease and death. Vaccination is particularly important for those with underlying health conditions given the high risk of severe disease in this population. The aim of this review was to examine the change in efficacy and effectiveness of COVID-19 vaccination over time in individuals with underlying conditions. A rapid review was undertaken in Cochrane, Embase, Medline, Europe PMC, MedRxiv and Google Scholar from 01/01/2020 to 27/10/2021. A total of 14 unique studies (3 randomised controlled trials and 11 observational studies) were included. Overall, there was limited and inconsistent evidence regarding vaccine efficacy and effectiveness in those with underlying health conditions. However, the evidence suggests potentially faster waning of vaccine effectiveness against infection, severe disease and death in individuals with underlying conditions, particularly for older adults with these conditions, and in those who are immunocompromised. Protection in younger age groups with underlying conditions who are not immunocompromised, may be largely comparable to that observed in the general population, though this is uncertain. Given the significant burden of infection on individuals with underlying conditions, any small decrease in protection is likely to have a substantial impact in this population. Hence, the evidence supports a policy of providing additional doses to those who are immunocompromised, and boosters to all those with underlying health conditions. Further research is required to understand the impact of new variants on vaccine efficacy/effectiveness in this population.}, }
@article {pmid40979395, year = {2024}, author = {Smaardijk, VR and Jajou, R and Kant, A and van Hunsel, FPAM}, title = {Menstrual disorders following COVID-19 vaccination: a review using a systematic search.}, journal = {Frontiers in drug safety and regulation}, volume = {4}, number = {}, pages = {1338466}, pmid = {40979395}, issn = {2674-0869}, abstract = {Introduction:Menstrual disorders are commonly reported after COVID-19 vaccination and heavy menstrual bleeding was added to the product information of the COVID-19 vaccines of Moderna and Pfizer. The aim of this review, using a systematic search, is to provide an overview of available literature on the risk of menstrual disorders after COVID-19 vaccination. Methods: The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. A PubMed search was performed on 15 August 2023, including solely quantitative studies in English and Dutch. Results: A total of 61 studies were included, of which 40 were cross-sectional studies, 18 cohort studies, and three self-controlled case series. Outcomes included a wide variety of menstrual disorders, including changes in cycle length (n = 54), changes in the amount of bleeding (n = 44), changes in menses length (n = 30), changes in the experience of (pre)menstrual pain (n = 21), and breakthrough bleeding (n = 18). All included studies found a higher percentage of at least one menstrual disorder in the first cycle after different types of COVID-19 vaccination and after different doses. Discussion: In conclusion, evidence suggests that COVID-19 vaccines may cause menstrual changes in women of reproductive age. However, there is a need for more longitudinal studies because of important limitations in the study designs of many of the included studies. Although menstrual changes are short-lived and predominantly mild, it is important for women and healthcare professionals to be informed about these potential adverse reactions and to assess these events in clinical trials on vaccines.}, }
@article {pmid41332461, year = {2024}, author = {Park, MJ}, title = {[Analyzing the Coronavirus Disease 2019 Pandemic Response Governance and Policy (January 2020-December 2021)].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {17}, number = {4}, pages = {128-148}, pmid = {41332461}, issn = {2586-0860}, abstract = {The severe acute respiratory syndrome coronavirus-2 virus caused the the coronavirus disease 2019 (COVID-19) pandemic, which was a first for the twenty-first century and an infectious disease that spotlighted the importance of the Korea Disease Control and Prevention Agency to public health. In response to the COVID-19 pandemic, the Korea Disease Control and Prevention Agency promptly implemented testing, treatment, and social distancing measures. Only a thorough analysis can evaluate the efficacy of the agency's COVID-19 response policies. It would be challenging to characterize the lessons and preventative actions learned from the findings as accurate insights. This paper analyzes the COVID-19 pandemic response strategy and governance from January 2020 to December 2021 by placing actions taken within the conceptual framework of infectious disease management policy. This strategy establishes a valuable policy evaluation framework that can integrate limitations of policy decisions in response to pandemic infectious diseases with imbalancing ripple effects. Infectious disease control countermeasures provoke an unexpected secondary outcome, like reduced economic growth or social isolation. It is very difficult to balance these negative consequences with the effectiveness of preventing infectious diseases. In other words, infectious disease prevention strategies can be specific obligations in specific contexts that are derived from ex post accountability. Therefore, infectious disease response policy assessment requires a step-by-step framework to evaluate potential negative impacts, and it is important to set parameters in advance to resolve competing interests arising in particular contexts.}, }
@article {pmid40980097, year = {2023}, author = {Ruddock, MW and Watt, J and Kurth, MJ and Lamont, JV and Mooney, L and Fitzgerald, P}, title = {A review of the prescribing culture of anti-depressants across government districts in Northern Ireland.}, journal = {Frontiers in drug safety and regulation}, volume = {3}, number = {}, pages = {1303572}, pmid = {40980097}, issn = {2674-0869}, abstract = {Introduction: The COVID-19 pandemic has caused a significant increase in mental health issues which general practitioners are now witnessing and managing in communities across Northern Ireland. Unfortunately, this new tsunami of patients with mental health issues has put tremendous strain on our already overburdened health system. As a result, Northern Ireland currently holds the unenviable record for prescribing more anti-anxiety and anti-depressant medication than any other country in the world. Methods: Data was obtained from the Northern Ireland Statistics and Research Agency (NISRA), Family Practitioner Services, General Pharmaceutical Services, Annual Statistics 2020/2021 (published June 2021) and 2021/2022 (published June 2022). Data was analysed by age, gender, district, and socioeconomic class on prescription medication [according to the British National Formulary (BNF)]. Results: From 2020/2021 to 2021/2022, the prescribing culture for anti-anxiety and/or anti-depressant medication in Northern Ireland did not abate (24% vs. 14%, female to male, respectively). The postcode and index of multiple deprivation (IMD) was analysed and a mean IMD for each constituency was taken as an estimate of the overall IMD to establish if money spent per patient was related to the IMD in each constituency. North Down, South Antrim, and East Antrim were least deprived, as indicated by their high IMD. Whereas, Foyle, and Belfast West were most deprived (low IMD). The cost of mood and anxiety medication per patient was compared against constituency; patients in Belfast West and Belfast North, followed by Foyle, had the highest costs per patient, and the lowest IMD (most deprived). Conclusion: This review concludes that there has been no change in the prescribing culture for anti-anxiety or anti-depressants across Northern Ireland (2020-2022). The cost of mood and anxiety medication per patient did not correlate with the index of multiple deprivation (IMD). Areas of low IMD trended to have higher spend. Is it now time to review the prescribing culture in Northern Ireland and offer greater support to our GPs to initiate a program of deprescribing and manage the wellbeing of our citizens?}, }
@article {pmid41262109, year = {2025}, author = {Lawrason, S and Manley, Z and Lomness, A and Hole, R}, title = {Remote support for individuals with intellectual disabilities living independently: a scoping review.}, journal = {International journal of developmental disabilities}, volume = {71}, number = {7}, pages = {953-970}, pmid = {41262109}, issn = {2047-3877}, abstract = {OBJECTIVES: The purpose of this project was to conduct a scoping review to understand factors related to remote support provision among individuals with intellectual disabilities in independent living.<br><br>METHODS: A systematic search was employed among eight large databases, yielding 207 articles. Following a two-phase screening process, 22 articles were included in this review. Data were charted and summarized according to types of remote support, outcomes, best practices, barriers and facilitators, and ethical considerations.<br><br>RESULTS: Overall, remote support provision was associated with positive outcomes (e.g. academic skills). Most studies used mobile apps or video self-modeling/prompting. Training for support workers facilitates use, and privacy concerns should be addressed among organizations.<br><br>DISCUSSION: Given the shift to online technology over the Covid-19 pandemic, remote support can complement in-person support when used skillfully and appropriately. Importantly, remote support should be individualized for each person. Greater research is needed using diverse study designs, assessing perceptions of support providers, and on remote support that enables live communication between users and providers.}, }
@article {pmid41333242, year = {2023}, author = {Jung, U and Kim, S and Jang, Y and Aum, J and Kim, D and Jung, T}, title = {[A Case Study on the Decision-making of Non-pharmaceutical Interventions].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {16}, number = {35}, pages = {1233-1254}, pmid = {41333242}, issn = {2586-0860}, abstract = {To cope with the coronavirus disease 2019 (COVID-19) pandemic, non-pharmaceutical interventions (NPIs) policies were introduced around the world, with significant socioeconomic costs being simultaneously incurred. For the NPIs to be effectively implemented, public acceptance of them must be thus considered. In the process of incorporating scientific evidence into policy decisions, different interests, values, or beliefs among societal groups needs to be comprehensively discussed and deliberated. In this study, we focus on two dimensions of the contradictory dynamics that a relation between science and policy would give rise to: the politics of health policy and the politics of evidence. Based on the literature review and consultations from expert seminars we organized, comparative case analysis is employed to explore how decision-making on NPIs was made in the United States (US), the United Kingdom (UK), Denmark, and Taiwan. To be specific, science advice mechanisms are examined in the cases of the US and UK, while the use of behavioral science expertise in Denmark and how civic technology governance works in Taiwan are briefly discussed as policy innovations during the pandemic. We conclude with recommendations for Korean's policymakers. They include risk communication strategies firmly based on behavioral and social science expertise and the activation of better science advice mechanisms.}, }
@article {pmid41333891, year = {2023}, author = {Lee, N and Kim, YG and Jung, S and Lee, W and Oh, J and Hwang, SS}, title = {[Comparing International Computing Systems of COVID-19 Core Indicators and Measures to Improve Usability].}, journal = {Jugan geon-gang gwa jilbyeong}, volume = {16}, number = {29}, pages = {973-991}, pmid = {41333891}, issn = {2586-0860}, abstract = {For effective pandemic control of coronavirus disease 2019 (COVID-19), production and management of relevant indicators to predict and analyze epidemic patterns, development and evaluation of dashboards that visually represent data have not yet been achieved. In this study, we utilized medical quality assessment methods to review key COVID-19 prevention indicators and evaluated both domestic and international dashboards in terms of usability. Most countries provide major prevention indicators focusing on COVID-19 incidence and hospital bed-related indicators. In Republic of Korea (ROK), a significant number of management indicators are also provided, but there is a shortage of publicly available indicators for specific targets and time periods. Therefore, it is necessary to develop indicators that encompass various infection and socio-economic vulnerability factors and to develop estimation models that can reflect the characteristics of infection in ROK through policy development and the utilization of these indicators. Interactive dashboards are the most useful in the COVID-19 pandemic situation. The interactive dashboards enable data management and processing, provide information to users at their view point, and implement appropriate visual elements. In addition, dashboard improvements that consider the use of clear indicators, easy accessibility, and information placement readability are needed.}, }
@article {pmid41287229, year = {2021}, author = {Liu, Y and Shukla, D and Newman, H and Zhu, Y}, title = {Soft wearable sensors for monitoring symptoms of COVID-19 and other respiratory diseases: a review.}, journal = {Progress in biomedical engineering (Bristol, England)}, volume = {4}, number = {1}, pages = {}, doi = {10.1088/2516-1091/ac2eae}, pmid = {41287229}, issn = {2516-1091}, abstract = {The COVID-19 pandemic has put extraordinary stress on medical systems and global society more broadly. The condition of infected patients may deteriorate rapidly due to overburdened hospital systems. This raises an urgent need for real-time and remote monitoring of physiological parameters to address the challenges associated with the COVID-19 pandemic. This review will present recent progress on soft wearable sensors that can potentially be used for monitoring respiratory diseases such as COVID-19. First, emerging monitoring devices and systems that can monitor key physiological parameters as suggested by the Centers for Disease Control and Prevention (e.g. body temperature, respiration rate, heart rate, oxygen saturation and body movement) are reviewed. Then, multimodal sensor systems consisting of two or more correlative sensors are presented. This review will conclude with challenges and future directions for wearable sensors for the diagnosis and therapy of respiratory diseases. While this review focuses on COVID-19, the sensing technologies reviewed can be applicable to other respiratory diseases such as H1N1 influenza.}, }
@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 &amp; 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.<br><br>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.<br><br>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%).<br><br>CONCLUSIONS: It seems COVID-19 anxiety is affected by psychological variables. Hence, psychological interventions represent effective treatments for anxiety due to COVID-19.}, }
@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 ; Pandemics/economics ; *Resilience, Psychological ; Social Capital ; }, 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.<br><br>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.<br><br>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.<br><br>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.}, }
@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 = {Adult ; Humans ; *Anticoagulants/therapeutic use ; Bayes Theorem ; *COVID-19/mortality/complications ; *COVID-19 Drug Treatment ; *Fibrinolytic Agents/therapeutic use/adverse effects ; Hemorrhage/chemically induced ; Platelet Aggregation Inhibitors/therapeutic use ; Randomized Controlled Trials as Topic ; SARS-CoV-2 ; *Thrombosis/prevention &amp; control ; }, 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.<br><br>DESIGN: Systematic review and Bayesian network meta-analysis (NMA).<br><br>DATA SOURCES: PubMed, Web of Science, Embase, Cochrane Library and ClinicalTrials.gov up to February 2024.<br><br>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&#x2265;18 years) with laboratory-confirmed SARS-CoV-2 infection. Eligible trials had at least one active antithrombotic arm versus another strategy or standard care.<br><br>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.<br><br>RESULTS: 35 RCTs that randomly assigned 39&#x2009;949 participants were included in the main analysis.<br><br>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.<br><br>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%&#x2009;CI 0.61 to 0.91; random-effect model: RR 0.71, 95%&#x2009;CI 0.48 to 1.05), but for critically ill patients, all antithrombotic strategies showed no significant difference.<br><br>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.<br><br>PROSPERO REGISTRATION NUMBER: CRD42022355213.}, }
@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.<br><br>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.<br><br>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-&#x3ba;B, and MAPK signaling.<br><br>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.}, }
@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.<br><br>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.<br><br>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.<br><br>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.<br><br>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.}, }
@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.<br><br>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.<br><br>RESULTS: The pooled willingness to receive the HPV vaccine among Chinese women was estimated at 65.7&#xa0;% (95&#xa0;% CI: 55.2&#xa0;%-76.2&#xa0;%). Subgroup analyses indicated higher intent among women with a college education or above (71.1&#xa0;% versus 60.1&#xa0;%), urban residents (68.3&#xa0;% versus 56.0&#xa0;% in rural areas), southern China residents (69.0&#xa0;% versus 59.7&#xa0;% in northern regions), individuals with medical-related backgrounds (84.2&#xa0;% versus 35.7&#xa0;%), and those with prior HPV or vaccine knowledge (66.1&#xa0;%/76.4&#xa0;% versus 50.2&#xa0;%/57.8&#xa0;%), Willingness was also higher among women with a family cancer history (74.5&#xa0;% versus 55.3&#xa0;%), and those impacted by COVID-19 (67.5&#xa0;% versus 57.5&#xa0;%). Anonymous questionnaires yielded higher willingness (71.8&#xa0;% versus. 58.8&#xa0;%). Other influencing factors included age, attitudes toward premarital sex, and awareness of HPV risks and vaccine benefits.<br><br>CONCLUSIONS: Chinese women's overall willingness to receive the HPV vaccine remains below the World Health Organization (WHO)'s 90&#xa0;% 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.<br><br>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.<br><br>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%).<br><br>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.<br><br>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.<br><br>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.<br><br>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).<br><br>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.}, }
@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 = {Animals ; Rats ; *Anticonvulsants/pharmacology/therapeutic use ; *Antioxidants/pharmacology/therapeutic use ; Disease Models, Animal ; Drug Therapy, Combination ; *Epilepsy/drug therapy/metabolism ; *Oxidative Stress/drug effects ; *Thioctic Acid/pharmacology/therapeutic use ; }, 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.}, }
@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.<br><br>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.<br><br>DESIGN: Critical discussion paper.<br><br>METHODS: This discussion paper is based on current literature on SBE and recontextualisation theory.<br><br>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.<br><br>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.<br><br>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 &amp; 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.<br><br>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.<br><br>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.<br><br>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.}, }
@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 = {27}, number = {11}, pages = {622-631}, pmid = {40889099}, issn = {1535-1645}, mesh = {Humans ; *COVID-19/psychology ; Child ; *Stress Disorders, Post-Traumatic/psychology/diagnosis ; *Psychological Trauma ; }, 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).<br><br>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.<br><br>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 = {30}, number = {10}, pages = {926-934}, doi = {10.1111/resp.70113}, pmid = {40887716}, issn = {1440-1843}, mesh = {Humans ; *Respiratory Tract Infections/epidemiology/prevention &amp; control/drug therapy/therapy ; *COVID-19/epidemiology/prevention &amp; control ; Influenza, Human/epidemiology/prevention &amp; control ; SARS-CoV-2 ; Respiratory Syncytial Virus Infections/epidemiology/prevention &amp; control ; }, 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 = {684}, number = {}, pages = {126096}, doi = {10.1016/j.ijpharm.2025.126096}, pmid = {40886810}, issn = {1873-3476}, mesh = {Humans ; *Artificial Intelligence ; *Nanotechnology/methods ; *Vaccine Development/methods ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; COVID-19/prevention &amp; control/immunology ; Animals ; Nanoparticles ; SARS-CoV-2/immunology ; }, 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 {pmid40867607, year = {2025}, author = {Babbarwal, A and Singh, M and Sen, U and Tyagi, M and Tyagi, SC}, title = {Kidney Stone Disease: Epigenetic Dysregulation in Homocystinuria and Mitochondrial Sulfur Trans-Sulfuration Ablation Driven by COVID-19 Pathophysiology.}, journal = {Biomolecules}, volume = {15}, number = {8}, pages = {}, pmid = {40867607}, issn = {2218-273X}, support = {R01 AR071789/AR/NIAMS NIH HHS/United States ; R01 DK116591/DK/NIDDK NIH HHS/United States ; R01 HL139047/HL/NHLBI NIH HHS/United States ; AR-71789; HL139047; and DK116591//National Institute Health (NIH)/ ; }, mesh = {Humans ; *COVID-19/complications/metabolism/virology/physiopathology ; *Kidney Calculi/metabolism/genetics/etiology ; *Mitochondria/metabolism ; *Epigenesis, Genetic ; *Homocystinuria/genetics/metabolism/complications ; *Sulfur/metabolism ; SARS-CoV-2 ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought to light unexpected complications beyond respiratory illness, including effects on kidney function and a potential link to kidney stone disease (KSD). This review proposes a novel framework connecting COVID-19-induced epigenetic reprogramming to disruptions in mitochondrial sulfur metabolism and the pathogenesis of kidney stones. We examine how SARS-CoV-2 interferes with host methylation processes, leading to elevated homocysteine (Hcy) levels and impairment of the trans-sulfuration pathway mechanisms particularly relevant in metabolic disorders such as homocystinuria. These epigenetic and metabolic alterations may promote specific kidney stone subtypes through disrupted sulfur and oxalate handling. Additionally, we explore the role of COVID-19-associated gut dysbiosis in increasing oxalate production and driving calcium oxalate stone formation. Together, these pathways may accelerate the transition from acute kidney injury (AKI) to chronic KSD, linking viral methylation interference, sulfur amino acid imbalance, mitochondrial dysfunction, and microbiota changes. Unlike earlier reviews that address these mechanisms separately, this work offers an integrated hypothesis to explain post-viral renal lithogenesis and highlights the potential of targeting sulfur metabolism and redox pathways as therapeutic strategies for KSD triggered or aggravated by viral infections such as COVID-19.}, }
@article {pmid40886308, year = {2025}, author = {Farkas, FB and Karászi, &#xc9; 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 &amp; control/epidemiology ; *Respiratory Syncytial Virus Vaccines/administration &amp; dosage ; COVID-19 ; Vaccination ; Respiratory Syncytial Virus, Human/immunology ; }, abstract = {Respiratory syncytial virus (RSV) is one of the leading pathogens causing lower respiratory tract infections in childhood, and it is also a significant factor of morbidity and mortality among older and immuno-compromised adults. Although RSV was already a well-known pathogen before the COVID–19 pandemic, the characteristics of the previously typical autumn–winter seasonal epidemics have significantly changed in recent years, placing a considerable additional burden on the healthcare system. Despite decades of research, no widely applicable preventive or therapeutic intervention has been available until now, and only recently have effective immunization strategies emerged that represent a breakthrough in preventing severe infection and its complications. This summary, based on a comprehensive literature review, provides an overview of the currently available vaccination armamentarium against RSV, with particular attention to the latest results, clinical trials, and practical questions of application, taking into account international guidelines and recommendations. Recent breakthroughs include a long-acting monoclonal antibody (nirsevimab) and the development of maternal immunization, which aim to provide passive immunity for newborns. Additionally, several new RSV vaccines for older adults also show promising efficacy in preventing severe illness. These milestones represent a paradigm shift from a toolkit based on symptomatic treatment towards prevention. Therefore, it is particularly important that national health policy decision-makers promptly consider the expansion and long-term sustainable implementation of new RSV immunization strategies. Orv Hetil. 2025; 166(35): 1362–1373.}, }
@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 {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}, 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}, 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 {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}, 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}, 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}, 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 {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}, pmid = {40884514}, issn = {1949-0984}, mesh = {*Gastrointestinal Microbiome/immunology ; Humans ; Animals ; Vaccination ; COVID-19 Vaccines/immunology ; Probiotics/administration &amp; dosage ; Influenza Vaccines/immunology ; SARS-CoV-2/immunology ; Hepatitis B Vaccines/immunology ; COVID-19/prevention &amp; 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.}, }
@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 = {33}, number = {9}, pages = {4895-4910}, pmid = {40883647}, issn = {1568-5608}, mesh = {Humans ; *MicroRNAs/genetics/metabolism ; *COVID-19/genetics/therapy ; *Inflammation/genetics ; *SARS-CoV-2 ; Animals ; }, 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 {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 &amp; administration ; *Delivery of Health Care/organization &amp; 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.}, }
@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 {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 &amp; administration ; *Pandemics ; *Laboratories/organization &amp; 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.<br><br>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).<br><br>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.<br><br>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.}, }
@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.<br><br>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 (<&#x2009;30 vs.&#x2009;&#x2265;&#x2009;30&#xa0;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.<br><br>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&#xa0;years and above compared to those aged&#x2009;<&#x2009;30&#xa0;years.<br><br>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.}, }
@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.}, }
@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 = {}, 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 = {}, 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.}, }
@article {pmid40872940, year = {2025}, author = {Szebeni, J and Koller, A}, title = {Multisystem Endothelial Inflammation: A Key Driver of Adverse Events Following mRNA-Containing COVID-19 Vaccines.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872940}, issn = {2076-393X}, support = {OTKA132596, K-19 (AK)//National Research, Development, and Innovation Office of Hungary/ ; Project no. TKP2020-NKA-17 and TKP2021-EGA-37//Ministry of Innovation and Technology of Hungary from the National Research, Develop-ment and Innovation Fund, and MTA/HAS-Post-Covid 2021-34/ ; project 825828 (Expert) and 2022-1.2.5-T&#xc9;T-IPARI-KR-2022-00009 (JS)//European Union Horizon 2020/ ; }, abstract = {mRNA-LNP-based COVID-19 vaccines, namely Pfizer-BioNTech's Comirnaty and Moderna's Spikevax, were successfully deployed to help control the SARS-CoV-2 pandemic, and their updated formulations continue to be recommended, albeit only for high-risk populations. One widely discussed aspect of these vaccines is their uniquely broad spectrum and increased incidence of adverse events (AEs), collectively referred to as post-vaccination syndrome (PVS). Although the reported PVS rate is low, the high number of administered doses among healthy individuals has resulted in a substantial number of reported vaccine-related injuries. A prominent manifestation of PVS is multisystem inflammation, hypothesized to result from the systemic transfection of organ cells with genetic instructions for a toxin, the spike protein, delivered with lipid nanoparticles (LNPs). In this narrative review, we focus on endothelial cells in the microcirculatory networks of various organs as primary sites of transfection with mRNA-LNP and consequent PVS. We outline the anatomical variations in the microcirculation contributing to the individual variability of symptoms and examine the molecular and cellular responses to vaccine nanoparticle exposure at the endothelial cell level with a focus on the pathways of a sustained cascade of toxic and autoimmune processes. A deeper understanding of the mechanisms underlying mRNA-LNP-induced AEs and PVS at the organ and cellular levels is critical for improving the safety of future vaccines and other therapeutic applications of this groundbreaking technology.}, }
@article {pmid40872939, year = {2025}, author = {la Cruz, RAR and Flores-Córdova, JM and Calderon-Hernandez, CC and Cahuapaza-Gutierrez, NL and Ccallalli-Ruiz, NA and Runzer-Colmenares, FM}, title = {Humoral and Cellular Immune Responses Against SARS-CoV-2 Following COVID-19 Vaccination in Older Adults: A Systematic Review.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872939}, issn = {2076-393X}, abstract = {BACKGROUND: Evidence on the humoral and cellular immune responses to SARS-CoV-2 following COVID-19 vaccination in older adults is warranted.<br><br>AIMS: To synthesize and analyze the current evidence on humoral and cellular immune responses to both standard and booster COVID-19 vaccination in individuals aged 60 years and older.<br><br>METHODS: Clinical trials and observational studies were included. Reviews, case series, letters to the editor, and similar publications were excluded. A selective literature search was conducted in the following databases: PubMed, Scopus, EMBASE, and Web of Science. The risk of bias and methodological quality of the included studies were assessed using the Newcastle-Ottawa Scale (NOS) and the Risk of Bias 2.0 (RoB 2) tool. Statistical analysis was conducted using Stata version 18 and Review Manager version 5.4.1.<br><br>RESULTS: Thirteen studies were included: eleven observational studies and two randomized clinical trials, evaluating humoral and cellular immune responses in 782 older adults. Messenger RNA vaccines were the most administered, particularly Pfizer-BioNTech (76.9%) and Moderna mRNA-1273 (23%). In most cases, immune responses were assessed after the second dose and booster doses. Most studies (61.5%) reported increased IgG titers specific to the SARS-CoV-2 Spike protein, while 23.1% reported a decrease. Regarding cellular immunity, 46.2% of the studies reported low interferon-gamma (IFN-&#x3b3;) levels post-vaccination, whereas 38.5% showed increases. These findings highlight the need for tailored vaccination strategies to address emerging variants, particularly in vulnerable populations such as older adults.<br><br>CONCLUSIONS: In older adults receiving COVID-19 vaccination, humoral immunity tends to increase, whereas cellular responses are frequently diminished, reflecting age-related immunosenescence that may limit the durability and breadth of protection following vaccination in older adults.}, }
@article {pmid40872918, year = {2025}, author = {Anastasiou, T and Sanidas, E and Lytra, T and Mimikos, G and Gogas, H and Mantzourani, M}, title = {Update on Thromboembolic Events After Vaccination Against COVID-19.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872918}, issn = {2076-393X}, abstract = {The association between COVID-19 vaccination and thromboembolic events has garnered significant research attention, particularly with the advent of vaccines based on adenoviral vectors, including AstraZeneca's and Johnson &amp; Johnson's vaccines. This review underscores the uncommon occurrence of venous thromboembolism (VTE), arterial thromboembolism (ATE), and vaccine-induced thrombotic thrombocytopenia (VITT) following COVID-19 vaccination. Although these complications are extremely rare compared to the heightened risk of thrombosis from COVID-19 infection, elements like age, biological sex, type of vaccine and underlying health conditions may contribute to their development. In addition, rare renal complications such as acute kidney injury and thrombotic microangiopathy have been documented, broadening the spectrum of potential vaccine-associated thrombotic manifestations. Current guidelines emphasize early detection, individualized risk assessment, and use of anticoagulation therapy to mitigate risks. Despite these events, the overwhelming majority of evidence supports the continued use of COVID-19 vaccines, given their proven efficacy in reducing severe illness and mortality. In addition, recent comparative data confirm that mRNA-based vaccines are associated with a significantly lower risk of serious thrombotic events compared to adenoviral vector platforms. Ongoing research is essential to further refine preventive and therapeutic strategies, particularly for at-risk populations.}, }
@article {pmid40872912, year = {2025}, author = {Chen, J and Lin, W and Yang, C and Lin, W and Cheng, X and He, H and Li, X and Yu, J}, title = {Immunogenicity, Safety, and Protective Efficacy of Mucosal Vaccines Against Respiratory Infectious Diseases: A Systematic Review and Meta-Analysis.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872912}, issn = {2076-393X}, abstract = {Background/Objectives: Mucosal vaccines, delivered intranasally or via inhalation, are being studied for respiratory infectious diseases like COVID-19 and influenza. These vaccines aim to provide non-invasive administration and strong immune responses at infection sites, making them a promising area of research. This systematic review and meta-analysis assessed their immunogenicity, safety, and protective efficacy. Methods: The study design was a systematic review and meta-analysis, searching PubMed and Cochrane databases up to 30 May 2025. Inclusion criteria followed the PICOS framework, focusing on mucosal vaccines for COVID-19, influenza, RSV, pertussis, and tuberculosis. Results: A total of 65 studies with 229,614 participants were included in the final analysis. Mucosal COVID-19 vaccines elicited higher neutralizing antibodies compared to intramuscular vaccines (SMD = 2.48, 95% CI: 2.17-2.78 for wild-type; SMD = 1.95, 95% CI: 1.32-2.58 for Omicron), with varying efficacy by route (inhaled VE = 47%, 95% CI: 22-74%; intranasal vaccine VE = 17%, 95% CI: 0-31%). Mucosal influenza vaccines protected children well (VE = 62%, 95% CI: 30-46%, I[2] = 17.1%), but seroconversion rates were lower than those of intramuscular vaccines. RSV and pertussis vaccines had high seroconversion rates (73% and 52%, respectively). Tuberculosis vaccines were reviewed systemically, exhibiting robust cellular immunogenicity. Safety was comparable to intramuscular vaccines or placebo, with no publication bias detected. Conclusions: Current evidence suggests mucosal vaccines are immunogenic, safe, and protective, particularly for respiratory diseases. This review provides insights for future research and vaccination strategies, though limitations include varying efficacy by route and study heterogeneity.}, }
@article {pmid40872911, year = {2025}, author = {Zambrano-Sánchez, G and Rivadeneira, J and Manterola, C and Otzen, T and Fuenmayor-González, L}, title = {Immunization as Protection Against Long COVID in the Americas: A Scoping Review.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872911}, issn = {2076-393X}, support = {Folio (85220114).//ANID + SUBVENCI&#xd3;N A INSTALACI&#xd3;N EN LA ACADEMIA CONVOCATORIA A&#xd1;O 2022/ ; }, abstract = {INTRODUCTION: Long COVID syndrome is defined as persistent or new symptoms that appear after an acute SARS-CoV-2 infection and last at least three months without explanation. It is estimated that between 10% and 20% of those infected develop long COVID; however, data is not precise in Latin America. Although high immunization rates have reduced acute symptoms and the pandemic's impact, there is a lack of evidence of its efficacy in preventing long COVID in the region.<br><br>METHODS: This scoping review followed PRISMA-ScR guidelines. Studies on vaccinated adults with long COVID from Central and South America and the Caribbean were included (Mexico was also considered). A comprehensive search across multiple databases was conducted. Data included study design, participant characteristics, vaccine type, and efficacy outcomes. Results are presented narratively and in tables.<br><br>RESULTS: Out of 3466 initial records, 8 studies met the inclusion criteria after rigorous selection processes. These studies encompassed populations from Brazil, Mexico, Latin America, and Bonaire, with 11,333 participants, 69.3% of whom were female. Vaccination, particularly with three or more doses, substantially reduces the risk and duration of long COVID. Variability was noted in the definitions and outcomes assessed across studies.<br><br>CONCLUSIONS: This scoping review highlights that SARS-CoV-2 vaccination exhibits potential in reducing the burden of long COVID in the Americas. However, discrepancies in vaccine efficacy were observed depending on the study design, the population studied, and the vaccine regimen employed. Further robust, region-specific investigations are warranted to delineate the effects of vaccination on long COVID outcomes.}, }
@article {pmid40872898, year = {2025}, author = {Jaca, A and Mathebula, L and Malinga, T and Rampersadh, K and Zulu, M and Hohlfeld, AS and Wiysonge, CS and Jacobson Vann, JC and Ndwandwe, D}, title = {Interventions to Improve Vaccination Uptake Among Adults: A Systematic Review and Meta-Analysis.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872898}, issn = {2076-393X}, abstract = {BACKGROUND: Immunization is a highly effective intervention for controlling over 20 life-threatening infectious diseases, significantly reducing both morbidity and mortality rates. One notable achievement in vaccination efforts was the global eradication of smallpox, which the World Health Assembly declared on 8 May 1980. Additionally, there has been a remarkable 99.9% reduction in wild poliovirus cases since 1988, decreasing from more than 350,000 cases that year to just 30 cases in 2022.<br><br>OBJECTIVES: The objective of this review was to assess the effects of various interventions designed to increase vaccination uptake among adults.<br><br>SEARCH METHODS: A thorough search was conducted in the CENTRAL, Embase Ovid, Medline Ovid, PubMed, Web of Science, and Global Index Medicus databases for primary studies. This search was conducted in August 2021 and updated in November 2024.<br><br>SELECTION CRITERIA: Randomized trials were eligible for inclusion in this review, regardless of publication status or language.<br><br>DATA ANALYSIS: Two authors independently screened the search outputs to select potentially eligible studies. Risk ratios (RR) with 95% confidence intervals (CI) were calculated for each randomized controlled trial (RCT). A meta-analysis was conducted using a random-effects model, and the quality of the evidence was assessed using the GRADE approach.<br><br>MAIN RESULTS: A total of 35 randomized controlled trials met the inclusion criteria and were included in this review, with the majority conducted in the United States. The interventions targeted adults aged 18 and older who were eligible for vaccination, involving a total of 403,709 participants. The overall pooled results for interventions aimed at increasing influenza vaccination showed a risk ratio of 1.41 (95% CI: 1.15, 1.73). Most studies focused on influenza vaccination (18 studies), while the remaining studies examined various other vaccines, including those for hepatitis A, COVID-19, hepatitis B, pneumococcal disease, tetanus, diphtheria, pertussis (Tdap), herpes zoster, and human papillomavirus (HPV). The results indicate that letter reminders were slightly effective in increasing influenza vaccination uptake compared to the control group (RR: 1.75, 95% CI: 0.97, 1.16; 6 studies; 161,495 participants; low-certainty evidence). Additionally, participants who received education interventions showed increased levels of influenza vaccination uptake compared to those in the control group (RR: 1.88, 95% CI: 0.61, 5.76; 3 studies; 1318 participants; low-certainty evidence). Furthermore, tracking and outreach interventions also led to an increase in influenza vaccination uptake (RR: 1.87, 95% CI: 0.78, 4.46; 2 studies; 33,752 participants; low-certainty evidence).<br><br>CONCLUSIONS: Letter reminders and educational interventions targeted at recipients are effective in increasing vaccination uptake compared to control groups.}, }
@article {pmid40872876, year = {2025}, author = {Soldatov, AA and Kryuchkov, NA and Gorenkov, DV and Avdeeva, ZI and Svitich, OA and Soshnikov, S}, title = {Challenges to the Effectiveness and Immunogenicity of COVID-19 Vaccines: A Narrative Review with a Systematic Approach.}, journal = {Vaccines}, volume = {13}, number = {8}, pages = {}, pmid = {40872876}, issn = {2076-393X}, abstract = {The COVID-19 pandemic accelerated the rapid development and distribution of various vaccine platforms, resulting in a significant reduction in disease severity, hospitalizations, and mortality. However, persistent challenges remain concerning the durability and breadth of vaccine-induced protection, especially in the face of emerging SARS-CoV-2 variants. This review aimed to evaluate the factors influencing the immunogenicity and effectiveness of COVID-19 vaccines to inform future vaccine advancement strategies. A narrative review with systematic approach was conducted following PRISMA guidelines for narrative review. Literature was sourced from databases including PubMed, Embase, and Web of Science for studies published between December 2019 and May 2025. Encompassed studies assessed vaccine efficacy, immunogenicity, and safety across various populations and vaccine platforms. Data were collected qualitatively, with quantitative data from reviews highlighted where available. We have uncovered a decline in vaccine efficacy over time and weakened protection against novel variants such as Delta and Omicron. Booster doses, specifically heterologous regimens, improved immunogenicity and increased protection. Vaccine-induced neutralizing antibody titers have been found to correlate with clinical protection, although the long-term correlates of immunity remain poorly defined. The induction of IgG4 antibodies after repeated mRNA vaccinations raised concerns about potential modulation of the immune response. COVID-19 vaccines have contributed significantly to pandemic control; however, their efficacy is limited by the evolution of the virus and declining immunity. Forthcoming vaccine strategies should focus on broad-spectrum, variant-adapted formulations and defining robust comparisons of protection. Recognizing the immunological basis of vaccine response, including the role of specific antibody subclasses, is fundamental for optimizing long-term protection.}, }
@article {pmid40872842, year = {2025}, author = {Rindi, LV and Zaçe, D and Sarmati, L and Parrella, R and Russo, G and Andreoni, M and Mastroianni, CM}, title = {Pharmacological and Adjunctive Management of Non-Hospitalized COVID-19 Patients During the Omicron Era: A Systematic Review and Meta-Analysis.}, journal = {Viruses}, volume = {17}, number = {8}, pages = {}, pmid = {40872842}, issn = {1999-4915}, mesh = {Humans ; *Antiviral Agents/therapeutic use ; *COVID-19/therapy/mortality/virology ; *COVID-19 Drug Treatment ; *SARS-CoV-2/drug effects ; Hospitalization/statistics &amp; numerical data ; Alanine/analogs &amp; derivatives/therapeutic use ; Adenosine Monophosphate/analogs &amp; derivatives/therapeutic use ; Ritonavir/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; }, abstract = {INTRODUCTION: The emergence of SARS-CoV-2 Omicron subvariants characterized by increased transmissibility and immune escape has raised concerns about the efficacy of current treatments. This systematic review and meta-analysis evaluated pharmacological and non-pharmacological interventions in Omicron-infected non-hospitalized patients, focusing on key clinical outcomes such as hospitalization, respiratory failure, ICU admission, and 30-day mortality.<br><br>METHODS: Searches were performed in MEDLINE, EMBASE, Web of Science, Cochrane, and ClinicalTrials.gov (last update: 13 July 2025). Eligible studies reported outcomes on antiviral agents, monoclonal antibodies, adjunctive therapies, or telemedicine. Random-effects meta-analyses were conducted when appropriate, with heterogeneity assessed by I[2]. Publication bias was evaluated via funnel plots and Egger's test. Subgroup analyses explored sources of heterogeneity.<br><br>RESULTS: Eighty-eight studies were included. Meta-analyses, comparing treatment vs. no treatment, revealed that nirmatrelvir/ritonavir reduced hospitalization by 52% (RR 0.48, 95% CI 0.36-0.63) and all-cause mortality by 84% (RR 0.16, 95% CI 0.11-0.24). Remdesivir reduced hospitalization by 70% (RR 0.30, 95% CI 0.19-0.47) and respiratory failure by 89% (RR 0.11, 95% CI 0.03-0.44). Sotrovimab decreased hospitalization (RR 0.71, 95% CI 0.54-0.93) and mortality (RR 0.34, 95% CI 0.19-0.61). Molnupiravir modestly reduced hospitalization (RR 0.80, 95% CI 0.70-0.91) and respiratory failure (RR 0.45, 95% CI 0.27-0.77).<br><br>CONCLUSIONS: Nirmatrelvir/ritonavir and remdesivir remain important for reducing severe outcomes, while sotrovimab retains partial efficacy. Rapid access to antivirals remains an important factor in mitigating SARS-CoV-2's burden.}, }
@article {pmid40872813, year = {2025}, author = {Muthiah, D and Vaddadi, K and Liu, L}, title = {Breathless Aftermath: Post-COVID-19 Pulmonary Fibrosis.}, journal = {Viruses}, volume = {17}, number = {8}, pages = {}, pmid = {40872813}, issn = {1999-4915}, support = {P30 GM149368/GM/NIGMS NIH HHS/United States ; R01 HL157450/HL/NHLBI NIH HHS/United States ; R21 AI189861/AI/NIAID NIH HHS/United States ; R01HL157450, R21AI189861 and P30GM149368//National Institutes of Health grants, Oklahoma Center for Adult Stem Cell Research and the Lundberg-Kienlen Endowment fund (to LL)/ ; }, mesh = {Humans ; *COVID-19/complications ; *Pulmonary Fibrosis/etiology/epidemiology/diagnosis/therapy/pathology/virology ; SARS-CoV-2 ; Lung/pathology/virology ; Post-Acute COVID-19 Syndrome ; Quality of Life ; }, abstract = {A significant number of individuals recovering from COVID-19 continue to experience persistent symptoms, collectively referred to as Post-Acute Sequelae of SARS-CoV-2 infection (PASC), or long COVID. Among these complications, post-COVID-19 pulmonary fibrosis (PC19-PF) is one of the most severe long-term outcomes, characterized by progressive lung scarring, chronic respiratory impairment, and reduced quality of life. Despite the increasing prevalence of PC19-PF, its underlying mechanisms remain poorly understood. In this review, we provide a comprehensive overview of PC19-PF, including its epidemiology, clinical manifestations, diagnostic strategies, and mechanistic insights. Additionally, we highlight the shared pathways between PC19-PF and other fibrotic lung diseases and discuss emerging therapeutic strategies. This review consolidates emerging insights from both clinical and experimental studies to advance our understanding of PC19-PF pathogenesis and guide the development of mechanism-based therapeutic approaches.}, }
@article {pmid40872778, year = {2025}, author = {Soares, VC and Moreira, IBG and Dias, SSG}, title = {SARS-CoV-2 Infection and Antiviral Strategies: Advances and Limitations.}, journal = {Viruses}, volume = {17}, number = {8}, pages = {}, pmid = {40872778}, issn = {1999-4915}, mesh = {Humans ; *Antiviral Agents/therapeutic use/pharmacology ; *SARS-CoV-2/drug effects/genetics ; *COVID-19 Drug Treatment ; COVID-19/virology ; Drug Resistance, Viral ; Adenosine Monophosphate/analogs &amp; derivatives/therapeutic use ; Alanine/analogs &amp; derivatives/therapeutic use ; }, abstract = {Since the onset of the COVID-19 pandemic, remarkable progress has been made in the development of antiviral therapies for SARS-CoV-2. Several direct-acting antivirals, such as remdesivir, molnupiravir, and nirmatrelvir/ritonavir, offer clinical benefits. These agents have significantly contributed to reducing the viral loads and duration of the illness, as well as the disease's severity and mortality. However, despite these advances, important limitations remain. The continued emergence of resistant SARS-CoV-2 variants highlights the urgent need for adaptable and durable therapeutic strategies. Therefore, this review aims to provide an updated overview of the main antiviral strategies that are used and the discovery of new drugs against SARS-CoV-2, as well as the therapeutic limitations that have shaped clinical management in recent years. The major challenges include resistance associated with viral mutations, limited treatment windows, and unequal access to treatment. Moreover, there is an ongoing need to identify novel compounds with broad-spectrum activity, improved pharmacokinetics, and suitable safety profiles. Combination treatment regimens represent a promising strategy to increase the efficacy of treating COVID-19 while minimizing the potential for resistance. Ideally, these interventions should be safe, affordable, and easy to administer, which would ensure broad global access and equitable treatment and enable control of COVID-19 cases and preparedness for future threats.}, }
@article {pmid40872762, year = {2025}, author = {Cao, Y and Wang, Y and Huang, D and Tan, YJ}, title = {The Role of SARS-CoV-2 Nucleocapsid Protein in Host Inflammation.}, journal = {Viruses}, volume = {17}, number = {8}, pages = {}, pmid = {40872762}, issn = {1999-4915}, support = {T2EP30121-0012//Ministry of Education/ ; }, mesh = {Humans ; *Coronavirus Nucleocapsid Proteins/immunology/metabolism ; *COVID-19/immunology/virology ; *SARS-CoV-2/immunology ; *Inflammation/immunology/virology ; *Phosphoproteins/immunology/metabolism ; Host-Pathogen Interactions ; Animals ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has posed substantial health threats and triggered widespread global economic disruption. The nucleocapsid (N) protein of SARS-CoV-2 is not only a key structural protein but also instrumental in mediating the host immune response, contributing significantly to inflammation and viral pathogenesis. Due to its immunogenic properties, SARS-CoV-2 N protein also interacts with host factors associated with various pre-existing inflammatory conditions and may possibly contribute to the long-term symptoms suffered by some COVID-19 patients after recovery-known as long COVID. This review provides a comprehensive overview of recent advances in elucidating the biological functions of the N protein. In particular, it highlights the mechanisms by which the N protein contributes to host inflammatory responses and elaborates on its association with long COVID and pre-existing inflammatory disorders.}, }
@article {pmid40872752, year = {2025}, author = {Loor-Giler, A and Galdo-Novo, S and Nuñez, L}, title = {Enteric Viruses in Turkeys: A Systematic Review and Comparative Data Analysis.}, journal = {Viruses}, volume = {17}, number = {8}, pages = {}, pmid = {40872752}, issn = {1999-4915}, support = {543.A.XVI.25.//Universidad de Las Am&#xe9;ricas, Quito - Ecuador./ ; }, mesh = {Animals ; Genetic Variation ; Phylogeny ; *Poultry Diseases/virology/epidemiology ; *Turkeys/virology ; }, abstract = {Enteric diseases represent one of the main causes of morbidity and mortality in poultry production, especially in turkeys (Meleagris gallopavo), significantly affecting the profitability of the sector. Turkey enteric complex (PEC) is a multifactorial syndrome characterized by diarrhea, stunting, poor feed conversion, and increased mortality in young turkeys. Its aetiologia includes multiple avian enteric viruses, including astrovirus, rotavirus, reovirus, parvovirus, adenovirus, and coronavirus, which can act singly or in co-infection, increasing clinical severity. This study performs a systematic review of the literature on these viruses and a meta-analysis of their prevalence in different regions of the world. Phylogenetic analyses were used to assess the genetic diversity of the main viruses and their geographical distribution. The results show a wide regional and genetic variability, which underlines the need for continuous epidemiological surveillance. Health and production implications are discussed, proposing control strategies based on biosecurity, targeted vaccination, and optimized nutrition. These findings highlight the importance of integrated management to mitigate the impact of CSF in poultry.}, }
@article {pmid40872614, year = {2025}, author = {Marinescu, M and Zalaru, C}, title = {Benzimidazole-Pyrimidine Hybrids: Synthesis and Medicinal Properties.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {8}, pages = {}, pmid = {40872614}, issn = {1424-8247}, abstract = {Background: Heterocyclic compounds represent a key class of compounds in medicinal chemistry. Both benzimidazoles and pyrimidines are essential heterocycles in medicinal chemistry, with various therapeutic properties. Recent literature presents a series of hybrid heterocyclic compounds, as their medicinal properties are generally improved compared to those of single heterocyclic rings. Methods: A literature search was conducted across relevant scientific literature from peer-reviewed sources, using keywords, including "benzimidazole", "pyrimidine", "Biginelli", "benzimidazole-pyrimidine hybrids", "anticancer", "antiviral", "antimicrobial", and "anti-inflammatory". Results: In this review, benzimidazole-pyrimidine hybrids are reported as anticancer, antimicrobial, antiviral, anti-inflammatory, analgesic, antiulcer, antidepressant, anti-Alzheimer's, or antioxidant agents, with activities even better than those of existing drugs. The IC50 values for these anticancer hybrids are in the nanomolar range, which signifies potent anticancer agents. It can be mentioned here that the anticancer hybrid Abemaciclib, as a CDK4/6 inhibitor for the treatment of certain types of breast cancer, was approved in 2017. The antimicrobial activity of these hybrids proved especially potent against a broad variety of infections, with MIC values in the range of µM or even nM. Moreover, these hybrids exhibited good antiviral properties against SARS-CoV-2, HIV-1, and the hepatitis C virus. The hybrids also functioned as JAK3 inhibitors, COX-1 inhibitors, and MAO-A inhibitors. Conclusions: This review presents synthesis methods of benzimidazole-pyrimidine hybrids, their medicinal properties, and SAR studies reported in the last 20 years. For almost every therapeutic activity, SAR studies have revealed the essential presence of a substituent on the aromatic rings or between the two benzimidazole and pyrimidine nuclei.}, }
@article {pmid40872326, year = {2025}, author = {Pati, I and Masiello, F and Piccinini, V and De Fulvio, L and Massari, MS and De Angelis, V and Cruciani, M}, title = {Risk of Venous Thromboembolism in Infectious Diseases: A Literature Review.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {8}, pages = {}, pmid = {40872326}, issn = {2076-0817}, mesh = {Humans ; *Venous Thromboembolism/epidemiology/etiology/prevention &amp; control ; Risk Factors ; COVID-19/complications ; *Communicable Diseases/complications ; Anticoagulants/therapeutic use ; SARS-CoV-2 ; HIV Infections/complications ; Tuberculosis/complications ; }, abstract = {Systemic or localized infections increase the risk of venous thromboembolism (VTE). All types of infection can elevate the risk of VTE thrombosis, although some appear to increase risk more than others. In the current narrative review, we seek to overview the available evidence related to the epidemiology of VTE caused by infections. We focused on patients with infection in community setting or hospitalized, on patients with COVID-19, HIV infection, tuberculosis, HCV infection, and CMV infection, as well as on individuals with other types of infection that might increase the risk of VTE. Moreover, we tried to evaluate how the risk of VTE in person with different types of infections could be addressed in clinical practice with the use of anticoagulants. Extended VTE prophylaxis may not be warranted for all infections, but may be very helpful for some, such as those with intra-abdominal infection, systemic bloodstream infection, lower respiratory infection, and symptomatic urinary tract infection.}, }
@article {pmid40872323, year = {2025}, author = {Nagasawa, M}, title = {Perspectives on the History and Epidemiology of the Varicella Virus Vaccine and Future Challenges.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {8}, pages = {}, pmid = {40872323}, issn = {2076-0817}, mesh = {Humans ; *Chickenpox Vaccine/immunology/history/administration &amp; dosage/adverse effects ; *Chickenpox/epidemiology/prevention &amp; control ; *Herpesvirus 3, Human/immunology ; History, 20th Century ; History, 21st Century ; Japan/epidemiology ; Vaccines, Attenuated/immunology ; Vaccination ; }, abstract = {The varicella attenuated virus vaccine, developed in Japan in the 1970s, has dramatically reduced the number of pediatric chickenpox cases over the past 30 years due to its widespread use. However, a small number of cases of chickenpox, shingles, aseptic meningitis, and acute retinal necrosis caused by vaccine strains have been reported. There are also issues that need to be addressed, such as breakthrough infections and the persistence of the preventive effect of vaccination. In addition, there is the possibility of the emergence of revertants or mutations in the vaccine strain. In recent years, subunit vaccines have been developed, their immune-stimulating effects have been demonstrated, and they are being applied clinically. In addition, development of an mRNA varicella vaccine is underway. In this review, the history and impact of the varicella vaccine are overviewed, as well as its future challenges.}, }
@article {pmid40872258, year = {2025}, author = {Livieratos, A and Kagadis, GC and Gogos, C and Akinosoglou, K}, title = {AI Methods Tailored to Influenza, RSV, HIV, and SARS-CoV-2: A Focused Review.}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {8}, pages = {}, pmid = {40872258}, issn = {2076-0817}, mesh = {Humans ; *COVID-19/diagnosis ; *Influenza, Human/diagnosis/therapy ; *HIV Infections/diagnosis/therapy ; *Artificial Intelligence ; SARS-CoV-2 ; *Respiratory Syncytial Virus Infections/diagnosis/therapy ; Neural Networks, Computer ; Machine Learning ; }, abstract = {Artificial intelligence (AI) techniques-ranging from hybrid mechanistic-machine learning (ML) ensembles to gradient-boosted decision trees, support-vector machines, and deep neural networks-are transforming the management of seasonal influenza, respiratory syncytial virus (RSV), human immunodeficiency virus (HIV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Symptom-based triage models using eXtreme Gradient Boosting (XGBoost) and Random Forests, as well as imaging classifiers built on convolutional neural networks (CNNs), have improved diagnostic accuracy across respiratory infections. Transformer-based architectures and social media surveillance pipelines have enabled real-time monitoring of COVID-19. In HIV research, support-vector machines (SVMs), logistic regression, and deep neural network (DNN) frameworks advance viral-protein classification and drug-resistance mapping, accelerating antiviral and vaccine discovery. Despite these successes, persistent challenges remain-data heterogeneity, limited model interpretability, hallucinations in large language models (LLMs), and infrastructure gaps in low-resource settings. We recommend standardized open-access data pipelines and integration of explainable-AI methodologies to ensure safe, equitable deployment of AI-driven interventions in future viral-outbreak responses.}, }
@article {pmid40871554, year = {2025}, author = {Jin, J and Quan, M and Cao, X and Zhang, Y and Xu, X and Wang, Z}, title = {PROTACs in Antivirals: Current Advancements and Future Perspectives.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {16}, pages = {}, pmid = {40871554}, issn = {1420-3049}, mesh = {*Antiviral Agents/pharmacology/therapeutic use ; Humans ; *Proteolysis/drug effects ; SARS-CoV-2/drug effects ; *COVID-19 Drug Treatment ; COVID-19/virology ; Hepacivirus/drug effects ; Ubiquitination ; Host-Pathogen Interactions/drug effects ; Proteolysis Targeting Chimera ; }, abstract = {Proteolysis-targeting chimera (PROTAC) technology has demonstrated remarkable progress in tumor therapy, attributed to its unique capability of catalytically degrading "undruggable" targets. In the context of the ongoing global health threat posed by the Coronavirus Disease 2019 (COVID-19) pandemic, the application scope of PROTAC technology has been gradually extended to the field of antiviral research. Unlike traditional small molecule inhibitors, PROTAC employs an "event-driven" mechanism to achieve ubiquitination-mediated degradation of target proteins. This approach holds great promise in addressing challenges such as drug resistance, targeting host-dependent factors, and high-mutagenic viral proteins. This article provides a comprehensive review of the application progress of PROTAC technology in antiviral therapy, with a particular emphasis on successful cases across a range of viral pathogens, including Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), influenza virus, and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Additionally, it delves into the challenges encountered in this field and ponders future development directions. Through the integration of the latest research findings, this article proposes a dual-target degradation strategy based on the host-pathogen interaction interface. These proposals aim to offer theoretical support for the clinical translation of antiviral PROTACs.}, }
@article {pmid40871409, year = {2025}, author = {Papaneri, A and Cui, G and Chen, SH}, title = {Next-Generation Nucleic Acid-Based Diagnostics for Viral Pathogens: Lessons Learned from the SARS-CoV-2 Pandemic.}, journal = {Microorganisms}, volume = {13}, number = {8}, pages = {}, pmid = {40871409}, issn = {2076-2607}, support = {ZIA ES103310/ImNIH/Intramural NIH HHS/United States ; ZIC ES102506/ImNIH/Intramural NIH HHS/United States ; 1ZICES102506//NIH Intramural Research Program/ ; 1ZIAES103310//NIH Intramural Research Program/ ; }, abstract = {The COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), catalyzed unprecedented innovation in molecular diagnostics to address critical gaps in rapid pathogen detection. Over the past five years, CRISPR-based systems, isothermal amplification techniques, and portable biosensors have emerged as transformative tools for nucleic acid detection, offering improvements in speed, sensitivity, and point-of-care applicability compared to conventional PCR. While numerous reviews have cataloged the technical specifications of these platforms, a critical gap remains in understanding the strategic and economic hurdles to their real-world implementation. This review provides a forward-looking analysis of the feasibility, scalability, and economic benefits of integrating these next-generation technologies into future pandemic-response pipelines. We synthesize advances in coronavirus-specific diagnostic platforms and attempt to highlight the need for their implementation as a cost-saving measure during surges in clinical demand. We evaluate the feasibility of translating these technologies-particularly CRISPR-Cas integration with recombinase polymerase amplification (RPA)-into robust first-line diagnostic pipelines for novel viral threats. By analyzing the evolution of diagnostic strategies during the COVID-19 era, we aim to provide strategic insights and new directions for developing and deploying effective detection platforms to better confront future viral pandemics.}, }
@article {pmid40871375, year = {2025}, author = {Esposito, S and Masetti, M and Calanca, C and Canducci, N and Rasmi, S and Fradusco, A and Principi, N}, title = {Recent Changes in the Epidemiology of Group A Streptococcus Infections: Observations and Implications.}, journal = {Microorganisms}, volume = {13}, number = {8}, pages = {}, pmid = {40871375}, issn = {2076-2607}, support = {CUP I83C22001810007//NextGenerationEU-MUR M4C2.I.1.3PNRR/ ; }, abstract = {Streptococcus pyogenes (Group A Streptococcus, GAS) is a major human pathogen capable of causing infections ranging from mild pharyngitis and impetigo to severe invasive diseases such as bacteremia, necrotizing fasciitis, and streptococcal toxic shock syndrome (STSS). Historically, the incidence of GAS infections declined during the early antibiotic era but began rising again from the early 2000s, driven partly by the emergence of hyper-virulent strains such as emm1 and emm12. From 2005 onward, significant increases in GAS infections were reported globally, accompanied by rising antibiotic resistance, particularly to macrolides and tetracyclines. During the COVID-19 pandemic, widespread public health measures led to a sharp decline in GAS infections, including invasive cases, but this trend reversed dramatically in late 2022 and 2023, with surges exceeding pre-pandemic levels, notably in children. Recent data implicate factors such as "immunity debt," viral co-infections, and the spread of virulent clones like M1UK. Looking forward, continued surveillance of GAS epidemiology, virulence factors, and resistance patterns is critical. Moreover, the emergence of GAS isolates with reduced susceptibility to beta-lactams underscores the need for vigilance despite the absence of fully resistant strains. The development of an effective vaccine remains an urgent priority to reduce GAS disease burden and prevent severe outcomes. Future research should focus on vaccine development, molecular mechanisms of virulence, and strategies to curb antimicrobial resistance.}, }
@article {pmid40871305, year = {2025}, author = {Vlok, M and Majer, A}, title = {Global Prevalence of Non-Polio Enteroviruses Pre- and Post COVID-19 Pandemic.}, journal = {Microorganisms}, volume = {13}, number = {8}, pages = {}, pmid = {40871305}, issn = {2076-2607}, abstract = {Non-polio enteroviruses continue to cause numerous epidemics world-wide that range from mild to severe disease, including acute flaccid paralysis, meningitis, severe respiratory infections and encephalitis. Using publicly available data we present a comprehensive global and regional temporal distribution of non-polio enteroviruses, with a focus on highly prevalent genotypes. We found that regional distribution did vary compared to global prevalence where the top prevalent genotypes included CVA6 and EV-A71 in Asia, EV-D68 in North America and CVA13 in Africa, while E-30 was prevalent in Europe, South America and Oceania. In 2020, the COVID-19 pandemic did interrupt non-polio enterovirus detections globally, and cases rebounded in subsequent years, albeit at lower prevalence and with decreased genotype diversity. Environmental surveillance for non-polio enteroviruses does occur and has been used in some regions as an early-warning system; however, further development is needed to effectively supplement potential gaps in clinical surveillance data. Overall, monitoring for non-polio enteroviruses is critical to identify true incidence, improve understanding of genotype circulation, provide an early warning system for emerging/re-emerging genotypes and allow for better outbreak control.}, }
@article {pmid40871295, year = {2025}, author = {Caliman-Sturdza, OA and Soldanescu, I and Gheorghita, RE}, title = {SARS-CoV-2 Pneumonia: Advances in Diagnosis and Treatment.}, journal = {Microorganisms}, volume = {13}, number = {8}, pages = {}, pmid = {40871295}, issn = {2076-2607}, abstract = {The development of severe SARS-CoV-2 pneumonia is characterized by extensive lung inflammation, which, in turn, leads to respiratory distress and a decline in blood oxygen levels. Hospital admission, along with intensive care or ventilator usage, becomes necessary because this condition leads to serious respiratory problems. This review aims to provide a comprehensive overview of the pathophysiological mechanisms, diagnostic methods, and current therapeutic options for pneumonia caused by the SARS-CoV-2 virus. The pathophysiological process of severe pneumonia due to SARS-CoV-2 infection is characterized by direct lung damage from viral replication, an excessive immune system response, inflammation, impaired gas exchange, and multi-organ failure. The coexistence of various medical conditions leads to substantial lung impairment, resulting in hypoxia and respiratory failure, which can ultimately lead to fatal outcomes. The diagnosis of severe SARS-CoV-2 pneumonia is made through a combination of clinical, radiologic, and laboratory findings. A multifaceted approach integrating antiviral therapy, corticosteroids, oxygen supplementation, ventilatory management, and immunomodulation is imperative to control inflammation and enhance clinical outcomes. Early intervention, meticulous monitoring, and personalized care are paramount for enhancing survival and mitigating complications in critically ill patients with COVID-19 pneumonia.}, }
@article {pmid40871289, year = {2025}, author = {Ramos-Cela, M and Forconi, V and Antonelli, R and Manenti, A and Montomoli, E}, title = {Exploring the Use of Viral Vectors Pseudotyped with Viral Glycoproteins as Tools to Study Antibody-Mediated Neutralizing Activity.}, journal = {Microorganisms}, volume = {13}, number = {8}, pages = {}, pmid = {40871289}, issn = {2076-2607}, abstract = {Recent outbreaks of highly pathogenic human RNA viruses from probable zoonotic origin have highlighted the relevance of epidemic preparedness as a society. However, research in vaccinology and virology, as well as epidemiologic surveillance, is often constrained by the biological risk that live virus experimentation entails. These also involve expensive costs, time-consuming procedures, and advanced personnel expertise, hampering market access for many drugs. Most of these drawbacks can be circumvented with the use of pseudotyped viruses, which are surrogate, non-pathogenic recombinant viral particles bearing the surface envelope protein of a virus of interest. Pseudotyped viruses significantly expand the research potential in virology, enabling the study of non-culturable or highly infectious pathogens in a safer environment. Most are derived from lentiviral vectors, which confer a series of advantages due to their superior efficiency. During the past decade, many studies employing pseudotyped viruses have evaluated the efficacy of vaccines or monoclonal antibodies for relevant pathogens such as HIV-1, Ebolavirus, Influenza virus, or SARS-CoV-2. In this review, we aim to provide an overview of the applications of pseudotyped viruses when evaluating the neutralization capacity of exposed individuals, or candidate vaccines and antivirals in both preclinical models and clinical trials, to further help develop effective countermeasures against emerging neutralization-escape phenotypes.}, }
@article {pmid40870742, year = {2025}, author = {Qin, X and Yang, X and Deng, Y and Guo, L and Li, Z and Yang, X and Hou, C}, title = {Cannabis Derivatives as Ingredients of Functional Foods to Combat the COVID-19 Pandemic.}, journal = {Foods (Basel, Switzerland)}, volume = {14}, number = {16}, pages = {}, pmid = {40870742}, issn = {2304-8158}, abstract = {Lower respiratory infections predominantly affect children under five and the elderly, with influenza viruses and respiratory syncytial viruses (including SARS-CoV-2) being the most common pathogens. The COVID-19 pandemic has posed significant global public health challenges. While vaccination remains crucial, its efficacy is limited, highlighting the need for complementary approaches to mitigate immune hyperactivation in severe COVID-19 cases. Medicinal plants like Cannabis sativa show therapeutic potential, with over 85% of SARS-CoV-2-infected patients in China receiving traditional herbal treatments. This review explores the antiviral applications of cannabis and its bioactive compounds, particularly against SARS-CoV-2, while evaluating their pharmacological and food industry potential. Cannabis contains over 100 cannabinoids, terpenes, flavonoids, and fatty acids. Cannabinoids may block viral entry, modulate immune responses (e.g., suppressing pro-inflammatory cytokines via CB2/PPARγ activation), and alleviate COVID-19-related psychological stress. There are several challenges with pharmacological and food applications of cannabinoids, including clinical validation of cannabinoids for COVID-19 treatment and optimizing cannabinoid solubility/bioavailability for functional foods. However, rising demand for health-focused products presents market opportunities. Genetic engineering to enhance cannabinoid yields and integrated pharmacological studies are needed to unlock cannabis's full potential in drug discovery and nutraceuticals. Cannabis-derived compounds hold promise for antiviral therapies and functional ingredients, though further research is essential to ensure safety and efficacy.}, }
@article {pmid40869923, year = {2025}, author = {Tan, X and Li, J and Cui, B and Wu, J and Toischer, K and Hasenfuß, G and Xu, X}, title = {CRISPR/Cas13-Based Anti-RNA Viral Approaches.}, journal = {Genes}, volume = {16}, number = {8}, pages = {}, pmid = {40869923}, issn = {2073-4425}, mesh = {*CRISPR-Cas Systems ; Humans ; *RNA, Viral/genetics ; SARS-CoV-2/genetics/drug effects ; *RNA Viruses/genetics/drug effects ; COVID-19/virology/therapy ; *Antiviral Agents/pharmacology/therapeutic use ; Virus Replication ; Animals ; }, abstract = {RNA viruses pose significant threats to global health, causing diseases such as COVID-19, HIV/AIDS, influenza, and dengue. These viruses are characterized by high mutation rates, rapid evolution, and the ability to evade traditional antiviral therapies, making effective treatment and prevention particularly challenging. In recent years, CRISPR/Cas13 has emerged as a promising antiviral tool due to its ability to specifically target and degrade viral RNA. Unlike conventional antiviral strategies, Cas13 functions at the RNA level, providing a broad-spectrum and programmable approach to combating RNA viruses. Its flexibility allows for rapid adaptation of guide RNAs to counteract emerging viral variants, making it particularly suitable for highly diverse viruses such as SARS-CoV-2 and HIV. This review discusses up-to-date applications of Cas13 in targeting a wide range of RNA viruses, including SARS-CoV-2, HIV, dengue, influenza, and other RNA viruses, focusing on its therapeutic potential. Preclinical studies have demonstrated Cas13's efficacy in degrading viral RNA and inhibiting replication, with applications spanning prophylactic interventions to post-infection treatments. However, challenges such as collateral cleavage, inefficient delivery, potential immunogenicity, and the development of an appropriate ethical framework must be addressed before clinical translation. Future research should focus on optimizing crRNA design, improving delivery systems, and conducting rigorous preclinical evaluations to enhance specificity, safety, and therapeutic efficacy. With continued advancements, Cas13 holds great promise as a revolutionary antiviral strategy, offering novel solutions to combat some of the world's most persistent viral threats.}, }
@article {pmid40869890, year = {2025}, author = {Abdel-Motaal, KA and Chun, S}, title = {Governance in Crisis: A Mixed-Methods Analysis of Global Health Governance During COVID-19.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {8}, pages = {}, pmid = {40869890}, issn = {1660-4601}, mesh = {*COVID-19/epidemiology/prevention &amp; control ; *Global Health ; Humans ; SARS-CoV-2 ; Pandemics ; *Health Policy ; }, abstract = {BACKGROUND: The COVID-19 pandemic exposed major structural deficiencies in global health governance, including stark inequities in vaccine access, intervention timing, and mortality outcomes. While economic resources played a role, the influence of governance performance remains insufficiently examined. This study addresses a significant gap by integrating governance metrics with pandemic response data to assess how governance quality, independent of income level, affected national outcomes. Although the Oxford COVID-19 Government Response Tracker (OxCGRT) dataset has been widely used to document policy responses, this study offers a novel contribution by linking these policy interventions with governance performance and evaluating their joint effect on health outcomes and vaccine equity.<br><br>METHODS: This mixed-methods study combines quantitative analysis of global datasets with a qualitative literature review. Quantitative data were mainly obtained from the Oxford COVID-19 Government Response Tracker (OxCGRT), the World Bank's Worldwide Governance Indicators (WGIs), and World Bank/WHO databases. A governance performance index was constructed using two WGI components: Government Effectiveness and Regulatory Quality. Countries were grouped into high, medium, or low governance categories. Statistical tests included ANOVA, Kaplan Meier survival analysis, and multivariable OLS regression. The qualitative component reviewed 45 academic and institutional sources on governance performance during COVID-19.<br><br>RESULTS: Countries with high governance performance had earlier public health interventions, lower mortality, and broader vaccine coverage, independent of income level. Kaplan Meier analysis revealed faster school closures in these countries (p < 0.01). Multivariable regression showed governance remained a significant predictor after adjusting for income and health spending. Qualitative findings highlighted recurring weaknesses in legal enforceability, intergovernmental coordination, and global financing mechanisms.<br><br>CONCLUSIONS: Governance performance had a decisive impact on pandemic outcomes. The COVID-19 crisis revealed the need for robust governance systems capable of responding to complex emergencies that extend beyond the health sector into institutional, economic, and social spheres.}, }
@article {pmid40869505, year = {2025}, author = {Starshinova, A and Belyaeva, E and Irtyuga, O and Sefiyeva, G and Mitrofanova, L and Makarov, I and Makarova, T and Kulpina, A and Kudlay, D}, title = {Tuberculosis in Pregnant Women After COVID-19: Features of Prevention, Diagnosis, and Treatment (Narrative Review).}, journal = {Journal of clinical medicine}, volume = {14}, number = {16}, pages = {}, pmid = {40869505}, issn = {2077-0383}, support = {&#x2116; 075-15-2025-013//Financial support was provided by the Ministry of Science and Higher Education of the Russian Federation/ ; }, abstract = {Tuberculosis remains a serious infectious disease that causes over 1.3 million deaths annually. Following the COVID-19 pandemic, the global incidence of tuberculosis has increased to 10.8 million cases. Pregnant women represent a particularly vulnerable population requiring tailored approaches to the prevention, diagnosis, and treatment of tuberculosis. SARS-CoV-2 infection may have impacted existing clinical protocols. Implementing updated methods of tuberculosis prevention, diagnosis, and treatment in pregnant women could help reduce adverse maternal and fetal outcomes. The aim of this review was to explore potential modifications in tuberculosis management among pregnant women in the post-COVID-19 era, including co-infection with SARS-CoV-2. Methods: A review was conducted, incorporating a systematic literature search across major international databases, including Medline, PubMed, Web of Science, Scopus, and Google Scholar. The search covered publications released between December 2019 and September 2024 and used targeted keywords such as "COVID-19" OR "SARS-CoV-2", "tuberculosis" OR "TB" OR "latent tuberculosis infection" OR "pulmonary tuberculosis", and "pregnancy" OR "pregnant women". Results: Pregnant women living with HIV are at increased risk of developing tuberculosis, which can negatively affect both maternal and perinatal outcomes. Screening for tuberculosis is recommended for all HIV-positive pregnant women, even in the absence of clinical symptoms. Notably, immunological testing before and during pregnancy facilitates the timely and safe detection of tuberculosis infection, enabling preventive and therapeutic interventions during any stage of gestation and the early postpartum period, for the benefit of both mother and child. Drug-drug interactions play a significant role in tuberculosis management, both among anti-tuberculosis agents and with medications for comorbid conditions. Current knowledge of the pharmacokinetics and pharmacodynamics of antituberculosis agents, coupled with therapeutic drug monitoring, supports the development of individualized and effective treatment regimens, which are particularly critical for pregnant patients. Recommendations for managing tuberculosis in pregnant women after COVID-19 infection include measuring D-dimer levels, performing echocardiography, and consulting cardiologists to prevent treatment-related complications. Conclusions: Pregnant women represent a distinct subgroup of tuberculosis patients requiring individualized management. Changes observed in tuberculosis progression and treatment responses in pregnant women before and after SARS-CoV-2 infection should inform therapeutic choices, especially in cases of drug-resistant tuberculosis treated with bedaquiline. COVID-19 has been associated with increased cardiovascular risk, which may heighten the likelihood of adverse drug reactions in this population, especially given the limited therapeutic options. Further research is required to assess the long-term outcomes of latent tuberculosis infection in pregnant women and to evaluate the safety and efficacy of novel regimens for drug-resistant TB during pregnancy.}, }
@article {pmid40869221, year = {2025}, author = {Elhabyan, A and Khan, MUS and Elhabyan, A and Abukhatwa, R and Uzair, H and Jimenez, C and Elhabyan, A and Chan, YL and Shabana, B}, title = {Broad-Spectrum Antiviral Activity of Cyclophilin Inhibitors Against Coronaviruses: A Systematic Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {16}, pages = {}, pmid = {40869221}, issn = {1422-0067}, support = {BB/T00875X/1//UKRI/ ; }, mesh = {Animals ; Humans ; *Antiviral Agents/pharmacology/therapeutic use ; *Coronavirus/drug effects ; *Coronavirus Infections/drug therapy/virology ; COVID-19/virology ; COVID-19 Drug Treatment ; *Cyclophilins/antagonists &amp; inhibitors/metabolism ; *Cyclosporine/pharmacology/therapeutic use ; SARS-CoV-2/drug effects ; Virus Replication/drug effects ; }, abstract = {Cyclophilins (Cyps), a family of peptidyl-prolyl isomerases, play essential roles in the life cycle of coronaviruses by interacting with viral proteins and modulating host immune responses. In this systematic review, we examined cell culture, animal model, and clinical studies assessing the anti-viral efficacy of cyclosporine A (CsA, PubChem CID: 5284373) and its non-immunosuppressive derivatives against coronaviruses. CsA demonstrated robust anti-viral activity in vitro across a broad range of coronaviruses, including but not limited to HCoV-229E, SARS-CoV, MERS-CoV, and SARS-CoV-2, with potent EC50 values in the low micromolar range. Non-immunosuppressive analogs such as Alisporivir and NIM811 exhibited similar inhibitory effects. In vivo, CsA treatment significantly reduced viral load, ameliorated lung pathology, and improved survival in coronavirus-infected animals. Clinical studies further indicated that CsA administration was associated with improved outcomes in COVID-19 patients, including reduced mortality and shorter hospital stays. Mechanistic studies revealed that CsA disrupts the formation of viral replication complexes, interferes with critical Cyp-viral protein interactions, and modulates innate immune signaling. These findings collectively demonstrate the therapeutic potential of cyclophilin inhibitors as broad-spectrum anti-virals against current and emerging coronaviruses.}, }
@article {pmid40868989, year = {2025}, author = {Cimmino, G and D'Elia, S and Morello, M and Titolo, G and Luisi, E and Solimene, A and Serpico, C and Conte, S and Natale, F and Loffredo, FS and Bianco, A and Golino, P}, title = {Cardio-Pulmonary Features of Long COVID: From Molecular and Histopathological Characteristics to Clinical Implications.}, journal = {International journal of molecular sciences}, volume = {26}, number = {16}, pages = {}, pmid = {40868989}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/complications/pathology ; SARS-CoV-2 ; *Cardiovascular Diseases/etiology/pathology ; Lung/pathology/virology ; Post-Acute COVID-19 Syndrome ; }, abstract = {Long COVID is a persistent post-viral syndrome with the significant involvement of both the cardiovascular and pulmonary systems, often extending well beyond the acute phase of SARS-CoV-2 infection. Emerging evidence has highlighted a spectrum of chronic alterations, including endothelial dysfunction, microvascular inflammation, perivascular fibrosis, and in some cases, the persistence of viral components in the cardiac and pulmonary tissues. At the molecular level, a sustained inflammatory milieu-characterized by elevated pro-inflammatory cytokines such as interleukin 6 (IL-6)-and chronic platelet hyperreactivity contribute to a prothrombotic state. These mechanisms are implicated in microvascular damage, cardiac strain, and impaired gas exchange, correlating with clinical manifestations such as fatigue, dyspnea, chest discomfort, and reduced exercise capacity. In certain patients, especially those who were not hospitalized during the acute phase, cardiac MRI and myocardial biopsy may reveal signs of myocardial inflammation and autonomic dysregulation. These often subclinical cardiovascular alterations underscore the need for improved diagnostic strategies, integrating molecular and histopathological markers during post-COVID evaluations. Recognizing persistent inflammatory and thrombotic activity may inform risk stratification and individualized therapeutic approaches. The interdependence between pulmonary fibrosis and cardiac dysfunction highlights the importance of multidisciplinary care. In this context, molecular and tissue-based diagnostics play a pivotal role in elucidating the long-term cardio-pulmonary sequelae of long COVID and guiding targeted interventions. Early identification and structured follow-up are essential to mitigate the burden of chronic complications in affected individuals.}, }
@article {pmid40868961, year = {2025}, author = {Florea, CE and Bălaș-Maftei, B and Rotaru, A and Abudanii, PL and Vieru, ST and Grigoriu, M and Stoian, A and Manciuc, C}, title = {Multiorgan Involvement and Particularly Liver Injury in Long COVID: A Narrative Review.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {8}, pages = {}, pmid = {40868961}, issn = {2075-1729}, abstract = {Since the start of the COVID-19 pandemic, increasing evidence has shown that SARS-CoV-2 infection can cause long-term symptoms, collectively known as long COVID, and that patients with mild COVID-19 can also be affected by persistent fatigue, cognitive impairment, dyspnea, muscle pain, etc. Recent research has also found multiple organ systems, including the liver, to be significant sites of ongoing injury. This narrative review summarizes current knowledge on organ involvement during and after COVID-19, with particular focus on early and delayed hepatic manifestations and associated risk factors. Pathogenesis appears to be multifactorial, involving direct virus action, the body's immune-mediated inflammatory response, microvascular damage, drug-induced hepatotoxicity, and, in some cases, reactivation or exacerbation of pre-existing liver conditions. The hepatic clinical manifestations range from asymptomatic elevations of transaminases to cholangiopathy and even fibrosis. These can persist or progress for months after the initial infection with SARS-CoV-2 is resolved, requiring prolonged monitoring and interdisciplinary care, especially in the presence of metabolic disorders, obesity, or hepatitis. Neurological, cardiovascular, and other sequelae are discussed in parallel, with attention paid to common inflammatory and thrombotic pathways. This review concludes that liver dysfunction is of particular interest in long-COVID due to the liver's central role in metabolism and inflammation. While further research is being conducted into organ-specific and systemic interactions, the available evidence makes a compelling case for extended monitoring and integrated management strategies post infection.}, }
@article {pmid40868652, year = {2025}, author = {Medani, IE and Hakami, AM and Chourasia, UH and Rahamtalla, B and Adawi, NM and Fadailu, M and Salih, A and Abdelmola, A and Hashim, KN and Dawelbait, AM and Yousf, NM and Hassan, NM and Ali, NA and Rizig, AA}, title = {Telemedicine in Obstetrics and Gynecology: A Scoping Review of Enhancing Access and Outcomes in Modern Healthcare.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {16}, pages = {}, pmid = {40868652}, issn = {2227-9032}, abstract = {Telemedicine has transformed obstetrics and gynecology (OB/GYN), accelerated by the COVID-19 pandemic. This study aims to synthesize evidence on the adoption, effectiveness, barriers, and technological innovations of telemedicine in OB/GYN across diverse healthcare settings. This scoping review synthesized 63 peer-reviewed studies (2010-2023) using PRISMA-ScR guidelines to map global applications, outcomes, and challenges. Key modalities included synchronous consultations, remote monitoring, AI-assisted triage, tele-supervision, and asynchronous communication. Results demonstrated improved access to routine care and mental health support, with outcomes for low-risk pregnancies comparable to in-person services. Adoption surged >500% during pandemic peaks, stabilizing at 9-12% of services in high-income countries. However, significant disparities persisted: 43% of rural Sub-Saharan clinics lacked stable internet, while socioeconomic, linguistic, and cultural barriers disproportionately affected vulnerable populations (e.g., non-English-speaking, transgender, and refugee patients). Providers reported utility but also screen fatigue (41-68%) and diagnostic uncertainty. Critical barriers included fragmented policies, reimbursement variability, data privacy concerns, and limited evidence from conflict-affected regions. Sustainable integration requires equity-centered design, robust policy frameworks, rigorous longitudinal evaluation, and ethically validated AI to address clinical complexity and systemic gaps.}, }
@article {pmid40868618, year = {2025}, author = {Wypych-Ślusarska, A and Krupa-Kotara, K and Słowinski, J and Yanakieva, A and Grajek, M}, title = {The Impact of Polycrisis on Healthcare Systems-Analyzing Challenges and the Role of Social Epidemiology.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {16}, pages = {}, pmid = {40868618}, issn = {2227-9032}, abstract = {In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises-collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses.}, }
@article {pmid40868601, year = {2025}, author = {Kalogerakou, T and Antoniadou, M}, title = {Enhancing Dentists' Resilience and Occupational Sustainability Through Physical Activity: A Systematic Review in the Post-Pandemic Context.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {16}, pages = {}, pmid = {40868601}, issn = {2227-9032}, abstract = {BACKGROUND: Dental professionals face high levels of occupational stress, which intensified during the COVID-19 pandemic, contributing to increased burnout, diminished well-being, and signs of accelerated biological aging. This systematic review explores the role of physical activity as a protective factor for mental and physical health, with a focus on promoting resilience and long-term occupational sustainability in a post-pandemic volatile, uncertain, complex, and ambiguous (VUCA) environment.<br><br>METHODS: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Studies published between 2000 and 2024 were identified through PubMed, Scopus, and the Cochrane Library using MeSH terms related to dentistry, physical activity, stress management, and occupational health. Of 850 records screened, 28 studies were included: 24 cross-sectional, 2 systematic reviews, 1 retrospective, and 1 case-control study. Inclusion and quality appraisal followed standardized criteria.<br><br>RESULTS: The included studies consistently showed that physical activity was associated with reduced burnout, improved psychological well-being, enhanced postural function, and potential markers of slowed biological aging in dental professionals. Several studies reported moderate-to-strong associations, with effect sizes ranging from small improvements in perceived stress scores to substantial reductions in MSD prevalence. Interventions combining exercise with ergonomic education, stress management, and institutional support demonstrated the stronger and more consistent benefits for professional sustainability.<br><br>CONCLUSIONS: Physical activity, when integrated into comprehensive workplace wellness frameworks, significantly enhances the mental and physical resilience of dental professionals. Embedding movement, ergonomics, and psychosocial support into practice environments offers a promising strategy for safeguarding long-term workforce sustainability and improving public health outcomes.}, }
@article {pmid40868563, year = {2025}, author = {Bailo, P and Gibelli, F and Cennamo, M and Pesel, G and Basello, E and Spasari, T and Ricci, G}, title = {Violence Against Healers in Italy: A Medico-Legal Inquiry into Patient Aggression.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {16}, pages = {}, pmid = {40868563}, issn = {2227-9032}, abstract = {In recent years, Italy has experienced a significant increase in violence against healthcare workers, mirroring a global trend. Manifesting as verbal, physical, psychological, and material aggression, this phenomenon endangers both personnel safety and the foundational principles of the National Health Service (SSN) as outlined in Article 32 of the Italian Constitution. The escalation-most acute in emergency departments, psychiatric units, inpatient wards, and community services-affects a broad spectrum of professionals, compromising care quality and institutional integrity. Data from the FNOMCeO-CENSIS Report 2023-2024 reveal over 18,000 reported incidents in 2024, with verbal assaults disproportionately affecting female nursing staff. The COVID-19 pandemic further exacerbated systemic vulnerabilities, heightening user dissatisfaction and psychological strain among healthcare providers. In response, legislative actions-such as Law No. 113/2020 and Decree-Law No. 137/2024-aim to strengthen prevention, monitoring, and penal measures. This article examines legal, institutional, and organizational responses, including on-the-ground and hospital-based strategies to mitigate violence. Adopting a multidisciplinary perspective, it analyzes recent policy developments, regional dynamics, and victim-perpetrator profiles, arguing that safeguarding healthcare environments is both a public security priority and an ethical imperative essential to preserving the dignity of care work and the resilience of the health system.}, }
@article {pmid40868207, year = {2025}, author = {Soczyńska, J and Topola, E and Gawełczyk, W and Viscardi, S and Butyńska, K and Woźniak, S}, title = {Intestinal Dysbiosis and Immune Activation in Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: A Comparative Review of Mechanisms and Clinical Manifestations.}, journal = {Biomedicines}, volume = {13}, number = {8}, pages = {}, pmid = {40868207}, issn = {2227-9059}, abstract = {Although Kawasaki disease (KD) has been known since 1967, when it was first described by Dr. Tomisaku Kawasaki, the literature indicates that its etiology-similarly to Multisystem Inflammatory Syndrome in Children (MIS-C)-remains largely unclear and is the subject of intensive research. The former disease, which typically occurs shortly after infection, is the most common cause of primary vasculitis in children worldwide. The latter-MIS-C, associated with SARS-CoV-2 infection-is characterized by involvement of at least two organ systems. Undoubtedly, both diseases exhibit heightened immune system activity and significant inflammation. In recent years, increasing attention has been directed towards alterations in the microbiota observed in affected patients. We undertake an analysis and systematic review of the current scientific findings in this field. We emphasize the role of the microbiome-which encompasses not only bacteria but also viruses, fungi, parasites, and archaea-in health and disease. We track its composition from birth and highlight factors influencing its diversity, such as the mode of delivery. We recognize the microbiome's role in reducing the likelihood of allergic diseases in children and its interactions with the immune system. In addition to comparing the pathomechanisms and clinical manifestations of KD and MIS-C, also known as Pediatric Inflammatory Multisystem Syndrome (PIMS), we investigate microbiota alterations in these conditions and analyze potential applications of microbiome knowledge, for example, in identifying diagnostic markers. We also point out potential directions for future research, such as the use of short-chain fatty acids (SCFAs) in MIS-C and the long-term changes in the gut microbiota associated with these diseases, which remain poorly documented and currently represent significant gaps in knowledge.}, }
@article {pmid40868058, year = {2025}, author = {Gonzaga, A and Martinez-Navarrete, G and Macia, L and Anton-Bonete, M and Cahuana, G and Tejedo, JR and Zorrilla-Muñoz, V and Fernandez-Jover, E and Andreu, E and Eguizabal, C and Pérez-Martínez, A and Solano, C and Hernández-Blasco, LM and Soria, B}, title = {Non-Viral Therapy in COVID-19: Where Are We Standing? How Our Experience with COVID May Help Us Develop Cell Therapies for Long COVID Patients.}, journal = {Biomedicines}, volume = {13}, number = {8}, pages = {}, pmid = {40868058}, issn = {2227-9059}, support = {ICI21/00016//Instituto de Salud Carlos III/ ; AVI-GVA-COVID19-068//Valencian Agency of Innovation(AVI)/ ; GVA-COVID19/2021-047//Valencian Agency of Innovation(AVI)/ ; NA//Al-Andalus Biopharma SL/ ; }, abstract = {Objectives: COVID-19, caused by the SARS-CoV-2 virus, has infected over 777 million individuals and led to approximately 7 million deaths worldwide. Despite significant efforts to develop effective therapies, treatment remains largely supportive, especially for severe complications like acute respiratory distress syndrome (ARDS). Numerous compounds from diverse pharmacological classes are currently undergoing preclinical and clinical evaluation, targeting both the virus and the host immune response. Methods: Despite the large number of articles published and after a preliminary attempt was published, we discarded the option of a systematic review. Instead, we have done a description of therapies with these results and a tentative mechanism of action. Results: Preliminary studies and early-phase clinical trials have demonstrated the potential of Mesenchymal Stem Cells (MSCs) in mitigating severe lung damage in COVID-19 patients. Previous research has shown MSCs to be effective in treating various pulmonary conditions, including acute lung injury, idiopathic pulmonary fibrosis, ARDS, asthma, chronic obstructive pulmonary disease, and lung cancer. Their ability to reduce inflammation and promote tissue repair supports their potential role in managing COVID-19-related complications. This review demonstrates the utility of MSCs in the acute phase of COVID-19 and postulates the etiopathogenic role of mitochondria in Long-COVID. Even more, their combination with other therapies is also analyzed. Conclusions: While the therapeutic application of MSCs in COVID-19 is still in early stages, emerging evidence suggests promising outcomes. As research advances, MSCs may become an integral part of treatment strategies for severe COVID-19, particularly in addressing immune-related lung injury and promoting recovery. However, a full pathogenic mechanism may explain or unify the complexity of signs and symptoms of Long COVID and Post-Acute Sequelae (PASC).}, }
@article {pmid40867903, year = {2025}, author = {Hallan, SS and Ferrara, F and Sguizzato, M and Cortesi, R}, title = {Cyclodextrin-Based Nanotransporters as a Versatile Tool to Manage Oxidative Stress-Induced Lung Diseases.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {14}, number = {8}, pages = {}, pmid = {40867903}, issn = {2076-3921}, abstract = {Oxidative stress is one of the key elements in lung-related complications such as cystic fibrosis, acute lung injury, pulmonary hypertension, bronchopulmonary dysplasia, chronic airway diseases, lung cancer, COVID-19, and many others. Antioxidant and anti-inflammatory therapy can be considered as supportive alternatives in their management. However, most naturally derived antioxidants face issues with poor aqueous solubility and stability, which hinder their clinical utility. Remarkably, local pulmonary delivery circumvents the severe limitations of oral delivery, including hepatic first-pass metabolism and organ toxicity, and enables a higher drug payload in the lungs. Here, in this review, we present cyclodextrin as a potential drug carrier for pulmonary administration, exploring the possibilities of its surface modification, complexation with other drug transporters, and loading of cannabidiols, siRNA, and antibodies as future trends. However, the lack of a robust physiological model for assessing the efficacy of lung-oriented drug targeting is a significant concern in its path to clinical and commercial success.}, }
@article {pmid40867811, year = {2025}, author = {Villegas Sánchez, V and Chávez Pacheco, JL and Palacios Arreola, MI and Sierra-Vargas, MP and Colín Godinez, LA and Ahumada Topete, VH and Fernández Plata, R and Higuera-Iglesias, A and Lara-Lemus, R and Aquino-Gálvez, A and Torres-Espíndola, LM and Castillejos-López, M}, title = {A Systematic Review of Genetic Variants in Glutathione S-Transferase Genes and Their Dual Role in SARS-CoV-2 Pathogenesis: From Acute Respiratory Complications to Long COVID.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {14}, number = {8}, pages = {}, pmid = {40867811}, issn = {2076-3921}, abstract = {Oxidative stress (OS) occurs when there is an imbalance between oxidants and antioxidants, leading to disruptions in cellular signaling and causing damage to molecules. Glutathione S-transferase (GST) enzymes are crucial for maintaining redox balance by facilitating glutathione conjugation. Increased oxidative damage has been noted during the COVID-19 pandemic, and its persistence may be linked to the onset of long COVID. This systematic review aimed to assess the relationship between GST gene polymorphisms and the prognosis of COVID-19, including long COVID. Adhering to the PRISMA guidelines, a thorough search was carried out in MEDLINE, CENTRAL, PubMed, and EMBASE for studies published from September 2020 to February 2025. Out of an initial selection of 462 articles, ten studies (four concerning COVID-19 severity and six related to long COVID) satisfied the inclusion criteria. The findings regarding GST polymorphisms were not consistent, especially concerning the GSTM1 and GSTT1 isoforms. Nevertheless, evidence indicates a sustained state of oxidative stress in patients with long COVID. The majority of research has focused on cytosolic GSTs, while the functions of microsomal and mitochondrial GST families remain largely unexplored. These findings suggest that further research into the various GST subfamilies and their genetic variants is necessary to enhance our understanding of their impact on COVID-19 severity and the pathophysiology of long COVID.}, }
@article {pmid40867207, year = {2025}, author = {Huang, X and Chen, Z and Xu, Z and Liu, X and Lv, Y and Yu, L}, title = {The Relationship Between Physical Activity and Depression in College Students: A Systematic Review and Meta-Analysis.}, journal = {Brain sciences}, volume = {15}, number = {8}, pages = {}, pmid = {40867207}, issn = {2076-3425}, support = {24YJC890065//Humanities and Social Science Fund of Ministry of Education of China/ ; }, abstract = {Objectives: Depression is a significant and growing global concern with substantial societal impact. College students, being particularly vulnerable to depression, necessitate exploration of physical activity (PA) as a potential mitigating factor. This study aims to examine the relationship between PA and depression in college students. Methods: Studies were identified through systematic searches of PubMed, Embase, Cochrane, Scopus, and Web of Science. The Pearson correlation coefficient was utilized to assess the PA-depression relationship. Heterogeneity was evaluated, and subgroup analyses were performed. Sensitivity analysis via the leave-one-out method was conducted. Quality assessment was assessed using the Joanna Briggs Institute literature quality assessment approach, resulting in the inclusion of 38 high-quality, low-risk studies. Results: A significant negative correlation between PA and depression was found (r = -0.238; 95% CI, -0.307 to -0.173; p < 0.001). Subgroup analyses revealed notable PA-depression correlations post-COVID-19 (r = -0.324; 95% CI, -0.493 to -0.132; p < 0.001), in developing countries (r = -0.202; 95% CI, -0.213 to -0.191; p < 0.001), and in physical education majors (r = -0.390; 95% CI, -0.589 to -0.147; p < 0.001). Moderate PA levels were associated with reduced depression (r = -0.428; 95% CI, -0.708 to -0.031; p = 0.035). Conclusions: This systematic review and meta-analysis suggests that PA is significantly and negatively associated with depression and plays a crucial role in alleviating depression in college students. Various influences, including the pandemic, national development level, student major, and PA intensity, moderate this relationship. Post-pandemic, developing countries, physical education majors, and moderate PA intensity emerged as optimal factors for enhancing the depression-alleviating effects of PA.}, }
@article {pmid40867179, year = {2025}, author = {Amate, JJS and Luque de la Rosa, A and Tadeu, P}, title = {Educational Discrimination and Challenges of Inclusion During the Pandemic: The Case of Students with Autism Spectrum Disorder (ASD) from an International Perspective.}, journal = {Brain sciences}, volume = {15}, number = {8}, pages = {}, pmid = {40867179}, issn = {2076-3425}, abstract = {Background: The COVID-19 pandemic exposed the fragility of educational systems in ensuring inclusive schooling, especially for students with Autism Spectrum Disorder (ASD). Disruptions to daily routines, the shift to remote learning, and the suspension of specialized services intensified pre-existing inequalities and affected the educational continuity and well-being of this group. Methods: This narrative review analyzes the educational discrimination experienced by students with ASD during the pandemic. A structured search was conducted across databases including Scopus, Web of Science, PubMed, ERIC, Dialnet, and Google Scholar. Sixteen empirical studies published between 2020 and 2024 were selected based on criteria such as open access, focus on compulsory education, and direct analysis of pandemic-related exclusion. Results: The findings reveal four key challenges: unequal access to digital resources, the interruption of support services, increased family burden, and limited institutional responses. These factors contributed to emotional distress, regression in skills, and reduced participation in educational and social settings. Conclusions: The review concludes that the pandemic acted as a magnifying glass for structural barriers already present in inclusive education. Moving forward, educational systems must develop flexible, sustainable, and equity-oriented frameworks to ensure that students with ASD are not left behind during future crises.}, }
@article {pmid40864750, year = {2025}, author = {Zheng, L and Xu, S}, title = {Pseudovirus as an Emerging Reference Material in Molecular Diagnostics: Advancement and Perspective.}, journal = {Current issues in molecular biology}, volume = {47}, number = {8}, pages = {}, pmid = {40864750}, issn = {1467-3045}, abstract = {In recent years, the persistent emergence of novel infectious pathogens (epitomized by the global coronavirus disease-2019 (COVID-2019) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) has propelled nucleic acid testing (NAT) into an unprecedented phase of rapid development. As a key technology in modern molecular diagnostics, NAT achieves precise pathogen identification through specific nucleic acid sequence recognition, establishing itself as an indispensable diagnostic tool across diverse scenarios, including public health surveillance, clinical decision-making, and food safety control. The reliability of NAT systems fundamentally depends on reference materials (RMs) that authentically mimic the biological characteristics of natural viruses. This critical requirement reveals significant limitations of current RMs in the NAT area: naked nucleic acids lack the structural authenticity of viral particles and exhibit restricted applicability due to stability deficiencies, while inactivated viruses have biosafety risks and inter-batch heterogeneity. Notably, pseudovirus has emerged as a novel RM that integrates non-replicative viral vectors with target nucleic acid sequences. Demonstrating superior performance in mimicking authentic viral structure, biosafety, and stability compared to conventional RMs, the pseudovirus has garnered substantial attention. In this comprehensive review, we critically summarize the engineering strategies of pseudovirus platforms and their emerging role in ensuring the reliability of NAT systems. We also discuss future prospects for standardized pseudovirus RMs, addressing key challenges in scalability, stability, and clinical validation, aiming to provide guidance for optimizing pseudovirus design and practical implementation, thereby facilitating the continuous improvement and innovation of NAT technologies.}, }
@article {pmid40859188, year = {2025}, author = {Li, L and Li, Q and Wang, J and Fu, Q and Chi, M}, title = {Effects of different interventions on anxiety disorders in children and adolescents: a systematic review and bayesian network meta-analysis.}, journal = {BMC psychiatry}, volume = {25}, number = {1}, pages = {809}, pmid = {40859188}, issn = {1471-244X}, support = {KXYJS2024007//China Association for Science and Technology Graduate Student Science Popularization Ability Improvement Project/ ; CIT&amp;TCD20180335//Beijing Municipal University Great Wall Scholar Training Program/ ; }, mesh = {Adolescent ; Child ; Humans ; *Acceptance and Commitment Therapy ; *Anxiety Disorders/therapy ; Bayes Theorem ; *Cognitive Behavioral Therapy/methods ; *COVID-19 ; Randomized Controlled Trials as Topic ; Virtual Reality Exposure Therapy ; }, abstract = {BACKGROUND: Anxiety disorders are among the most prevalent psychiatric conditions, particularly affecting children and adolescents. Since the COVID-19 pandemic, the incidence of anxiety in this population has increased, making it a significant public health concern. This study aimed to evaluate the effectiveness of various interventions for anxiety disorders in children and adolescents and identify the most effective approach to mitigate the impact of these disorders.<br><br>METHODS: We conducted a thorough search of eligible randomized controlled trials across five databases: Cochrane, Embase, PubMed, Scopus, and Web of Science. A Bayesian network meta-analysis was performed using R Studio, and the quality of evidence was evaluated using the GRADE method.<br><br>RESULTS: From 19,442 publications retrieved, 30 RCTs involving 1,711 participants were included. The results showed that Acceptance and Commitment Therapy was the most effective intervention for treating anxiety disorders in children and adolescents (MD = -3.83 [95% CrI: -9.33, 1.51]). Cognitive Behavioral Therapy was the second most effective (MD = -3.64 [95% CrI: -7.36, -0.48]), followed by Virtual Reality Exposure Therapy (MD = -2.53 [95% CrI: -8.23, 3.32]) and Physical Exercise (MD = -2.16 [95% CrI: -9.99, 5.52]).<br><br>CONCLUSIONS: Acceptance and Commitment Therapy (ACT) appears to be the most effective intervention for anxiety disorders in children and adolescents. However, this finding should be interpreted with caution due to the overall low quality of evidence, high heterogeneity, and imprecision in the results. Future research should investigate the potential benefits of combining physical exercise or virtual reality-assisted therapies. Moreover, large-scale, high-quality randomized controlled trials are essential to further validate and refine these findings.<br><br>TRIAL REGISTRATION: PROSPERO, CRD42024587910.}, }
@article {pmid40881746, year = {2025}, author = {Bozkurt, HB and Özdemir, &#xd6;}, 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 {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}, pmid = {40881694}, issn = {1664-3224}, mesh = {Humans ; *Immunity, Cellular ; *COVID-19/immunology/prevention &amp; control ; *SARS-CoV-2/immunology ; *Respiratory Syncytial Virus Infections/immunology/prevention &amp; control ; Animals ; *COVID-19 Vaccines/immunology ; *Respiratory Tract Infections/immunology/prevention &amp; control/virology ; *Influenza, Human/immunology/prevention &amp; 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.}, }
@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 = {99}, number = {9}, pages = {e0113225}, pmid = {40879383}, issn = {1098-5514}, support = {32372983//National Natural Science Foundation of China/ ; Y2025YC117//Central Public-interest Scientific Institution Basal Research Fund/ ; }, mesh = {*Organoids/virology ; Humans ; *Virus Diseases/virology/drug therapy ; Gene Editing ; Animals ; Antiviral Agents/pharmacology ; CRISPR-Cas Systems ; SARS-CoV-2 ; Models, Biological ; Viruses ; }, 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 {pmid40866295, year = {2025}, author = {Ammit, M and River, J and Montebello, M and Dawson, A}, title = {Factors that facilitate treatment uptake for women with alcohol use disorders in high-income countries: A systematic review.}, journal = {Women's health (London, England)}, volume = {21}, number = {}, pages = {17455057251363713}, pmid = {40866295}, issn = {1745-5065}, mesh = {Humans ; Female ; *Patient Acceptance of Health Care/psychology ; *Health Services Accessibility ; *Alcoholism/therapy/psychology ; Developed Countries ; Motivation ; *Alcohol-Related Disorders/therapy ; }, abstract = {BACKGROUND: Harmful alcohol use among some groups of women is increasing globally. Despite being susceptible to negative health impacts, women are less likely than men to seek treatment and can face barriers of access, acceptability, and affordability to treatment.<br><br>OBJECTIVES: This study aims to identify key factors affecting treatment access for women with alcohol use disorders (AUDs), and to identify individual, social, and organizational factors that facilitate treatment uptake.<br><br>DESIGN: Systematic review with narrative synthesis, guided by a social-ecological framework to identify organizational, individual, and societal enablers of treatment uptake among women with AUDs.<br><br>METHODS: Six electronic databases were systematically searched for studies published between 2000 and 2024 in high-income countries. Data on study design, sample characteristics, interventions, and outcomes were extracted and synthesized.<br><br>RESULTS: Twenty-five studies, conducted in various countries, identified factors affecting women's treatment uptake. Key themes included individual motivators linked to problem perception, alcohol use severity, age, relationships, and family cohesion; societal motivators influenced by social norms and relationships; and organizational themes of accessibility, acceptability, and affordability were positively affected by healthcare provider knowledge of treatment options.<br><br>CONCLUSION: Facilitating factors of treatment uptake for women with AUDs include relational and personal goals, societal environments, normative expectations, and the knowledge of alcohol treatment from individual and organizational perspectives. Sober curiosity movements, alcohol-free months, and digital strategies can positively impact women's alcohol treatment uptake.}, }
@article {pmid40861621, year = {2025}, author = {Secades, D and Dufner Krieger, S and Hidalgo Ramos, RA and Hong, I and Ortiz, M and Mac Courtney, C}, title = {Incidence of Deep Vein Thrombosis in Patients With COVID-19: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {7}, pages = {e88697}, pmid = {40861621}, issn = {2168-8184}, abstract = {COVID-19 is a contagious respiratory infection. This disease affected the healthcare system globally due to its complications related to vascular morbidity and mortality. There is a pathophysiological connection between COVID-19 and deep vein thrombosis (DVT). The blood hypercoagulability, venous stasis, and endothelial dysfunction in patients with COVID-19 have been associated with a higher risk of developing DVT. In this systematic review, 15 studies were selected to determine if COVID-19 can be taken as an independent risk factor for DVT. The search was done to determine studies analyzing the incidence of DVT in patients with COVID-19. The studies chosen were observational studies between 2020 and 2025.}, }
@article {pmid40875678, year = {2025}, author = {Schapowal, A}, title = {[Long COVID, Post-COVID-Syndrom: Langzeitfolgen von SARS-CoV-2-Infektionen und Nutzen von standardisierten Ginkgo-biloba Extrakten].}, journal = {Complementary medicine research}, volume = {32}, number = {5}, pages = {432-437}, doi = {10.1159/000548075}, pmid = {40875678}, issn = {2504-2106}, mesh = {Humans ; *Ginkgo biloba/chemistry ; *Plant Extracts/therapeutic use ; *COVID-19/complications ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Pandemics ; COVID-19 Drug Treatment ; Phytotherapy ; Ginkgo Extract ; }, abstract = {Hintergrund: Long COVID und das Post-COVID-Syndrom sind langfristige Folgen einer SARS-CoV-2-Infektion, die eine Vielzahl physischer, kognitiver und psychischer Symptome hervorrufen können. Dazu gehören Erschöpfung, Atemnot, Gedächtnisstörungen und Schlafprobleme. Die zugrunde liegenden Mechanismen sind noch nicht vollständig geklärt, umfassen jedoch persistierende Viruspartikel, mikrovaskuläre Dysfunktionen, Autoimmunreaktionen und eine Dysregulation des autonomen Nervensystems. Fragestellung: Welchen Nutzen könnten standardisierte Ginkgo-biloba-Extrakte aufgrund ihrer pharmakologischen Wirkungen und ihrer klinischen Wirksamkeit bei Long COVID und Post-COVID-Syndrom bringen? Zusammenfassung: Die Diagnose von Long COVID bleibt aufgrund fehlender standardisierter Tests eine Herausforderung. Therapeutisch wird ein multimodaler Ansatz empfohlen, der symptomatische Medikation, Physiotherapie, Psychotherapie sowie Ernährungs- und Bewegungstherapie umfasst. Ein vielversprechender ergänzender Therapieansatz ist die Verwendung von standardisierten Ginkgo-biloba-Extrakten. Dank ihrer antioxidativen, entzündungshemmenden und neuroprotektiven Eigenschaften könnten sie zur Verbesserung kognitiver Beeinträchtigungen, Fatigue und kardiovaskulärer Symptome beitragen. Erste Studien und Fallberichte deuten auf positive Effekte hin, jedoch sind weitere klinische Untersuchungen erforderlich, um die Wirksamkeit zu bestätigen. Kernaussagen: Long COVID und das Post-COVID-Syndrom betreffen zahlreiche Organsysteme und beeinträchtigen die Lebensqualität erheblich. Die Diagnose bleibt schwierig, da es keine spezifischen Tests gibt. Eine multimodale Therapie ist derzeit der vielversprechendste Behandlungsansatz. Standardisierte Ginkgo-biloba-Extrakte zeigen in ersten Studien positive Effekte auf neurokognitive und kardiovaskuläre Symptome.}, }
@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 = {16}, number = {10}, pages = {e0192125}, pmid = {40874746}, issn = {2150-7511}, mesh = {Animals ; Cats ; Virulence ; Dogs ; *Mutation ; *Recombination, Genetic ; *Coronavirus, Feline/pathogenicity/genetics ; Spike Glycoprotein, Coronavirus/genetics ; Swine ; Feline Infectious Peritonitis/virology ; Humans ; Genome, Viral ; *Coronavirus Infections/virology/veterinary ; *Alphacoronavirus/pathogenicity/genetics ; Phylogeny ; }, 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 &amp; purification ; *Viruses/isolation &amp; purification ; Orthomyxoviridae/isolation &amp; purification ; Hepatitis Viruses/isolation &amp; purification ; *Virus Diseases/diagnosis/virology ; HIV/isolation &amp; 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.}, }
@article {pmid40870447, year = {2025}, author = {Pecoraro, L and Di Muri, E and Lezzi, G and Picciolo, S and De Musso, M and Piazza, M and Bosoni, M and Indrio, F}, title = {Nasal Irrigations: A 360-Degree View in Clinical Practice.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {8}, pages = {}, pmid = {40870447}, issn = {1648-9144}, mesh = {Humans ; *Nasal Lavage/methods ; COVID-19/prevention &amp; control ; Rhinitis/therapy ; Sinusitis/therapy ; Respiratory Tract Infections/therapy ; SARS-CoV-2 ; }, abstract = {Nasal irrigation (NI) is an effective, safe, low-cost strategy for treating and preventing upper respiratory tract diseases. High-volume, low-pressure saline irrigations are the most efficient method for removing infectious agents, allergens, and inflammatory mediators. This article reviews clinical evidence supporting NI use in various conditions: nasal congestion in infants, recurrent respiratory infections, acute and chronic rhinosinusitis, allergic and gestational rhinitis, empty nose syndrome, and post-endoscopic sinus surgery care. NI improves symptoms, reduces recurrence, enhances the efficacy of topical drugs, and decreases the need for antibiotics and decongestants. During the COVID-19 pandemic, NI has also been explored as a complementary measure to reduce viral load. Due to the safe profile and mechanical cleansing action on inflammatory mucus, nasal irrigations represent a valuable adjunctive treatment across a wide range of sinonasal conditions.}, }
@article {pmid40869200, year = {2025}, author = {Lesgards, JF and Cerdan, D and Perronne, C}, title = {Do Long COVID and COVID Vaccine Side Effects Share Pathophysiological Picture and Biochemical Pathways?.}, journal = {International journal of molecular sciences}, volume = {26}, number = {16}, pages = {}, pmid = {40869200}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/immunology/prevention &amp; control/physiopathology ; *COVID-19 Vaccines/adverse effects/immunology ; SARS-CoV-2/immunology ; Spike Glycoprotein, Coronavirus/immunology/metabolism ; Post-Acute COVID-19 Syndrome ; }, abstract = {COVID affects around 400 million individuals today with a strong economic impact on the global economy. The list of long COVID symptoms is extremely broad because it is derived from neurological, cardiovascular, respiratory, immune, and renal dysfunctions and damages. We review here these pathophysiological manifestations and the predictors of this multi-organ pathology like the persistence of the virus, altered endothelial function, unrepaired tissue damage, immune dysregulation, and gut dysbiosis. We also discuss the similarities between long COVID and vaccine side effects together with possible common immuno-inflammatory pathways. Since the spike protein is present in SARS-CoV-2 (and its variants) but also produced by the COVID vaccines, its toxicity may also apply to all mRNA or adenoviral DNA vaccines as they are based on the production of a very similar spike protein to the virus. After COVID infection or vaccination, the spike protein can last for months in the body and may interact with ACE2 receptors and mannan-binding lectin (MBL)/mannan-binding lectin serine protease 2 (MASP-2), which are present almost everywhere in the organism. As a result, the spike protein may be able to trigger inflammation in a lot of organs and systems similar to COVID infection. We suggest that three immuno-inflammatory pathways are particularly key and responsible for long COVID and COVID vaccine side effects, as it has been shown for COVID, which may explain in large part their strong similarities: the renin-angiotensin-aldosterone system (RAAS), the kininogen-kinin-kallikrein system (KKS), and the lectin complement pathway. We propose that therapeutic studies should focus on these pathways to propose better cures for both long COVID as well as for COVID vaccine side effects.}, }
@article {pmid40866305, year = {2025}, author = {Bombardieri, AM and Denoue, CF}, title = {Cervical sympathetic block to treat Long COVID: a scoping review.}, journal = {Regional anesthesia and pain medicine}, volume = {}, number = {}, pages = {}, doi = {10.1136/rapm-2025-106879}, pmid = {40866305}, issn = {1532-8651}, abstract = {BACKGROUND: Long COVID is a complex and poorly understood condition characterized by persistent symptoms such as autonomic dysfunction, fatigue, neurocognitive impairment, and olfactory disturbances. Current treatments offer limited and inconsistent benefits. Dysregulation of the sympathetic nervous system is increasingly recognized as a contributor to Long COVID pathophysiology. Cervical sympathetic block (CSB), a procedure that modulates sympathetic tone, has emerged as a potential therapeutic approach.<br><br>OBJECTIVE: To review the existing literature on CSB, for Long COVID, focusing on symptom outcomes, proposed mechanisms, and procedural considerations.<br><br>EVIDENCE REVIEW: A structured literature search across PubMed, Embase, Scopus, and Web of Science identified studies published between 2022 and March 2025 reporting on CSB in adults with Long COVID. Eligible articles included case reports, case series, observational studies, and one randomized controlled trial evaluating symptom outcomes after the procedure.<br><br>FINDINGS: Sixteen studies involving 224 patients were included. Most reported improvement in fatigue, brain fog, and autonomic symptoms, including reduced heart rate and enhanced orthostatic tolerance. Cognitive and psychiatric symptoms such as memory impairment, anxiety, and depression showed variable improvement. Olfactory recovery was inconsistent and appeared to depend on symptom severity. Symptom relief was observed after both unilateral and bilateral blocks, with some responses lasting up to 1 year. No serious complications were reported.<br><br>CONCLUSIONS: CSB may offer symptom relief in Long COVID, particularly for fatigue, brain fog, and dysautonomia. However, the evidence remains preliminary and limited by small sample sizes and methodological heterogeneity. Controlled trials are needed to establish efficacy and patient selection criteria.}, }
@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.<br><br>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.<br><br>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&#x202f;% confidence interval [CI]: 0.04-1.31) with high heterogeneity (I[2] = 98&#x202f;%), while the pooled risk for mortality was 1.49 (95&#x202f;% confidence interval: 0.60-3.72), with moderate heterogeneity (I[2] = 65&#x202f;%). The chi-squared test for heterogeneity (X[2] = 125.62, p-value <0.00001) revealed considerable variation.<br><br>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.}, }
@article {pmid40863226, year = {2025}, author = {Denegri, A and Dall'Ospedale, V and Covani, M and Pruc, M and Szarpak, L and Niccoli, G}, title = {Cardiovascular Complications of COVID-19 Disease: A Narrative Review.}, journal = {Diseases (Basel, Switzerland)}, volume = {13}, number = {8}, pages = {}, pmid = {40863226}, issn = {2079-9721}, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has had a profound impact on global health, extending beyond pulmonary complications. Cardiovascular involvement in COVID-19 is multifactorial and may be influenced by viral load, inflammatory response, and pre-existing comorbidities.<br><br>DISCUSSION: Acute complications include myocardial injury, arrhythmias, acute coronary syndromes (ACS), heart failure, Takotsubo cardiomyopathy, myopericarditis, and cardiac arrest. Notably, atrial fibrillation (AF) emerges as a frequent arrhythmic complication, particularly among critically ill patients, and is associated with increased mortality. COVID-19-patients with concomitant ACS present more severe clinical profiles and higher rates of thrombotic events, including stent thrombosis. Cardiac arrest predominantly presents with non-shockable rhythms and is associated with dismal outcomes. COVID-19 also exacerbates heart failure, both by aggravating existing cardiac dysfunction or by precipitating de novo heart failure. Takotsubo cardiomyopathy and myocarditis, although less frequent, have been reported and are often underdiagnosed due to subtle clinical presentations. Right ventricular dysfunction, linked to pulmonary involvement, has emerged as a key prognostic marker. Post-COVID-19 syndrome include persistent cardiac abnormalities such as reduced ventricular function and myocardial inflammation. Cardiac magnetic resonance imaging and strain echocardiography have proven useful in identifying subclinical cardiac involvement.<br><br>CONCLUSIONS: Early recognition and monitoring of cardiovascular complications are crucial for improving outcomes in patients affected by COVID-19. This review summarizes current evidence regarding cardiovascular manifestations associated with COVID-19.}, }
@article {pmid40858380, year = {2025}, author = {van Uum, RT and Breteler, M and Hardeman, H and van de Pol, AC and Smit, K and Boeijen, JA and Ahmad, A and Rigter, F and Venekamp, RP and Rutten, FH and Zwart, DL}, title = {How Dutch initiatives to early discharge COVID-19 patients were organised during the pandemic: a scoping review.}, journal = {BMJ open}, volume = {15}, number = {8}, pages = {e097839}, pmid = {40858380}, issn = {2044-6055}, mesh = {Humans ; *COVID-19/epidemiology/therapy ; Netherlands/epidemiology ; *Patient Discharge ; SARS-CoV-2 ; Pandemics ; Patient Readmission/statistics &amp; numerical data ; Telemedicine ; Home Care Services/organization &amp; administration ; }, abstract = {INTRODUCTION: The steep rise in hospital admissions during the COVID-19 pandemic put a strain on available resources and provision of adequate healthcare globally. Translocation of care to the home setting through early discharge with remote monitoring has the potential to relieve pressure on the hospital care system, reduce costs and could simultaneously benefit patients' well-being.<br><br>OBJECTIVE: Provide an overview of similarities, differences and outcomes of early discharge initiatives for COVID-19 patients in the Netherlands to foster future development of safe and effective 'hospital at home interventions'.<br><br>DESIGN: Grey and academic literature searches from 1 March 2020 to 1 December 2024 to identify initiatives that discharged COVID-19 patients early through a remote monitoring intervention.<br><br>SETTING: The Netherlands.<br><br>Hospitals that initiated an early discharge programme for COVID-19 patients.<br><br>We descriptively compared the available protocols to identify similarities and differences in the execution of the early discharge process. Next, we compared clinical outcomes as reported in available publications and retrieved from post-publication follow-up data collection.<br><br>RESULTS: We retrieved 15 protocols (55.6%) and six publications (5 retrospective cohorts, 1 randomised controlled trial) of 27 early discharge initiatives. Two initiatives provided follow-up data. Overall, initiatives were fairly similar, however, with differences in (i) patient selection, (ii) the responsible physician, (iii) the duration and parameters of monitoring and (iv) use of a dedicated monitoring centre. Readmission rates were low, and deaths did not occur except for one initiative (n=8, 3.8%). Patient satisfaction assessed by questionnaires was very high.<br><br>CONCLUSION: This study provides insights into the design and potential of early discharge initiatives with remote monitoring launched in the Netherlands during the COVID-19 pandemic. Preliminary data suggest relatively low readmission and mortality rates, and good patient acceptance, but future research should provide definitive conclusions.}, }
@article {pmid40854836, year = {2025}, author = {Sharif-Nia, H and Heidari, M and Moshtagh, M and Nabi Foodani, M and Goudarzian, AH}, title = {Post-COVID-19 depression prevalence in Iranian nurses: a systematic review and meta-analysis.}, journal = {BMJ open}, volume = {15}, number = {8}, pages = {e103969}, pmid = {40854836}, issn = {2044-6055}, mesh = {Humans ; Iran/epidemiology ; *COVID-19/psychology/epidemiology ; Prevalence ; *Depression/epidemiology ; *Nurses/psychology ; SARS-CoV-2 ; Female ; Male ; }, abstract = {OBJECTIVES: This systematic review and meta-analysis aimed to assess the pooled prevalence of post-COVID-19 depression among Iranian nurses, identify at-risk groups and provide practical recommendations for intervention.<br><br>DESIGN: In adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic review and meta-analysis, encompassing studies published from 2019 to 2024. Comprehensive searches were performed across international and Iranian databases.<br><br>DATA SOURCES: PubMed, Scopus, Web of Science, Google Scholar and Scientific Information Database.<br><br>Studies meeting the following criteria were included in the analysis: (1) conducted on the population of Iranian nurses, (2) keywords explicitly included in the title or abstract, (3) studies published between 2019 and 2024, (4) published in Persian or English and (5) reported the prevalence of depression either in the entire population or differentiated by gender.<br><br>DATA EXTRACTION AND SYNTHESIS: Data extraction was conducted independently by two reviewers, and quality assessment was performed using the Newcastle-Ottawa Scale. Statistical analyses were executed using random effects models to estimate pooled prevalence rates, with subgroup analyses and sensitivity tests conducted to explore sources of heterogeneity and confirm result robustness.<br><br>RESULTS: A total of 22 studies met the inclusion criteria, capturing data from various provinces across Iran. The pooled prevalence of depression among Iranian nurses post-COVID-19 was estimated at 23% (95% CI 19% to 30%), indicating a substantial mental health burden within this population. Subgroup analyses revealed notable disparities in depression rates across demographic and professional characteristics. Nurses holding advanced degrees exhibited a higher mean depression score (13.33, 95% CI 9.48 to 16.74) compared with those with bachelor's degrees. Male nurses also reported slightly higher depression scores (12.04, 95% CI 7.58 to 16.50) than their female counterparts. Furthermore, moderate depression emerged as the most common severity level, affecting 24% of nurses. Sensitivity analyses demonstrated that no single study disproportionately influenced the pooled estimates, reinforcing the reliability of the findings.<br><br>CONCLUSIONS: This review and meta-analysis illuminate the mental health challenges faced by Iranian nurses in the wake of COVID-19. With a significant proportion of nurses experiencing depression, addressing their psychological needs is imperative. Tailored interventions, such as stress management workshops, access to professional counselling and workplace policies that prioritise mental health, are essential to enhance resilience and sustain healthcare quality during future public health crises. Efforts must also focus on structural changes to create a supportive environment that fosters well-being and professional satisfaction among nurses, ultimately improving patient outcomes and overall healthcare system performance.}, }
@article {pmid40853332, year = {2025}, author = {Rezk, N and McClean, S}, title = {Harnessing the Potential of mRNA Vaccines Against Infectious Diseases.}, journal = {Microbial biotechnology}, volume = {18}, number = {8}, pages = {e70212}, pmid = {40853332}, issn = {1751-7915}, support = {//Higher Education Authority/ ; }, mesh = {Humans ; *Vaccines, Synthetic/immunology/genetics ; Vaccine Development ; COVID-19/prevention &amp; control ; *mRNA Vaccines/immunology ; Bacterial Infections/prevention &amp; control ; Parasitic Diseases/prevention &amp; control ; *Communicable Diseases/immunology ; Bacterial Vaccines/immunology/genetics ; Animals ; *RNA, Messenger/immunology/genetics ; SARS-CoV-2/immunology ; }, abstract = {mRNA vaccines have emerged as promising alternatives to conventional vaccines because of their flexible design, high immunogenicity, favourable safety profile, efficacy and potential for rapid clinical development. The accelerated development of mRNA vaccines during the COVID-19 pandemic has revolutionised the field of vaccinology, highlighting their potential for combating emerging infectious diseases. The mRNA platforms can induce robust humoral as well as CD4+ and CD8+ T-cell-mediated immunity, offering broader protection than subunit protein vaccines. Consequently, they have been extensively studied against a wide range of viral, bacterial and parasitic infections, although the development of mRNA vaccines against bacterial and parasitic infections has lagged behind those targeting viruses. This review highlights recent studies on mRNA vaccine development and applications against a wide range of infectious diseases including non-COVID viral infections, bacterial pathogens such as Mycobacteria or Pseudomonas aeruginosa and parasitic infections, including malaria. Moreover, it discusses key optimisation strategies and highlights candidates that have progressed to clinical trials, and the current challenges in enhancing immunogenicity and improving delivery systems.}, }
@article {pmid40865105, year = {2025}, author = {Izeli Portilho, A and De Gaspari, E}, title = {Is meningococcal B vaccination needed in the post-COVID-19 world?.}, journal = {Biomedica : revista del Instituto Nacional de Salud}, volume = {45}, number = {3}, pages = {359-368}, pmid = {40865105}, issn = {2590-7379}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Meningococcal Vaccines ; *Neisseria meningitidis, Serogroup B/immunology ; *Meningococcal Infections/prevention &amp; control/epidemiology ; *Meningitis, Meningococcal/prevention &amp; control/epidemiology ; Vaccination ; Pandemics ; SARS-CoV-2 ; Global Health ; }, abstract = {Neisseria meningitidis is the main cause of bacterial meningitis worldwide and is transmitted through respiratory secretions. Meningitis is a serious public health problema because of its high morbidity and mortality rates and the risk of causing epidemics. Although vaccines are available to prevent meningococcal disease, serogroup B infections are still challenging, given that many countries do not include meningococcal B vaccines in their national immunization programs. In addition, recent data suggests somewhat sustained N. meningitidis B infections during the COVID-19 pandemic and increasing levels of meningococcal disease after its control. These findings agree with previous observations indicating that respiratory viruses facilitate respiratory bacterial infections. This essay intends to present epidemiological data on meningococcal disease and discusses studies exploring why the prevention of bacterial and viral infections is an intricate subject.}, }
@article {pmid40864414, year = {2025}, author = {Al-Kuraishy, HM and Abdelnaby, MA and Papadakis, M and Alexiou, A and Batiha, GE}, title = {The potential role of carvedilol in COVID-19 management: perspective and take-away.}, journal = {Inflammopharmacology}, volume = {33}, number = {9}, pages = {4883-4893}, pmid = {40864414}, issn = {1568-5608}, mesh = {Humans ; *Carvedilol/therapeutic use/pharmacology ; *COVID-19 Drug Treatment ; COVID-19 ; Anti-Inflammatory Agents/pharmacology/therapeutic use ; Antioxidants/pharmacology/therapeutic use ; SARS-CoV-2/drug effects ; *Adrenergic beta-Antagonists/pharmacology/therapeutic use ; Animals ; Oxidative Stress/drug effects ; }, abstract = {Carvedilol (CVL) is a lipophilic third generation non-selective beta and alpha-1 adrenoceptor blocker. CVL has pleiotropic antioxidant and anti-inflammatory effects by reducing the production of reactive oxygen species (ROS) and inhibiting of inflammatory signaling pathways. In virtue of its antioxidant and anti-inflammatory effects, CVL can ameliorate COVID-19 and related complications. Therefore, the aim of the present review was to illustrate the potential role of CVL in the management of COVID-19. CVL has anti-SARS-CoV-2 activity by inhibiting 3-CLpro, which is involved in the replication of this virus. CVL inhibits the release of pro-inflammatory cytokines, improves anti-inflammatory cytokines, inhibit β/αadrenoceptors-mediated immune activation, and suppression of sympathetic over-activity. Thus, CVL may prevent the association between sympathetic and cytokine storms in COVID-19. These verdicts suggest that CVL through its antioxidant, anti-inflammatory, and blocking of β/αadrenoceptors, might be a possible candidate against COVID-19-induced inflammatory changes, oxidative stress, and the development of dysautonomia. In conclusion, CVL could be a possible drug in the management of COVID-19 by attenuating the development of cytokine and sympathetic storms.}, }
@article {pmid40864193, year = {2025}, author = {Djassemi, N and Hanisch, B and Motta, C and Maghzian, N and Vatsayan, A and Durkee-Shock, JR and Keller, MD}, title = {Harnessing virus-specific T cells: expanding therapeutic strategies across diverse populations.}, journal = {Blood advances}, volume = {9}, number = {23}, pages = {5965-5975}, doi = {10.1182/bloodadvances.2024013727}, pmid = {40864193}, issn = {2473-9537}, mesh = {Humans ; *T-Lymphocytes/immunology/transplantation ; *Virus Diseases/therapy/immunology ; SARS-CoV-2/immunology ; COVID-19/therapy/immunology ; Immunocompromised Host ; *Immunotherapy, Adoptive/methods/adverse effects ; Hematopoietic Stem Cell Transplantation ; *Adoptive Transfer/methods ; }, abstract = {Adoptive transfer of virus-specific T cells (VSTs) has been used for managing viral diseases in immunocompromised patients, including those undergoing hematopoietic stem cell transplantation and solid organ transplantation. Clinical trials targeting viruses such as cytomegalovirus, Epstein-Barr virus, adenovirus, and BK virus have demonstrated effective viral control without the toxicities associated with conventional antiviral therapies. This review explores the manufacturing, feasibility, safety, and efficacy of VSTs, complemented by 2 case studies illustrating their real-world application. We examine recent advancements in VST manufacturing that broaden their accessibility and applicability to a wider range of viral infections and immunocompromised populations. Key safety considerations, including cytokine release syndrome and graft-versus-host disease, are discussed. Lastly, we assess the expanding applications of VSTs against emerging viral targets, such as COVID-19, and address current barriers to their implementation beyond the research setting.}, }
@article {pmid40862029, year = {2025}, author = {Conching, A and Chriqui, S and Granberg, H and Patel, S and Khan, MF and Stone, L and Brown, N and Pham, M}, title = {Neurosurgery Residency Program Directors' Perspectives: A Scoping Review of Program Director Survey Responses.}, journal = {Cureus}, volume = {17}, number = {8}, pages = {e90910}, pmid = {40862029}, issn = {2168-8184}, abstract = {Entrance to neurological surgery residency is highly competitive due to the large number of applicants vying for a limited number of spots. The process has become even more competitive in recent years, with a significant increase in applicants but a consistent number of available residency positions. Program director (PD) surveys offer valuable insights into the selection process and expectations for neurosurgical residency, guiding prospective candidates to navigate the challenging training path. We conducted a three-database scoping review confined to the last 20 years to compile all available PD survey results, excluding those released through the official National Resident Matching Program (NRMP) data. Studies were screened and selected according to specific inclusion and exclusion criteria. The selected articles were evaluated for survey year, distribution method, response rate, question type, number of items, and content. Most importantly, survey responses were detailed and summarized. Nineteen PD survey studies were eligible for inclusion in the present review. These revealed substantial diversity in survey structure and topics addressed over the past 20 years, with response rates averaging 54%. Studies focused on PD perspectives on applicant evaluation criteria, residency training factors, and the impact of COVID-19 on the application process. Key findings included the importance of the interview process, United States Medical Licensing Exam (USMLE) Step 2 scores, and letters of recommendation in resident selection, concerns about the impact of the USMLE Step 1 transitioning to pass/fail, and the need for enhanced research opportunities and mentorship to increase interest in neurosurgery. Residency training studies highlighted challenges related to duty hour restrictions, the importance of surgical simulation for resident education, and variations in subspecialty training experiences. The impact of COVID-19 on residency applications posed challenges for certain applicant groups during virtual interviews, and barriers remain in the post-pandemic era. Recent studies provide an in-depth look at PD perspectives on essential factors in the neurosurgery residency match, the impact of COVID-19 on recruitment, and the current state of training. Selection criteria still heavily rely on USMLE scoring, letters of recommendation, and interviews, with debates arising from the shift to pass/fail Step 1 scoring. Challenges in evaluating candidates, concerns about training quality, and the effects of the 80-hour workweek mandate are ongoing issues, while research participation is encouraged to enhance academic productivity. The pandemic has influenced the application process and led to mixed outcomes and financial barriers for some applicants despite the return to in-person interviews. These findings illustrate the continuous evolution of neurosurgical residency programs in response to various challenges and reforms.}, }
@article {pmid40861492, year = {2025}, author = {Yu, X and Yu, X and Wang, Y and Guo, X and Wang, C and Wang, F}, title = {Respiratory diseases and the gut microbiota: an updated review.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1629005}, pmid = {40861492}, issn = {2235-2988}, mesh = {Humans ; *Gastrointestinal Microbiome/physiology ; Dysbiosis/microbiology ; COVID-19/microbiology ; Lung/microbiology/immunology ; *Respiratory Tract Diseases/microbiology ; SARS-CoV-2 ; Probiotics ; Animals ; Pulmonary Disease, Chronic Obstructive/microbiology ; }, abstract = {The gut microbiota constitutes a vital ecosystem within the human body playing a pivotal role in immune regulation and metabolic homeostasis. Emerging research underscores a sophisticated interplay between the gut and lungs, termed the "gut-lung axis." Gut microbes exert influence over pulmonary immunity and metabolism via immune mediators (e.g., cytokines and interleukins), metabolites (e.g., short-chain fatty acids) and direct microbial translocation. Dysbiosis of the gut microbiota has been implicated in a spectrum of respiratory diseases, including asthma, chronic obstructive pulmonary disease (COPD), acute lung injury (ALI), Coronavirus Disease 2019 (COVID-19), lung cancer, idiopathic pulmonary fibrosis (IPF), pulmonary arterial hypertension (PAH), acute lower respiratory infection (ALRI) and tuberculosis (TB). Although multi-omics technologies have elucidated certain mechanisms underlying the gut-lung axis, numerous pathways remain to be fully delineated. This review synthesizes current knowledge on the role of gut microbiota and their metabolites in respiratory diseases and assesses their therapeutic potential. Future investigations should prioritize strategies to restore and maintain microbial homeostasis, such as dietary modifications, probiotic supplementation and fecal microbiota transplantation to pioneer novel preventive and therapeutic approaches. These summaries of advances in gut microbiology research promise better management and exploration of therapeutic strategies for respiratory diseases.}, }
@article {pmid40860776, year = {2025}, author = {Wu, B and Li, R and Liu, Q and Jin, S and Wei, H and Xu, M and Zhang, Y and Liu, Y}, title = {Effect of Pituitary-Target Gland Axis on RAAS in the Context of COVID-19.}, journal = {International journal of medical sciences}, volume = {22}, number = {13}, pages = {3439-3453}, pmid = {40860776}, issn = {1449-1907}, mesh = {*COVID-19/metabolism ; *Renin-Angiotensin System/physiology ; *Pituitary Gland/metabolism/virology ; Pituitary Hormones/metabolism ; SARS-CoV-2/physiology ; Angiotensin-Converting Enzyme 2/metabolism ; Humans ; Estrogens/metabolism ; Arginine Vasopressin/metabolism ; }, abstract = {The pituitary gland is a very important endocrine gland in the human body. It secretes and releases many hormones crucial for controlling physiological processes, such as energy metabolism, human growth and development, and reproduction. The renin-angiotensin-aldosterone system regulates water and salt homeostasis, controlling blood pressure. Since the discovery of the renin-angiotensin-aldosterone system, exploring and studying its role in pathophysiology has never stopped, and patients have benefited from drug-based and clinical studies. This review focuses on the effects of the pituitary-target gland axis (pituitary-thyroid axis, pituitary-adrenal axis, pituitary-growth hormone axis, pituitary-gonadal axis) and some hormones secreted and stored by the pituitary gland on the RAAS. While considering that SARS-CoV-2 reinfection still occurs, we aim to provide new insights into water-electrolyte balance and blood pressure regulation.}, }
@article {pmid40860064, year = {2025}, author = {Parihar, M and W N, N and Sahana,  and Biswas, R and Dehury, B and Mazumder, N}, title = {Point-of-care biosensors for infectious disease diagnosis: recent updates and prospects.}, journal = {RSC advances}, volume = {15}, number = {36}, pages = {29267-29283}, pmid = {40860064}, issn = {2046-2069}, abstract = {The ongoing demand for rapid, accurate, accessible diagnostics has significantly increased point-of-care (POC) biosensors. This review provides an overview of diverse biosensors, focusing on their principles, components, detection mechanisms, and applications in infectious disease diagnosis. We explore how these biosensors utilize various transduction techniques-such as current modulation, refractive index shifts, and mechanical resonance to convert biorecognition events into measurable signals. The importance of biosensors in detecting infectious diseases such as COVID-19, HIV, Tuberculosis, and Malaria is highlighted, particularly for early detection in resource-limited settings. However, persistent challenges remain in achieving integrated, miniaturized platforms capable of real-time, multianalyte detection. Additionally, the full potential of biosensors is yet to be realized owing to limited clinical translation, scalability issues, and insufficient integration with digital health technologies. This review identifies these critical areas for future innovation and discusses strategies to increase diagnostic accuracy, accessibility, and global health impact.}, }
@article {pmid40859782, year = {2025}, author = {Kim, T and Choi, SH}, title = {Diabetes Mellitus and Infectious Diseases: Current Evidence and Clinical Implications.}, journal = {Diabetes &amp; metabolism journal}, volume = {49}, number = {5}, pages = {915-933}, pmid = {40859782}, issn = {2233-6087}, mesh = {Humans ; *Communicable Diseases/epidemiology/therapy ; *Diabetes Complications/epidemiology/therapy ; COVID-19 ; *Diabetes Mellitus/epidemiology ; SARS-CoV-2 ; }, abstract = {Diabetes mellitus predisposes individuals to a broad spectrum of infections. People with diabetes face a 1.5- to 4-fold increased risk of both common and severe infections, and infections remain the leading cause of morbidity and mortality. Chronic hyperglycemia impairs neutrophil chemotaxis, oxidative burst, and complement activation, while vascular insufficiency and neuropathy compromise tissue perfusion and barrier integrity. These defects, together with altered skin, mucosal, and gut microbiota, influence the marked susceptibility to urinary tract infections (especially renal abscess and emphysematous pyelonephritis), osteomyelitis, diabetic foot infections, pneumonia (including influenza), tuberculosis, skin and soft tissue infections, and lifethreatening syndromes such as emphysematous cholecystitis and rhino-orbital mucormycosis that are almost exclusive to people with diabetes. Outcomes from infections are worse in diabetes. Although the core therapeutic principles align with those for patients without diabetes, management should be individualized. Glycemic control should balance infection risk and hypoglycemia; antimicrobial dosing should account for renal function and drug interactions; and strict antimicrobial stewardship is required. If needed, prompt debridement and multidisciplinary intervention are necessary to mitigate complications and reduce mortality. Preventive care relies on comprehensive vaccination (influenza, pneumococcus, severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2], hepatitis B, herpes zoster, and Tdap/Td) and regular foot surveillance with offloading to avert ulceration.}, }
@article {pmid40858865, year = {2025}, author = {Umar, K and Sutradhar, T and Prakash, P and Bavanilatha, M and Hemamalani, AU and Prakashini, RS and Thangam, T and Parthasarathy, K}, title = {Dengue virus: structure, genome, evolution and challenges to control and prevent transmission.}, journal = {Antonie van Leeuwenhoek}, volume = {118}, number = {9}, pages = {139}, pmid = {40858865}, issn = {1572-9699}, support = {No. 6/9-7 (328)/2023/ECD-II, VIR/COVID-19/33/2021/ECD-I).//Indian Council of Medical Research/ ; }, mesh = {Animals ; Humans ; Aedes/virology ; *Dengue/diagnosis/transmission/virology ; *Dengue Virus/chemistry/genetics/immunology ; *Genome, Viral ; Immunity, Innate ; Mosquito Vectors/virology ; *Evolution, Molecular ; }, abstract = {Dengue virus (DENV) is a major global health threat, primarily transmitted by Aedes mosquitoes. It manifests in mild to severe forms, including dengue hemorrhagic fever and dengue shock syndrome, causing significant morbidity and mortality. With four serotypes (DENV-1 to DENV-4), the virus exhibits rapid genetic evolution, complicating vaccine development and disease control. This review explores the structural and genomic characteristics of DENV, emphasizing its evolutionary pressures, immune evasion mechanisms, and emerging strains. The virus's adaptation to environmental and host factors has led to increased outbreaks, notably in tropical regions. Global warming and urbanization have exacerbated the spread, challenging current vector control strategies. Laboratory diagnosis remains complex, relying on molecular and serological techniques with varying sensitivity. The lack of effective antiviral drugs and universally protective vaccines highlights critical gaps in disease management. Ongoing genomic surveillance and integrated control strategies are crucial for mitigating the impact of new DENV variants. This review highlights the importance of investigating the effect of emerging dengue strains on society, as well as how environmental factors exacerbate their severity.}, }
@article {pmid40857586, year = {2025}, author = {Barman, H and Kabir, ME and Borah, A and Afzal, NU and Loying, R and Sharmah, B and Ibeyaima, A and Kalita, J and Manna, P}, title = {Therapeutic Uses of Dietary Organosulfur Compounds in Response to Viral (SARS-CoV-2)/Bacterial Infection, Inflammation, Cancer, Oxidative Stress, Cardiovascular Diseases, Obesity, and Diabetes.}, journal = {Chemistry &amp; biodiversity}, volume = {}, number = {}, pages = {e00731}, doi = {10.1002/cbdv.202500731}, pmid = {40857586}, issn = {1612-1880}, support = {CRG/2022/002891//Science and Engineering Research Board/ ; }, abstract = {Phytonutrients are widely recognized for their protective health benefits in humans. Mounting studies suggest that dietary organosulfur compounds play a significant role in preventing various pathological conditions. Organosulfur compounds, such as diallyl disulfide, diallyl trisulfide, alliin, allicin, S-allyl cysteine, and sulforaphane, possess broad pharmacological activities, making them versatile therapeutic agents. Their antiviral, antibacterial, anti-inflammatory, anticancer, and antioxidant properties, along with their effectiveness in managing cardiovascular diseases (CVDs), obesity, and diabetes, highlight their potential as single-drug solutions for multiple health issues simultaneously. Plants belonging to Allium genus and Brassicaceae family are the most predominant sources of these compounds. This review aims to summarize the different natural sources and bioavailability of various organosulfur compounds as well as discuss the therapeutic potential of various organosulfur compounds in response to viral/bacterial infection, inflammation, cancer, oxidative stress, CVDs, obesity, and diabetes with special emphasis on SARS-CoV-2. This review also includes the effective doses as well as the mode of action underlying the therapeutic potential of specific organosulfur compound against respective pathophysiology. The outcome of this review will open new avenue for further investigation of organosulfur compounds against different pathophysiology and that will be helpful for the development of innovative therapeutics with promising health benefits.}, }
@article {pmid40857408, year = {2025}, author = {Bayarri-Olmos, R and Bain, W and Iwasaki, A}, title = {The role of complement in long COVID pathogenesis.}, journal = {JCI insight}, volume = {10}, number = {16}, pages = {}, pmid = {40857408}, issn = {2379-3708}, mesh = {Humans ; *COVID-19/immunology/complications ; *Complement System Proteins/immunology ; SARS-CoV-2/immunology ; Immunity, Innate/immunology ; Inflammation/immunology ; Complement Activation ; Post-Acute COVID-19 Syndrome ; }, abstract = {Long COVID is a debilitating condition that can develop after a SARS-CoV-2 infection and is characterized by a wide range of chronic symptoms, including weakness, neurocognitive impairment, malaise, fatigue, and many others, that affect multiple organ systems. At least 10% of individuals with a previous infection may develop long COVID, which affects their ability to perform daily functions and work. Despite its severity and widespread impact, this multisystemic condition remains poorly understood. Recent studies suggest that dysregulation of the complement system, a key component of the innate immune response, may contribute to the pathogenesis of long COVID, particularly in connection with coagulation, inflammation, and vascular injury. In this Review, we examine the evidence linking complement system dysregulation to long COVID and explore its potential role in driving disease pathology.}, }
@article {pmid40852002, year = {2025}, author = {Mokhtari, M and Kouhpayeh, H}, title = {A systematic review of COVID-19's impact on pregnancy outcomes.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {7}, pages = {4384-4394}, pmid = {40852002}, issn = {2049-0801}, abstract = {BACKGROUND: Contradictory data exists regarding COVID-19's impact on pregnancy outcomes. This study will compare pandemic pregnancy outcomes to pre-pandemic levels in local, regional, and national populations.<br><br>METHODS: We searched three international electronic databases (PubMed) for research on COVID-19 infection and pregnancy outcomes from the first accessible to 10 December 2021. We included articles on COVID-19's effects on pregnancy, maternal, and neonatal outcomes, using pregnancy as the main endpoint.<br><br>RESULTS: Twenty-eight studies were examined. The exposed population sampled 1&#xa0;476&#xa0;827, and the total sample was 23&#xa0;819&#xa0;822. One-third of studies found a pandemic-related increase in maternal mortality. Six of fourteen stillbirth studies showed a substantial increase. Ten of fourteen studies found no substantial increase in preterm birth rates. After the pandemic, postnatal depression, maternal anxiety, or both increased in five of nine mother mental health studies.<br><br>CONCLUSION: There is a significant increase in postnatal maternal mental disorders and a probable increase in maternal mortality and stillbirth compared to before the pandemic. However, our study's findings might result from healthcare inefficiency. COVID-19 vaccination is highly recommended for pregnant and breastfeeding women.}, }
@article {pmid40847375, year = {2025}, author = {Zhang, Z and Du, J and Zhang, D and Han, R and Wu, X and Liang, Y}, title = {Research progress of mRNA vaccines for infectious diseases.}, journal = {European journal of medical research}, volume = {30}, number = {1}, pages = {792}, pmid = {40847375}, issn = {2047-783X}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology ; SARS-CoV-2/immunology ; *mRNA Vaccines/immunology ; COVID-19 Vaccines/immunology ; *Vaccines, Synthetic/immunology ; *Communicable Diseases/immunology ; *RNA, Messenger/immunology ; Nanoparticles ; }, abstract = {mRNA vaccines for infectious diseases prevent diseases by stimulating the body to produce specific immune responses through mRNA molecules encoding pathogenic proteins. Compared to traditional vaccines (e.g., inactivated, live attenuated, subunit, recombinant protein and viral vectors), mRNA vaccines offer several advantages including high safety, potent efficacy, scalable large-scale production, and cost-effectiveness. mRNA vaccines have demonstrated significant potential in combating infectious diseases since their inception. In particular, during the 2019 Coronavirus Disease (COVID-19) pandemic, the mRNA vaccines delivered with lipid nanoparticles (LNPs) have been developed by BioNTech and Moderna, their exceptional protective efficacy and extensive clinical application further proved the rapid responsiveness of mRNA vaccines in addressing emerging infectious diseases. This success has brought mRNA vaccines back into the spotlight of the scientific community. This article reviews the molecular biological basis, delivery systems, and immune mechanisms of mRNA vaccines, as well as the progress of research and clinical trials related to mRNA vaccines targeting the COVID-19 virus, influenza virus, rabies virus, Zika virus, human immunodeficiency virus, and Mycobacterium tuberculosis (M.tb), while also discussing the current challenges faced in the application of mRNA vaccines. These discussions provide a theoretical foundation and practical guidance for the future development of mRNA vaccines targeting bacterial infectious diseases such as tuberculosis (TB).}, }
@article {pmid40844207, year = {2025}, author = {Herrera-Uribe, J and Stevenson, NJ}, title = {SOCS Proteins: Key Players in Immune Regulation During SARS-CoV-2 Infection.}, journal = {European journal of immunology}, volume = {55}, number = {8}, pages = {e51645}, pmid = {40844207}, issn = {1521-4141}, support = {SFI 20/SPP/3685/SFI_/Science Foundation Ireland/Ireland ; SFI 19/FFP/6483/SFI_/Science Foundation Ireland/Ireland ; }, mesh = {Humans ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Suppressor of Cytokine Signaling Proteins/immunology/metabolism ; Signal Transduction/immunology ; Animals ; }, abstract = {Suppressor of cytokine signaling (SOCS) proteins are crucial components of the immune response against viral infections. SOCS proteins inhibit cytokine signaling through various mechanisms, such as blocking STAT binding to JAKs and targeting proteins for ubiquitination and degradation. While these proteins maintain immune balance by suppressing excessive inflammatory responses, many viruses, including SARS-CoV-2, exploit SOCS proteins to evade host immunity. In consequence, understanding their modulatory functions in viral disease has become increasingly relevant. Therefore, this review aims to describe and discuss studies involving SOCS expression data in COVID-19 and their potential modulation as a valuable use for therapeutic strategies.}, }
@article {pmid40842429, year = {2025}, author = {Koca, O and Koksal, G}, title = {Point-of-care Lung ultrasound assessment of positional changes in COVID-19 ARDS in intensive care: A case report and review of the literature.}, journal = {Physiological reports}, volume = {13}, number = {16}, pages = {e70484}, pmid = {40842429}, issn = {2051-817X}, mesh = {Humans ; *COVID-19/therapy/diagnostic imaging/complications/physiopathology ; Critical Care/methods ; Head-Down Tilt ; *Lung/diagnostic imaging/physiopathology ; *Patient Positioning/methods ; *Point-of-Care Systems ; Prone Position ; Respiration, Artificial ; *Respiratory Distress Syndrome/diagnostic imaging/therapy/physiopathology/etiology ; SARS-CoV-2 ; Ultrasonography/methods ; }, abstract = {Prone positioning is a cornerstone in the management of acute respiratory distress syndrome (ARDS), including COVID-19-related ARDS. However, alternative positioning strategies such as reverse Trendelenburg position (RTP) have received limited attention. The objective is to evaluate the physiological effects of RTP on lung aeration using lung ultrasound (LUS) in a patient with severe COVID-19 ARDS. We performed serial LUS assessments across 12 lung regions in a mechanically ventilated ARDS patient undergoing three different positional changes: Trendelenburg, flat supine/prone, and reverse Trendelenburg. LUS scores were used to quantify regional aeration and global lung aeration. Oxygenation parameters were monitored in parallel. RTP was associated with a reduction in global LUS score (from 21 to 17), indicating improved lung aeration, particularly in the superior and posterior regions. Oxygenation improved concurrently, with increases in peripheral and central venous oxygen saturations. No significant change in lung compliance was observed. This case demonstrates that RTP may facilitate redistribution of extravascular lung water and improve aeration in select lung regions. LUS offers a dynamic, noninvasive method to assess and guide individualized positioning strategies in ARDS. These findings support further exploration of vertical positioning as an adjunct in ARDS management when prone positioning is not feasible.}, }
@article {pmid40853836, year = {2025}, author = {Yıldız, E and Harmancı, P}, title = {Digital Support for Complex Interventions in Psychiatric Nursing: Implementation Models and Effectiveness Evaluation.}, journal = {Issues in mental health nursing}, volume = {46}, number = {9}, pages = {878-890}, doi = {10.1080/01612840.2025.2531543}, pmid = {40853836}, issn = {1096-4673}, mesh = {Humans ; *Psychiatric Nursing ; *Telemedicine ; *COVID-19 ; *Digital Technology ; }, abstract = {Digital technologies are increasingly integrated into psychiatric nursing, yet a comprehensive understanding of their implementation and effectiveness remains limited. This bibliometric analysis explored the research landscape of digitally-supported interventions, focusing on models, effectiveness, and future directions. A systematic search of the Web of Science Core Collection (2019-2024) was conducted, combining bibliometric mapping with thematic analysis. Four thematic clusters emerged: (1) Digital Psychiatry and m-Health Applications, (2) Simulation and VR in Nursing Education, (3) Telemedicine and Mental Health in the COVID-19 Era, and (4) Foundational Concepts of Digital Mental Health. m-Health applications were central themes, while telemedicine's role was crucial during the pandemic. The study highlights the importance of digital technologies, especially m-health, in psychiatric nursing and underscores the need to enhance nurses' digital skills and develop effective nurse-led interventions. The analysis also identifies critical research gaps concerning clinically meaningful outcomes, cost-effectiveness, transferability, and patient/provider experiences. These findings provide a roadmap for future investigations to improve patient care.}, }
@article {pmid40853681, year = {2025}, author = {Dionisio, DN and Torres, RA}, title = {Reducing pain into a tablet substantiating and numbing race-based mental health during the COVID-19 pandemic.}, journal = {Journal of ethnicity in substance abuse}, volume = {}, number = {}, pages = {1-25}, doi = {10.1080/15332640.2025.2548523}, pmid = {40853681}, issn = {1533-2659}, abstract = {The COVID-19 pandemic may have had many negative consequences, and yet a lot was left in its wake that could help shape mental health discussions in health care settings in Canada. This paper is shaped by stories told by Filipino nurses working in Northern Ontario. While there is a plethora of studies looking at mental health issues among nurses and other health care professionals in Canadian hospitals, a gap still remains in regard to the experiences of nurses and health care workers in Northern Ontario during COVID-19. This study seeks to look at the differentiated experiences of mental health among health care professionals during and after COVID-19. This qualitative study employs a narrative approach to discuss how neoliberal capitalism, gendered racism, substance use and colonialism shaped mental health outcomes among Filipino health care workers. While many studies have focused on mental health issues among health care providers, there has been minimal focus on race-based trauma and the ways in which substance use is employed to reduce mental health issues to an individual issue, leaving pharmaceutical companies free to boost their profits. This paper employs intersectional analysis to argue for a more comprehensive understanding of mental health issues among health care workers and allow an understanding of a culturally informed perspective to inform health care policies. The result to the study depicts the various forms of race-based trauma faced by Filipino health care workers and the use of over-the-counter medication to navigate themselves through the health care system. Note that the paper will employ the term healthcare workers and nurses interchangeably.}, }
@article {pmid40853591, year = {2025}, author = {Gopalakrishnan, M and Sumathi, KV and Velegatla, SV and Muthu, Y and Sankar, P and Kanagarajan, H}, title = {Multi-strategic approaches to healthcare wastewater treatment amidst COVID-19 pandemic in India-a narrative review.}, journal = {Environmental science and pollution research international}, volume = {}, number = {}, pages = {}, pmid = {40853591}, issn = {1614-7499}, abstract = {The COVID-19 pandemic has led to a significant increase in healthcare waste, including personal protective equipment (PPE), pharmaceutical residues, and viral pathogens, posing environmental and public health risks, especially in emerging economies like India. This study evaluates the environmental and health risks of healthcare wastewater during the pandemic, focusing on emerging pollutants like microplastics from PPE and pharmaceutical residues. A literature review analyzed the environmental impact, including the presence of SARS-CoV-2 RNA, antimicrobial residues, and microplastics, and explored wastewater-based epidemiology (WBE) for tracking viral spread and antimicrobial resistance (AMR). The review found that traditional wastewater treatments are insufficient for emerging pollutants, while advanced methods like ozonation, nanofiltration, and hybrid approaches offer better removal efficiencies but are hindered by high costs. Cost analysis reveals that some effective methods may not be economically viable in low-resource settings. Future research should enhance treatment efficiency, reduce costs, and explore the long-term impacts of microplastics and pharmaceutical residues. The study highlights the need for robust, cost-effective wastewater management strategies to address the growing environmental and health risks in the post-pandemic era.}, }
@article {pmid40852653, year = {2025}, author = {Burke, EM and Fox, JA and Tager, K and McDowell, S and Phelps, F and Koh, H}, title = {Toward a public health leadership national training agenda: a review of conceptual frameworks and core competencies.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1630046}, pmid = {40852653}, issn = {2296-2565}, mesh = {*Leadership ; Humans ; *COVID-19/epidemiology ; *Public Health/education ; *Professional Competence/standards ; SARS-CoV-2 ; Pandemics ; }, abstract = {Strong and effective leadership is essential for the success of public health systems. It serves as the driving force that inspires, guides, and empowers individuals to improve the health of their communities and strengthen their organizations. Leadership is not merely supplementary but a core element in tackling the increasingly complex challenges facing public health today. The COVID-19 pandemic exposed significant weaknesses in our systems for emergency preparedness and response, highlighting just how critical capable leadership is within governmental public health. These challenges are magnified by persistent workforce issues, including knowledge gaps, limited development opportunities, and concerns around long-term sustainability. Further complicating the landscape are rising levels of political polarization and incidents of harassment directed at public health professionals. In response to these pressures and a growing wave of workforce attrition, there is now a heightened national focus on developing the next generation of public health leaders. This development must be intentional and structured, relying on well-designed, competency-based approaches rather than informal or inconsistent methods. Public health leaders must be equipped with the skills to navigate the evolving demands of modern health systems. In 2022, the Association of Schools and Programs of Public Health (ASPPH) convened an expert panel to develop a national leadership training agenda tailored to the governmental public health workforce. The panel consisted of 15 academic and practice leaders in the United States. Between 2022 and 2024, the panel met regularly to define the essential attributes of public health leadership and determine effective strategies for cultivating them through education and capacity-building efforts. The result of this collaborative effort is the ASPPH Public Health Leadership Competency Mapping and Training Agenda: a foundational framework designed to strengthen capabilities across current and future governmental public health professionals. This article presents that framework, marking an important step toward building a more resilient, competent, and adaptive public health workforce.}, }
@article {pmid40852084, year = {2025}, author = {Janko, RK and Haussmann, I and Patel, A}, title = {The Prevalence of Infectious Diseases Among Seventh-Day Adventists: A Systematic Review.}, journal = {American journal of lifestyle medicine}, volume = {}, number = {}, pages = {15598276251370238}, pmid = {40852084}, issn = {1559-8284}, abstract = {Background: Several studies have investigated the incidence of chronic diseases among Adventists, but less is known about the association between the prevalence of infectious diseases and the Adventist lifestyle. Methods: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and has been registered on PROSPERO under CRD42024502363. Relevant studies were searched in databases such as PubMed, Google Scholar, and Scopus. Observational studies reporting on the prevalence or occurrence of infectious diseases within the Adventist community were included if they were published in English language. The included studies were synthesised in the form of a narrative synthesis. Results: The outcomes related to infectious conditions identified were Toxoplasma gondii, Helicobacter pylori, antibodies to Vibrio species and Norwalk virus, upper respiratory infections (URIs), COVID-19 disease, H1N1 influenza, and infectious disease-related mortality. A lower prevalence of some infectious diseases was shown among Adventists. A study noted lower Toxoplasma gondii seroprevalence in Adventists, and another associated high fruit, vegetable, and water intake with fewer respiratory infections. Conclusions: The Adventist lifestyle may be associated with a lower prevalence of infectious diseases, likely due in part to the Adventist diet. However, further research is needed to clarify the relative contributions of individual lifestyle factors to these protective effects.}, }
@article {pmid40851973, year = {2025}, author = {Bhatti, HF and Tahir, M and Faheem, MSB and Khabir, M and Tahir, A and Qureshi, MAA and Ashraf, DA and Iqbal, MS and Samadi, S}, title = {Trends in schizophrenia-related mortality from 1999 to 2020: year, gender, and regional variations.}, journal = {Annals of medicine and surgery (2012)}, volume = {87}, number = {7}, pages = {4336-4343}, pmid = {40851973}, issn = {2049-0801}, abstract = {BACKGROUND: Schizophrenia affects about 1% of the global population, with 1.5 million Americans diagnosed annually. Despite higher mortality rates in this group, trends by year, gender, and region remain insufficiently explored. This study evaluated global trends in schizophrenia (F20) mortality from 1999 to 2020, analyzing variations by year, gender, and region. Additionally, we examined age-adjusted mortality rates (AAMRs) by place of death and year to provide a comprehensive understanding of these trends.<br><br>METHODS: The CDC WONDER database was used to analyze schizophrenia-related mortality from 1999 to 2020, calculating mortality rates and 95% confidence intervals (CIs) to assess national trends.<br><br>RESULTS: Throughout the study, males had higher AAMRs for schizophrenia (1.3%, 95% CI: 1.3-1.3) than females (0.9%, 95% Cl: 0.9-1.4). In metropolitan areas, the AAMR was 96.6, declining from 1999 to 2015 (APC:&#xa0;-1.07%) before rising (APC: 6.41%). Non-metropolitan areas had an AAMR of 58.9, decreasing from 1999 to 2017 (APC:&#xa0;-0.86%) before increasing by 2020 (APC: 8.95%). Overall, schizophrenia-related AAMRs rose from 1.2 in 1999 to 1.4 in 2020, with fluctuations.<br><br>CONCLUSION: Schizophrenia-related mortality declined from 1999 to 2015 but rose afterward. Males consistently had higher AAMRs, while urban areas showed greater mortality, reflecting social and environmental risks. Early declines may be linked to improved psychiatric care, whereas the recent rise correlates with the opioid epidemic and COVID-19. These findings highlight the need for better investment in mental health care, early intervention, access in underserved areas, and better management of comorbidities.}, }
@article {pmid40851910, year = {2025}, author = {Mujumdar, V and Huang, M and Smith, LC and Musa, F}, title = {Ivermectin and gynecologic cancer: What's the data?.}, journal = {Gynecologic oncology reports}, volume = {60}, number = {}, pages = {101803}, pmid = {40851910}, issn = {2352-5789}, abstract = {•Ivermectin is currently approved by the US Food and Drug Administration (FDA) in 1996 as an oral medication for intestinal strongyloidiasis and onchocerciasis.•The data on ivermectin as a gynecologic cancer-fighting compound is lacking.•Clinical studies on ivermectin use in cancer are limited to effects observed in cell lines.•We have not assessed ivermectin's safety and efficacy in gynecologic cancers.•We do not recommend and strongly caution the use of ivermectin in the treatment of gynecologic cancers.}, }
@article {pmid40851885, year = {2025}, author = {Lazzari, C and Rabottini, M}, title = {The use of Introduction, Situation, Background, Assessment, and Recommendation handover in the COVID-19 pandemic and non-COVID clinical settings: a systematic review and meta-analysis.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1380948}, pmid = {40851885}, issn = {2813-0146}, abstract = {INTRODUCTION: The Introduction, Situation, Background, Assessment, and Recommendation (ISBAR) approach to clinical handovers assists healthcare providers in sharing information about patients within clinical teams and across health sectors while reducing information gaps and medical errors. However, despite its significance, uncertainties remain about the clear outcomes of applying ISBAR and training, especially in settings managing COVID-19 and those not dealing with the pandemic.<br><br>METHODS: This review was conducted following the PRISMA guidelines. All the selected articles underwent a progressive check for bias and validity using GRADEpro GDT and RoB-2 as per Cochrane guidelines. This review utilized a meta-analysis of 29 studies and a critical narrative review of seminal articles to condense the non-numerical findings. All articles were checked for heterogeneity with the I [2] coefficient. The extracted effect size was the common language effect size (CLES), with 95% confidence intervals.<br><br>RESULTS: ISBAR strengthens communication skills in clinical teams, increases self-confidence and efficacy among healthcare practitioners, improves interprofessional communication, reduces medical errors, and enhances patient safety.<br><br>CONCLUSIONS: Our systematic review confirms that ISBAR handover improved the quality of care during the COVID-19 pandemic and non-COVID clinical practice. The limitation of this study is related to the lack of randomized controlled trials and blinding. Almost all studies were cross-sectional, which only provides information regarding associations but not causation.}, }
@article {pmid40850887, year = {2025}, author = {Chapman, A and Berenbaum, F and Curigliano, G and Pliakas, T and Sheikh, A and Abduljawad, S}, title = {Risk of Severe Outcomes From COVID-19 in Immunocompromised People During the Omicron Era: A Systematic Review and Meta-Analysis.}, journal = {Clinical therapeutics}, volume = {47}, number = {9}, pages = {770-787}, doi = {10.1016/j.clinthera.2025.07.006}, pmid = {40850887}, issn = {1879-114X}, mesh = {Humans ; *COVID-19/mortality/immunology/epidemiology/therapy ; Hospitalization/statistics &amp; numerical data ; *Immunocompromised Host ; Intensive Care Units/statistics &amp; numerical data ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; }, abstract = {PURPOSE: COVID-19 imposes a high burden on people with immunocompromising/immunosuppressive (IC/IS) conditions. This is the first large-scale, comprehensive meta-analysis encompassing major IC/IS categories to assess the risks of severe outcomes from COVID-19 in people with IC/IS conditions during the Omicron era-the period dominated by the most recent major COVID-19 variant.<br><br>METHODS: A systematic search of Embase, MEDLINE, PubMed, Europe PMC, Latin American and Caribbean Health Sciences Literature, Cochrane COVID-19 Study Register, and WHO COVID-19 database was performed to identify studies published between January 1, 2022, and March 13, 2024. Studies included people (all ages) with at least one of the following conditions: unspecified IC/IS, transplant, malignancy, autoimmune diseases, liver diseases, chronic or end-stage kidney disease, and advanced/untreated HIV. Studies were synthesized quantitatively using random-effects models. Evaluated outcomes were risks of death, hospitalization, intensive care unit (ICU) admission, and any combination of these outcomes.<br><br>FINDINGS: Seventy-two studies were included, of which 66 were included in the meta-analysis. Minimum numbers of participants per IC/IS condition ranged from 12,634 to 3,287,816. Of all meta-analyzed IC/IS conditions, transplant recipients had the highest risk of death (pooled relative risk [RR], 6.78; 95% CI: 4.41-10.43; P < 0.001), hospitalization (RR, 6.75; 95% CI 3.41-13.37; P < 0.001), and combined outcomes (RR, 8.65; 95% CI 4.01-18.65; P < 0.001), while participants in the unspecified IC/IS group had the highest risk of ICU admission (RR, 3.38; 95% CI 2.37-4.83; P < 0.001) compared with participants without the respective IC/IS conditions or general population.<br><br>IMPLICATIONS: In the Omicron era, people with IC/IS conditions have a substantially higher risk of death and hospitalization from COVID-19.}, }
@article {pmid40850278, year = {2025}, author = {Ezeh, OV and Ternero-Hidalgo, JJ and Lintag, RMN and Han, W and Yeung, KL}, title = {Exploring innovations in antimicrobial protective mask filters: A review.}, journal = {Advances in colloid and interface science}, volume = {345}, number = {}, pages = {103635}, doi = {10.1016/j.cis.2025.103635}, pmid = {40850278}, issn = {1873-3727}, mesh = {*Masks ; Humans ; *COVID-19/prevention &amp; control/transmission/virology ; *Anti-Infective Agents/pharmacology ; *Filtration/instrumentation ; *SARS-CoV-2/isolation &amp; purification ; }, abstract = {Mask filters are necessary for personal protection. The COVID-19 pandemic exemplified this need. Nonetheless, they can pose risk of transmission as captured microbes or respiratory droplets can remain viable on filters and propagate under ideal environmental conditions. It became evident during the COVID-19 pandemic that conventional masks alone are insufficient for ensuring adequate safety and disrupting the route of spread. Equipping protective masks with antimicrobial property is fundamental to overcoming the survivability of microbes on the surface of filter media and ensuring personal safety. Consequently, this has become a significant research focus, with a sharp upsurge in publications in the COVID-19 era. In this work, we present a comprehensive review of crucial advancements in antimicrobial mask filters, emphasizing the relevance of this topic within the contemporary framework of the COVID-19 pandemic, in addition to the anticipated performance standards associated with the expanding market of antimicrobial protective mask filters.}, }
@article {pmid40850218, year = {2025}, author = {Baykara, Y and Sevgi, K and Akgun, Y}, title = {COVID-19 Microangiopathy: Insights into plasma exchange as a therapeutic strategy.}, journal = {Hematology, transfusion and cell therapy}, volume = {47}, number = {4}, pages = {103963}, pmid = {40850218}, issn = {2531-1387}, abstract = {COVID-19-associated thrombotic microangiopathy has emerged as a severe complication that exacerbates morbidity and mortality in critical cases. Thrombotic microangiopathy, characterized by microvascular thrombosis and endothelial injury, includes conditions like thrombotic thrombocytopenic purpura and atypical hemolytic uremic syndrome. This review investigates therapeutic plasma exchange as a potential strategy to mitigate COVID-19-induced thrombotic microangiopathy, examining its role in removing pro-inflammatory cytokines, immune complexes, and pro-thrombotic factors. Additionally, it highlights the synergistic effects when therapeutic plasma exchange is combined with treatments such as complement inhibitors and immunosuppressants. Preliminary evidence, drawn from case reports and early trials, supports the efficacy of therapeutic plasma exchange in improving outcomes for COVID-19-associated thrombotic microangiopathy. However, larger randomized controlled trials are necessary to definitively establish its place in COVID-19 management, particularly for high-risk and transplant patients with underlying immunological vulnerabilities.}, }
@article {pmid40850048, year = {2025}, author = {Genest, G and Liu, Z and Boivin, M and Alvarez, F and Banjar, S and Ton-Leclerc, S and Khoudja, R and Peero, EK and Piccirillo, CA and Mazer, BD}, title = {Intravenous immunoglobulin (IVIg) use in recurrent implantation failure: Is it time for another randomized controlled trial?.}, journal = {Journal of reproductive immunology}, volume = {171}, number = {}, pages = {104634}, doi = {10.1016/j.jri.2025.104634}, pmid = {40850048}, issn = {1872-7603}, mesh = {Humans ; *Immunoglobulins, Intravenous/therapeutic use ; *COVID-19/immunology ; Female ; Randomized Controlled Trials as Topic ; SARS-CoV-2/immunology ; *Fertilization in Vitro/methods ; *Embryo Implantation/immunology/drug effects ; Pregnancy ; }, abstract = {Recurrent implantation failure (RIF) affects up to 5 % of patients undergoing in-vitro fertilization (IVF) yet remains unexplained in over 50 % of cases. Perturbation of the permissive immune environment required for implantation is thought to explain a proportion of RIF cases but remains a diagnosis of exclusion due to the lack of validated testing to confirm the condition. Patients are often empirically treated with immunomodulatory medications, with intravenous immunoglobulin (IVIg) being prominently featured. While some suggest potential benefit, available studies are heterogenous, often underpowered and do not consider recent definitions of RIF; IVIg remains a heavily debated IVF adjunct. With the recent COVID pandemic-induced global blood product shortage, IVIg prescribing practices for RIF must be reviewed. A well designed, adequately powered randomized controlled trial (RCT) is needed to determine if IVIg should be featured in our armamentarium. However, prior to its design, data amassed over the last 3 decades must be incorporated to ensure it yields robust and clinically meaningful data. This narrative review synthesizes our current state of knowledge on the topic, discussing proposed mechanisms of immune-mediated RIF, potential mechanisms of action of IVIg as well as patient populations most likely to benefit from immune-modulation. Lastly, with use and prices of IVIg rising globally, we discuss our collective responsibility towards ensuring IVIg stewardship while proposing timely and cost-effective interventions for our patients.}, }
@article {pmid40849821, year = {2025}, author = {Chen, Y and Wu, X and Xu, C and Huang, J and Zhang, L and Qiu, P and Zheng, D and Chen, W and Zhang, S}, title = {Pathogen virulence genes: Advances, challenges and future directions in infectious disease research (Review).}, journal = {International journal of molecular medicine}, volume = {56}, number = {5}, pages = {}, pmid = {40849821}, issn = {1791-244X}, mesh = {Humans ; *Communicable Diseases/microbiology/genetics ; Virulence/genetics ; Candida albicans/pathogenicity/genetics ; Host-Pathogen Interactions/genetics ; *Virulence Factors/genetics ; Animals ; SARS-CoV-2/genetics/pathogenicity ; }, abstract = {Pathogens, including bacteria, viruses and fungi, employ virulence genes to invade their hosts, circumvent immunity and induce diseases. The present review examines the categorization and regulatory mechanisms of virulence genes and their co‑evolution with antimicrobial resistance. The present review focused on the fimbrial adhesion H adhesion gene of Escherichia coli, the spike protein gene of severe acute respiratory syndrome coronavirus 2 and the enhanced filamentous growth protein 1 (EFG1) morphological transition gene of Candida albicans, as well as their roles in host adhesion, immune evasion and tissue damage. Application of technologies, including multi‑omics integration, artificial intelligence and CRISPR‑based genome editing, is discussed in the context of precision diagnostics, targeted therapy and vaccine development. By elucidating pathogen adaptation dynamics and host‑pathogen interactions, the present review offers a basis for reducing the global burden of drug‑resistant infections through improved surveillance and personalized interventions.}, }
@article {pmid40848858, year = {2025}, author = {Chen, X and Ma, Y and Liu, H and Wang, Y}, title = {Multifunctional regulation and treatment of ubiquitin specific protease 10.}, journal = {Biochemical pharmacology}, volume = {242}, number = {Pt 1}, pages = {117251}, doi = {10.1016/j.bcp.2025.117251}, pmid = {40848858}, issn = {1873-2968}, abstract = {USP10 is a critical deubiquitinating enzyme within the ubiquitin-specific protease family, playing multifaceted roles in cellular physiology and disease pathogenesis. Structurally composed of a G3BP1-interacting motif, a N-terminal domain (mediating most protein interactions), and a catalytic USP domain (residues 415-795, catalytic triad C424-H736-D751), USP10 regulates diverse cellular pathways by stabilizing key proteins through deubiquitination. It exhibits context-dependent functional duality, particularly in cancer: USP10 promotes tumorigenesis in various cancers (e.g., glioblastoma, esophageal, pancreatic, breast cancers) by stabilizing oncoproteins like CCND1, YAP1, HDAC7, and RUNX1, enhancing proliferation, metastasis, and immune evasion. Conversely, it suppresses tumors (e.g., NSCLC, CRC, thyroid cancer) by stabilizing tumor suppressors like p53, PTEN, and Axin1, inhibiting pathways such as Wnt/β-catenin. Beyond oncology, USP10 contributes to neurodegenerative diseases (neuroprotective in PD/ALS, neurotoxic in AD via Tau stabilization), viral immunity (inhibits SARS-CoV-2 infection), inflammatory responses, male reproduction, and metabolic/cardiovascular disorders. Its regulatory mechanisms include phosphorylation (e.g., by AMPK, AKT, ATM) controlling subcellular localization and activity, and ubiquitination via USP13. USP10's therapeutic significance drives inhibitor development (Spautin-1, D1, Wu-5, P22077, Parthenolide), though cross-reactivity within the USP family due to conserved catalytic domains remains a challenge. Novel strategies like PROTACs and engineered ubiquitin variants (UbVs) offer promise for future selective targeting of USP10 dysregulation in diverse diseases. A comprehensive understanding of its structure and context-specific functions is essential for exploiting its full therapeutic potential.}, }
@article {pmid40848675, year = {2025}, author = {Tscherne, A and Sun, W and Liu, STH and Krammer, F}, title = {Mucosal COVID-19 vaccines in clinical development.}, journal = {Vaccine}, volume = {63}, number = {}, pages = {127602}, doi = {10.1016/j.vaccine.2025.127602}, pmid = {40848675}, issn = {1873-2518}, mesh = {*COVID-19 Vaccines/immunology/administration &amp; dosage ; Humans ; *COVID-19/prevention &amp; control/immunology ; Animals ; *SARS-CoV-2/immunology ; *Immunity, Mucosal ; Clinical Trials as Topic ; *Vaccine Development ; Administration, Mucosal ; }, abstract = {Mucosal vaccines are designed to elicit both a strong systemic and mucosal immune response gaining importance as the next generation of vaccines to combat the respiratory coronavirus disease 2019 (COVID-19). The ability of these vaccines to induce mucosal immune responses in the upper respiratory tract may allow efficient prevention of infection and transmission, which could potentially reduce virus circulation in the population. In addition, they have the advantage that they can be administered by non-medical personnel and without needles. Several preclinical studies in small animal models and non-human primates, but also early phase clinical studies confirmed the capability of mucosal COVID-19 candidate vaccines to induce long-lasting immunity and to provide protection against an infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition to five vaccines which are already approved/licensed, at least 28 mucosal COVID-19 vaccines, based on different vaccine platforms, are currently being tested in clinical trials. However, clinical data for most of the conducted and completed clinical trials are not publicly available yet. In addition, several initiated trials have been terminated or were withdrawn. In this review, we aim to discuss the advantages and disadvantages of mucosal COVID-19 vaccines and to summarize the current status of mucosal COVID-19 vaccines in clinical development, with an emphasis on the most advanced candidates and the key findings observed in preclinical animal models and clinical studies.}, }
@article {pmid40848491, year = {2025}, author = {Ravindran, C and Mukherjee, S}, title = {Zebrafish as a model for SARS-CoV-2 infection, pathogenesis, transmission, and drug screening.}, journal = {Virology}, volume = {611}, number = {}, pages = {110662}, doi = {10.1016/j.virol.2025.110662}, pmid = {40848491}, issn = {1096-0341}, mesh = {*Zebrafish/virology ; Animals ; *SARS-CoV-2/drug effects/pathogenicity/physiology ; *Disease Models, Animal ; *Antiviral Agents/pharmacology/therapeutic use ; *COVID-19/transmission/virology/pathology ; Drug Evaluation, Preclinical ; Humans ; Viral Load/drug effects ; COVID-19 Drug Treatment ; Virus Internalization/drug effects ; }, abstract = {Causative agent, Severe acute respiratory syndrome coronavirus - 2 (SARS-CoV-2) requires a host for its infection, replication, and spread. With the availability of several animal models and their limitations, there is a need for an alternative animal model with a high degree of conserved synteny at a laboratory scale. Zebrafish resemble humans in terms of conserved genetic homology aiding to understand the viral pathology and screening a variety of drug molecules. For e.g., the SARS-CoV-2 transmission was well established via air, infected people, and other surfaces. However, the viral titers in domestic sewage of infected people's excrements transmission through the water bodies were not well studied with a suitable model system. Thus, in the present study, we explore zebrafish as a potential host for SARS-CoV-2 like viruses entry, pathophysiology, transmission, and preclinical assessment of drugs involved in immune response and viral load reduction against SARS-CoV like viruses.}, }
@article {pmid40847787, year = {2025}, author = {Siqueira, RP and Nascimento de Lira, CR and Cunha, CM and de Farias Costa, PR and Conceição-Machado, MEPD}, title = {Influence of mental health on eating practices among university students during the COVID-19 pandemic: A systematic review.}, journal = {Journal of health psychology}, volume = {}, number = {}, pages = {13591053251361714}, doi = {10.1177/13591053251361714}, pmid = {40847787}, issn = {1461-7277}, abstract = {This systematic review examines how anxiety, depression, and stress influence university students' dietary behaviors during the COVID-19 pandemic. After registering the protocol at PROSPERO(CRD42025639716), we searched seven databases, gray literature and references list. Observational studies assessing mental health as exposure and dietary changes as outcomes were selected by two reviewers. The JBI tools assessed risk of bias. A qualitative synthesis of the findings was performed to integrate results narratively. Of 2,624 records, 22 studies (20 cross-sectional, 2 cohort) were included, 95.46% at low risk of bias but methodologically diverse. Heightened anxiety, depression, and stress were linked to emotional or uncontrolled eating and increased ultra-processed food intake. A small subset (13.64%) reported atypical patterns, such as reduced dessert consumption or increased consumption of fresh/minimally processed foods. Pandemic-related disruptions appeared to exacerbate psychological-disstress-induced dietary changes. Future longitudinal or intervention studies should clarify causal pathways and assess programs targeting mental health and nutrition.}, }
@article {pmid40846319, year = {2025}, author = {Chau, LW and Lam, RW and Minas, H and Hayashi, K and Nguyen, VC and O'Neil, J}, title = {Digital Health Interventions for Depression and Anxiety in Low- and Middle-Income Countries: Rapid Scoping Review.}, journal = {JMIR mental health}, volume = {12}, number = {}, pages = {e68296}, pmid = {40846319}, issn = {2368-7959}, mesh = {Humans ; *Developing Countries ; *Telemedicine ; COVID-19 ; *Depression/therapy ; *Anxiety/therapy ; Digital Health ; }, abstract = {BACKGROUND: Low- and middle-income countries (LMICs), which bear a larger proportion of the global mental illness burden, have been disproportionately impacted by the COVID-19 pandemic due to preexisting mental health care system deficiencies. The pandemic has also led to a considerable increase in care delivered through digital mental health interventions (DMHIs), many of which have been adapted from in-person formats. Thus, there is a need to examine their fidelity to the original format along with issues regarding usability and other challenges to and facilitators of their uptake in LMICs. As most DMHIs have been developed in high-income countries, examining their cultural adaptation to LMIC settings is also critical.<br><br>OBJECTIVE: The purpose of this research was to conduct a rapid scoping review of the available evidence on DMHIs for depression and anxiety, two of the most common mental disorders, in LMICs.<br><br>METHODS: A rapid scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and processes for rapid reviews by Tricco et al. The PubMed and PsycINFO databases were searched for records published between January 2020 (when COVID-19 was declared a public health emergency) and January 2025 using a search strategy developed in consultation with a liaison librarian. The pandemic accelerated the development and application of DMHIs, and this time frame was used to capture the recent literature that may have incorporated new methods of application. The search strategy was developed across three domains: (1) digital health interventions, (2) depression or anxiety, and (3) LMICs. Data were charted from the final records according to (1) intervention type; (2) discussions on fidelity, usability, and cultural adaptation; and (3) challenges to and facilitators of their uptake in LMICs.<br><br>RESULTS: A total of 80 records were included in the final analysis, with reasons for exclusion (eg, focused on mental health in general, not being a DMHI, or not focused on LMICs) reported. Six DMHI platforms were identified: (1) mobile app, (2) the web, (3) virtual reality, (4) videoconferencing, (5) telemedicine, and (6) social media. Less than half of the records referenced fidelity (16/80, 20%), usability (29/80, 36%), and cultural adaptation (31/80, 39%). Challenges pertained to the technological system, engagement issues, structural barriers, and concerns regarding privacy and confidentiality. Facilitators included widespread mobile phone use, built-in supervision and training features, and convenience.<br><br>CONCLUSIONS: Despite the opportunities that DMHIs offer for reducing the mental health treatment gap, further work examining and improving their fidelity, usability, and cultural adaptation is required. In addition, various challenges to the uptake of DMHIs in LMICs, including contextual issues, structural barriers, and privacy concerns, must be mitigated to avoid contributing further to the digital divide.}, }
@article {pmid40841899, year = {2025}, author = {Lee, NJ and Katsuyama, ES and Fukunaga, CK and Neto, WF and Coan, ACC and Faria, HS and Medeiros, EA}, title = {Efficacy and safety of 3CL protease inhibitors in patients with mild or moderate COVID-19: a systematic review and meta-analysis of randomized controlled trials.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {286}, pmid = {40841899}, issn = {1743-422X}, abstract = {BACKGROUND: Remdesivir has been established as a safe treatment for patients with COVID-19. However, given the SARS-CoV-2 random mutations, 3CL protease inhibitors have been studied in recent randomized controlled trials. Therefore, this meta-analysis aims to compare 3CL protease inhibitors versus placebo in patients with mild to moderate COVID-19.<br><br>METHODS: We systematically searched PubMed, Embase, and Cochrane Central for RCTs comparing the treatment regimens in patients with mild to moderate COVID-19. Outcomes of interest were the number of patients with symptomatic resolution, recovery rates, viral load change from baseline, alleviation rates, any adverse events, and serious/severe adverse events. Risk ratios (RRs) and hazard ratios (HRs) with 95% CI were calculated for binary outcomes, and standardized mean differences (SMDs) were calculated for continuous outcomes. R version 4.3.2 was used for statistical analysis with the random effects model.<br><br>RESULTS: Ten studies were included, comprising 8,511 patients, of whom 4,654 (55.97%) received 3CL protease inhibitors. Follow-up ranged from 21 to 29 months. In our time-to-event analysis, 3CL protease inhibitors significantly increased the rate of alleviation (HR 1.17; 95% CI [1.09;1.25]; p&#x2009;<&#x2009;0.01), and recovery rates (HR 1.18; 95% CI [1.11;1.26]; p&#x2009;<&#x2009;0.01) in patients with mild to moderate COVID-19. However, 3CL protease inhibitors significantly reduced viral load at 72&#xa0;h (SMD &#x2212;&#x2009;0.95; 95% CI [-1.23; -0.66]; p&#x2009;<&#x2009;0.01) compared with placebo in these patients. There was no significant difference between groups in symptomatic resolution (RR 1.01; 95% CI [1.00;1.03]; p&#x2009;=&#x2009;0.147).<br><br>CONCLUSION: 3CL protease inhibitors significantly reduced the change in the viral load and increased the rate of symptom alleviation and recovery, underscoring their importance as a potential therapeutic option.<br><br>SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12985-025-02899-0.}, }
@article {pmid40844222, year = {2025}, author = {Mikulska, M and Bassetti, M and Busca, A and Cento, V and Giannella, M and Bartoletti, M}, title = {Role of remdesivir for the treatment of COVID-19 in patients with hematologic malignancy-A narrative review and expert opinion.}, journal = {European journal of clinical investigation}, volume = {55}, number = {12}, pages = {e70108}, pmid = {40844222}, issn = {1365-2362}, support = {//Gilead Sciences Srl Italy/ ; }, mesh = {Humans ; *Adenosine Monophosphate/analogs &amp; derivatives/therapeutic use ; *Alanine/analogs &amp; derivatives/therapeutic use ; *Antiviral Agents/therapeutic use ; *COVID-19 Drug Treatment ; *Hematologic Neoplasms/therapy/complications/immunology ; COVID-19/complications ; Immunocompromised Host ; SARS-CoV-2 ; Hematopoietic Stem Cell Transplantation ; Oxygen Inhalation Therapy ; }, abstract = {BACKGROUND: COVID-19 remains a potentially severe condition for immunocompromised individuals, such as patients with hematologic malignancy. These patients are at increased risk of progressing to severe-critical or prolonged COVID-19. Prompt treatment with antivirals has proven effective in preventing disease progression and is recommended by current guidelines. We discuss here the position of remdesivir in the management of onco-hematologic patients infected with SARS-CoV-2 and strategies for its use.<br><br>METHODS: Narrative review of current evidence regarding remdesivir in the treatment of COVID-19 in patients with hematologic malignancy.<br><br>RESULTS: Patients with non-severe COVID-19 should receive remdesivir as soon as possible after diagnosis, and within 7&#x2009;days from symptom onset. A 3-day treatment duration is recommended. In patients at high risk of developing severe COVID-19 - patients with B-cell depletion and recipients of allogeneic HSCT or CAR T cell therapy or bispecific antibodies - treatment may be prolonged and/or combined with other COVID-19 therapeutics. Patients with severe COVID-19 requiring supplemental oxygen should receive remdesivir as soon as possible, preferentially for 10&#x2009;days. In those at high risk of progressing to critical COVID-19, combination of remdesivir with other COVID-19 therapeutics can be considered. In case of relapse or persisting symptoms, remdesivir treatment can be prolonged and/or repeated or combined with other COVID-19 therapeutics.<br><br>CONCLUSIONS: Evidence from clinical trials and real-world studies shows that remdesivir is a valid option for the treatment of SARS-CoV-2-infected onco-hematologic patients, across a wide spectrum of COVID-19 severity. The drawback of remdesivir-intravenous administration mode-is counterbalanced by good tolerability, negligible drug-drug interactions and a high barrier to virus resistance.}, }
@article {pmid40843392, year = {2025}, author = {Pargar, F and Rabiei, Z and Keramat, A}, title = {Menstrual Disorders Following Covid 19 Vaccination in Women of Reproductive Age and Post-Menopause. A Systematic Review.}, journal = {Health science reports}, volume = {8}, number = {8}, pages = {e71103}, pmid = {40843392}, issn = {2398-8835}, abstract = {BACKGROUND: During the coronavirus pandemic, several factors such as stress, depression, infection, and vaccination against the COVID-19 virus have caused changes in the menstrual cycle.<br><br>OBJECTIVE &amp; AIMS: This systematic review intended to provide a comprehensive interpretation of the changes in the menstrual cycle of women of reproductive age and menopause after coronavirus vaccination. Method: Electronic databases, including Web of Science, PubMed, Scopus, ScienceDirect, ProQuest, Cochrane, SAGE, Springer, Google Scholar, and CINHAL were searched for published studies from March 2020 to June 2023. Of the 682 references identified in the initial search, 27 studies met the inclusion criteria.<br><br>RESULTS: The results of this systematic review showed that COVID-19 vaccination is associated with a wide range of menstrual disorders in women of reproductive age and postmenopausal women. The most commonly reported disorders were menorrhagia, delayed menstruation, changes in menstrual cycle length, spotting between periods, and increased bleeding volume. In postmenopausal women, complications such as spotting and resumption of bleeding were also observed. Although the prevalence and incidence of each disorder varied across studies, these findings suggest that vaccination can lead to changes in the menstrual cycle.<br><br>CONCLUSION: COVID-19 vaccination may lead to menstrual disorders in women of reproductive and postmenopausal age, which can cause concern and reduce social and psychological quality of life. However, these effects are usually temporary and transient, resolving after a few menstrual cycles. Further studies are needed to investigate the possible mechanisms of this association and identify associated risk factors.}, }
@article {pmid40843141, year = {2025}, author = {Park, HY and Kong, S and Lee, M and Ryu, H and Hamakawa, Y and Luppi, F and Leung, JM}, title = {Digital health technologies for improving the management of people with chronic obstructive pulmonary disease.}, journal = {Frontiers in digital health}, volume = {7}, number = {}, pages = {1640585}, pmid = {40843141}, issn = {2673-253X}, abstract = {Advances made in digital health in recent years have the potential to improve the care of patients living with chronic obstructive pulmonary disease (COPD) for whom substantial disability still exists. In particular, telehealth and telerehabilitation programs, wearable devices, and apps have been studied as novel methods of providing care to COPD patients who may have limited access to clinical centers or who may benefit from an increased level of monitoring. Many of these interventions gained traction during the COVID-19 pandemic when mandated social isolation required the rapid implementation of remote care models. While these digital health interventions have since demonstrated promise in delivering care to otherwise isolated communities, the ongoing need for more evidence proving their positive impact on important clinical outcomes remains a barrier to their full implementation. How to best integrate digital health solutions into existing care models requires greater consideration of the technological, financial, and labor demands such solutions may entail.}, }
@article {pmid40842802, year = {2025}, author = {Awad Abdu Alla, AMM and M Osman, HM and Khalid Babikir, TA and Hag Elzain Eltoum, AH and Mohammed Alawad, SA and Ali Hassanin, SH}, title = {Endocrine Disorders and COVID-19 Severity in Pediatric Populations: A Systematic Review.}, journal = {Cureus}, volume = {17}, number = {7}, pages = {e88458}, pmid = {40842802}, issn = {2168-8184}, abstract = {The COVID-19 pandemic has significantly impacted global health systems, with emerging evidence suggesting unique implications for pediatric populations with endocrine disorders. While children generally experience milder acute COVID-19 symptoms, those with pre-existing endocrine conditions may face heightened risks due to the interplay between viral infection and endocrine homeostasis. This systematic review aimed to synthesize evidence on the relationship between endocrine disorders and COVID-19 severity in children, focusing on disease outcomes, metabolic control, and management challenges during the pandemic. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a systematic search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library. Ten studies meeting the inclusion criteria were selected after screening 638 records. Data were extracted on study characteristics, patient demographics, endocrine disorders, COVID-19 severity outcomes, and key findings. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS) tool. A narrative synthesis was performed due to heterogeneity in study designs and outcomes. The review revealed significant pandemic-related disruptions in pediatric endocrine health, including increased central precocious puberty cases and elevated BMI z-scores in children with obesity. Diabetes outcomes were mixed: type 1 diabetes patients had better mortality prognoses than type 2 diabetes patients, but diabetic ketoacidosis rates surged. Thyroid dysfunction and stable medication adherence in congenital adrenal hyperplasia were also noted. Risk of bias varied, with three studies rated low, five rated moderate, and two rated as high risk of bias. COVID-19 exacerbated endocrine disorders in children through direct viral effects and indirect lifestyle and healthcare disruptions. The findings underscore the need for adaptive care strategies, including telehealth and mental health support, to mitigate long-term impacts. Future research should prioritize prospective studies to evaluate sustained effects and interventions for at-risk populations.}, }
@article {pmid40842707, year = {2025}, author = {Doutrelepont, DW and Fernandes, CP and Vernier, LS and Machado, MS}, title = {Characteristics of Tinnitus in Patients Affected by COVID-19: A Systematic Review.}, journal = {International archives of otorhinolaryngology}, volume = {29}, number = {3}, pages = {1-20}, pmid = {40842707}, issn = {1809-9777}, abstract = {INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has brought up reports of an increase in new cases of tinnitus and changes in chronic and/or preexisting episodes. Nevertheless, there is no established data on the characteristics of tinnitus and its correlation with coronavirus disease 2019 (COVID-19).<br><br>OBJECTIVE: To analyze the characteristics of tinnitus in subjects affected by COVID-19 while detailing the correlation between these two factors.<br><br>DATA SYNTHESIS: We found 327 articles, 37 of which were selected: 11 cross-sectional studies, 4 case-control studies, 3 cohort studies, and 19 observational studies. The sum of the samples totaled 399,524 patients included in the present review. The prevalence of new tinnitus varied from 0.2% to 96.2%. Most articles provided incomplete information or were missing information. Systemic arterial hypertension was the most common underlying disease. Finally, we found a predominance of hearing loss and olfactory and taste disorders, followed by fever and cough.<br><br>CONCLUSION: The prevalence of new tinnitus ranged from 0.2 to 96.2%, whereas the prevalence of preexisting tinnitus varied from 8 to 76.2%. It was not possible to satisfactorily assess the characteristics of tinnitus. Therefore, a direct correlation between tinnitus and COVID-19 could not be determined, as this symptom may be influenced by other factors.}, }
@article {pmid40842595, year = {2025}, author = {Liu, Q and Wang, X and Zhou, X}, title = {Meta-analysis of mortality factors after COVID-19 infection in pediatric oncology patients.}, journal = {Frontiers in oncology}, volume = {15}, number = {}, pages = {1594617}, pmid = {40842595}, issn = {2234-943X}, abstract = {OBJECTIVE: There are few clinical studies related to COVID-19 in pediatric cancer patients, and systematic reviews or meta-analyses on its mortality risk factors are particularly lacking. Therefore, we conducted this meta-analysis to systematically analyze the mortality risk factors of pediatric cancer patients after COVID-19 infection, providing effective evidence-based medical evidence for epidemic prevention and control and clinical treatment of pediatric COVID-19 patients.<br><br>METHODS: Electronic databases of PubMed, Embase, Cochrane Library and Web of Science were searched using "cancer" "COVID-19" "children" "mortality" related subject headings and keywords. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Outcomes included age, weight, clinical complications in patients, cancer type, consolidation of cancer treatment, and critical illness. The quality of observational studies was assessed using the Newcastle-Ottawa Scale, which includes criteria such as study population selection, comparability, and evaluation of exposure or outcome, by two independent reviewers.<br><br>RESULTS: A computerized search of the literature yielded six observational studies with a total of 2,696 patients, and a pooled assessment of predictive factors revealed that the occurrence of adverse clinical complications, the presence of solid tumors, and the presence of acute and critical conditions significantly increased mortality in pediatric oncology patients (P < 0.05), although, overall, aggressive consolidation of cancer treatment significantly reduced the death of patients. Although overall,being in the cancer consolidation treatment period is significantly associated with a reduced risk of patient mortality, there is still an increase in mortality with Radiotherapy, possibly due to immunocompromise (P < 0.05), whereas Immunotherapy and Surgery do not affect patient prognosis. Subgroup analyses showed that prolonged consolidation of cancer treatment reduced mortality. The sensitivity analysis of the results of the outcome indicators was stable with low sensitivity and high confidence.<br><br>CONCLUSION: Adverse clinical complications, the presence of solid tumors, and the occurrence of critical conditions increase mortality in pediatric cancer patients. Receiving aggressive cancer treatment is associated with lower mortality rates, but this association should be interpreted with caution, as it may be confounded by other factors.<br><br>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420250570932.}, }
@article {pmid40842447, year = {2025}, author = {Almegren, MO}, title = {Cerebral venous thrombosis: A comprehensive narrative review.}, journal = {Brain circulation}, volume = {11}, number = {3}, pages = {178-186}, pmid = {40842447}, issn = {2455-4626}, abstract = {Cerebral venous thrombosis (CVT) is a rare cause of cerebral infarction, accounting for <1% of stroke cases worldwide. The pathophysiology of CVT is multifactorial, encompassing the direct effects of thrombosis, interference with the blood-brain barrier and development of cerebral edema. Several genetic and acquired risk factors of CVT have been identified, more recently this includes the pro-thrombotic effects of coronavirus disease of 2019 infection. CVT can present with wide variation of clinical characteristics, with headache being the most common clinical manifestation. Diagnosis is based on radiological imaging. The mainstay of CVT management is prompt initiation of anti-coagulation. Failure to recognize insidious symptoms of CVT, will lead to a delay in diagnosis and consequently treatment which eventually lead to significant complications, including neurological disability and death. The aim of this narrative review is to consolidate the existing knowledge on CVT, a rare condition with a challenging diagnosis and treatment.}, }
@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}, pmid = {40842393}, issn = {1531-698X}, mesh = {Humans ; *Whooping Cough/epidemiology/prevention &amp; control ; *COVID-19/epidemiology/prevention &amp; control ; Bordetella pertussis ; Infant ; Child ; Anti-Bacterial Agents/therapeutic use ; Pertussis Vaccine ; Global Health ; Infant, Newborn ; SARS-CoV-2 ; Vaccination Coverage/statistics &amp; 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.<br><br>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.<br><br>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.}, }
@article {pmid40842319, year = {2025}, author = {Kelly, FE and Scholz, A and Mayer, J and Groom, P and McGuire, B and Cook, TM}, title = {Implementation of default videolaryngoscopy instead of direct laryngoscopy for tracheal intubation: a narrative review of evidence and experiences.}, journal = {Anaesthesia}, volume = {80}, number = {12}, pages = {1540-1555}, doi = {10.1111/anae.16731}, pmid = {40842319}, issn = {1365-2044}, mesh = {Humans ; *Laryngoscopy/methods ; *Intubation, Intratracheal/methods ; COVID-19 ; Pandemics ; *Video-Assisted Techniques and Procedures ; SARS-CoV-2 ; *Coronavirus Infections ; *Pneumonia, Viral ; Video Recording ; Laryngoscopes ; }, abstract = {INTRODUCTION: Default videolaryngoscopy - use of a videolaryngoscope in preference to a direct laryngoscope - remains a hotly debated topic. High-risk tracheal intubations performed during the COVID-19 pandemic added to the extensive existing evidence of advantages of videolaryngoscopy for patients and staff. Despite this, and calls for implementation of default videolaryngoscopy, it has not been adopted widely.<br><br>METHODS: We summarise current evidence for the benefits of videolaryngoscopy and discuss (and where appropriate dispute) the common reasons given for not using videolaryngoscopy. The experiences of five UK NHS hospitals which have made a move to default videolaryngoscopy are described, with practical advice to assist other hospitals planning similar projects.<br><br>RESULTS: Several recent large randomised controlled trials and meta-analyses, incorporating data from over 200 trials, support the use of videolaryngoscopes. Guidelines and reports published since 2015 have recommended immediate access to videolaryngoscopes plus training and skill acquisition in the required techniques. Recent guidelines have recommended the routine use of videolaryngoscopes whenever possible. Reported advantages include: technical benefits (improved safety, efficacy and ease of tracheal intubation plus fewer complications); non-technical benefits (including improved teamwork and communication); improved direct laryngoscopy training; and environmental benefits. Reasons cited for not using a videolaryngoscope include concerns that they: are unnecessary; lead to decay in or failure to learn direct laryngoscopy skills; videolaryngoscopy failure; ineffectiveness in a soiled airway; cost; and challenges relating to decontamination of reusable blades. We discuss these and, where appropriate, provide counter arguments.<br><br>DISCUSSION: This narrative review provides the relevant evidence and information for clinicians, managers, procurement teams and sterile services departments to use, should a business case be proposed to implement default videolaryngoscopy. We describe effective practical strategies for addressing implementation challenges.}, }
@article {pmid40840775, year = {2025}, author = {Chivé, C and Martín-Faivre, L and Michoud, V and Baeza-Squiban, A and Garcia-Verdugo, I}, title = {Contribution of ambient airborne particles on the susceptibility to respiratory viral infections.}, journal = {Environmental toxicology and pharmacology}, volume = {119}, number = {}, pages = {104797}, doi = {10.1016/j.etap.2025.104797}, pmid = {40840775}, issn = {1872-7077}, mesh = {*Particulate Matter/toxicity ; Humans ; *Respiratory Tract Infections/virology/immunology ; Animals ; *Virus Diseases/immunology/virology ; *Air Pollutants/toxicity ; Disease Susceptibility ; Immunity, Innate ; }, abstract = {The respiratory tract is the primary entry point for inhaled particles from anthropogenic or biological origin such as respiratory viruses. Ambient particulate matter (PM) has adverse effects on the respiratory tract through mechanisms eliciting inflammatory responses, oxidative stress, and other pathophysiological effects. At the same time, respiratory viruses cause a range of infections. By compromising the integrity of the respiratory barrier and by modulating the host immune response, PM may facilitate viral entry and replication, thereby enhancing the pathogenicity of respiratory viruses. While epidemiological studies suggest that PM exposure may influence susceptibility to and severity of viral infection, the underlying mechanisms are not fully understood. This review aims to synthesise experimental studies that investigate how PM exposure may modulate virus infection and antiviral defence. These findings will be contextualised by an overview of the characteristics and effects of PM, the major respiratory viruses, and innate lung immunity.}, }
@article {pmid40840059, year = {2025}, author = {Holzer, H and Diviani, N and Rubinelli, S}, title = {COVID-19 misinformation and healthcare workers: A scoping review.}, journal = {Patient education and counseling}, volume = {141}, number = {}, pages = {109309}, doi = {10.1016/j.pec.2025.109309}, pmid = {40840059}, issn = {1873-5134}, mesh = {Humans ; *COVID-19/psychology ; *Health Personnel/psychology ; *Communication ; SARS-CoV-2 ; Social Media ; Trust ; }, abstract = {OBJECTIVE: The Covid-19 pandemic was accompanied by an infodemic characterised by widespread misinformation and disinformation, particularly concerning the virus's origin, treatments, and vaccines. Healthcare workers (HCWs) were uniquely positioned at the intersection of clinical care and public communication. This scoping review aims to map and synthesise the existing literature on HCWs' experiences and engagement with Covid-19-related misinformation, identifying recurring themes across qualitative and quantitative studies.<br><br>METHODS: A scoping review was conducted following PRISMA-ScR guidelines. Four scientific databases (PubMed, Science Direct, Web of Science, and Wiley Online Library) were searched for studies published between 1 January 2020 and 31 August 2024, yielding 55 eligible publications that included surveys and interviews with HCWs, employing both qualitative and quantitative approaches. The analysis focused on identifying common themes related to HCWs' experiences with misinformation.<br><br>RESULTS: Five key themes emerged: (1) belief in misinformation, shaped by trust and uncertainty; (2) frustration with inconsistent and overwhelming official communication; (3) strained patient-provider relationships due to eroded trust; (4) social media as both a source of misinformation and professional support; and (5) mental health impacts, including anxiety and exhaustion.<br><br>CONCLUSION: The review highlights the significant burden that Covid-19 misinformation placed on HCWs, contributing to professional dissatisfaction, strained patient relationships, and emotional distress. Despite their lower susceptibility to misinformation, HCWs expressed a need for reliable information channels and training to manage misinformation in clinical interactions.<br><br>PRACTICE IMPLICATIONS: To enhance pandemic preparedness, targeted infodemic management training for HCWs is crucial, focusing on misinformation detection, effective communication strategies, and patient education. Strengthening public health communication efforts can help alleviate the burden on HCWs by reducing the spread of misinformation, thereby supporting their well-being and professional efficacy during future public health crises.}, }
@article {pmid40840011, year = {2025}, author = {Thomas, KA and Jackman, RP}, title = {Potential immune consequences of cold-stored platelet transfusion.}, journal = {Current opinion in immunology}, volume = {96}, number = {}, pages = {102645}, doi = {10.1016/j.coi.2025.102645}, pmid = {40840011}, issn = {1879-0372}, mesh = {Humans ; *Platelet Transfusion/adverse effects/methods ; *Blood Platelets/immunology ; *COVID-19/immunology ; *SARS-CoV-2/immunology ; *Blood Preservation/methods/adverse effects ; Animals ; Cold Temperature ; *Hemorrhage/therapy/immunology ; }, abstract = {The rising interest in using cold-stored platelets (CSP) for improving outcomes in patients with active bleeding has led to multiple clinical trials with the goal of determining the in vivo hemostatic efficacy of CSP compared to standard-of-care room temperature-stored platelets. These trials are concentrated predominantly on safety and hemostatic efficacy measurements in response to therapeutic transfusion with CSP, with safety focused on the usual immune-mediated adverse reactions associated with transfusion, such as allergic and alloimmune reactions. However, given the established relationship between thrombosis and inflammation/immune activation as seen in atherosclerosis, autoimmune disease, and infection (to include the recent COVID-19 pandemic), the goal of this review is to highlight additional mechanisms by which CSP may potentiate or dampen immune activity in the context of therapeutic CSP transfusion in actively bleeding patients, thus highlighting areas of future research.}, }
@article {pmid40839983, year = {2025}, author = {Ramacciati, N and Morales Palomares, S}, title = {Violence towards emergency nurses: an update of a narrative review of theories and frameworks.}, journal = {International emergency nursing}, volume = {82}, number = {}, pages = {101661}, doi = {10.1016/j.ienj.2025.101661}, pmid = {40839983}, issn = {1878-013X}, mesh = {Humans ; *Workplace Violence/psychology/prevention &amp; control/statistics &amp; numerical data ; *Emergency Nursing ; Emergency Service, Hospital/organization &amp; administration ; COVID-19/nursing ; Workplace/psychology/standards ; }, abstract = {BACKGROUND: Workplace violence (WPV) in emergency departments (EDs) remains a growing concern worldwide, necessitating updated theoretical perspectives. A 2018 review identified 24 frameworks, but ongoing healthcare challenges, particularly the COVID-19 pandemic, warrant a re-examination and expansion of these models.<br><br>METHODS: A narrative review was conducted using PubMed/Medline, CINAHL, Scopus, and ProQuest databases for studies published from 2017 onward, focusing on theoretical frameworks explaining WPV in EDs.<br><br>RESULTS: The 18 included studies in this review introduce novel or refined theories addressing psychosocial, organizational, and environmental factors that trigger or mitigate WPV. Frameworks range from physiological deterioration and psychosocial moderation to architectural design and resilience-based models. These comprehensive approaches reflect a growing consensus on the need for integrated, multilevel interventions.<br><br>CONCLUSIONS: Contemporary theories underscore WPV as a multifactorial issue requiring solutions that go beyond single-factor models. By examining the broader interplay among patients, staff, organizational, and environmental determinants, these frameworks offer valuable insights for more effective, holistic WPV prevention and management strategies in EDs.}, }
@article {pmid40839804, year = {2025}, author = {Ni, K and Korfmacher, KS}, title = {A Scoping Review on the Ethics of Wastewater Surveillance for COVID-19.}, journal = {Journal of public health management and practice : JPHMP}, volume = {31}, number = {6}, pages = {E387-E395}, pmid = {40839804}, issn = {1550-5022}, support = {P30 ES001247/ES/NIEHS NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Wastewater ; SARS-CoV-2 ; Public Health/ethics/methods ; Pandemics ; }, abstract = {CONTEXT: Wastewater surveillance (WWS) emerged as a tool to monitor public health during the COVID-19 pandemic. Wastewater surveillance is generally undertaken voluntarily by public health and wastewater treatment agencies. Therefore, public trust and support is essential to its sustainability. Development and implementation of ethically informed practices may contribute to public support for expansion of WWS to other public health applications.<br><br>OBJECTIVE: We conducted a scoping review of existing publications on the ethics of WWS for COVID-19. We characterized these publications and identified research gaps.<br><br>DESIGN: This scoping review was based on searches through Scopus and PubMed for the period January 2020 to December 2023 focusing on four concepts: wastewater, surveillance, ethics, and COVID-19. We included studies published in journals, reports, and books and identified 31 publications. Publications were coded thematically as well as by approach, region, discipline, and publication type.<br><br>RESULTS: The majority of publications focused on the need to develop ethical guidelines that promote long-term public support for WWS. A number of publications proposed ethical guidelines and also emphasized that these considerations are context-specific and dynamic, requiring an ongoing system for input as new situations, endpoints, and technologies evolve. Themes included protection of privacy, potential to stigmatize communities with high COVID-19 signals, the importance of effective communication, equitable application of WWS, community engagement, and high standards for data quality. There were few empirical studies of diverse populations' preferences for WWS. Ethical considerations may vary across communities and countries and as new applications of wastewater surveillance emerge.<br><br>CONCLUSIONS: We provide an overview of the emerging principles for ethical practice of WWS and identify gaps in knowledge. These findings may guide future research and consideration of ethics as decisionmakers consider new monitoring endpoints (eg, pharmaceuticals, illegal drugs, infectious diseases, and indicators of population health).}, }
@article {pmid40839033, year = {2025}, author = {Huang, L and Li, M and Niu, T and Chang, H}, title = {Anti-plasma cell therapy in patients with monoclonal gammopathy-associated refractory pure red cell aplasia: A report of three cases and literature review.}, journal = {Annals of hematology}, volume = {104}, number = {9}, pages = {4837-4841}, pmid = {40839033}, issn = {1432-0584}, support = {No. ZYAI24039//1.3.5 Project for Artificial Intelligence/ ; No. 82370192, U24A20680//National Natural Science Foundation of China/ ; }, mesh = {Humans ; *Red-Cell Aplasia, Pure/etiology/therapy/drug therapy ; Female ; Middle Aged ; Dexamethasone/administration &amp; dosage/therapeutic use ; Aged ; Lenalidomide/therapeutic use/administration &amp; dosage ; COVID-19/complications/therapy ; *Monoclonal Gammopathy of Undetermined Significance/complications/therapy/drug therapy ; Bortezomib/therapeutic use/administration &amp; dosage ; Male ; *Plasma Cells/immunology ; *Paraproteinemias/complications ; SARS-CoV-2 ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; }, abstract = {Acquired pure red cell aplasia (aPRCA) is a clinical syndrome that may be secondary to a diverse array of diseases. It is rarely secondary to monoclonal gammopathy of undetermined significance (MGUS). Currently, there is no consensus on when to initiate anti-plasma cell therapy. This study reports three cases of patients with MGUS-associated aPRCA who responded to anti-plasma cell therapy after failing conventional immunosuppressive treatment. Patient 1 achieved complete remission after treatment with the BD (bortezomib and dexamethasone) and BRD (bortezomib, lenalidomide, and dexamethasone) regimens. She subsequently received lenalidomide as maintenance treatment. She has remained in treatment-free survival (TFS) for 22 months to date. Patient 2 achieved complete remission after treatment with the BRD regimen and was maintained with lenalidomide. She has maintained TFS for 16 months so far. Patient 3 was treated with the BD regimen and became transfusion-independent, but relapsed after treatment discontinuation due to COVID-19 infection.This study suggests that anti-plasma cell therapy may be an effective strategy for aPRCA patients unresponsive to conventional immunosuppressive therapy and exhibiting monoclonal protein (M-protein). However, further studies are needed to explore the optimal timing and duration of such therapy.}, }
@article {pmid40839011, year = {2025}, author = {Gamus, A and Chodick, G and Blachar, Y and Shalom, T}, title = {Triadic Model of Assisted Telemedicine: Review of Adoption Challenges Globally and in Israel.}, journal = {Telemedicine journal and e-health : the official journal of the American Telemedicine Association}, volume = {31}, number = {12}, pages = {1414-1421}, doi = {10.1177/15305627251370936}, pmid = {40839011}, issn = {1556-3669}, mesh = {Humans ; Israel/epidemiology ; *Telemedicine/organization &amp; administration ; *COVID-19/epidemiology ; SARS-CoV-2 ; Attitude of Health Personnel ; }, abstract = {Background: The COVID-19 pandemic accelerated the global adoption of telemedicine; however, the triadic model of assisted remote care, where nursing assistants or caregivers facilitate patient interaction with remote physicians, remains underutilized. This narrative review examines the challenges and opportunities associated with assisted telemedicine globally, with a particular focus on the Israeli health care system. Emphasis is placed on health care providers' attitudes, as well as the competencies and training required for effective care delivery within this model. Methods: The review of PubMed, Scopus, and Google Scholar publications was conducted from 2015 to 2025. Results: Evidence suggests that assisted telemedicine contributes to improved patient outcomes, including reduced hospitalizations and mortality among those with chronic conditions. In Israel, despite a robust digital infrastructure, the health care system faces professional shortages, particularly in nursing and secondary care. While current remote services are mostly phone-based, studies indicate that the triadic model of assisted care can enhance diagnostic accuracy, streamline physician workflows, and improve continuity of care. Conclusions: The triadic model of assisted telemedicine holds considerable potential for equitable, efficient, and high-quality care. Its success relies on the establishment of clear protocols, robust technological platforms, ethical safeguards, and comprehensive training initiatives for all participants involved.}, }
@article {pmid40838527, year = {2025}, author = {Chiu, CSL and Gerrits, W and Guglielmo, M and Cramer, MJ and van der Harst, P and van Es, R and Meine, M}, title = {From Clinic to Cloud: Efficacy of AI-Assisted Remote Monitoring of Patients With Implantable Cardiac Devices.}, journal = {Pacing and clinical electrophysiology : PACE}, volume = {48}, number = {10}, pages = {1106-1113}, pmid = {40838527}, issn = {1540-8159}, mesh = {Humans ; *Artificial Intelligence ; *Defibrillators, Implantable ; COVID-19/epidemiology ; *Pacemaker, Artificial ; Telemedicine ; *Cloud Computing ; *Remote Sensing Technology ; Monitoring, Physiologic/methods ; }, abstract = {The integration of telehealth, particularly remote monitoring (RM), has profoundly improved the care of patients with cardiac implantable electronic devices (CIEDs). The recent COVID-19 pandemic has further accelerated the adoption of RM systems. The implementation of RM to standard clinical care has been accompanied by a surge of device transmissions. Especially unscheduled transmissions have resulted in an overwhelming workload for clinicians. As the number of device transmissions is expected to increase further while clinical resources remain limited, workflow optimization is crucial. Artificial intelligence (AI) presents a promising solution. This review outlines recent advances in RM and AI applications for CIEDs. It explores the potential of AI to streamline RM workflows, reduce clinician workload, and enhance heart failure care by enabling early detection of clinical deterioration and timely intervention. In addition, key barriers to implementation are addressed, including data standardization and regulatory considerations. Beyond improving monitoring efficiency and patient outcomes, AI-supported RM may also help expand access to care through more effective resource allocation and contribute to a more sustainable, future-proof healthcare system.}, }
@article {pmid40838034, year = {2025}, author = {Gunawan, VJ and Siregar, FR and Vidiasratri, AR and Hanindriyo, L}, title = {The Role of Poly Vinyl Pyrrolidone Iodine (PVP-I) in Preventing Cross-Infection during Dental Procedures: A Systematic Review in the COVID-19 Context.}, journal = {Journal of International Society of Preventive &amp; Community Dentistry}, volume = {15}, number = {3}, pages = {197-210}, pmid = {40838034}, issn = {2231-0762}, abstract = {AIM: As the dental community navigates the challenges posed by the coronavirus disease 2019 (COVID-19) pandemic, mitigating the risk of viral cross-transmission among dentists and dental clinic operators remains paramount. Polyvinyl pyrrolidone iodine (PVP-I) has emerged as a promising agent in reducing the chance of cross-transmission, primarily through its broad-spectrum antiseptic properties and ability to kill viruses rapidly. This study aimed to explore the role of PVP-I in preventing cross-infection of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and assess its effectiveness as a prophylaxis before dental treatment.<br><br>MATERIALS AND METHODS: A comprehensive search of multiple databases, including Science Direct, PubMed, Sage Journal, Cochrane, and Wiley Online Library, was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study selection process utilized the Patient, Intervention, Comparison, Outcome, and Study Design framework (P: SARS-CoV-2 positive individuals, I: PVP-I mouthwash, C: various PVP-I concentrations, O: virucidal effect, S: randomized-controlled trials and clinical trials). Titles and abstracts were screened for relevance, and full-text articles were assessed for eligibility based on predefined inclusion and exclusion criteria. The risk of bias was assessed using the Cochrane Risk of Bias Tool version 2 for randomized controlled trials and Toxicological Data Reliability Assessment Tool for in vitro studies. A total of 11 articles (seven in vitro and four in vivo) were included in the systematic review.<br><br>RESULTS: Our findings suggest that PVP-I exhibits superior antiseptic properties compared to other agents, with gargling using PVP-I solutions of 0.2% and 0.5% demonstrating significant efficacy in reducing viral load in saliva. Notably, PVP-I showed rapid virucidal action, effectively reducing SARS-CoV-2 viral particles and potentially lowering the risk of cross-infection during dental procedures. However, despite these promising results in viral reduction, the evidence remains insufficient to definitively recommend PVP-I as a routine clinical prophylaxis for preventing cross-infection in dental care settings during the COVID-19 pandemic. Further large-scale clinical trials are necessary to establish its widespread use.<br><br>CONCLUSION: This systematic review highlights the potential of PVP-I as a critical antiseptic in dental settings to mitigate the risk of SARS-CoV-2 transmission. The rapid and significant reduction in viral load suggests that PVP-I could play a pivotal role in infection control protocols. Nonetheless, further robust clinical trials are essential to confirm its efficacy and guide its adoption in routine dental care practices.}, }
@article {pmid40838007, year = {2025}, author = {Arioua, A and Shaw, D}, title = {The burden of thalassemia disorder: Past and present: The feedback of patients experience in the COVID-19 pandemic crisis.}, journal = {Asian journal of transfusion science}, volume = {19}, number = {1}, pages = {125-129}, pmid = {40838007}, issn = {0973-6247}, abstract = {Thalassemia is a genetic blood condition and one of the emerging global public health concerns in the world, with an estimated prevalence of 300,000,000. The genes controlling hemoglobin production are affected, leading to an anemia of variable severity. Carriers of this hereditary anemia are found globally, but a high frequency is observed around the Mediterranean basin, in the Middle East, in the Indian subcontinent, and in Southeast Asia, so called the thalassemia belt. This article aims to review the history and factors of spreading of thalassemia, to identify the burden of the disease on individuals, population, and public health, and the issues that thalassemia patients have experienced during the pandemic of COVID-19. Online literature and previous studies on the disease are used to prepare this article. We identified various factors that have contributed to the spread of thalassemia in the last decades and affected the health condition of individuals and population. The recent worldwide pandemic of COVID-19 worsened the situation and made it more complicated for most patients, especially in the emerging countries.}, }
@article {pmid40837898, year = {2025}, author = {Khanani, MI and Khan, MR and Farooqi, MF and Fazal, J and Aabideen, Z and Alkuwaiti, NS}, title = {Digital Media Use and Screen Time Exposure Among Youths: A Lifestyle-Based Public Health Concern.}, journal = {Cureus}, volume = {17}, number = {7}, pages = {e88373}, pmid = {40837898}, issn = {2168-8184}, abstract = {The pervasive rise of digital media and screen-based entertainment has transformed the developmental landscape for children and adolescents. The COVID-19 pandemic further amplified screen exposure, exacerbating public health concerns. While digital media offers educational, social, and recreational benefits, growing concerns have emerged regarding its adverse health outcomes. Several international guidelines recommend limited screen time particularly for children under five; however, adherence remains inconsistent. This review combines recent global data and research findings to examine the physical, mental, cognitive, developmental, and emotional health consequences of digital media use and excessive screen time among youth. Physical effects include increased risks of obesity, sleep disturbances, visual impairments, and musculoskeletal pain, particularly with prolonged sedentary behaviors. Mental health outcomes are equally concerning, with excessive screen exposure associated with depression, anxiety, low self-esteem, and, alarmingly, self-harm and suicidal tendencies. Screen time exceeding 2-4 hours per day is consistently linked with increased cognitive and developmental health risks, though the threshold for harm remains debated. Despite some potential benefits of high-quality, interactive content, the evidence highlights the need for balanced media use, age-appropriate limits, and active parental guidance. By integrating findings from international studies and public health recommendations, this review provides a comprehensive foundation for clinicians, educators, and policymakers to develop targeted strategies that promote healthier digital behaviors in children and adolescents.}, }
@article {pmid40837807, year = {2025}, author = {Yang, CQ and Woo, BKP}, title = {Mental health of older Asian Americans: Current issues, updates, and future directions.}, journal = {World journal of psychiatry}, volume = {15}, number = {8}, pages = {106806}, pmid = {40837807}, issn = {2220-3206}, abstract = {As the population of older Asian Americans continues to grow rapidly, understanding their mental health needs has become increasingly critical. This literature review summarizes current issues, developments, and future directions in addressing the mental health challenges faced by older Asian Americans in the last five years. We briefly touch on the comparative prevalence of mental health disorders experienced by ethnic subgroups. Additionally, we review recent studies highlighting the role of the coronavirus disease 2019, racism, social support, cultural stigma, and self-rated health as significant factors influencing mental well-being of this population. We discuss the utilization of health services among older Asian Americans. We conclude with thoughts for future research, emphasizing the importance of longitudinal studies, consideration of diverse Asian American ethnic subgroups, and culturally sensitive diagnostic and treatment approaches.}, }
@article {pmid40837720, year = {2025}, author = {Sabetrohani, H and Koohpayehzadeh, J and Sheikhtaheri, A and Goli, S and Abhari, MB and Keramat, A}, title = {Virtual-Based Prenatal Care Methods and Their Reported Outcomes-A Scoping Review.}, journal = {Health science reports}, volume = {8}, number = {8}, pages = {e71150}, pmid = {40837720}, issn = {2398-8835}, abstract = {BACKGROUND AND OBJECTIVE: The use of virtual technologies in prenatal care has significantly increased, particularly during the COVID-19 pandemic; however, the implications of this approach remain a topic of discussion. This review aimed to categorize virtual-based prenatal care methods and their reported clinical and nonclinical outcomes.<br><br>METHODS: This scoping review was conducted by searching the Web of Science, PubMed, Scopus, ProQuest, SID, Irandoc, Magiran databases, and Google Scholar search engine from January 2005 to February 2021 and completed until December 2023. Our included studies were quantitative and review studies in English that mentioned virtual prenatal care and related outcomes. We followed the narrative approach for presenting and synthesizing results and PRISMA-ScR guidelines for the accompanying explanation.<br><br>RESULTS: After retrieving 1324 studies and removing duplicates, 35 articles were reviewed. We divided virtual-based prenatal care into two main categories: only using virtual methods and modified care models by virtual methods. Mhealth was the most widely used virtual care method due to its accessibility to most mothers, low cost, and use of dedicated apps. The reported outcomes were also classified into seven subcategories. Maternal and neonatal outcomes, maternal and provider satisfaction, and change in patient knowledge, attitude, and practice were the three most commonly reported outcomes.<br><br>CONCLUSION: Improvement of a variety of clinical and nonclinical outcomes is anticipated to facilitate the effective implementation of tailored virtual interventions for mothers, ultimately improving health outcomes for both mothers and fetuses.}, }
@article {pmid40837287, year = {2025}, author = {Farooq, M and Al-Qudah, AM and Khan, AM and Muthana, A and Shahnoor, S and Ahmad, H and Hoz, SS}, title = {Global trends and hotspots in recent neurotrauma-related research in war-stricken countries: A bibliometric and visualization analysis.}, journal = {Surgical neurology international}, volume = {16}, number = {}, pages = {293}, pmid = {40837287}, issn = {2229-5097}, abstract = {BACKGROUND: The increase of interest in neurotrauma is growing worldwide due to the increase in military conflicts in war-stricken countries around the globe. There is an increasing trend of publishing about it worldwide. We aim to sort out the topic trends in the field of neurotrauma in countries experiencing military conflicts from the perspective of bibliometrics in the last 3 years, from 2020 to 2023. This will provide a status update on the current situation of publication productivity on the related topic, while simultaneously studying the potential effect of COVID-19 pandemic on it.<br><br>METHODS: We looked into articles and reviews published between 2020 and 2023 in Scopus based on predefined inclusion criteria which included neurotrauma-related publications sourced or co-authored by authors from war-stricken countries. 80 articles were included in the final analysis. The global research publication output, contributions of countries, institutions, journals, authors, average citation index (ACI), and keywords were analyzed.<br><br>RESULTS: There was a rise in publication productivity in 2020, which declined in 2021 and then again increased in 2022 onward. The United States published the largest number of articles either sourced or co-authored with authors from war-stricken countries (32/80, 40%) while Russia had the highest total citations (70). The order of countries with the highest ACI was Azerbaijan (18.5) followed by Spain and Egypt (14.7). The American University of Beirut was the most prolific institution. It had the highest number of publications (8) and citations (41). Gardner R.C. was the author with the most publications (3), followed by F. Anwar, M. N. Kravtsov, and R. Darwazeh. (2). World Neurosurgery had the most publications (6), but Frontiers in Surgery was the most impactful journal (ACI = 4.5). The most recent keywords predominantly revolve around topics such as "traumatic brain injury" (occurred 22 times) followed by rehabilitation' (6), veterans (4) and humanitarian activities (3). There were significant collaborations among developed countries and war-stricken countries for publications related to the topic.<br><br>CONCLUSION: An increasing trend in publications regarding neurotrauma in war-stricken countries was seen. Enhanced collaborations tell us about the combined interest of countries, irrespective of being at peace or at war. Our findings could provide useful information to identify potential research fronts in the coming years.}, }
@article {pmid40836846, year = {2025}, author = {Srinivasan, G and Anaikutti, P and Mohan, S and Arukkani, M}, title = {Versatile Application of Calixarenes and Their Derivatives: From Drug Delivery to Industrial Catalysis and Environmental Remediation.}, journal = {Critical reviews in analytical chemistry}, volume = {}, number = {}, pages = {1-58}, doi = {10.1080/10408347.2025.2538731}, pmid = {40836846}, issn = {1547-6510}, abstract = {Calixarenes are a structurally versatile class of macrocyclic compounds that exhibit broad functionality across pharmaceutical, analytical, industrial, and environmental domains. Their conformational flexibility and functionalize upper and lower rims facilitate selective host-guest interactions, enabling their use in targeted drug delivery systems with demonstrated antiviral, antibacterial, antifungal, and anticancer efficacy. In analytical chemistry, calixarene-based sensors have been integrated into colorimetric, fluorometric, potentiometric, and voltammetric platforms, offering high selectivity and low detection limits for analytes such as metal ions, nucleotides, and neurotransmitters. Advances in medical imaging have leveraged calixarene derivatives to enhance MRI contrast and specificity. Their strong chelating capabilities and environmental stability support their application in water purification and soil remediation. Commercial developments, including green leather tanning agents, anti-corrosion coatings, and COVID-19-era antiviral coatings, highlight their real-world potential. Furthermore, computational and AI-driven molecular modeling approaches have facilitated rational calixarene design by predicting binding affinities, dynamic conformations, and interaction energies. While promising, considerations such as low intrinsic solubility, scale-up limitations, and dose-dependent cytotoxicity require further exploration for clinical translation. This review provides a comprehensive evaluation of calixarenes, emphasizing their evolving role as supramolecular platforms in next-generation scientific and industrial innovations.}, }
@article {pmid40836727, year = {2025}, author = {Ghosh, S and Khanra, D and Kala, C and Krishna, V and Thakur, AK}, title = {Diagnosis of Cardiac Amyloidosis in South Asia: Need for a Collaborative Approach from Researchers and Clinicians.}, journal = {The Journal of the Association of Physicians of India}, volume = {73}, number = {7}, pages = {79-87}, doi = {10.59556/japi.73.1050}, pmid = {40836727}, issn = {0004-5772}, mesh = {Humans ; *Amyloidosis/diagnosis/therapy/epidemiology ; COVID-19/epidemiology ; India/epidemiology ; *Cardiomyopathies/diagnosis/therapy ; SARS-CoV-2 ; Asia, Southern ; }, abstract = {Recent developments in diagnostic approaches for cardiac amyloidosis (CA) have augmented the possibility of its accurate diagnosis. Rising cardiovascular diseases in South Asian countries along with many undiagnosed cases make it important for cardiologists to screen patients for CA. Besides, the increasing susceptibility of amyloidosis patients to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection needs prompt diagnosis and management of CA in the COVID-19 era. With this focus in mind, a review of recent diagnostic approaches and treatment options adapted for CA is outlined in this article. In addition, a layout of different initiatives to diagnose such patients in the future has also been depicted. These approaches, if collaboratively adopted by the researchers and clinicians, would aid in the accurate diagnosis of CA patients in the South Asian population including India.}, }
@article {pmid40836603, year = {2025}, author = {Gupta, A and Srivastava, S and Golmei, P and Yadav, L and Kumar, S}, title = {Signal Amplification to Improve Electrochemical Biosensing for Infectious Diseases.}, journal = {Biotechnology and applied biochemistry}, volume = {}, number = {}, pages = {}, doi = {10.1002/bab.70044}, pmid = {40836603}, issn = {1470-8744}, abstract = {Infectious disease detection and monitoring are critical for public health management. Electrochemical biosensors have emerged as promising tools for rapid and sensitive detection of infectious diseases. This review explores signal amplification approaches to improve the sensitivity and limit of detection of electrochemical biosensors for infectious diseases. Enzymatic signal amplification methods, utilizing enzymes such as endonuclease, nucleotidyl transferase, DT-diaphorase, and alkaline phosphatase, are discussed along with examples of their application in detecting tuberculosis, HIV, and COVID-19. Nanoparticle-based amplification approaches, including gold nanoparticles, quantum dots, and magnetic nanoparticles, are explored, highlighting their utility in detecting hepatitis B, Zika virus, and Ebola virus. Additionally, label-free amplification techniques such as electrochemical impedance spectroscopy and surface plasmon resonance are examined, with examples demonstrating their efficacy in detecting dengue virus and influenza virus. Hybrid signal amplification methods combining enzymatic, nanoparticle-based, and label-free approaches are also discussed, showcasing their potential in detecting malaria and bacterial infections. Challenges such as the need for point-of-care testing and overcoming interferences are addressed, along with future research directions, including multiplexed assays and integration with smartphones for data analysis. This review provides insights into the diverse signal amplification strategies for electrochemical biosensors and their impact on infectious disease diagnosis and control.}, }
@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 &amp; control/epidemiology/immunology ; *Pertussis Vaccine/administration &amp; dosage/immunology ; COVID-19/epidemiology/prevention &amp; control ; Vaccines, Acellular/administration &amp; dosage/immunology ; South America/epidemiology ; Female ; Central America/epidemiology ; Vaccination Coverage/statistics &amp; 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.<br><br>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.<br><br>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.}, }
@article {pmid40835908, year = {2025}, author = {Morillon, GF and Guillon, M and Laberge, M and Sowanou, A and Poder, TG}, title = {Patients' perspective about synchronous teleconsultation with a general practitioner: a mixed-method systematic literature review.}, journal = {BMC primary care}, volume = {26}, number = {1}, pages = {259}, pmid = {40835908}, issn = {2731-4553}, support = {Project PJT 186075/CAPMC/CIHR/Canada ; Project PJT 186075/CAPMC/CIHR/Canada ; Project PJT 186075/CAPMC/CIHR/Canada ; }, mesh = {Humans ; *Remote Consultation ; *Patient Satisfaction ; COVID-19/epidemiology ; *General Practitioners ; Primary Health Care ; SARS-CoV-2 ; Patient Preference ; }, abstract = {BACKGROUND: Synchronous teleconsultations using video or phone have become an increasingly popular method for delivering healthcare, especially in primary care. This modality enhances access to care, particularly for individuals in remote or underserved areas, and was especially significant during disruptions like the COVID-19 pandemic. Despite these benefits, patient perspectives on teleconsultations with general practitioners (GPs) remain underexplored. Factors such as consultation type, convenience, and technology influence patient satisfaction and acceptance, but concerns persist about the effectiveness of remote consultations for complex cases. This systematic review explores patients' use, attitudes, experiences, satisfaction, and preferences regarding synchronous teleconsultations with GPs, aiming to identify factors influencing the choice of teleconsultation over face-to-face consultations.<br><br>METHODS: The review included 46 studies published until March 2023, sourced from PubMed, Web of Science, EBSCO, and Cochrane Library, following PRISMA guidelines. Quantitative, qualitative, and mixed-method studies were analyzed, representing diverse contexts.<br><br>RESULTS: Findings reveal that patient satisfaction with teleconsultation is influenced by consultation purpose, convenience, technological capabilities, and continuity of care. Video consultations are preferred over phone consultations, particularly for follow-ups and routine issues. Teleconsultation is seen as less effective for complex consultations requiring physical exams. Patient characteristics, including age, socioeconomic status, and technology familiarity, impact acceptance. Privacy concerns, data security, and diagnostic accuracy remain significant barriers. Continuity of care is better maintained when teleconsultation involves established patient-GP relationships.<br><br>CONCLUSIONS: The review emphasizes the need for hybrid care models and policies aligned with patient preferences, focusing on accessibility, technology, and privacy safeguards. Future research should address barriers for vulnerable populations and equitable access.}, }
@article {pmid40835454, year = {2025}, author = {Morimoto, Y and Higashi, H and Izumi, H and Tomonaga, T and Nishida, C and Yamato, H and Eguchi, H and Kawanami, S and Suzuki, K and Yatera, K}, title = {[Preventive measures against infections, including viruses in the workplace].}, journal = {Sangyo eiseigaku zasshi = Journal of occupational health}, volume = {67}, number = {6}, pages = {253-264}, doi = {10.1539/sangyoeisei.2025-018-A}, pmid = {40835454}, issn = {1349-533X}, mesh = {Humans ; *COVID-19/prevention &amp; control/transmission ; *Workplace ; SARS-CoV-2 ; *Occupational Health ; *Infection Control/methods ; Ventilation ; Masks ; *Occupational Exposure/prevention &amp; control ; *Pandemics/prevention &amp; control ; Air Conditioning ; }, abstract = {Pandemics such as COVID-19 have wreaked havoc on society in general, and they are still having a lasting impact, with peak infections in summer and winter. Novel emerging infectious diseases and re-emerging ones that are attracting renewed attention will continue to affect workplaces in the future. Herein, we focus on the latest reports on COVID-19 and explain what preventive measures are necessary in the workplace, taking into account the route of virus infection. Although droplets and airborne exposure are the main infection routes, contact infection cannot be overlooked. Infection prevention measures include the uses of natural and mechanical ventilation, air conditioning equipment, and masks as well as the recommendation of vaccination, all of which have reported effectiveness However, since indoor environments vary, we do not recommend preventive control through any one measure alone. Instead, implementing infection control by using a combination of measures is important for adaptation to various situations.}, }
@article {pmid40835394, year = {2025}, author = {Iversen, KK and Roldgaard, MS and Konstantinidis, I and Lindhardt, MS and Ahlström, MG and Morris, A and Ronit, A and Benfield, T}, title = {Recovery of lung function during the first year after COVID-19: a systematic review and meta-analysis.}, journal = {European respiratory review : an official journal of the European Respiratory Society}, volume = {34}, number = {177}, pages = {}, pmid = {40835394}, issn = {1600-0617}, support = {K08 HL169023/HL/NHLBI NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/physiopathology/diagnosis ; Recovery of Function ; *Lung/physiopathology/virology ; Vital Capacity ; Time Factors ; Forced Expiratory Volume ; Pulmonary Diffusing Capacity ; Respiratory Function Tests ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Several studies have reported lung function impairment following COVID-19. Less is known about the subsequent recovery.<br><br>RESEARCH QUESTION: What is the recovery in lung function after COVID-19 during the first year after infection?<br><br>METHODS: We conducted a systematic review and meta-analysis of studies that monitored individuals' lung function from the time of infection to at least 1 year after infection. Primary outcomes were change in percent predicted forced expiratory volumes in 1 s (FEV1), forced vital capacity (FVC) and diffusing capacity for carbon monoxide (D LCO). Mean differences (MDs) with 95% confidence intervals were estimated using a random effects model.<br><br>RESULTS: We included 23 studies (n=3347 participants). 20 (86.9%) studies had their first follow-up 3 months after infection and 21 (91.3%) had their second follow-up 12 months after infection. The MDs between the second and first follow-up visits of FEV1, FVC and D LCO were 3.1% (95% CI 1.8-4.5; p<0.01), 4.4% (95% CI 2.7-6.0; p<0.01) and 6.6% (95% CI 4.4-8.9; p<0.01), respectively. Recovery of FEV1, FVC and D LCO was greater in mechanically ventilated patients compared to individuals with less severe disease. Current smoking status, pre-existing chronic lung disease and age did not impact recovery during the first year after infection.<br><br>INTERPRETATION: Recovery in lung function was evident during the first year after COVID-19, with the largest improvement in patients with the most severe infection. Further follow-up and large-scale studies are warranted to establish recovery trajectories of COVID-19 and other respiratory infections to identify patient subgroups needing additional follow-up to ascertain modifiable factors influencing pulmonary recovery.}, }
@article {pmid40834932, year = {2025}, author = {Oliveros, MJ and Ibrahim, S and Bravo-Soto, G and Chahin-Inostroza, N and Zaror, C and Ulloa-Lopez, C and Sanhueza, &#xc1; and Seron, P and Zeraatkar, D and Guyatt, G and Santesso, N and Brignardello-Petersen, R}, title = {Including conference abstracts rarely changed systematic review conclusions: a case study from a living network meta-analysis of COVID-19 treatments.}, journal = {Journal of clinical epidemiology}, volume = {187}, number = {}, pages = {111931}, doi = {10.1016/j.jclinepi.2025.111931}, pmid = {40834932}, issn = {1878-5921}, mesh = {Humans ; *Systematic Reviews as Topic ; Network Meta-Analysis as Topic ; *COVID-19 Drug Treatment ; *COVID-19/therapy ; Retrospective Studies ; *Abstracting and Indexing ; Publication Bias ; SARS-CoV-2 ; *Congresses as Topic ; Reproducibility of Results ; }, abstract = {BACKGROUND AND OBJECTIVES: Including conference abstracts (CAs) in systematic reviews (SRs) helps reduce publication bias but raises concerns about reporting quality and reliability. While discrepancies with full publications are known, excluding CAs may overlook relevant early evidence. To evaluate the reporting quality of CAs, their consistency with full-text publications, and the impact of including them on effect estimates and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework in a living systematic review and network meta-analysis (SRNMA) of COVID-19 drug treatments.<br><br>STUDY DESIGN AND SETTING: We conducted a retrospective methodological study of all CAs included in the COVID-19 SRNMA until May 19, 2024. We assessed trial characteristics, reporting quality using Consolidated Standards of Reporting Trials (CONSORT)-A, and consistency with full-text publications. We also compared meta-analyses with and without CAs at predefined time points for mortality and hospital length of stay, evaluating changes in effect and GRADE domains.<br><br>RESULTS: We included 105 CAs; 53% (56/105) were linked to a full publication. Only 7% met high reporting standards. Average consistency with full-text publications across key methodological items was 67.6%, often due to missing details in both sources. CAs enabled meta-analyses that would not have been possible at 14% of time points. Their inclusion did not affect conclusions when using the null threshold but changed the effect estimate in 55.6% and imprecision ratings in 16% of cases when using minimally important differences (MIDs). In a few instances, CAs also influenced risk of bias and inconsistency assessments.<br><br>CONCLUSION: CAs can fill evidence gaps when data are limited or emerging. Although they rarely change conclusions based on the null threshold, their inclusion has a greater impact when using MID. Reviewers should assess their inclusion case by case and promote better reporting practices to enhance their contribution to SRs.}, }
@article {pmid40834399, year = {2025}, author = {Hollinrake, G and Stevenson, L and Wilkinson, LL and Komninou, S and Brown, A}, title = {How Does Household Food Insecurity Impact Complementary Feeding, in High Income Countries, in a Cost-of-Living Crisis? A Systematic Scoping Review.}, journal = {Maternal &amp; child nutrition}, volume = {}, number = {}, pages = {e70082}, doi = {10.1111/mcn.70082}, pmid = {40834399}, issn = {1740-8709}, abstract = {Complementary feeding, when infants are introduced to solid foods, is an important stage of learning new tastes, textures and eating behaviours. Austerity, post-BREXIT (in the UK) and the COVID-19 pandemic have created a cost-of-living crisis, exacerbating prevalence of food insecurity in high-income countries. Understanding how this may impact upon parents' experience of complementary feeding is important. This systematic scoping review therefore examined how food insecurity impacts diet and feeding practices during the complementary feeding period for infants aged 6-18 months. Four electronic databases were searched, identifying 5822 articles. 3293 titles and abstracts, from which 30 full texts were screened by two independent reviewers. The final review included five articles (two qualitative and three quantitative). Three articles were conducted in Australia, one in America, one in New Zealand with 1044 parent/child dyads in total. Strategies such as encouraging children to finish their food, avoiding foods that might not be accepted and reducing food variety were common. These strategies may ensure children are fed but may reduce elements of complementary feeding that we know are important such as exposing infants to wide varieties of tastes, textures and nutrients and adopting a responsive feeding style. The sparsity of evidence in this review, particularly for research based in the UK, highlights the need for further research in high-income countries to explore the impact of household food insecurity on complementary feeding. This will help to identify priorities for those working in policy and practice to support families with complementary feeding during the cost-of-living crisis and beyond.}, }
@article {pmid40834236, year = {2025}, author = {Kara, B and Scharf, N and McCormick, KC and Bhreathnach, L and Currie, C and Symonds, J}, title = {Adolescent Anxiety During the COVID-19 Pandemic: A Qualitative Systematic Review of Risk and Protective Factors.}, journal = {Journal of adolescence}, volume = {97}, number = {8}, pages = {2048-2066}, pmid = {40834236}, issn = {1095-9254}, support = {//This work was funded by the European Association for Research on Adolescence (EARA)./ ; }, mesh = {Humans ; *COVID-19/psychology/epidemiology ; Adolescent ; *Anxiety/epidemiology/psychology/etiology ; Risk Factors ; Protective Factors ; Qualitative Research ; Pandemics ; Adaptation, Psychological ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: The COVID-19 pandemic significantly disrupted adolescents' lives, leading to increased stress and anxiety rates globally. Although existing research highlights the necessity of understanding the increased rates of anxiety in adolescents during and after the pandemic, it offers little insight into the risk and protective factors for the development of adolescent anxiety at this time. To more deeply understand how the pandemic impacted anxiety in adolescents around the world, the current study adopted a qualitative approach to synthesising the global evidence on adolescents' lived experiences of anxiety during the pandemic.<br><br>METHODS: Five databases (Academic Search Complete, British Education Index, Education Research Information Centre, APA PsycINFO, and Scopus) were searched for studies that included qualitative data reported by adolescents on their lived experiences of anxiety during the pandemic. After duplicate records were removed, 348 records were title and abstract screened, a shortlist of 117 publications for full text screening, resulting in 34 papers to be included in the review.<br><br>RESULTS: Thematic analysis of data uncovered adolescents' experiences of anxiety during the pandemic in relation to a wide range of risk factors (i.e., academic stressors, family and economic stressors, social isolation, online dangers, uncertainties and health-related concerns) and protective factors (e.g., social support, personal coping, accurate information and clear guidelines, digital tools) in different developmental contexts.<br><br>CONCLUSIONS: These findings can guide the development of effective practices and policies for young people navigating the complexities of the post-pandemic world.}, }
@article {pmid40833114, year = {2025}, author = {Abney, SE and Bloomfield, SF and Boone, SA and Cutts, T and Gerba, CP and Ijaz, MK and Lyons, AK and Maillard, J-Y and Mena, KD and McKinney, J and Park, GW and Scott, E and Reynolds, KA and Rutala, WA and Sattar, SA and Weber, DJ and Verhougstraete, MP and Williams, MM and Furin, WA and Wilson, AM and Whitworth, JC and Zargar, B}, title = {Fomite workshop recommendations addressing the role of surfaces in virus transmission in the built environment.}, journal = {mSphere}, volume = {10}, number = {9}, pages = {e0092724}, pmid = {40833114}, issn = {2379-5042}, mesh = {Humans ; *Fomites/virology ; *COVID-19/transmission/prevention &amp; control ; SARS-CoV-2 ; *Built Environment ; }, abstract = {The emergence of SARS-CoV-2 has led to a need to assess the role of fomites in viral transmission within the built environment. Assessing the role of fomites is necessary for developing intervention strategies for controlling emerging pathogens. A fomite workshop with experts was convened in November 2024 by academia, several government agencies, and public health officials to evaluate existing data and discuss how to mitigate risks. Fomite transmission is influenced by the nature of the built environment, population density and proximity, environmental factors (humidity, heat, etc.), virus survival, surface type, engineering controls (ventilation, physical barriers, etc.), and human behaviors. Based on our current data, direct contact with a contaminated surface/fomite, even for respiratory viruses, presents a risk of viral exposure and transmission by both contact with the fomite and resuspension in the air. Even respiratory viruses can be resuspended from fomites following human and pet movement, activities (e.g., vacuuming, toilet flushing, etc.), or changes in ventilation/indoor airflow. After resuspension from surfaces, microbes can be potentially inhaled (contributing to droplet and/or aerosol exposure) and/or re-deposited from primary to secondary fomites. Development of standard methods (molecular, chemical/physical, and infectivity assays) for detecting the presence of viruses on fomites and human behavior modeling would help to determine the most effective infection prevention strategies.}, }
@article {pmid40832038, year = {2025}, author = {Sardinha, DM and Silva, MJA and Bispo, SKS and da Silva, APO and Lima, KVB and Ferreira, IP and Lima, LNGC}, title = {Prevalence of COVID-19 vaccine hesitancy in Brazil: a systematic review and meta-analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1622247}, pmid = {40832038}, issn = {2296-2565}, mesh = {Humans ; Brazil/epidemiology ; *Vaccination Hesitancy/statistics &amp; numerical data ; *COVID-19 Vaccines/administration &amp; dosage ; *COVID-19/prevention &amp; control/epidemiology ; Prevalence ; SARS-CoV-2 ; Female ; Male ; }, }
@article {pmid40831635, year = {2025}, author = {Tao, X and Ma, Z and Yuan, H and Zhao, W and Liu, J and Tian, J}, title = {Research hotspots and global trends in respiratory syncytial virus over past five years.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1599093}, pmid = {40831635}, issn = {1664-302X}, abstract = {Respiratory syncytial virus (RSV) is the main cause of acute lower respiratory tract infections in children under 2 years old. This bibliometric analysis is used to determine the characteristics, hotspots, and frontiers of RSV global scientific output over the past 5 years. In this study, the Science Citation Index Expanded (SCI-Expanded) version from the Web of Science Core Collection (WoSCC) for publications and record information published from 2020 to 2024 was retrieved. Bibliometric software package was used to analyze the bibliometric indicators, and the research trends and hotspots of RSV were visualized by VOSviewer and Citespace. We assessed paper influence with the Global Citation Score (GCS). A total of 7,238 articles and comments were searched. The USA is the most productive country in the field of RSV research and also the country with the closest cooperation with other countries and institutions. The most influential journal in this field is "VIRUSES BASEL" with 246 publications. The co-citation analysis of references showed that the RSV-related topics with the highest focus are "covid-19 pandemic," "respiratory syncytial virus prefusion," "American academy," and "protein vaccine." From 2020 to 2024, keyword cluster and keyword burst analyses showed that "Respiratory Syncytial Virus," "Infection," and "Children." "Viral co-infection," "anti-virus," and "vaccines" are currently research hotspots. The research area in this field is mainly distributed among "Immunology," "Pediatrics," "Pharmacology Pharmacy," and "Biochemistry Molecular Biology." Our study highlights the trends and hotspots in the field of RSV research over the past 5 years. Identifying the most critical indicators in the field of RSV research would be able to help researchers in this field better understand RSV and make decisions.}, }
@article {pmid40830785, year = {2025}, author = {Liang, Y and Peng, H and Luo, X and Wang, M and Zhang, Y and Huang, H and Zhu, J and Chen, M and Tian, W and Mo, J and Nong, Y and Wang, Y and Huang, Y and Tan, S and Jiang, L and Pan, W and Ning, C}, title = {The impact of health emergencies on nurses' burnout: a systematic review and meta-analysis.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {2847}, pmid = {40830785}, issn = {1471-2458}, support = {GKLKP-KF-202202//Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response/ ; 2023GXNSFFA026007//Outstanding Youth Fund of The Natural Science Foundation of Guangxi in China/ ; }, mesh = {Humans ; *Burnout, Professional/epidemiology/psychology ; *COVID-19/epidemiology ; *Emergencies/psychology ; *Nurses/psychology ; SARS-CoV-2 ; Personnel Turnover ; *Nursing Staff, Hospital/psychology ; }, abstract = {BACKGROUND: Burnout is a prevalent occupational phenomenon among healthcare workers. To evaluate the current evidence on nurses' burnout and the impact of turnover intention during the pandemic is imperative.<br><br>OBJECTIVE: We aimed to comprehensively synthesize and quantify the impact of health emergencies caused by the COVID-19 pandemic outbreak on nurses' burnout and identify factors associated with the negative impact.<br><br>METHODS: Systematic searches were conducted in PubMed, Web of Science, EBSCO (ASP), Cochrane Library, and supplemented by a manual search, for publications from December 2019 to February 2023.<br><br>RESULTS: A total of 176 articles involving 110,316 nurses were identified. The overall pooled estimate of the prevalence of burnout was 48% (95% confidence interval [CI] 42-55%). The mean score for overall burnout on the 22-item (7-point) Maslach Burnout Inventory (MBI) was 59.83 (95% CI 49.33 to 70.34). In the work environment, nurses who were exposed to COVID-19 (SMD 0.19, 95% CI 0.04 to 0.33) or worked in emergency departments and ICUs (SMD 0.10, 95% CI 0.06 to 0.14) scored higher for burnout compared to those in general wards. In the presence of increased burnout, overall burnout in nurses was associated with a sevenfold increase in depression (OR 7.40, 95% CI 3.82 to 14.35), a fourfold increase in anxiety (OR 4.14, 95% CI 2.15 to 7.98) and stress (OR 4.60, 95% CI 2.31 to 9.17), and a fourfold increase in low resilience (OR 4.06, 95% CI 2.13 to 7.76) in mental health outcomes. As burnout increased, turnover intention was nearly four times as likely compared with retention (OR 3.55, 95% CI 1.73 to 7.28), and it was related to the quality of care.<br><br>CONCLUSION: The results of this meta-analysis indicate that half of the nurses experienced burnout during the COVID-19. Nurses' burnout is associated with the sustainability of healthcare organizations. Healthcare organizations and societies should invest more time and effort in implementing evidence-based strategies to mitigate nurses' burnout across specialties, especially in emergency medicine and for younger nurses in specialized departments, to better prepare for future public health emergencies.}, }
@article {pmid40829499, year = {2025}, author = {Olivier, G and Luigia, E}, title = {SARS-CoV-2 and chronic kidney disease: challenges and future directions.}, journal = {Current opinion in immunology}, volume = {96}, number = {}, pages = {102642}, doi = {10.1016/j.coi.2025.102642}, pmid = {40829499}, issn = {1879-0372}, mesh = {Humans ; *COVID-19/immunology/epidemiology/prevention &amp; control ; *SARS-CoV-2/immunology ; *Renal Insufficiency, Chronic/immunology/therapy/epidemiology/complications ; *COVID-19 Vaccines/immunology ; Vaccination ; Kidney Transplantation ; }, abstract = {Patients with chronic kidney disease (CKD), especially those with end-stage kidney disease on dialysis or kidney transplant recipients (KTRs), are highly susceptible to infections, including the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 pandemic disproportionately affected this vulnerable population, leading to increased morbidity and mortality. Immune dysfunction in CKD patients contributes to a suboptimal defense against infections and a reduced response to SARS-CoV-2 vaccinations. Although vaccination has significantly reduced severe outcomes, dialysis patients and KTRs exhibit lower seroconversion rates and faster antibody waning compared to the general population. Recent evidence suggests that booster doses improve immune responses, but vaccine efficacy remains lower in immunosuppressed individuals. This review highlights the epidemiology of COVID-19 in nephropathic patients, the mechanisms underlying their immune dysregulation, and the effectiveness of vaccination strategies. Future directions include optimizing booster regimens, integrating serological and avidity testing to tailor vaccination strategies, and exploring novel immunotherapeutic approaches. A multidisciplinary effort involving nephrologists, immunologists, and public health experts is essential to improve pandemic preparedness and develop targeted strategies to protect nephropathic patients from future viral threats.}, }
@article {pmid40829362, year = {2025}, author = {Anwar, S and Khan, S and Azmi, I and Islam, KU and Ahmad, T and Iqbal, J}, title = {CRISPR-based molecular detection of SARS-CoV-2, its emerging variants, and diverse pathogens.}, journal = {Diagnostic microbiology and infectious disease}, volume = {113}, number = {4}, pages = {117062}, doi = {10.1016/j.diagmicrobio.2025.117062}, pmid = {40829362}, issn = {1879-0070}, mesh = {Humans ; *SARS-CoV-2/genetics/isolation &amp; purification ; *COVID-19/diagnosis/virology ; Sensitivity and Specificity ; *Molecular Diagnostic Techniques/methods ; *CRISPR-Cas Systems ; *Clustered Regularly Interspaced Short Palindromic Repeats ; *COVID-19 Nucleic Acid Testing/methods ; Point-of-Care Testing ; }, abstract = {Pathogenic viruses such as SARS-CoV-2 (SCoV-2), continue to pose a significant threat to human civilization. The lessons learnt from SCoV-2 infections have highlighted the requirement for robust and readily available diagnostic tools in order to limit the virus transmission and prevent future pandemics such as COVID-19. RT-qPCR-based detection is routinely used for sensitive and accurate diagnosis, which requires a sophisticated instrument, laboratory setup, and technical expertise. Though RT-qPCR is highly reliable and considered the gold standard for pathogen detection, it is costly, time-consuming, and unaffordable for the masses. Therefore, other reliable methods for nucleic acid-based detection with sensitivity, specificity, and accuracy on-par with RT-qPCR are required. Recent advancement in CRISPR technology promises its development as a POC testing device, providing a high-end, instrument-free, portable, and cost-effective workflow. Further, COVID-19 pandemic has encouraged the development of next-generation CRISPR-based diagnostics with a provision for home-testing which has resulted in the development of portable and smart-phone integrated hand-held devices which can detect various pathogenic infections in a shorter time frame than RT-qPCR. For diagnosing the presence of SCoV-2, CRISPR-based diagnostics (SHERLOCK/DETECTR) are quicker (30-60 min), less expensive ($5-15/test), and portable than RT-qPCR (90-180 min; $10-50/test) demonstrating equivalent specificity (100%) and near-equivalent sensitivity (93-100% for CRISPR-based diagnostics vs 95-100% for RT-qPCR). For high-sensitivity centralized testing, RT-qPCR is still the gold standard, but CRISPR works well in point-of-care settings because it requires little equipment (like lateral flow strips or heating blocks) and allows multiplexing. CRISPR-based diagnostics breakthrough platform like CARMEN leverages microfluidic technology to test 5,000 plus samples in a single run, unlike RT-qPCR, which requires separate reactions for each target.In this review, the advancement in CRISPR technology such as SHERLOCK, DETECTR, and other Cas-9-based diagnostics are highlighted which exclusively focuses on the CRISPR-based diagnostics to detect SCoV-2 and its emerging VOCs, highlighting their advantages and limitations compared to the gold-standard RT-qPCR.}, }
@article {pmid40828459, year = {2025}, author = {Asadi, Z and Vaisi-Raygani, A and Safari-Faramani, R and Ghasemi, M and Aghaz, F}, title = {Association Between SARS-COV-2 Infection and Sperm DNA Fragmentation: A Systematic Review and Meta-Analysis.}, journal = {American journal of reproductive immunology (New York, N.Y. : 1989)}, volume = {94}, number = {2}, pages = {e70143}, doi = {10.1111/aji.70143}, pmid = {40828459}, issn = {1600-0897}, support = {//Student Research Committee of Kermanshah University of Medical Sciences/ ; }, mesh = {Humans ; Male ; *DNA Fragmentation ; *COVID-19 ; *Spermatozoa/pathology ; *SARS-CoV-2/physiology ; }, abstract = {INTRODUCTION: SARS-CoV-2 infection affects various sperm quality parameters. This study examines the impact of COVID-19 infection on sperm DNA fragmentation (SDF).<br><br>METHODS: A systematic literature search was performed across four databases for studies published between January 1, 2019, and January 1, 2025. The inclusion criteria focused on studies evaluating sperm DNA fragmentation in healthy men infected with the virus. The risk of bias was assessed using the Newcastle-Ottawa scale (NOS). A meta-analysis was conducted using a random effects model based on the tests employed in the studies to measure SDF. Data were reported as weighted mean differences (WMD) and corresponding 95% confidence intervals (CI). Out of 105 identified citations, seven articles were included in this analysis. The NOS results indicated that all studies were of high quality. Subgroup analysis revealed that all testing methods, including TUNEL, flow cytometry, and the sperm chromatin dispersion (SCD) test, demonstrated high heterogeneity, with the lowest heterogeneity found in the TUNEL test.<br><br>RESULTS: The pooled analysis indicated a statistically significant increase in SDF (random effects model, WMD = 12.558, 95% CI: 4.482 to 20.635, I[2] = 99%, Z = 3.05, p < 0.0001). This meta-analysis suggests a statistically significant reduction in sperm DNA integrity 2-3 months following COVID-19 infection.<br><br>CONCLUSION: However, caution is warranted when interpreting these results due to the high heterogeneity, which may affect the outcomes. A thorough analysis considering participant characteristics and infection status is recommended.}, }
@article {pmid40827836, year = {2025}, author = {Pérez-Gisbert, L and Brea-Gómez, B and Valenza, MC and Calvache-Mateo, A and Ortiz-Rubio, A and Torres-Sánchez, I}, title = {Does pulmonary rehabilitation improve fatigue in patients with post-COVID-19 syndrome? A meta-analysis of randomized clinical trials.}, journal = {Disability and rehabilitation}, volume = {}, number = {}, pages = {1-21}, doi = {10.1080/09638288.2025.2546553}, pmid = {40827836}, issn = {1464-5165}, abstract = {PURPOSE: To assess the efficacy of pulmonary rehabilitation (PR) on fatigue in patients with post-COVID-19 syndrome (PCS).<br><br>METHODS: A systematic review and a meta-analysis were performed until 21 October 2024 in 4 databases (CINAHL, Medline, Scopus and Web of Science). Inclusion criteria: Population: patients (&#x2265;18&#x2009;years) with PCS; Intervention: PR; Comparison: control group (CG) vs. placebo; Outcome: fatigue assessed before and after the intervention; Study: randomized clinical trials. Methodological quality was assessed with Downs and Black scale and risk of bias with Cochrane risk-of-bias tool. Meta-analysis was conducted with RevMan 5.4.<br><br>RESULTS: Thirteen studies were included in the systematic review and 10 in the meta-analysis. The meta-analysis showed a moderate effect size (SMD = -0.59, 95% CI = -0.89, -0.28; p&#x2009;=&#x2009;0.0002, n&#x2009;=&#x2009;973) in favor of PR compared to CG for fatigue, with significant differences. Compared to CG, fatigue in patients with PCS was reduced to a greater extent in PR group (both center-based PR and home-based PR, and both <12&#x2009;weeks of PR and &#x2265;12&#x2009;weeks of PR), with significant differences.<br><br>CONCLUSION: This review demonstrates the efficacy of PR as a promising intervention for alleviating fatigue in patients with PCS, revealing a significantly greater reduction in fatigue in PR group compared to CG.<br><br>PROSPERO REGISTRATION NUMBER: CRD42022310791.}, }
@article {pmid40826253, year = {2025}, author = {Qin, Y and Li, C and Yuan, X and Li, Z}, title = {Immunological orchestration and dysregulation in COVID-19 pneumonia: from viral pathogenesis to precision therapeutics in the post-pandemic era.}, journal = {Folia microbiologica}, volume = {70}, number = {4}, pages = {779-795}, pmid = {40826253}, issn = {1874-9356}, mesh = {Humans ; *COVID-19/immunology/therapy/virology ; *SARS-CoV-2/immunology/pathogenicity ; Cytokines/immunology ; Precision Medicine ; Pandemics ; Cytokine Release Syndrome/immunology ; }, abstract = {The COVID-19 pandemic revolutionized our understanding and treatment of pneumonia, particularly highlighting its complex immunological aspects. In this review, we synthesized recent research on COVID-19 clinical management, shedding light on the immune-related landscape of pneumonia in the post-pandemic era. We explored key features of SARS-CoV-2, such as transmission dynamics, emerging variants, and infection mechanisms, before delving into the host immune response following viral exposure. Our discussion emphasized the critical role of immune cells, inflammatory cytokines, and cytokine storms in pneumonia development, alongside immune-mediated lung damage and thrombotic complications. Clinically, we summarized evolving diagnostic methods, treatment approaches, and intensive care protocols, all with a focus on the pivotal role of immunology in pneumonia management. Looking forward, we advocated for a comprehensive approach to addressing ongoing pneumonia challenges, including strengthening epidemic surveillance and advancing immunotherapy research to target abnormal immune responses. Additionally, refining vaccine strategies for durable immunity against evolving viral strains was deemed essential. Overall, this review underscored the central role of immunology in shaping pneumonia management post-COVID-19, aiming to enhance our understanding of disease mechanisms and immunological responses in the post-pandemic era.}, }
@article {pmid40825607, year = {2025}, author = {Charles-Rodriguez, U and Ngwezi, DP and Damag, S and Johnson, N and Bharwani, A and Ladha, T and Salami, O}, title = {Uncovering systemic barriers related to equity, diversity and inclusion in child health research: a scoping review addressing marginalised communities.}, journal = {BMJ global health}, volume = {10}, number = {8}, pages = {}, pmid = {40825607}, issn = {2059-7908}, mesh = {Humans ; *Child Health ; Child ; Canada ; *Health Equity ; *Cultural Diversity ; Social Determinants of Health ; *Social Marginalization ; Female ; }, abstract = {INTRODUCTION: Despite abundant evidence illustrating the impact of social determinants of health on children and youth from marginalised communities, their continued marginalisation in research contributes to a negative feedback loop that perpetuates health inequities. Previous reviews have identified barriers in marginalised adult communities. However, no comprehensive review outlines the scope of barriers to equity, diversity and inclusion (EDI) in child health research across multiple marginalised communities, particularly as they are defined in Canada.<br><br>METHODS: The purpose of this review is to scope and summarise research discussing systemic barriers influencing EDI in child health research, focusing on racialised and black individuals, 2SLGBTQIA+ individuals, Indigenous peoples, women and girls and individuals with disabilities (identified as priority communities in the Canadian government's research policy). Our team followed the steps proposed by Arksey and O'Malley for scoping reviews.<br><br>RESULTS: From 3336 identified records, 53 publications met the inclusion criteria. Most studies were based in the USA (n=40) and/or other English-speaking countries (n=14), emphasising the need for global perspectives. Some publications were based in more than one country; others addressed more than one marginalised community. We identified more publications discussing racialised individuals (n=30) and black individuals (n=20) than women and girls (n=10), Indigenous peoples (n=9), children with disabilities (n=7) or 2SLGBTQIA+ individuals (n=4). Publications increased from 3 in 2020 to 15 in 2022, reflecting heightened awareness of structural racism and health inequities during the COVID-19 pandemic. Our findings suggest systemic under-recruitment and tokenism. Other factors in the research ecosystem include misleading conceptualisations of race and other social categories, power dynamics, lack of cultural safety and discrimination. Finally, we recommend applying the socio-ecological model to systematically map barriers and develop tailored, multilevel solutions that promote equity and inclusivity in research.<br><br>CONCLUSION: To foster a more equitable and impactful child health research ecosystem, institutions must address individual, interpersonal, organisational and policy-level barriers by embedding community-driven priorities, promoting diverse and inclusive practices, and ensuring long-term, reciprocal relationships with historically marginalised communities.}, }
@article {pmid40825236, year = {2025}, author = {Niazy, M and Murphy, H and Nadeem, K and Ricker, N}, title = {A comprehensive guide to selecting the right modeling strategy for explanatory and predictive data analysis.}, journal = {Canadian journal of microbiology}, volume = {71}, number = {}, pages = {1-18}, doi = {10.1139/cjm-2025-0038}, pmid = {40825236}, issn = {1480-3275}, mesh = {*COVID-19/virology ; Humans ; SARS-CoV-2 ; Machine Learning ; Reproducibility of Results ; *Models, Statistical ; Biomarkers ; *Data Analysis ; }, abstract = {Declining costs of sequencing technology have catalyzed the widespread use of high-dimensional complex omics datasets in microbiology. While rich in information, these datasets present major analytical challenges, including sparsity, heterogeneity, and the need for robust statistical validation. Concerns about the reproducibility of findings across microbiological studies underscore the importance of standardized, transparent analytical approaches. Despite the availability of diverse statistical frameworks and machine learning methods, designing an appropriate statistical workflow (from method selection to model evaluation) remains challenging, particularly for researchers with limited advanced statistical training. Missteps in this process can lead to misinterpretation, irreproducibility, and flawed conclusions. This paper provides a structured, step-by-step framework to guide and validate the methodology of choosing the right statistical methods for both explanatory and predictive modeling in microbiology and translational research. We outline essential decision points spanning data preprocessing, feature selection, model assumptions, and model evaluation, and highlight common trade-offs and practical considerations. To demonstrate the guide's utility, we analyze a real-world COVID-19 dataset to identify cytokine biomarkers associated with disease severity. By aligning analytical strategies with microbiology inquiry, this guide aims to enhance reproducibility, empower data-informed decisions, and promote more rigorous, interpretable research in microbiology and public health.}, }
@article {pmid40823416, year = {2025}, author = {Yang, X and Xiao, L and Lan, Y and Xue, J and He, Y}, title = {A meta-analysis of the meaning in life and suicidal ideation based on Chinese samples.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1610351}, pmid = {40823416}, issn = {1664-1078}, abstract = {Previous research has examined the link between meaning in life and suicidal ideation across cultures, highlighting cultural background as a moderator. However, few studies focus on single cultural contexts. To address this gap within China, this meta-analysis investigates the association between meaning in life and suicidal ideation, specifically examining moderators including regional economic differences, measurement tools for suicidal ideation, and the impact of public health emergency (e.g., COVID-19). Results show a negative correlation between meaning in life and suicidal ideation [r = -0.387, 95% CI (-0.425, -0.344)]. Subgroup analyses revealed stronger effects in undeveloped regions, when using specific measurement tools, and during public health emergency. Unlike previous studies, gender did not significantly moderate this relationship. These findings confirm that enhancing meaning in life may be a key protective factor against suicidal ideation in China, especially in undeveloped regions and during crises. Future interventions should develop tailored strategies to strengthen meaning in life, prioritizing economic inequality and crisis resilience.}, }
@article {pmid40823261, year = {2025}, author = {Hong, Y and Zhu, S and Liu, Y and Tian, C and Xu, H and Chen, G and Tao, L and Xie, T}, title = {The integration of machine learning into traditional Chinese medicine.}, journal = {Journal of pharmaceutical analysis}, volume = {15}, number = {8}, pages = {101157}, pmid = {40823261}, issn = {2214-0883}, abstract = {Traditional Chinese medicine (TCM) is an ancient medical system distinctive and effective in treating cancer, depression, coronavirus disease 2019 (COVID-19), and other diseases. However, the relatively abstract diagnostic methods of TCM lack objective measurement, and the complex mechanisms of action are difficult to comprehend, which hinders the application and internationalization of TCM. Recently, while breakthroughs have been made in utilizing methods such as network pharmacology and virtual screening for TCM research, the rise of machine learning (ML) has significantly enhanced their integration with TCM. This article introduces representative methodological cases in quality control, mechanism research, diagnosis, and treatment processes of TCM, revealing the potential applications of ML technology in TCM. Furthermore, the challenges faced by ML in TCM applications are summarized, and future directions are discussed.}, }
@article {pmid40823235, year = {2025}, author = {Rani, R and Bajos, N and Counil, &#xc9;}, title = {Social inequalities in SARS-CoV-2 infection in high income countries: highlighting the need for an intersectional perspective in quantitative research.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1642407}, pmid = {40823235}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology ; *Health Status Disparities ; Female ; Socioeconomic Factors ; *Developed Countries/statistics &amp; numerical data ; SARS-CoV-2 ; Male ; France/epidemiology ; Social Class ; }, }
@article {pmid40823166, year = {2025}, author = {Weichselbaum, L and Kupferman, J and Kwong, AJ and Moreno, C}, title = {"The alcohol-harm paradox": Understanding socioeconomic inequalities in liver disease.}, journal = {JHEP reports : innovation in hepatology}, volume = {7}, number = {9}, pages = {101480}, pmid = {40823166}, issn = {2589-5559}, abstract = {The alcohol-harm paradox (AHP) refers to the fact that people from lower socioeconomic groups experience higher rates of alcohol-related illness despite consuming the same or even lower amounts of alcohol than their more affluent counterparts. While differences in drinking patterns and associations with other risky behaviours partially explain the paradox, they do not fully account for the disparities in morbidity and mortality across socioeconomic groups. The existence of an alcohol-harm paradox in liver disease has been demonstrated in many countries worldwide. Recently, the COVID-19 pandemic further exacerbated these differences and led to an increase in alcohol intake and alcohol-related mortality among racial and ethnic minorities in the United States. Approaches to limit alcohol sales, through introduction of minimum unit pricing or taxation, have led to reductions in alcohol-related liver disease, particularly in socioeconomically deprived areas. Disparities in access to treatment of alcohol use disorder, liver disease and liver transplantation further contribute to the AHP. This review focuses on the AHP, its impact on liver disease and the multi-level strategy that will be required to curb this phenomenon.}, }
@article {pmid40822692, year = {2025}, author = {Starshinova, A and Kudryavtsev, I and Rubinstein, A and Dovgalyuk, I and Kulpina, A and Churilov, LP and Kudlay, D}, title = {BCG vaccination: historical role, modern applications, and future perspectives in tuberculosis and beyond.}, journal = {Frontiers in pediatrics}, volume = {13}, number = {}, pages = {1603732}, pmid = {40822692}, issn = {2296-2360}, abstract = {Tuberculosis (TB) remains a fatal disease primarily transmitted through airborne droplets, with children who are the most susceptible, particularly in the areas with poor tuberculosis control. The BCG vaccine, developed by Albert Calmette and Camille Guérin, has a history spanning a century. This vaccine has been implemented in numerous countries, significantly reducing child mortality in regions heavily affected by TB. In this review, we aim to revisit the vaccine's development and rollout, while also highlighting its current attributes and the successful application in the Russian Federation, where 90% of newborns receive the anti-tuberculosis vaccination. Due to that practice, only a few isolated cases of young children with generalized tuberculosis (about five to seven annually) are observed in Russia. Research on the BCG vaccine is ongoing, revealing significant genetic alterations in BCG strains that have evolved from the original variant. These genetic differences may contribute to variations in vaccine efficacy, making screening important to predict effectiveness. The BCG vaccine can initiate a localized mucosal immune response, offering, besides the anti-TB effect, some protection against infections involving mucous membranes, including salmonellosis, HIV, and acute viral respiratory infections. It is essential to investigate the role of BCG in various applications; however, this exploration should not detract from its main protective benefits against tuberculosis (TB). Future studies may provide evidence of the vaccine's safety and efficacy to support its use beyond TB prevention. While BCG vaccination does not lower the risk of infection with Mycobacterium tuberculosis, it does prevent the progression to the most severe clinical manifestations (such as miliary TB and tuberculous meningitis) caused by hematogenous spread of M.tuberculosis. The challenge of protecting HIV-infected children from TB remains urgent, especially in regions burdened with drug-resistant TB, highlighting the need for robust protective measures.}, }
@article {pmid40822451, year = {2025}, author = {Prabhakornritta, P and Waranuch, N and Fuangchan, A and Srikham, K and Boonpattharatthiti, K and Barnig, C and Boonyasuppayakorn, S and Pitaksuteepong, T and Bhattarakosol, P and Moulari, B and Pellequer, Y and Dhippayom, T}, title = {Exploring the clinical effects of Andrographis paniculata-derived compounds, its extract, or derivatives for the treatment of COVID-19: a systematic review and meta-analysis.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1598255}, pmid = {40822451}, issn = {1663-9812}, abstract = {UNLABELLED: The COVID-19 pandemic created a global health crisis, with limited effective treatments. Andrographis paniculata (Burm. f.) Nees (AP), with known anti-inflammatory and antiviral properties, has been explored as adjunctive therapy for COVID-19, but its clinical evidence remains inconclusive. We hypothesized that AP-derived compounds may improve symptoms and inflammatory responses in mild-to-moderate COVID-19. This systematic review and meta-analysis aimed to evaluate the clinical and biological effects of AP-derived compounds, its extract (APE), or its derivatives in patients with mild-to-moderate COVID-19. A systematic search was conducted in PubMed, EMBASE, CENTRAL, and EBSCO Open Dissertations from January 2020 to October 2024. Randomized controlled trials (RCTs) examining the effects of single-herb AP products compared to antivirals or supportive care (SC) in patients with mild-to-moderate COVID-19 were included if they reported clinical recovery, fever or cough resolution, C-reactive protein (CRP), or interleukin-6 (IL-6) levels. Risk of bias (RoB) was assessed using Cochrane RoB 2.0. A random-effects model was used to estimate pooled effects of included trials, expressed as relative risk (RR) and mean difference (MD) with 95% confidence intervals (CIs). Six RCTs involving 660 adults aged 18 to 60 were included. Compared to antivirals or SC, single-herb AP products showed no significant improvements in fever resolution (RR 1.12; 95%CI 0.90 to 1.38; I[2] = 0.0%) or cough resolution (RR 0.98; 95%CI 0.74 to 1.31; I[2] = 47.0%). No significant differences were observed in serum CRP (MD -0.04; 95%CI -0.26 to 0.18; I[2] = 0.0%) and IL-6 levels (MD -0.07; 95%CI -0.17 to 0.03; I[2] = 0.0%). While some studies not included in the meta-analysis suggested early reductions in CRP and IL-6, the findings were inconsistent. RoB was high for fever resolution but low for biomarkers. Mild adverse events, primarily liver enzyme elevations, resolved without severe complications. Our systematic review and meta-analysis suggest a potential role for AP extract and its derivatives as adjunctive therapy for COVID-19, with trends indicating possible benefits in symptom improvement and inflammation reduction. These findings highlight the need for further research to explore AP as a complementary therapeutic strategy in COVID-19 management.<br><br>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024608858, identifier CRD42024608858.}, }
@article {pmid40822319, year = {2025}, author = {Correia, G and Calheiros, D and Rosa, N and Rodrigues, L and Cunha, S and Santiago, LM and Costa, J and Gameiro da Silva, M and Gonçalves, T}, title = {Indoor air quality and airborne transmission under the One Health lens: A scoping review.}, journal = {One health (Amsterdam, Netherlands)}, volume = {21}, number = {}, pages = {101160}, pmid = {40822319}, issn = {2352-7714}, abstract = {Humans spend around 90 % of their time indoors, making Indoor Air Quality (IAQ) of utmost importance. Its importance has been recently highlighted by COVID-19. However, IAQ significantly impacts public health, concerning not only respiratory, but also cardiovascular diseases. The World Health Organization defines One Health as "an approach to designing and implementing programmes, policies, legislation and research in which multiple sectors communicate and work together to achieve better public health outcomes". This scoping review fills a gap in the literature by exploring the One Health approach, which integrates human, animal, and environmental health, applied to the study of airborne transmission. We searched various databases for articles that assessed microbiological IAQ using the One Health approach. Eligible documents assessed air contamination, with a focus on infectious threats and antimicrobial resistance. Our work maps the topics covered, the methodologies employed, and the evidence gaps identified. Our literature search yielded 8471 articles, from which 18 studies were selected for detailed analysis. Findings indicate that the One Health approach effectively addresses the complex challenge of airborne microbiological contamination. This approach comprises a comprehensive view of topics, contexts, agents and methodologies employed to study airborne transmission in indoor spaces. The agents included range from influenza, legionella and others, to the dispersal of mycotoxins and antibiotic resistance genes. The role of animals in diverse human-animal interaction settings was highlighted as a significant factor influencing IAQ, particularly in relation to zoonotic spillover risks, and the airborne transmission of antimicrobial resistance. The review also identified evidence gaps in research and highlighted the need for interdisciplinary collaboration. Incorporating One Health principles into IAQ research is essential for developing comprehensive health strategies that can address both current and emerging infectious threats. Future research should prioritise settings involving animal-human indoor interactions, focusing on workplace contamination, zoonotic spillover, emergent threats, and the airborne transmission of antimicrobial resistance, to ensure a robust framework for safeguarding global health.}, }
@article {pmid40821797, year = {2025}, author = {Yin, Q and Huang, Y and Wang, H and Wang, Y and Huang, X and Song, Y and Wang, Y and Han, L and Yuan, B}, title = {COVID-19: a vascular nightmare unfolding.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1593885}, pmid = {40821797}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/complications/immunology ; *SARS-CoV-2 ; *Thrombosis/prevention &amp; control/etiology/drug therapy ; COVID-19 Drug Treatment ; Anticoagulants/therapeutic use ; }, abstract = {The emergence of COVID-19 has been associated with an increased risk of arteriovenous thrombosis, with immune inflammation playing a significant role in the pathogenesis of thrombosis. Numerous drug-related clinical trials have been undertaken to prevent thrombosis, and guidelines for its prevention and treatment are continuously evolving as our understanding of the disease progresses. This article provides a comprehensive review of the mechanisms underlying thrombosis in COVID-19 patients, as well as the advancements in clinical trials and guidelines for thrombosis prevention with pharmacological interventions.}, }
@article {pmid40821146, year = {2025}, author = {Kikuchi, K}, title = {Restructuring Physical Therapy Education After COVID-19: A Narrative Review on the Global Perspectives and the Emerging Role of Hybrid Learning Models.}, journal = {Cureus}, volume = {17}, number = {7}, pages = {e88034}, pmid = {40821146}, issn = {2168-8184}, abstract = {The COVID-19 pandemic rapidly transformed physical therapy (PT) education from traditional face-to-face instruction to online and hybrid models worldwide. While online education effectively supports theoretical knowledge acquisition, it falls short in developing hands-on clinical skills, highlighting the necessity of integrating in-person training. Various countries reported benefits and challenges of online learning, including issues with learning environments, faculty ICT skills, and student motivation. Hybrid education models combining online lectures with practical face-to-face sessions emerged as optimal solutions. Future PT education requires flexible, sustainable, and learner-centered approaches grounded in educational technology and human-centered design. Key priorities include standardizing hybrid models, enhancing faculty support, reforming assessment methods, and ensuring equitable access to digital resources. Overall, PT education faces a pivotal opportunity to evolve into a resilient system balancing educational quality with accessibility and adaptability, guided by comprehensive, evidence-based strategies.}, }
@article {pmid40820906, year = {2025}, author = {Mulkey, SB}, title = {Developmental impacts of perinatal infections.}, journal = {Current opinion in pediatrics}, volume = {37}, number = {6}, pages = {585-590}, pmid = {40820906}, issn = {1531-698X}, mesh = {Humans ; Pregnancy ; *Pregnancy Complications, Infectious/virology ; Female ; Zika Virus Infection/complications/congenital ; Infant, Newborn ; *COVID-19/complications ; Child ; *Developmental Disabilities/virology/etiology ; Cytomegalovirus Infections/complications/congenital ; *Neurodevelopmental Disorders/virology/etiology ; *Prenatal Exposure Delayed Effects ; Risk Factors ; Infectious Disease Transmission, Vertical ; }, abstract = {PURPOSE OF REVIEW: Perinatal infections and their potential consequences on child neurodevelopment have become a topic of greater interest over the past decade. The purpose of this review is to describe the current knowledge of neurodevelopmental impacts from some of these infections including congenital cytomegalovirus, Zika virus, Chikungunya, and severe acute respiratory syndrome coronavirus 2. These infections have had recent publications about neurodevelopmental impacts.<br><br>RECENT FINDINGS: Children with congenital cytomegalovirus infection, especially those with symptomatic infection, are at a high risk for developmental delays. They also seem to be at an increased risk for autism spectrum disorder. Studies indicate that prenatal exposure to severe acute respiratory syndrome coronavirus 2 may also be a risk factor for developmental delay and that all children exposed prenatally should be followed more closely for early neurodevelopment. Children with congenital Zika syndrome and birth defects are at risk for a range of neurodevelopmental sequalae and at high risk for early mortality. However, normocephalic children with antenatal Zika virus exposure are also at risk for a range of neurodevelopmental effects including lower cognitive performance at school age.<br><br>SUMMARY: Congenital and perinatal infectious exposures increase the risk for impaired child neurodevelopment. All children with perinatal infections should have close neurodevelopmental follow-up during childhood.}, }
@article {pmid40820807, year = {2025}, author = {Wullimann, D and Ljunggren, HG}, title = {Human T Cell Responses to Flavivirus Vaccines.}, journal = {European journal of immunology}, volume = {55}, number = {8}, pages = {e70027}, pmid = {40820807}, issn = {1521-4141}, mesh = {Humans ; *Flavivirus/immunology ; *Flavivirus Infections/immunology/prevention &amp; control ; *Viral Vaccines/immunology ; Cross Reactions ; SARS-CoV-2/immunology ; Immunity, Cellular ; CD8-Positive T-Lymphocytes/immunology ; CD4-Positive T-Lymphocytes/immunology ; Animals ; COVID-19/immunology/prevention &amp; control ; *T-Lymphocytes/immunology ; Immunologic Memory ; Vaccines, Attenuated/immunology ; }, abstract = {Flaviviruses are major human pathogens that continue to pose a global health threat, and vaccination is an effective strategy to protect against disease from several flaviviruses. Flavivirus vaccines are believed to confer protection primarily through antibody responses; however, the role of T cells in vaccine immunity remains less explored despite demonstrated contribution in the response to natural infection. This review examines T cell responses induced by licensed or developing flavivirus vaccines, their contribution to protection, and key findings highlighting the importance of cellular immunity. We discuss the role of memory T cells, including CD4+ and CD8+ subsets, in flavivirus vaccine-induced immunity and compare the immunogenicity of live attenuated versus inactivated vaccines. We also discuss the significance of T cell immunity, cross-reactivity, and vaccine platform design in shaping durable and broad protection. Additionally, we broaden the discussion toward other human RNA viruses, including the influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A better understanding of the role of T cell immunity will be essential for optimizing the use of current flavivirus vaccines and developing next-generation approaches capable of providing long-lasting immunity against emerging and re-emerging flavivirus threats.}, }
@article {pmid40820583, year = {2025}, author = {Chen, L and Kita, S and Fukuhara, H and Maenaka, K}, title = {Understanding the structure of measles virus and its implications for novel drug discovery.}, journal = {Expert opinion on drug discovery}, volume = {20}, number = {9}, pages = {1131-1140}, doi = {10.1080/17460441.2025.2546888}, pmid = {40820583}, issn = {1746-045X}, mesh = {Humans ; *Measles virus/drug effects/chemistry ; *Drug Discovery/methods ; *Antiviral Agents/pharmacology/chemistry ; *Measles/drug therapy/virology ; Animals ; Drug Development/methods ; Antibodies, Neutralizing/immunology ; COVID-19/epidemiology ; }, abstract = {INTRODUCTION: Despite having a stably effectively vaccine for decades, the Measles virus (MV) still causes periodic outbreaks given its highly contagious nature and a consistent decline in immunization coverage, which was further exacerbated during the COVID-19 pandemic, leading to reduced immunization rates. Equally concerning, there are also no approved treatments for measles.<br><br>AREAS COVERED: Herein, the authors explore the current challenges of MV therapy discovery. Firstly, the article will provide an overview of the potential drug-targeted steps in the MV infection process, followed by discussion on the characteristics of existing drugs as well as the feasibility of structure-based drug discovery. Finally, the authors highlight the current progress in the field and the future opportunities for antiviral development. This article is based on a literature review including original publications, standard sources, the Protein Data Bank and clinical trials.<br><br>EXPERT OPINION: First and foremost, a comprehensive structural analysis of neutralizing antibodies and RdRp inhibitors is required for efficient antiviral development. Moreover, the therapeutic prospects and current limitations for acute MV and subacute sclerosing panencephalitis (SSPE) treatments should be considered. Due to various factors including mutations, the development of broad-spectrum antivirals may minimize many of the existing barriers.}, }
@article {pmid40819607, year = {2025}, author = {Bakhshaei, K and Rezaei, Z and Ahmadi, M and Banad, YM}, title = {Pandemic transition: A review of social media text mining for pandemic transition in the post-vaccination era.}, journal = {Artificial intelligence in medicine}, volume = {169}, number = {}, pages = {103242}, doi = {10.1016/j.artmed.2025.103242}, pmid = {40819607}, issn = {1873-2860}, mesh = {Humans ; *Social Media ; *Data Mining/methods ; *COVID-19/prevention &amp; control/epidemiology ; *Pandemics/prevention &amp; control ; SARS-CoV-2 ; *COVID-19 Vaccines/administration &amp; dosage ; *Vaccination ; Vaccination Hesitancy ; Public Health ; }, abstract = {In the post-vaccination phase of the COVID-19 pandemic, surveillance have become critical for sustaining disease control, identifying new variants, and preserving vaccine efficacy. This study explores how social media text mining can support these priorities by providing valuable insights into public sentiment, vaccine hesitancy, and the emergence of novel viral strains. By analyzing online conversations, researchers can gain a deeper understanding of questions and concerns surrounding booster shots, enabling the development of targeted public health initiatives to address vaccine reluctance and promote booster uptake. Moreover, social media data can assist governments in identifying areas with high vaccine hesitancy or low vaccination rates, allowing for the strategic allocation of resources and interventions. Importantly, this study also highlights the potential of social media text mining to serve as an early warning system for new viral variants. By monitoring discussions related to symptoms and outbreaks, researchers can detect risks before they become widespread, informing timely public health responses and mitigation strategies. Complementing these surveillance efforts, the study emphasizes the significance of pattern prediction, which leverages historical data and models to forecast disease dynamics and guide resource allocation. By integrating social media data with epidemiological and clinical information, more accurate and responsive pandemic management strategies can be implemented. Ultimately, this research underscores the critical role of continuous pandemic monitoring and pattern prediction in the post-vaccination phase, enabling evidence-based decision-making and the effective control of infectious diseases. The insights gained from this study can inform the development of robust, data-driven frameworks for pandemic preparedness and response in the aftermath of widespread vaccination campaigns.}, }
@article {pmid40819231, year = {2025}, author = {Levin, J and Bradshaw, M}, title = {The Challenge of Long COVID: Is the Pandemic Really Over?.}, journal = {Public health reports (Washington, D.C. : 1974)}, volume = {140}, number = {5-6}, pages = {506-513}, pmid = {40819231}, issn = {1468-2877}, mesh = {Humans ; *COVID-19/epidemiology/complications ; United States/epidemiology ; SARS-CoV-2 ; Prevalence ; Public Health ; Pandemics ; Post-Acute COVID-19 Syndrome ; Incidence ; }, abstract = {Sequelae of SARS-CoV-2 infection began appearing among patients who had COVID-19 within months of the first wave of the COVID-19 pandemic in 2020. This phenomenon, termed post-COVID-19 condition and also known as long COVID, has been a source of controversy among physicians, as presentation of long COVID has been a somewhat mysterious constellation of signs and symptoms that seem mostly impervious to efficacious treatment. Although a considerable amount has been learned about the pathophysiology and other biomedical features of long COVID, the epidemiologic parameters of long COVID, including incidence and prevalence, are uncertain in the United States and globally. The best estimates are that millions of people have long COVID. Despite the declining incidence of COVID-19, the low case fatality of long COVID suggests that its prevalence is poised to continue to grow. This increasing prevalence of long COVID presents a challenge for the public health sector. Here, we examine the public health implications of long COVID. We offer policy recommendations, including ending congratulatory talk that the pandemic is over, encouraging more focused attention from the United States and global nongovernmental organizations, and establishing a multinational research initiative to better understand and respond to long COVID and other postviral and postinfectious chronic conditions. Although COVID-19 may not be as widespread and disruptive as in the early months of the pandemic, it would be a mistake to presume that, because the acute crisis is behind us, the pandemic is past. Long COVID is an ongoing public health threat and merits our concern.}, }
@article {pmid40819227, year = {2025}, author = {Karacuschansky, A and Organick-Lee, P and Horton, K and Seiler, N}, title = {Telehealth Use in Medicaid: Implications for Quality Care for Individuals With ADHD and Tourette Syndrome.}, journal = {Public health reports (Washington, D.C. : 1974)}, volume = {140}, number = {5-6}, pages = {496-505}, pmid = {40819227}, issn = {1468-2877}, mesh = {Humans ; *Attention Deficit Disorder with Hyperactivity/therapy ; *Telemedicine/statistics &amp; numerical data/organization &amp; administration ; *Medicaid/organization &amp; administration ; United States ; *Tourette Syndrome/therapy ; *Quality of Health Care ; COVID-19/epidemiology ; Health Services Accessibility ; }, abstract = {The expansion of telehealth during the COVID-19 pandemic transformed behavioral health care delivery, including for individuals with attention-deficit/hyperactivity disorder (ADHD) and Tourette syndrome (TS), conditions that require ongoing treatment and monitoring. We explored the implications of telehealth on the quality of care for Medicaid beneficiaries with ADHD and TS, highlighting the benefits, challenges, and policy considerations. Telehealth has increased access to behavioral health services, including for ADHD and TS, by reducing geographic and financial barriers to care. The expanded use of telehealth has allowed patients to more easily interact with health care providers, and it particularly benefits those with limited access to specialized care. However, challenges remain, such as concerns about stimulant misuse in online ADHD treatments and the limited privacy offered in home telehealth settings. Furthermore, disparities in broadband access may exacerbate existing inequalities in care. Despite telehealth's potential to increase access to specialized care, the quality of telehealth provided is not guaranteed. Current quality measures for Medicaid telehealth services, especially for ADHD and TS, are insufficient. While some Medicaid programs have integrated telehealth into quality reporting, a need exists for more tailored measures that assess the unique needs of people with ADHD and TS. We recommend the development of quality measures for ADHD and TS, performance improvement projects for these conditions, better alignment of Medicaid managed care oversight, and research into the long-term outcomes of telehealth for care of people with ADHD and TS. Such efforts would support continued Medicaid telehealth expansion while ensuring high-quality care.}, }
@article {pmid40819047, year = {2025}, author = {Nourani, A and Hosseini, SM and Rassoulian, M and Joudivand, L and Samimi, T and Rahimi, B}, title = {A systematic review of methods used for COVID-19 telehealth systems evaluation: lessons from past experiences for future use.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1089}, pmid = {40819047}, issn = {1472-6963}, mesh = {*COVID-19/epidemiology ; Humans ; *Telemedicine/organization &amp; administration/standards ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: During the COVID-19 emergency, telehealth systems were rapidly designed and integrated into healthcare delivery frameworks. The main question is whether these systems have been adequately evaluated and whether they are worthy of entering the health service cycle. Thus, this study's objective was to critically analyze the literature on remote health systems developed in response to COVID-19, focusing specifically on the evaluation approaches used.<br><br>METHODS: The present investigation was executed in 2024, focusing on literature published over five years following the onset of the COVID-19 pandemic, extending until January 2024. Comprehensive searches were conducted across PubMed, Web of Science, and Scopus databases. A team of four researchers systematically evaluated and critically appraised relevant articles. Subsequently, the extracted data underwent rigorous analysis, comparison, and reporting to distill key findings.<br><br>RESULTS: Overall, 26 articles met the inclusion criteria. The results indicated that the predominant objective of evaluations was to examine system performance (n&#x2009;=&#x2009;8, 30.77%). Also, the methodology used in most evaluations was Qualitative and quantitative (non-integrated) (n&#x2009;=&#x2009;18, 69.23%). In terms of evaluation period, most evaluations were summative (n&#x2009;=&#x2009;12,46.15%), and the evaluator population in most systems was the healthcare team (n&#x2009;=&#x2009;14, 53.85%).<br><br>CONCLUSIONS: Given the COVID-19 emergency conditions, evaluations of telehealth systems have not been conducted systematically and with adequate methods, tools, and populations. Therefore, appropriate systems should be designed and adequately evaluated for future epidemics. Ultimately, the proactive and comprehensive design and evaluation of telehealth systems will create infrastructures that can respond effectively and sustainably to future outbreaks.}, }
@article {pmid40818824, year = {2025}, author = {da Silva Chaar Neta, R and da Silva Batista, C and Machado Palmerim, &#xc9;M and Costa Dias, HM and Costa Nóbrega, KC and de Oliveira, CA and Visco, DB}, title = {The impact of social isolation due to the COVID-19 pandemic on functional performance, fall risk, and gait in individuals with Parkinson's Disease: a systematic review.}, journal = {Neuroscience}, volume = {584}, number = {}, pages = {113-126}, doi = {10.1016/j.neuroscience.2025.08.014}, pmid = {40818824}, issn = {1873-7544}, mesh = {Humans ; *Accidental Falls ; COVID-19 ; *Gait/physiology ; Pandemics ; *Parkinson Disease/physiopathology/psychology/complications ; *Physical Functional Performance ; SARS-CoV-2 ; *Social Isolation/psychology ; }, abstract = {Parkinson's Disease (PD) is a progressive neurodegenerative disorder marked by motor impairments such as tremors, rigidity, and bradykinesia. Regular physical activity plays a key role in managing these symptoms, yet the COVID-19 pandemic imposed social isolation measures that significantly curtailed physical activity, potentially accelerating motor decline. This systematic review aimed to synthesize evidence on the impact of pandemic-related social isolation on motor symptom deterioration in individuals with PD. The review was registered in PROSPERO (CRD42022369245) and conducted according to PRISMA guidelines. Systematic searches were performed in Embase, PubMed, Scopus, Web of Science, and the Cochrane Library, using a combination of keywords and Boolean operators related to Parkinson's Disease and the COVID-19 pandemic. Eligible studies included those addressing individuals with PD, exposure to social isolation, and outcomes related to motor performance. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. From 1534 identified records, 34 studies met inclusion criteria: 23 cross-sectional, 7 prospective longitudinal, 3 retrospective longitudinal, and 1 qualitative study. Findings consistently indicated a reduction in physical activity and a consequent worsening of motor symptoms, such as tremors, bradykinesia, and postural instability, leading to impaired functional performance, increased fall risk, and gait disturbances. Most studies demonstrated moderate to high methodological quality. These results underscore the potential detrimental impact of prolonged isolation and highlight the importance of interventions that help preserve motor function in individuals with PD during periods of restricted mobility.}, }
@article {pmid40817668, year = {2025}, author = {Abdollahpour, S and Khadivzadeh, T and Shafeei, M and Arian, M}, title = {Prevalence of global preterm labor in pregnant women infected with coronavirus: A systematic review and meta-meta-analysis.}, journal = {Journal of neonatal-perinatal medicine}, volume = {}, number = {}, pages = {19345798251365165}, doi = {10.1177/19345798251365165}, pmid = {40817668}, issn = {1878-4429}, abstract = {BackgroundPreterm labor is a key factor in neonatal morbidity and mortality globally. Therefore, in the crisis of the coronavirus pandemic, it is important to investigate the prevalence of preterm labor in mothers with COVID-19 infection.Materials and methodsWe performed, according to the PRISMA guideline, a search of the PubMed and Web of Science database on September 1, 2022, to identify systematic reviews and meta-analyses that have summarized studies that report the prevalence of preterm labor in pregnant women with COVID-19. Based on the focused search strategy and eligibility criteria, finally, 66 studies were included in this review. After critical appraisal, using Comprehensive Meta Analysis V3 software, data analysis was done. A random-effects model was employed to account for heterogeneity among studies, and publication bias was assessed. Pooled estimates and their 95% confidence intervals were reported using forest plots.ResultsSixty-six meta-analysis studies, involving a total of 335,964 preterm labors among a sample of 2,260,032 women pregnant with coronavirus infection, were analyzed. Prevalence of preterm delivery in women infected with COVID-19 is 18.8% (lower limit = 0.148; upper limit = 0.235; CI = 95%' df = 65; I-Squared = 99.87; Egger test = 0.40).ConclusionsThe pooled global prevalence of preterm delivery in women infected with COVID-19 is higher than the global estimate in the era before the coronavirus pandemic. Given the global burden of preterm birth, efforts should be intensified to improve the quality of care for all COVID-infected pregnant women.}, }
@article {pmid40816910, year = {2024}, author = {Pekara-, J and Kearns, PB and Janoušková, M and Šeblová, J and Kuklová, M and Kučera, M and Wolfová, K and Šeblová, D}, title = {Mental health of healthcare professionals in Czechia during and after the COVID-19 pandemic.}, journal = {Casopis lekaru ceskych}, volume = {163}, number = {7-8}, pages = {328-333}, pmid = {40816910}, issn = {0008-7335}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; *Health Personnel/psychology ; Czech Republic/epidemiology ; *Mental Health ; Burnout, Professional/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {Healthcare workers caring for COVID-19 patients faced a high risk of infection, staff shortages, contact with patient deaths and their own risk of infection during the pandemic. These factors greatly affected their mental health. This narrative review summarizes the results of studies published in Czech and English between 2020 and 2024 on the impact of the pandemic on the mental health of healthcare professionals in the Czechia. Of the 20 studies identified, 8 met the inclusion criteria. Studies describe symptoms of depression, stress, burnout, stigmatization, discrimination, and violence. The results show a severe impact of these factors on the mental well-being of healthcare professionals. Finally, we emphasize the need for preventive measures, including supervision, psychological assistance and support from management. An emphasis on the mental health of healthcare professionals is key to their protection and sustainability of care in crisis situations.}, }
@article {pmid40816539, year = {2025}, author = {Zhang, L and Tian, S and Shi, Y and Liu, L and Yang, S}, title = {Heterogeneity in the incidence and mortality of COVID-19-associated pulmonary aspergillosis among ICU patients without hematological disorders: A systematic review, subgroup meta-analysis, and meta-regression.}, journal = {Respiratory medicine}, volume = {247}, number = {}, pages = {108306}, doi = {10.1016/j.rmed.2025.108306}, pmid = {40816539}, issn = {1532-3064}, mesh = {Humans ; *COVID-19/complications/mortality/epidemiology ; Incidence ; *Intensive Care Units/statistics &amp; numerical data ; *Invasive Pulmonary Aspergillosis/mortality/epidemiology ; SARS-CoV-2 ; *Pulmonary Aspergillosis/mortality/epidemiology ; }, abstract = {BACKGROUND: The heterogeneity in the incidence and mortality rates of COVID-19 associated pulmonary aspergillosis (CAPA) across studies is striking. However, the implications of this heterogeneity for patients without hematological disorders have been inadequately explored.<br><br>OBJECTIVES: This subgroup meta-analysis and meta-regression aimed to examine the clinical characteristics, incidence and mortality rates of CAPA patients without hematological disorders in intensive care units (ICU), and sought to explore the impact of and potential reasons for the observed variability in CAPA incidence and mortality rates.<br><br>DATA SOURCES: Data from PubMed, Embase and Web of Science were systematically searched for articles published between November 1, 2019 and March 31, 2024.<br><br>STUDY ELIGIBILITY CRITERIA: This study included cross-sectional, case-control and cohort studies published in English with full texts, which examined COVID-19 patients admitted to ICU and assessed both the incidence and mortality of invasive pulmonary aspergillosis, were included.<br><br>PARTICIPANTS: COVID-19 patients without hematological disorders admitted in ICU and who were evaluated for invasive pulmonary aspergillosis by any specific published definitions.<br><br>INTERVENTIONS: No.<br><br>METHODS: The incidence and mortality rates of CAPA patients were calculated using Der Simonian-Laird random effects meta-analyses. The impact and sources of heterogeneity were assessed through meta-regression and subgroup analyses, conducted with Review Manager 5.4 and Stata 17 software. The review protocol has been registered with the International Prospective Register of Systematic Reviews (CRD 42024569801).<br><br>RESULTS: A total of 46 studies were included in the analysis. Among 18,487 enrolled ICU patients without hematological disorders, 1608 CAPA cases were reported, resulting in a pooled incidence rate of 0.13 (95&#xa0;% CI: 0.11-0.14, I[2]&#xa0;=&#xa0;96.11&#xa0;%, p-value<0.001). The incidence of CAPA varied significantly based on diagnostic definitions (p-value&#xa0;=&#xa0;0.009), Newcastle-Ottawa Scale (NOS) (p-value<0.001), and publication time (p-value<0.001). Factors such as diagnostic criteria, NOS, chronic respiratory diseases, solid organ transplantation, smoking history, Extracorporeal Membrane Oxygenation (ECMO), mechanical ventilation, corticosteroid use and anti-interleukin therapies were significantly associated with CAPA incidence. The pooled CAPA mortality rate was found to be 0.58 (95&#xa0;% CI: 0.52-0.64, I[2]&#xa0;=&#xa0;83.31&#xa0;%, p-value<0.001) and varied by NOS (p-value&#xa0;=&#xa0;0.047). Furthermore, NOS and chronic liver diseases were positively associated with CAPA mortality.<br><br>CONCLUSIONS: The incidence and mortality of CAPA in ICU patients without hematological disorders varied significantly across different studies. There is a pressing need for more high-quality research focused on screening for Aspergillus in COVID-19 ICU patients without hematological disorders, particularly those with chronic liver diseases.}, }
@article {pmid40815775, year = {2025}, author = {Bhundoo, AK and Pillay, JD and Wilke, J}, title = {The Effectiveness of Online Exercise on Physical Activity, Motor Function, and Mental Health: Systematic Review and Meta-Analysis.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e64856}, pmid = {40815775}, issn = {1438-8871}, mesh = {Humans ; *Exercise ; *Mental Health ; COVID-19 ; Randomized Controlled Trials as Topic ; *Exercise Therapy/methods ; SARS-CoV-2 ; *Motor Activity ; Adult ; }, abstract = {BACKGROUND: Regular engagement in physical activity and exercise is associated with a multitude of physical and mental health benefits. Hence, it has been widely encouraged as a measure by which to combat somatic and psychological ailments. In view of the technical progress, the aging society and the public life restrictions issued during the COVID-19 pandemic, the delivery of interventions using digital devices has become highly popular.<br><br>OBJECTIVE: This systematic review and meta-analysis aimed to examine the effects of online exercise programs on physical activity (PA), motor performance, and mental health.<br><br>METHODS: Two independent investigators performed a systematic literature search, using PubMed, Cochrane Library, and Google Scholar. Randomized controlled trials assessing the effects of online exercise (OE) versus no exercise or face-to-face exercise (FFE) in healthy adults were included. Effect sizes (standardized mean difference [SMD]) were pooled using robust variance estimation. The quality of the included studies was assessed by 2 independent reviewers applying the PEDro scale, and publication bias was checked by means of funnel plots. To determine the certainty about the evidence, the results were rated by means of the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) criteria.<br><br>RESULTS: A total of 18 articles with moderate to high methodological quality (7/10 points on the PEDro scale), including a total of 3571 participants, were identified. Visual inspection of funnel plots provided indications of a publication bias for 2 out of 16 outcomes. According to the meta-analysis, OE was superior to no exercise regarding strength (SMD=0.61, 95% CI 0.06 to 1.15, n=5 studies), balance (SMD=0.52, 95% CI 0.06 to 0.99, n=4 studies), endurance (SMD=0.85, 95% CI -0.01 to 1.70, n=5 studies), PA (SMD=0.46, 95% CI 0.05 to 0.87, n=5 studies), depression (SMD=1.08, 95% CI -0.01 to 2.16, n=4 studies), mood or emotion (SMD=0.47, 95% CI 0.05 to 0.90, n=5 studies), mental well-being (SMD=0.79, 95% CI 0.06 to 1.52, n=4 studies), and self-efficacy (SMD=1.1, 95% CI 1.03 to 1.17, n=3 studies). Compared to FFE, OE was noninferior (P>.05) except for gait speed which improved more following FFE (SMD=0.25, 95% CI 0.24 to 0.26, n=2 studies). The certainty about the evidence (GRADE criteria) was low to moderate for all comparisons.<br><br>CONCLUSIONS: OE represents an effective strategy to improve PA, physical function, and mental health in healthy adults and may hence help combat physical inactivity. However, despite the encouraging findings, some limitations need to be tackled before drawing definitive conclusions. These, inter alia, include a small total number of studies and substantial between-trial heterogeneity for some outcomes. Furthermore, as this review focused on healthy adults, future research examining other populations (eg, children and adolescents) is needed.}, }
@article {pmid40815485, year = {2025}, author = {Sugarman, OK}, title = {Leveraging Electronic Health Records and Claims Data to Improve HIV and Comorbidity Care Trajectories: A Scoping Review.}, journal = {Current HIV/AIDS reports}, volume = {22}, number = {1}, pages = {43}, pmid = {40815485}, issn = {1548-3576}, mesh = {Humans ; *Electronic Health Records ; *HIV Infections/epidemiology/therapy ; Comorbidity ; COVID-19/epidemiology ; SARS-CoV-2 ; *Insurance Claim Review ; }, abstract = {PURPOSE OF REVIEW: Big Data sources, specifically electronic health records (EHR) and insurance claims data, are key in advancing HIV research. This scoping review summarizes recent research using EHR/claims to understand the evolving relationship between HIV and comorbidities.<br><br>RECENT FINDINGS: Data sources ranged from individual health system EHR to multi-system integrated datasets. Datasets that linked insurance claims or EHR with external sources (e.g. public health HIV surveillance, social systems) had the richest findings. PLWH who maintained care for HIV and comorbidities, including COVID-19, had similar health outcomes to peers living without HIV. Mental health, substance use disorders, and HPV-related cancers remain prevalent in PLWH. HIV stigma and racial disparities in non-HIV comorbidity care were detected. These findings reinforce evidence of improving general health for PLWH as research and evidence-based treatment progress, and the utility of Big Data for PLWH in public health emergencies like COVID-19. There is continued need for tailored interventions for co-morbid mental health and some cancers. Linking EHR/claims data to external sources are critical to research and practice innovations in approaching whole-person care on the path to HIV elimination.}, }
@article {pmid40814331, year = {2025}, author = {Dawood, I and Alhussein, ST and Wadi, WYA and Abdalgadir, RAY and Mohammed, SSI and Ahmed, EHM}, title = {Viral myocarditis in pediatrics: A review of current diagnostic methods and future directions.}, journal = {Annals of pediatric cardiology}, volume = {18}, number = {1}, pages = {42-48}, pmid = {40814331}, issn = {0974-2069}, abstract = {Viral myocarditis is the inflammation of heart myocytes resulting from viral infection. Incidence in the pediatric population could reach 2 per 100,000 per year, and COVID-19 infection is a significant risk factor, which increases the possibility of having an infection by 40 times. Early detection results in catching the disease early and consequently improves outcomes. Clinical presentation of viral myocarditis in children could vary from mild prodromal symptoms to severe heart failure. Clinical examination, electrocardiogram, and chest X-ray may give clues for physiological and structural signs usually associated with the disease. However, they are inconclusive as they lack both accuracy and specificity. Biomarkers used to track the disease usually lack sensitivity and specificity. Cardiac magnetic resonance (CMR) is the imaging of choice to diagnose viral myocarditis by showing edema and late gadolinium enhancement. Point-of-care ultrasound has been approved as a good imaging method for early detection. It can be used as an effective screening tool for high-risk patients. Positron emission tomography scan is very sensitive in detecting disease early in its acute phase, especially if combined with CMR. All imaging studies are prone to interpretation bias, leading to a misdiagnosis. Endomyocardial biopsy is the gold standard method for diagnosis. However, it is time-consuming and ineffective as an early detection tool. Artificial intelligence (AI) helps with interpretation, decreasing bias, improving accuracy, and saving time and manpower. With more research and evidence, adopting AI-based methods to diagnose myocarditis in pediatrics could offer early detection, reduce costs, and save time for early intervention. Genetics helps identify inflammatory pathways involved in vulnerable patients, and genetic therapy may suppress disease progression by mitigating these pathways. Research focused on children is highly encouraged, and collaboration between healthcare institutions to develop telemedicine-based programs is influential.}, }
@article {pmid40814093, year = {2025}, author = {Xie, Y and Zhou, X and Huang, D and Yao, H and Su, Z and Liu, Z and Cheng, A and Huang, Z and Li, J and Qin, R and Liu, Y and Xia, X and Song, Q and Zhao, L and Xiao, D and Wang, C}, title = {Association between e-cigarette use and COVID-19 diagnosis: a systematic review and meta-analysis.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {2764}, pmid = {40814093}, issn = {1471-2458}, support = {2022ZXJ03C02//Science and Technology Project of Heilongjiang Province of China/ ; CAMS 2021-I2M-1-010//Innovative Medicine/ ; }, mesh = {Humans ; *COVID-19/diagnosis/epidemiology ; *Vaping/epidemiology/adverse effects ; *Electronic Nicotine Delivery Systems/statistics &amp; numerical data ; }, abstract = {BACKGROUND: The impact of e-cigarettes on COVID-19 remains unclear. This study aims to assess the relationship between e-cigarette use and COVID-19 diagnosis and other related outcomes.<br><br>METHODS: This systematic review and meta-analysis searched studies from 2019 to April 2nd, 2024, in Medline (via OVID), EMBASE, Scopus and the Cochrane Central Register of Controlled Trials for eligible observational studies.<br><br>RESULTS: Among the initially identified 1116 items, a total of 20 studies met the inclusion criteria. The meta-analysis revealed that e-cigarette use was significantly associated with higher odds of COVID-19 diagnosis (N&#x2009;=&#x2009;14, adjusted odds ratio, OR 1.25, 95% confidence interval, CI 1.07 to 1.47, I2&#x2009;=&#x2009;62%). This association was more pronounced among the youth (N&#x2009;=&#x2009;4, adjusted OR 1.78, 95% CI 1.17 to 2.72, I2&#x2009;=&#x2009;75%) and current e-cigarette users (N&#x2009;=&#x2009;14, adjusted OR 1.30, 95% CI 1.10 to 1.55, I2&#x2009;=&#x2009;55%). Though the association was not significant among cohort or case-control studies at first, the robust results were shown excluding low-quality studies (N&#x2009;=&#x2009;3, adjusted OR 1.25, 95% CI 1.03 to 1.50, I2&#x2009;=&#x2009;0%). The results remained consistent in leave-one-out analyses. Drawing from the available but limited research, no significance was observed between e-cigarette use or other COVID-19 outcomes including severe COVID-19, COVID-19-related death, symptoms or hospital admission. Heterogeneity and risk of bias should be noticed when explaining our results.<br><br>CONCLUSIONS: E-cigarette use was associated with an increased risk of COVID-19 diagnosis, particularly among youth and current users. Further high-quality evidence is needed to assess the overall health effects of e-cigarettes, with a particular focus on the youth and current users.}, }
@article {pmid40813979, year = {2025}, author = {Heise, M and Madi, M and Mattern, E and Stengler, A and Steckelberg, A}, title = {Effects of the COVID-19 pandemic on working conditions of maternity staff - a scoping review.}, journal = {BMC pregnancy and childbirth}, volume = {25}, number = {1}, pages = {855}, pmid = {40813979}, issn = {1471-2393}, mesh = {Humans ; *COVID-19/epidemiology/psychology ; Female ; Pregnancy ; *Maternal Health Services/organization &amp; administration ; SARS-CoV-2 ; *Midwifery ; Personal Protective Equipment/supply &amp; distribution ; *Health Personnel/psychology ; Obstetrics ; Working Conditions ; }, abstract = {BACKGROUND: The COVID-19 pandemic significantly disrupted healthcare systems, with a pronounced impact on maternity care. Midwives and obstetricians faced numerous structural, organizational, and subjective challenges in maintaining high-quality care under unprecedented conditions. This review examines the multifaceted effects of the COVID-19 pandemic on maternity staff and the challenges encountered during this period.<br><br>METHODS: This scoping review adhered to the methodologies outlined by Arksey &amp; O'Malley and the Joanna Briggs Institute. We searched six bibliographic databases for English and German articles published between January 2020 and September 2023 that addressed the pandemic's impact on maternity staff in OECD countries. The themes and subthemes were deductively established from the extracted results, synthesized into descriptive narratives and charted within a schematic diagram. The reporting followed the PRISMA-ScR statement.<br><br>RESULTS: This scoping review included 83 articles. Key findings were categorized into the two broader topics "structural challenges" and "mental health impacts on the workforce". Structural challenges included staff shortages, restructuring, inadequate personal protective equipment (PPE), transition to virtual communication, managing SARS-CoV-2 positive patients, and restrictions on accompanying persons. Mental health impacts were significant, with increased levels of anxiety, stress and moral dilemmas among staff. Despite these challenges, a strong sense of occupational solidarity was observed.<br><br>CONCLUSIONS: The findings emphasize the need for improved support systems for maternity care staff during pandemics to mitigate these adverse effects. Recommendations include better resource allocation, enhanced mental health support, and clear communication strategies to navigate future healthcare crises effectively. These results may inform pandemic preparedness for future health crises.<br><br>TRIAL REGISTRATIONS: This scoping review was registered with OSF on October 24th, 2023 and the published protocol is openly available via https://doi.org/10.17605/OSF.IO/AVYDX.}, }
@article {pmid40813897, year = {2025}, author = {Dräger, S and Minichmayr, IK and Alipanah-Lechner, N and Barreto, EF and Bos, LDJ and Fleuren, LM and Hunfeld, NGM and Mathew, SK and Stocker, SL and Telles, JP and Torres, A and Koch, BCP and Endeman, H}, title = {Dose individualisation of antibiotics in critically ill patients with inflammation: A narrative review.}, journal = {British journal of clinical pharmacology}, volume = {91}, number = {11}, pages = {3042-3053}, pmid = {40813897}, issn = {1365-2125}, support = {//Erasmus MC MRace Grant/ ; //ESCMID PK/PD of Anti-Infectives Study Group/ ; 848017008/ZONMW_/ZonMw/Netherlands ; //Stichting de Merel/ ; K23 AI143882/AI/NIAID NIH HHS/United States ; K23AI143882//National Institute of Allergy and Infectious Diseases of the National Institutes of Health/ ; 3MS1093//University of Basel/ ; }, mesh = {Humans ; Critical Illness/therapy ; *Anti-Bacterial Agents/administration &amp; dosage/pharmacokinetics ; Drug Monitoring/methods ; *Inflammation/drug therapy ; Biomarkers/blood/metabolism ; Precision Medicine/methods ; Dose-Response Relationship, Drug ; Models, Biological ; }, abstract = {Due to extensive pathophysiological changes in critically ill patients, standard dosing of antibiotics may lead to inadequate drug exposure. This is concerning, as insufficient plasma drug concentrations may lead to treatment failure, whereas excessive drug exposure may increase the risk of toxic adverse events. The role of inflammation as a factor influencing the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics remains largely unknown. PK/PD target attainment of antibiotics can be improved through therapeutic drug monitoring, i.e., measurement of drug concentrations in the blood with subsequent dosage adjustment to reach a certain target. Besides, population PK models may be used to predict drug exposure and tailor dosing in an individual patient (model-informed precision dosing). Inflammatory biomarkers have been proposed to measure inflammation levels and guide antibiotic treatment. However, their potential to guide antibiotic dosing is unclear. This narrative review describes associations between inflammation and PK/PD of antibiotics in critically ill patients, and the role of biomarkers, therapeutic drug monitoring and model-informed precision dosing in improving antibiotic dosing. A focus of future research should be on the interplay between inflammation and PK/PD of antibiotics by including inflammatory biomarkers in PK/PD models and using big data to predict antibiotic exposure in critically ill patients.}, }
@article {pmid40813250, year = {2025}, author = {Boban, S and Patel, H and Cutlan, J and Mathew, B and Francis, L}, title = {Eosinophilic Fasciitis after Covid Infection: A Case Report and Review of Literature.}, journal = {Clinical medicine &amp; research}, volume = {23}, number = {2}, pages = {67-71}, pmid = {40813250}, issn = {1554-6179}, mesh = {Humans ; *Fasciitis/drug therapy/etiology/diagnosis/pathology/diagnostic imaging ; Female ; *Eosinophilia/drug therapy/diagnosis/etiology/pathology ; *COVID-19/complications ; Aged ; SARS-CoV-2 ; Methotrexate/therapeutic use ; Magnetic Resonance Imaging ; Diagnosis, Differential ; }, abstract = {Eosinophilic fasciitis (EF) is a rare fibrosing disorder caused by an autoimmune response to an unknown trigger. Many possible triggers have been suggested including strenuous exercise, drug or chemical exposure, and preceding infection. We present a case of a female patient, age 69 years, who developed EF following SARS-CoV-2 infection. There have been several advances in the diagnosis and management of EF since it was first described 50 years ago. EF is a mimic of scleroderma, but key clinical features can be used to differentiate between the two diagnoses. Laboratory abnormalities include eosinophilia, elevated inflammatory markers, and hypergammaglobulinemia. A full thickness biopsy of the skin including muscle and fascia is recommended to confirm the diagnosis. Imaging modalities such as ultrasound and magnetic resonance imaging have been increasingly used in the diagnosis and follow-up of EF. Corticosteroids remain the first line in treatment of EF. Combination of steroids and methotrexate have shown the best possible outcome. Early diagnosis is important for better treatment response.}, }
@article {pmid40813101, year = {2025}, author = {Li, S and Yu, X and Yao, Y and Yao, T and Xu, M}, title = {Accelerating the approval of mpox vaccines based on lessons learnt from COVID-19 vaccines through the lens of regulatory science.}, journal = {BMJ global health}, volume = {10}, number = {8}, pages = {}, pmid = {40813101}, issn = {2059-7908}, mesh = {Humans ; *COVID-19 Vaccines ; *Drug Approval/legislation &amp; jurisprudence/organization &amp; administration ; *COVID-19/prevention &amp; control ; United States ; United States Food and Drug Administration ; SARS-CoV-2 ; Japan ; World Health Organization ; }, abstract = {The expedited approval of mpox vaccines is critical to addressing this public health emergency. Building on the practice in approving COVID-19 vaccines, this analysis investigates the regulatory pathways used to accelerate vaccine approvals and their implications for mpox vaccine development. The study highlights the regulatory frameworks of the WHO Emergency Use Listing, the U.S. Food and Drug Administration Emergency Use Authorisation, the European Medicines Agency Conditional Marketing Authorisation and Japan's Pharmaceuticals and Medical Devices Agency Emergency Approval. A comparative analysis of these pathways reveals differences in application conditions, data requirements, review timelines and post-approval obligations. The study also draws key lessons from the case analysis of COVID-19 vaccine approvals, providing additional insights for the approval of mpox vaccines. Our study underscores the importance of maintaining rigorous regulatory standards while expediting vaccine development and identifies fit-for-purpose strategies to enhance global preparedness for future public health crises, ensuring the availability of safe, effective and high-quality vaccines.}, }
@article {pmid40812527, year = {2025}, author = {Sharma, N and Singh, A and Ratnesh, RK and Adhana, A and Tyagi, L and Singh, J}, title = {Insights of Surface Enhancing Raman Spectroscopy for Biomedical Application.}, journal = {Methods (San Diego, Calif.)}, volume = {243}, number = {}, pages = {16-30}, doi = {10.1016/j.ymeth.2025.08.005}, pmid = {40812527}, issn = {1095-9130}, mesh = {*Spectrum Analysis, Raman/methods ; Humans ; *COVID-19/diagnosis ; Metal Nanoparticles/chemistry ; SARS-CoV-2/isolation &amp; purification ; Neoplasms/diagnosis ; Substance-Related Disorders/diagnosis ; Brain Diseases/diagnosis ; Biomarkers/analysis ; Surface Properties ; }, abstract = {Raman spectroscopy is a powerful, non-invasive analytical technique that enables rapid identification of molecules based on their unique spectral fingerprints. Its sensitivity has been significantly enhanced through the use of metal nanoparticles in Surface-Enhanced Raman Spectroscopy (SERS), where molecules adsorbed on rough metallic surfaces or colloids produce Raman signals amplified by several orders of magnitude. This enhancement has opened new possibilities for molecular detection, particularly in surface chemistry and biomedical diagnostics. In clinical applications, timely and accurate diagnosis is critical, yet conventional bioanalytical methods often require multiple biochemical tests, leading to delays that are especially problematic in emergency settings. SERS provides a promising alternative, offering high sensitivity, specificity, and rapid analysis with minimal sample preparation. This review explores the integration of Raman spectroscopy-especially SERS-for both in vivo and ex vivo biomedical diagnostics. It covers sample preparation techniques, spectral data interpretation, and the correlation of Raman signals with disease-specific biomarkers. Special focus is given to the application of Raman-based methods in diagnosing brain disorders, various cancers, drug abuse, and COVID-19. Finally, the article discusses future prospects and challenges to guide the continued advancement of biomedical Raman technologies.}, }
@article {pmid40812337, year = {2025}, author = {Liu, C and Rosen, EA and Stohs, EJ and Imlay, H and Nigo, M and Gottesdiener, LS and So, M and Tverdek, F and Dadwal, S and Gudiol, C and Satlin, MJ and Seo, SK and Trubiano, JA and Banerjee, R and Hanson, KE and Abbo, LM}, title = {Tackling antimicrobial resistance in people who are immunocompromised: leveraging diagnostic and antimicrobial stewardship.}, journal = {The Lancet. Infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1473-3099(25)00311-1}, pmid = {40812337}, issn = {1474-4457}, support = {T32 AI118690/AI/NIAID NIH HHS/United States ; }, abstract = {Antimicrobial resistance (AMR) disproportionately affects people who are immunocompromised due to their frequent encounters with the health-care system and repeated, prolonged exposure to antibiotics. AMR threatens to undermine continued advances in cancer care, haematopoietic cell transplantation, and solid organ transplantation by severely restricting therapeutic options. The convergence of several factors in the diagnostic evaluation of infection among individuals with immunocompromising conditions contributes to excess and inappropriate antibiotic use. Diagnostic and antimicrobial stewardship are key complementary strategies to address these challenges with shared goals of improving patient outcomes, reducing harm, and mitigating the risk of AMR. In this Series paper, we discuss opportunities to enhance use of existing diagnostic tools (eg, culture-based diagnostics, molecular diagnostics, and other tools such as antibiotic allergy delabelling), emerging diagnostic tools (eg, metagenomic sequencing and host response profiling), and digital innovation, to optimise antibiotic use, and the potential for precision medicine approaches to combat AMR in people who are immunocompromised.}, }
@article {pmid40812100, year = {2025}, author = {Gil, AM and Barahona-Correa, J and Flórez, JB and Fernández-Ávila, DG and Cucunubá, ZM}, title = {Risk of new onset of immune-mediated diseases after SARS-CoV-2 infection: A systematic review and meta-analysis.}, journal = {Seminars in arthritis and rheumatism}, volume = {74}, number = {}, pages = {152805}, doi = {10.1016/j.semarthrit.2025.152805}, pmid = {40812100}, issn = {1532-866X}, mesh = {Humans ; *Autoimmune Diseases/epidemiology ; *COVID-19/immunology/complications/epidemiology ; *Immune System Diseases/epidemiology/immunology ; Risk Factors ; }, abstract = {OBJECTIVES: The association between SARS-CoV-2 infection and new onset of immune-mediated diseases is of interest given the conflicting evidence. This study aims to gather evidence and estimate the risk of immune-mediated diseases following SARS-CoV-2 infection.<br><br>METHODS: Analytical observational studies reporting immune-mediated diseases after confirmed SARS-CoV-2 infection, compared to individuals without infection history, were included. Thirty-nine immune-mediated diseases were defined as outcomes of interest. Studies including diagnosis within the first 30 days post-infection were excluded. PubMed, EMBASE, CINAHL, Web of Science, and Europe PMC were consulted. Relative risks were pooled using a random-effects model and the Mantel-Haenszel method.<br><br>RESULTS: Eight studies met the eligibility criteria. Meta-analyses were conducted for 13 outcomes of interest from six studies. The SARS-CoV-2 exposed group exhibited significantly higher risks for 11 conditions compared to non-exposed group: Beh&#xe7;et's disease, spondyloarthritis, systemic sclerosis, systemic lupus erythematosus, polymyalgia rheumatica, psoriasis, rheumatoid arthritis, Sj&#xf6;gren's syndrome, type 1 diabetes (in adults), vasculitis, and inflammatory bowel disease. The range of the associations varied between 2.31 (95 % CI: 1.87-2.85) for systemic sclerosis to 3.71 (95 % CI: 1.18-11.72) for Beh&#xe7;et's disease. Guillain-Barr&#xe9; syndrome and type 1 diabetes (in the paediatric population) showed no evidence of association with SARS-CoV-2 infection.<br><br>CONCLUSION: Our results support a higher risk of developing at least 11 immune-mediated diseases evaluated. As autoimmunity is a hallmark of post-COVID-19 syndrome, an increase in these diseases may be expected in the future. Healthcare professionals and stakeholders should prioritize research and public health surveillance based on these findings.}, }
@article {pmid40810963, year = {2025}, author = {Fassmer, AM and Wandscher, K and Bedri, A and Jobski, K and Poustka, L and Bachmann, CJ and Hoffmann, F}, title = {Change of antidepressant utilization in children, adolescents and young adults in Europe before and during the COVID-19 pandemic: a systematic review.}, journal = {European child &amp; adolescent psychiatry}, volume = {}, number = {}, pages = {}, pmid = {40810963}, issn = {1435-165X}, abstract = {BACKGROUND: In recent decades, antidepressant utilization among young persons in Western countries has increased, raising concerns about overprescribing and safety. The COVID-19 pandemic and respective restrictions might have impacted not only youth's mental health but also antidepressant prescribing. Our aim was to systematically investigate changes in antidepressant utilization during the pandemic compared to pre-pandemic periods in European young persons.<br><br>METHODS: This systematic review was registered in PROSPERO (CRD42024559951). Observational studies with &#x2265;&#x2009;100 European young persons (0-24 years) reporting prevalence or incidence data in antidepressant utilization before and during the pandemic (2018/2019 vs. 2021/2022) were included and percentage changes between two time periods calculated. MEDLINE (via PubMed), PsycINFO, and EMBASE were searched from January 1, 2021 to July 3, 2024 and supplemented by citation searching. Study quality was assessed using the Joanna Briggs Institute's tool.<br><br>FINDINGS: We screened 4,416 records for eligibility and included eight studies covering data from Austria, Denmark, Finland, France, Italy, Norway, Spain, and Sweden (n&#x2009;=&#x2009;4 from Nordic countries). The number of included young persons ranged from 1071 to 3,455,521 and all studies used secondary data, mostly from registries. All studies showed a relative increase in overall antidepressant use during the COVID-19 pandemic, with variability between countries ranging from 23 to 52%. Antidepressant utilization showed higher increases in adolescents (n&#x2009;=&#x2009;3 studies) and females (n&#x2009;=&#x2009;3 studies). Selective serotonin reuptake inhibitors were more common (73.9-90.9%; n&#x2009;=&#x2009;3 studies) than other antidepressant classes.<br><br>INTERPRETATION: During the COVID-19 pandemic, antidepressant utilization in young persons increased modestly in all studied European countries. This increase may mirror the surge in mental health problems in young persons during the pandemic, but may also reflect altered patterns of mental health services availability.}, }
@article {pmid40810495, year = {2025}, author = {Lloyd, EC and Wolf, J}, title = {Empiric Antibiotic Therapy for Mycoplasma pneumoniae Pneumonia in Children: A Pro/Con Discussion.}, journal = {Journal of the Pediatric Infectious Diseases Society}, volume = {14}, number = {9}, pages = {}, doi = {10.1093/jpids/piaf075}, pmid = {40810495}, issn = {2048-7207}, mesh = {Humans ; *Pneumonia, Mycoplasma/drug therapy/diagnosis ; *Anti-Bacterial Agents/therapeutic use ; Child ; *Mycoplasma pneumoniae/drug effects ; Community-Acquired Infections/drug therapy/diagnosis ; COVID-19 ; SARS-CoV-2 ; }, abstract = {Mycoplasma pneumoniae is a common respiratory pathogen of increasing clinical interest due to a recent rise in cases in the United States and worldwide following a period of reduced activity during the COVID-19 pandemic. While most cases are mild, M pneumoniae can cause severe community-acquired pneumonia (CAP), and cannot be reliably distinguished from other common causes of CAP based solely on features of clinical presentation or imaging. However, testing to confirm a diagnosis of M pneumoniae, when it is suspected, can be logistically challenging in some clinical settings. It also remains unclear which patients with M pneumoniae CAP benefit from antibiotic treatment, which raises the question of whether treatment should be offered, particularly when the diagnosis is not confirmed. This pro/con discussion explores the available data to support or refute routine testing and empiric antibiotic treatment for M pneumoniae.}, }
@article {pmid40810099, year = {2025}, author = {Hartwell-Kinnear, F}, title = {Food insecurity among older persons in the Southern African Development Community: a scoping review.}, journal = {JAR life}, volume = {14}, number = {}, pages = {100021}, pmid = {40810099}, issn = {2534-773X}, abstract = {Despite the heterogenous challenges of growing older in low- and middle-income settings, there is a deficiency of research explicating food insecurity among older persons. Given rapid population ageing in Sub-Saharan Africa, alongside worsening deprivation, this paper offers an interrogation of existing evidence and exposes concomitant shortfalls in the knowledgebase. Scoping review methodology was employed using PRISMA Guidelines which systematically searched and screened three academic databases. At the global level, climate shifts and natural disasters, pandemics and epidemics such as Coronavirus-2019 and HIV/AIDS affect food insecurity. At a national level, food and welfare systems play a comparatively well-researched role in food insecurity among older persons. Community factors; levels of self-mobilisation or actions of civil society, and intrahousehold dynamics of kinship and associated resource distribution also proved important variables in determining food insecurity. Finally, demographic characteristics; age, marital status, gender, physical and cognitive abilities and coping mechanisms are discussed. In critical review, the work identifies two salient shortcomings in the understanding of food insecurity among older persons. One, extant research fails to account for path dependency, either within the lives of older persons, or socio-economic and political structures surrounding them. The findings, therefore, call for greater impetus upon the adoption of a life-course perspective. Two, scholars have failed to acknowledge older persons' role in shaping these structures and the food/welfare matrix at large. The work concludes by advocating for further theoretical development toward a comprehensive political economy of food insecurity, accounting for changes in the life-course of the individual, and the food, family and welfare systems in which they find themselves.}, }
@article {pmid40809776, year = {2025}, author = {Vivas-Colmenares, GV and Ramírez-Iglesias, JR and Martínez-Pérez, AM}, title = {Telemedicine for educating parents or caregivers for postoperative care of pediatric patients: a systematic review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1606211}, pmid = {40809776}, issn = {2296-2565}, mesh = {Humans ; *Telemedicine ; *Caregivers/education/psychology ; *Parents/education ; Child ; *Postoperative Care ; Adolescent ; COVID-19/epidemiology ; Child, Preschool ; Infant ; }, abstract = {INTRODUCTION: Telemedicine reduces in-person appointments and extends healthcare services to rural areas. Despite its extended use after the COVID-19 pandemic, further analysis of educational applications and strategies is needed to better prepare parents and caregivers for postoperative pediatric care beyond routine clinical follow-up. Therefore, this review systematically evaluates the effectiveness of telemedicine interventions in educating parents or caregivers after pediatric surgery, with respect to caregiver knowledge and self-efficacy in postoperative care, caregiver satisfaction, and postoperative clinical outcomes.<br><br>METHODS: Following the PRISMA guidelines, we searched three databases, PubMed, Scopus, and LILACS, for articles published between 2013 and 2023 that involved patients aged 0-18&#x202f;years who underwent surgery and caregivers who received some form of education through telemedicine. We evaluated the effectiveness of telemedicine for educational purposes by assessing caregiver knowledge, satisfaction, and patient morbidities. Bias was analyzed using the RoB2 and ROBINS-I tools. The certainty of the presented evidence was assessed using the GRADE guidelines. The SWiM guideline was employed to report a structured narrative synthesis from the combined results. The protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024545858).<br><br>RESULTS: Four studies were included from 2,163 records initially registered: two randomized controlled trials (RCTs) and two uncontrolled before-after (UCBAs) studies. In the RCTs, caregiver knowledge was significantly higher in the telemedicine intervention group (p&#x202f;<&#x202f;0.05); in one UCBA, caregiver knowledge increased over time. All studies reported high satisfaction with telemedicine, with the RCTs showing significantly higher satisfaction levels than control groups (p&#x202f;<&#x202f;0.05). One UCBA also reported a significant improvement in patient continence. Bias was assessed as moderate in the RCTs and high in the UCBAs. The GRADE criteria indicate a certainty of evidence moderate for satisfaction and caregiver knowledge, and very low for morbidity and rate of complications or adverse events.<br><br>DISCUSSION: Telemedicine-based educational tools show promise as a strategy for healthcare systems, achieving high acceptance levels. However, further research is required to refine the methodological approaches for implementing telemedicine in caregiver education within the postoperative setting.<br><br>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024545858, identifier [CRD42024545858].}, }
@article {pmid40809451, year = {2025}, author = {Havercamp, SM and Krahn, GL and Murray, AJ and Akobirshoev, I and Bellamy, CD and Bonardi, A and Breslin, ML and Zhǎngsūn Brown, LX and Costa, M and Dembo, RS and Ellsworth, D and Hall, JP and Horner-Johnson, W and Hughes, D and McGee, M and Mudrick, NR and Otstot, E and Parodi, G and Sluzalis, S and Yee, S}, title = {A call to action to include disability in intersectional health equity research and policy.}, journal = {Lancet regional health. Americas}, volume = {49}, number = {}, pages = {101199}, pmid = {40809451}, issn = {2667-193X}, abstract = {Disability status is rarely included in health research and policy, including intersectional research, perpetuating health inequities for this population. This paper calls on researchers and policymakers to take concrete steps to advance health equity for disabled people, including those at the intersections of disability, race, ethnicity, poverty, and other marginalized identities. We propose four strategies with recommendations to promote: a) meaningful engagement of disabled and multiply marginalized people in research and policy planning; b) cohesive, systemic disability data collection and analyses; c) use of intersectional approaches to examine structural drivers of health inequities; and d) leveraging of administrative data to improve disability healthcare policies and practices.}, }
@article {pmid40809128, year = {2024}, author = {Sun, J and Aikawa, M and Ashktorab, H and Beckmann, ND and Enger, ML and Espinosa, JM and Gai, X and Horne, BD and Keim, P and Lasky-Su, J and Letts, R and Maier, CL and Mandal, M and Nichols, L and Roan, NR and Russell, MW and Rutter, J and Saade, GR and Sharma, K and Shiau, S and Thibodeau, SN and Yang, S and Miele, L and , }, title = {A multi-omics strategy to understand PASC through the RECOVER cohorts: a paradigm for a systems biology approach to the study of chronic conditions.}, journal = {Frontiers in systems biology}, volume = {4}, number = {}, pages = {1422384}, pmid = {40809128}, issn = {2674-0702}, abstract = {Post-Acute Sequelae of SARS-CoV-2 infection (PASC or "Long COVID"), includes numerous chronic conditions associated with widespread morbidity and rising healthcare costs. PASC has highly variable clinical presentations, and likely includes multiple molecular subtypes, but it remains poorly understood from a molecular and mechanistic standpoint. This hampers the development of rationally targeted therapeutic strategies. The NIH-sponsored "Researching COVID to Enhance Recovery" (RECOVER) initiative includes several retrospective/prospective observational cohort studies enrolling adult, pregnant adult and pediatric patients respectively. RECOVER formed an "OMICS" multidisciplinary task force, including clinicians, pathologists, laboratory scientists and data scientists, charged with developing recommendations to apply cutting-edge system biology technologies to achieve the goals of RECOVER. The task force met biweekly over 14 months, to evaluate published evidence, examine the possible contribution of each "omics" technique to the study of PASC and develop study design recommendations. The OMICS task force recommended an integrated, longitudinal, simultaneous systems biology study of participant biospecimens on the entire RECOVER cohorts through centralized laboratories, as opposed to multiple smaller studies using one or few analytical techniques. The resulting multi-dimensional molecular dataset should be correlated with the deep clinical phenotyping performed through RECOVER, as well as with information on demographics, comorbidities, social determinants of health, the exposome and lifestyle factors that may contribute to the clinical presentations of PASC. This approach will minimize lab-to-lab technical variability, maximize sample size for class discovery, and enable the incorporation of as many relevant variables as possible into statistical models. Many of our recommendations have already been considered by the NIH through the peer-review process, resulting in the creation of a systems biology panel that is currently designing the studies we proposed. This system biology strategy, coupled with modern data science approaches, will dramatically improve our prospects for accurate disease subtype identification, biomarker discovery and therapeutic target identification for precision treatment. The resulting dataset should be made available to the scientific community for secondary analyses. Analogous system biology approaches should be built into the study designs of large observational studies whenever possible.}, }
@article {pmid40809065, year = {2025}, author = {Patel, JC and Shukla, M and Shukla, M}, title = {From bench to bedside: translating mesenchymal stem cell therapies through preclinical and clinical evidence.}, journal = {Frontiers in bioengineering and biotechnology}, volume = {13}, number = {}, pages = {1639439}, pmid = {40809065}, issn = {2296-4185}, abstract = {Mesenchymal stem cells (MSCs) are emerging as a powerful tool in regenerative medicine due to their ability to differentiate into mesenchymal lineages, such as bone, cartilage, and fat, along with their low immunogenicity and strong immunomodulatory properties. Unlike traditional cell therapies that rely on engraftment, MSCs primarily function through paracrine signaling-secreting bioactive molecules like vascular endothelial growth factor (VEGF), transforming growth factor-beta (TGF-β), and exosomes. These factors contribute to tissue repair, promote angiogenesis, and modulate immune responses in damaged or inflamed tissues. Recent studies have identified mitochondrial transfer as a novel therapeutic mechanism, where MSCs donate mitochondria to injured cells, restoring their bioenergetic function. This has expanded the therapeutic potential of MSCs to include conditions such as acute respiratory distress syndrome (ARDS) and myocardial ischemia. Clinically, MSCs have shown efficacy in diseases like graft-versus-host disease (GVHD), Crohn's disease, and COVID-19. Trials such as REMODEL and REMEDY have demonstrated improved clinical outcomes, further validating MSC-based interventions. However, several challenges remain, including variability in cell potency, poor engraftment, and inconsistent results across clinical trials. Advances in genetic engineering such as CRISPR-modified MSCs and biomaterial scaffolds are being developed to enhance therapeutic efficacy and cell survival. Additionally, AI-driven platforms are being utilized to personalize MSC therapy and optimize cell selection. Innovative approaches like 3D bioprinting and scalable manufacturing are paving the way for more consistent and precise therapies. Moving forward, the integration of mechanistic insights with robust quality control and regulatory frameworks essential to translating MSC therapies from bench to bedside and ensuring their reliable application in clinical practice.}, }
@article {pmid40808732, year = {2025}, author = {Lyn, NLW and Yeo, HY and Startup, CC and Koh, JMY and Tran-Chi, VL and Ho, CSH and Chee, TT}, title = {Stock and cryptocurrency trading and problem gambling behavior during early phases of the COVID-19 pandemic: a narrative literature review.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1585094}, pmid = {40808732}, issn = {1664-1078}, abstract = {BACKGROUND: The Coronavirus Disease of 2019 (COVID-19) resulted in a global shift in gambling and trading behaviors. At present, a gap exists in understanding the relationship between excessive trading behavior and problem gambling, especially during the COVID-19 period. This narrative review analyzed (1) the changes in trading and gambling activity during the COVID-19 pandemic, (2) whether the pattern of trading activity resembles problem gambling, and (3) whether excessive trading and problem gambling share similar consequences.<br><br>METHODS: We searched databases such as Medline, PsychINFO, Scopus, and Google Scholar using relevant keywords, and included 60 reports for narrative synthesis.<br><br>RESULTS: During the COVID-19 pandemic, there were major changes to trading behavior, possibly due to market sentiments and psychology, personal financial needs, social media influence, and the behavior of other investors. The progression of the pandemic led to an increase in brokerage account openings and an increase in trading activities among existing investors, likely due to the development of digital trading platforms that enhanced accessibility for technology-adept investors. There was also a shift from gambling at physical destinations to online gambling, with an increase in frequency and spending among individuals who continued gambling. Feelings of boredom, stress, and the need for relaxation may motivate people to engage in gambling.<br><br>CONCLUSION: Individuals who engaged in excessive trading and problem gambling shared similar traits and may thus face similar psychiatric consequences. The findings indicate that we can apply the diagnostic criteria for pathological gambling and gambling disorders to excessive trading, given that many of these individuals meet the criteria for an addictive disorder.}, }
@article {pmid40806930, year = {2025}, author = {Rosset, F and Celoria, V and Delmonte, S and Mastorino, L and Sciamarrelli, N and Boskovic, S and Ribero, S and Quaglino, P}, title = {The Epidemiology of Syphilis Worldwide in the Last Decade.}, journal = {Journal of clinical medicine}, volume = {14}, number = {15}, pages = {}, pmid = {40806930}, issn = {2077-0383}, abstract = {Background/Objectives: Syphilis, a re-emerging global public health issue, has shown increasing incidence over the past decade, particularly among key populations such as men who have sex with men (MSM), people living with HIV, and pregnant women. This narrative review aimed to synthesize global epidemiological trends of syphilis from 2015 to 2025, with a focus on surveillance gaps, regional disparities, and structural determinants. Methods: A broad narrative approach was used to collect and analyze epidemiological data from 2015 to 2025. The literature was retrieved from databases (PubMed, Scopus) and official reports from the WHO, CDC, and ECDC. Included materials span observational studies, surveillance reports, and modeling data relevant to global trends and public health responses. Results: Globally, syphilis incidence has increased, with notable surges in North America, Europe, and Asia. MSM remain disproportionately affected, while congenital syphilis is resurging even in high-income countries. Low- and middle-income countries report persistent burdens, especially among women of reproductive age, often exacerbated by limited screening and surveillance infrastructure. The COVID-19 pandemic disrupted syphilis-related services and further exacerbated underreporting, hindering timely detection and response efforts. Surveillance systems vary widely in their completeness and quality, which significantly hinders global data comparability and coordinated public health responses. Conclusions: Despite its curability, syphilis continues to spread due to fragmented prevention strategies, inequities in access to care, and insufficient surveillance. Strengthening diagnostic access, integrating prevention efforts into broader health systems, and addressing social determinants are essential. Improved surveillance, equitable access, and innovation-including diagnostics and potential vaccine research-are critical to controlling the global syphilis epidemic.}, }
@article {pmid40806851, year = {2025}, author = {Mara, G and Nini, G and Frenț, SM and Cotoraci, C}, title = {Hematologic and Immunologic Overlap Between COVID-19 and Idiopathic Pulmonary Fibrosis.}, journal = {Journal of clinical medicine}, volume = {14}, number = {15}, pages = {}, pmid = {40806851}, issn = {2077-0383}, abstract = {Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing lung disease characterized by chronic inflammation, vascular remodeling, and immune dysregulation. COVID-19, caused by SARS-CoV-2, shares several systemic immunohematologic disturbances with IPF, including cytokine storms, endothelial injury, and prothrombotic states. Unlike general comparisons of viral infections and chronic lung disease, this review offers a focused analysis of the shared hematologic and immunologic mechanisms between COVID-19 and IPF. Our aim is to better understand how SARS-CoV-2 infection may worsen disease progression in IPF and identify converging pathophysiological pathways that may inform clinical management. We conducted a narrative synthesis of the peer-reviewed literature from PubMed, Scopus, and Web of Science, focusing on clinical, experimental, and pathological studies addressing immune and coagulation abnormalities in both COVID-19 and IPF. Both diseases exhibit significant overlap in inflammatory and fibrotic signaling, particularly via the TGF-β, IL-6, and TNF-α pathways. COVID-19 amplifies coagulation disturbances and endothelial dysfunction already present in IPF, promoting microvascular thrombosis and acute exacerbations. Myeloid cell overactivation, impaired lymphocyte responses, and fibroblast proliferation are central to this shared pathophysiology. These synergistic mechanisms may accelerate fibrosis and increase mortality risk in IPF patients infected with SARS-CoV-2. This review proposes an integrative framework for understanding the hematologic and immunologic convergence of COVID-19 and IPF. Such insights are essential for refining therapeutic targets, improving prognostic stratification, and guiding early interventions in this high-risk population.}, }
@article {pmid40806558, year = {2025}, author = {Sighencea, MG and Trifu, SC}, title = {Unravelling the Viral Hypothesis of Schizophrenia: A Comprehensive Review of Mechanisms and Evidence.}, journal = {International journal of molecular sciences}, volume = {26}, number = {15}, pages = {}, pmid = {40806558}, issn = {1422-0067}, mesh = {Humans ; *Schizophrenia/virology/etiology/immunology ; *Virus Diseases/complications/virology ; Animals ; Genetic Predisposition to Disease ; Pregnancy ; }, abstract = {Schizophrenia is a challenging multifactorial neuropsychiatric disease that involves interactions between genetic susceptibility and environmental insults. Increasing evidence implicates viral infections as significant environmental contributors, particularly during sensitive neurodevelopmental periods. This review synthesises current findings on the viral hypothesis of schizophrenia, encompassing a wide array of neurotropic viruses, including influenza viruses, herpesviruses (HSV-1 and 2, CMV, VZV, EBV, HHV-6 and 8), hepatitis B and C viruses, HIV, HERVs, HTLV, Zika virus, BoDV, coronaviruses (including SARS-CoV-2), and others. These pathogens can contribute to schizophrenia through mechanisms such as direct microinvasion, persistent central nervous system infection, immune-mediated neuroinflammation, molecular mimicry, and the disturbance of the blood-brain barrier. Prenatal exposure to viral infections can trigger maternal immune activation, resulting in cytokine-mediated alterations in the neurological development of the foetus that persist into adulthood. Genetic studies highlight the role of immune-related loci, including major histocompatibility complex polymorphisms, in modulating susceptibility to infection and neurodevelopmental outcomes. Clinical data also support the "mild encephalitis" hypothesis, suggesting that a subset of schizophrenia cases involve low-grade chronic neuroinflammation. Although antipsychotics have some immunomodulatory effects, adjunctive anti-inflammatory therapies show promise, particularly in treatment-resistant cases. Despite compelling associations, pathogen-specific links remain inconsistent, emphasising the need for longitudinal studies and integrative approaches such as viromics to unravel causal relationships. This review supports a "multi-hit" model in which viral infections interfere with hereditary and immunological susceptibilities, enhancing schizophrenia risk. Elucidating these virus-immune-brain interactions may facilitate the discovery of biomarkers, targeted prevention, and novel therapeutic strategies for schizophrenia.}, }
@article {pmid40805970, year = {2025}, author = {Gao, D and Xu, A and Yang, L}, title = {Virtual Care Perceptions and Experiences of Older Adults During COVID-19 in Canada: A Systematic Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {15}, pages = {}, pmid = {40805970}, issn = {2227-9032}, support = {892-2022-3086//Social Sciences and Humanities Research Council/ ; }, abstract = {Background/Objectives: Older adults (65+) are the fastest growing age group in Canada, comprising 18.8% of the country's population. During the COVID-19 pandemic, use of virtual care, including telehealth and tele-medicine, increased dramatically among older adults in Canada who often face higher health risks, mobility limitations, and many barriers to accessing healthcare. Despite the rapid expansion in virtual care, no systematic review has focused specifically on virtual care among older adults in Canada. This review aims to explore the factors influencing virtual care adoption and the experiences of older Canadians during the pandemic through a systematic review. Methods: Conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, the review involved a comprehensive search of PubMed, Scopus, ESCBOHost, and Web of Science on 2 May 2025, yielding 281 unique citations. After screening and applying eligibility criteria, 15 studies employing quantitative, qualitative, or mixed-methods designs, with sample sizes ranging from 15 to 2,282,798, were included and appraised using the Mixed Methods Appraisal Tool (MMAT). Results: The review identified three domains of factors and the ways in which each factor shapes older adults' virtual care experiences: (1) personal factors influencing virtual care use and demand (e.g., age, education, language, income, immigration status, community sizes), (2) resource factors impacting virtual care adoption (e.g., technology access, support), and (3) varying virtual care experiences among older adults (e.g., in assessment and communication efficacy, privacy, care quality, convenience, safety, and costs). Conclusions: This review highlights the complexities of virtual care engagement among older adults and underscores the need for inclusive, tailored strategies to improve the accessibility and effectiveness of virtual care delivery in both pandemic and post-pandemic contexts.}, }
@article {pmid40805931, year = {2025}, author = {Mazzonetto, LF and Cordeiro, JFC and Correia, IM and Oliveira, AS and Moraes, C and Brilhadori, J and Gomide, EBG and Kudlacek, M and Machado, DRL and Anjos, JRCD and Santos, APD}, title = {Physical Training Protocols for Improving Dyspnea and Fatigue in Long COVID: A Systematic Review with Meta-Analysis.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {15}, pages = {}, pmid = {40805931}, issn = {2227-9032}, abstract = {Objective: This study aimed to evaluate physical training protocols for alleviating long COVID symptoms, especially dyspnea and fatigue, through a systematic review with meta-analysis. Method: Data were collected from EMBASE, LILACS, PubMed, Scopus, CINAHL, Web of Science, and grey literature (Google Scholar, medRxiv). Studies evaluating dyspnea and/or fatigue before and after physical rehabilitation, using validated questionnaires, were included. Studies lacking pre- and post-assessments or physical training were excluded. Two reviewers independently extracted data on intervention type, duration, frequency, intensity, and assessment methods for dyspnea and fatigue. Bias risk was evaluated using the Cochrane tool. Results: Combined methods, such as respiratory muscle training with strength and aerobic exercise, were common for long COVID symptoms. Aerobic exercise notably improved dyspnea and/or fatigue. Among 25 studies, four had a low risk of bias. Meta-analysis of two studies found no significant reduction in fatigue. Conclusion: Combined training methods, particularly aerobic exercise, alleviate dyspnea and fatigue in long COVID. More high-quality studies are needed to confirm these findings.}, }
@article {pmid40805905, year = {2025}, author = {Aljinović-Vučić, V}, title = {Self-Medication as a Global Health Concern: Overview of Practices and Associated Factors-A Narrative Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {15}, pages = {}, pmid = {40805905}, issn = {2227-9032}, abstract = {Self-medication is a subject of global importance. If practiced responsibly, self-medication represents a part of self-care or positive care of an individual or a community in promoting their own health. However, today's practices of self-medication are often inappropriate and irresponsible, and as such appear all over the world. Inappropriate self-medication can be connected with possible serious health risks and consequences. Therefore, it represents a global health issue. It can even generate additional health problems, which will eventually become a burden to healthcare systems and can induce significant costs, which also raises socioeconomic concerns. Hence, self-medication attracts the attention of researchers and practitioners globally in efforts to clarify the current status and define feasible measures that should be implemented to address this issue. This narrative review aims to give an overview of the situation in the field of self-medication globally, including current practices and attitudes, as well as implications for actions needed to improve this problem. A PubMed/MEDLINE search was conducted for articles published in the period from 1995 up to March 2025 using keywords "self-medication" or "selfmedication" alone or in combinations with terms related to specific subthemes related to self-medication, such as COVID-19, antimicrobials, healthcare professionals, and storing habits of medicines at home. Studies were included if self-medication was their main focus. Publications that only mentioned self-medication in different contexts, but not as their main focus, were excluded. Considering the outcomes of research on self-medication in various contexts, increasing awareness of responsible self-medication through education and informing, together with surveillance of particular medicines and populations, could lead to more appropriate and beneficial self-medication in the future.}, }
@article {pmid40805896, year = {2025}, author = {Valeiro, C and Silva, V and Balteiro, J and Patterson, D and Bezerra, G and Mealiff, K and Matos, C and Jesus, &#xc2; and Joaquim, J}, title = {Pharmacy Technicians in Immunization Services: Mapping Roles and Responsibilities Through a Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {15}, pages = {}, pmid = {40805896}, issn = {2227-9032}, support = {2024-1-BE01-KA210-VET-000251165//Erasmus+/ ; }, abstract = {Background: Pharmacy technicians are increasingly involved in immunization services, enhancing vaccine accessibility and reducing pharmacies' workload. This scoping review aims to (1) provide a comprehensive overview of pharmacy technicians' involvement in immunization services across various healthcare settings and countries, and (2) conduct a comparative analysis of training curricula for pharmacy technicians on immunization. Methods: A scoping review was conducted following the Arksey and O'Malley framework. A comprehensive search of the PubMed and Scopus databases was performed using keywords and MeSH terms such as "pharmacy technician(s)", "immunization", "vaccination", "role", and "involvement". Studies included assessed pharmacy technicians' roles in vaccine administration, training, and public health outcomes. Descriptive and thematic analyses were used to synthesize the findings. In addition, a supplementary analysis of immunization training curricula was conducted, reviewing programs from different countries to identify similarities, differences, and gaps in course structure, content, and delivery formats. Lastly, a comprehensive toolkit was developed, offering guidelines intended to facilitate the implementation of immunization training programs. Results: A total of 35 articles met the inclusion criteria, primarily from the United States of America (n = 30), Canada (n = 2), Ethiopia (n = 1), Denmark (n = 1) and United Kingdom (n = 1). The findings indicate that pharmacy technicians contribute significantly to vaccine administration, patient education, and workflow optimization, particularly in community pharmacies. The COVID-19 pandemic accelerated their involvement in immunization programs. Key challenges include regulatory barriers, a lack of standardized training, and resistance from other healthcare professionals. Facilitators include legislative support (e.g., the PREP Act), structured training programs, and collaborative pharmacist-technician models. Conclusions: Pharmacy technicians can play a vital role in expanding immunization services, improving vaccine uptake, and reducing pharmacist workload. Addressing regulatory inconsistencies, enhancing training, and fostering interprofessional collaboration are crucial for their effective integration of immunization programs. Since immunization by pharmacy technicians is not yet allowed in many EU countries, this review will provide a foundational basis to address their potential to support the healthcare workforce and improve access to immunization services.}, }
@article {pmid40805129, year = {2025}, author = {Szymczyk, A and Drozd-Sokołowska, J and Hus, I}, title = {Infectious Complications in Patients with B-Cell Non-Hodgkin Lymphoma Treated with Bispecific Antibodies.}, journal = {Cancers}, volume = {17}, number = {15}, pages = {}, pmid = {40805129}, issn = {2072-6694}, abstract = {Bispecific antibodies (BsABs) have become a new standard of treatment of refractory/relapsed patients with diffuse large B-cell lymphoma and follicular lymphoma, being also intensively studied in other types of B-cell non-Hodgkin lymphoma (B-NHL). Since the therapy with BsABs results in profound B-cell depletion and T-cell exhaustion, it is associated with significantly increased risk of infections. Additional risk factors involve immune disorders caused by lymphoma itself and previous lines of therapy. In this review, we focus on the infectious complications in B-NHL patients treated BsABs, presenting their incidence in clinical trials, admittedly performed to a large extent during the COVID-19 pandemic, as well as the proposals of infection prophylaxis.}, }
@article {pmid40804893, year = {2025}, author = {Biuzzi, C and Modica, E and De Filippis, N and Pizzirani, D and Galgani, B and Di Chiaro, A and Marianello, D and Franchi, F and Taccone, FS and Scolletta, S}, title = {Old and New Definitions of Acute Respiratory Distress Syndrome (ARDS): An Overview of Practical Considerations and Clinical Implications.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {15}, pages = {}, pmid = {40804893}, issn = {2075-4418}, abstract = {Lower respiratory tract infections remain a leading cause of morbidity and mortality among Intensive Care Unit patients, with severe cases often progressing to acute respiratory distress syndrome (ARDS). This life-threatening syndrome results from alveolar-capillary membrane injury, causing refractory hypoxemia and respiratory failure. Early detection and management are critical to treat the underlying cause, provide protective lung ventilation, and, eventually, improve patient outcomes. The 2012 Berlin definition standardized ARDS diagnosis but excluded patients on non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) modalities, which are increasingly used, especially after the COVID-19 pandemic. By excluding these patients, diagnostic delays can occur, risking the progression of lung injury despite ongoing support. Indeed, sustained, vigorous respiratory efforts under non-invasive modalities carry significant potential for patient self-inflicted lung injury (P-SILI), underscoring the need to broaden diagnostic criteria to encompass these increasingly common therapies. Recent proposals expand ARDS criteria to include NIV and HFNCs, lung ultrasound, and the SpO2/FiO2 ratio adaptations designed to improve diagnosis in resource-limited settings lacking arterial blood gases or advanced imaging. However, broader criteria risk overdiagnosis and create challenges in distinguishing ARDS from other causes of acute hypoxemic failure. Furthermore, inter-observer variability in imaging interpretation and inconsistencies in oxygenation assessment, particularly when relying on non-invasive measurements, may compromise diagnostic reliability. To overcome these limitations, a more nuanced diagnostic framework is needed-one that incorporates individualized therapeutic strategies, emphasizes lung-protective ventilation, and integrates advanced physiological or biomarker-based indicators like IL-6, IL-8, and IFN-γ, which are associated with worse outcomes. Such an approach has the potential to improve patient stratification, enable more targeted interventions, and ultimately support the design and conduct of more effective interventional studies.}, }
@article {pmid40804722, year = {2025}, author = {Kidanemariam, YT and Abebe, F and Girma, E and Addisse, A and Birhanu, Z and Hassen, K and Taye, A and Amdisa, D and Lake, EA and Guta, MT and Morankar, S and Kedir, K and Mesfin, F and Wadilo, F and Hailemeskel, E and Dereje, M and Hailegebrel, E and Howe, R and Boltena, MT and Getachew, H and Mengesha, EW and Tesfaye, TD and Fentahun, N and Damtew, B and Debebe, A and Tariku, Z and Worku, A and Abraha, YG and Ababulgu, SA}, title = {Impact of COVID-19 pandemic on non-communicable diseases care and service deliveries in Sub-Saharan Africa: A systematic review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1075}, pmid = {40804722}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/epidemiology ; *Noncommunicable Diseases/therapy/epidemiology ; Africa South of the Sahara/epidemiology ; *Delivery of Health Care/organization &amp; administration ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: Non-communicable diseases (NCDs) care and services play a crucial role in reducing mortality and morbidity associated with NCDs. However, COVID-19 pandemic has worsened the disparities in NCDs care and services in Sub-Saharan Africa (SSA). To date, there is limited synthesized evidence on the impact of COVID-19 on NCDs care and service delivery in this region. Therefore, this review aims to examine the impact of the COVID-19 pandemic on NCDs care and service in SSA.<br><br>METHOD: A systematic search was conducted on various databases and grey literature sources, including PubMed, CINAHL, Web of Science, Embase, Scopus, Google Scholar, and the World Health Organization database. Studies evaluating the impacts of COVID-19 on the management and provision of major NCDs care in SSA were included. Data extraction and review were performed using the JBI SUMARI and PRISMA 2020 checklist, and a narrative synthesis approach was used due to the high heterogeneity of the included studies. The review protocol has been registered with PROSPERO code CRD42022350528.<br><br>RESULT: A total of 2,387 records were initially identified, with 2,207articles excluded during abstract and title screening, and 60 articles excluded during full-text screening. Ultimately, 18 studies (13 quantitative and 5 qualitative) were included. The review identified significant disruptions in delivery of care for NCD care across SSA during the pandemic. It include substantial reduction in outpatient attendance, delayed or cancelled diagnostic service and compromised disease management. These disruptions were influenced by healthcare system overloads, patient fears of contracting COVID-19, and public health measures limiting access to routine care. The studies emphasize an urgent need for adaptive strategies to maintain continuity of care for individuals with NCD during health crises.<br><br>CONCLUSION: The provision of healthcare services for NCDs experienced substantial disruptions during the COVID-19 pandemic, leading to a shift towards managing emergency care. Individuals with NCDs have encountered increased risks of morbidity and mortality due to the delayed access to essential care amidst the pandemic. Emergent solutions like digital health technologies have shown potential in enhancing NCD care access during such crises. Moving forward, it is critical that countries prioritize NCD care and integrate robust systems to ensure the continuous provision of essential services, regardless of the COVID-19 pandemic and other healthcare emergencies.}, }
@article {pmid40804645, year = {2025}, author = {Paval, NE and Căliman-Sturdza, OA and Lobiuc, A and Dimian, M and Sirbu, IO and Covasa, M}, title = {MicroRNAs in long COVID: roles, diagnostic biomarker potential and detection.}, journal = {Human genomics}, volume = {19}, number = {1}, pages = {90}, pmid = {40804645}, issn = {1479-7364}, support = {285/30.11.2022//Ministerul Cercet&#x103;rii, Inov&#x103;rii &#x15f;i Digitaliz&#x103;rii/ ; }, mesh = {Humans ; *COVID-19/genetics/diagnosis/virology ; *MicroRNAs/genetics ; Biomarkers/metabolism ; SARS-CoV-2 ; Sequence Analysis, RNA/methods ; Post-Acute COVID-19 Syndrome ; }, abstract = {Long COVID or Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), marked by persistent symptoms lasting weeks to months after acute SARS-CoV-2 infection, affects multiple organ systems including the respiratory, cardiovascular, neurological, gastrointestinal, and renal systems. These prolonged effects stem from chronic inflammation, immune dysregulation, and direct viral injury. MicroRNAs (miRNAs)-small non-coding RNAs involved in gene regulation-play a pivotal role in this process by modulating immune responses, inflammation, and cellular stress. Altered miRNA expression patterns during and after infection contribute to the pathogenesis of Long COVID. While conventional miRNA detection techniques have been valuable, they face limitations in sensitivity, throughput, and detecting RNA modifications. This review highlights Oxford Nanopore Sequencing (ONS) as a promising alternative, offering real-time, long-read, amplification-free RNA sequencing that preserves native modifications. ONS enables direct sequencing of full-length miRNAs and their precursors, providing novel insights into miRNA processing and regulatory roles. Despite current challenges with short-read accuracy, ongoing technical advances are improving ONS performance. Its integration in miRNA profiling holds significant potential for uncovering novel regulatory interactions and advancing clinical biomarker discovery in Long COVID and other conditions.}, }
@article {pmid40804538, year = {2026}, author = {Torres Montaguth, OE and Buddle, S and Morfopoulou, S and Breuer, J}, title = {Clinical metagenomics for diagnosis and surveillance of viral pathogens.}, journal = {Nature reviews. Microbiology}, volume = {24}, number = {1}, pages = {61-75}, pmid = {40804538}, issn = {1740-1534}, mesh = {*Metagenomics/methods ; Humans ; *Virus Diseases/diagnosis/virology ; *Viruses/genetics/isolation &amp; purification/classification ; SARS-CoV-2/genetics ; Animals ; COVID-19/diagnosis/virology/epidemiology ; }, abstract = {Metagenomics is becoming more widely used for diagnosis of viral infections and surveillance of viruses. Its pathogen-agnostic approach makes metagenomics useful for unknown and novel infection diagnosis, outbreak investigation, and new and emerging pathogen surveillance. New metagenomics methods, such as the use of rapid sequencing technologies and approaches that can selectively enrich for a wide range of viruses, are expanding the range of clinical and public health scenarios in which metagenomics can be used. Following the COVID-19 pandemic, there is increasing interest in viral surveillance worldwide, using clinical samples, potential zoonotic reservoirs and environmental sources, such as wastewater. Validation and accreditation of metagenomics protocols to ensure quality, together with further innovation in methods, will be necessary to bring metagenomics into routine service in clinical and public health laboratories.}, }
@article {pmid40804297, year = {2025}, author = {Rehan, MW and Rehan, MM}, title = {Survey, taxonomy, and emerging paradigms of societal digital twins for public health preparedness.}, journal = {NPJ digital medicine}, volume = {8}, number = {1}, pages = {520}, pmid = {40804297}, issn = {2398-6352}, abstract = {The emergence of SARS-CoV-2 (COVID-19) has demonstrated the severe impact of infectious diseases on global society, politics, and economies. To mitigate future pandemics, preemptive measures for effectively managing infection outbreaks are essential. In this context, Societal Digital Twin (SDT) technology offers a promising solution. To the best of our knowledge, this survey is the premier to conceptualize an SDT framework for infection containment under a novel systematic taxonomy. The framework categorizes infection management into five stages, namely infection initiation, spread, control, combat, and recovery. It provides an overview of SDT approaches within each category, discussing their validation strategies, generalizability, and limitations. Additionally, the survey examines applications, data-driven design issues, key components, and limitations of DT technology in healthcare. Finally, it explores key challenges, open research directions, and emerging paradigms to advance DT applications in the healthcare domain, highlighting smart service paradigms such as SDT as a Smart Service (SDTaaSS) and Healthcare Metaverse as a Smart Service (HMaaSS).}, }
@article {pmid40803938, year = {2025}, author = {Wang, CY and Chen, CH and Tsai, SF}, title = {Tacrolimus Toxicity Induced by Nirmatrelvir/Ritonavir in a Renal Transplant Recipient Managed With Phenytoin: A Case Report and Literature Review.}, journal = {Transplantation proceedings}, volume = {57}, number = {7}, pages = {1329-1333}, doi = {10.1016/j.transproceed.2025.06.019}, pmid = {40803938}, issn = {1873-2623}, mesh = {Humans ; Male ; *Kidney Transplantation ; Middle Aged ; *Ritonavir/adverse effects ; *Phenytoin/therapeutic use ; *Tacrolimus/adverse effects ; *Immunosuppressive Agents/adverse effects ; COVID-19 ; COVID-19 Drug Treatment ; }, abstract = {INTRODUCTION: The COVID-19 pandemic has led to widespread use of nirmatrelvir/ritonavir in high-risk populations. Ritonavir, a strong CYP3A4 inhibitor, can significantly increase tacrolimus levels, causing toxicity in transplant recipients. This report presents a case of nirmatrelvir/ritonavir -induced tacrolimus toxicity in a kidney transplant patient, successfully managed with phenytoin, a CYP3A4 inducer.<br><br>CASE REPORT: A 63-year-old male kidney transplant recipient experienced malaise and hand tremors after nirmatrelvir/ritonavir treatment for mild COVID-19. Lab tests revealed ac1ute kidney injury and supratherapeutic tacrolimus levels (>60 ng/mL). Tacrolimus was discontinued, and hydration was initiated. Persistent toxicity required phenytoin, leading to rapid improvement. A renal biopsy showed no toxicity, and the patient was discharged without complications.<br><br>DISCUSSION: Among 51 reported cases of nirmatrelvir/ritonavir -induced tacrolimus toxicity, 13 used CYP3A4 inducers. This case highlights phenytoin's efficacy in reducing toxicity and protecting renal function. Timely initiation with a loading dose is crucial for optimal outcomes.<br><br>CONCLUSION: Early recognition and prompt management with hydration and CYP3A4 inducers, such as phenytoin, are essential in mitigating nirmatrelvir/ritonavir -associated tacrolimus toxicity.}, }
@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 &amp; therapeutics}, volume = {33}, number = {5}, pages = {785-803}, 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 {pmid40803509, year = {2025}, author = {Cocking, E and Daher, J and Alabbood, M}, title = {New-onset diabetes mellitus post COVID-19 infection: a systematic review and meta-analysis.}, journal = {Diabetes research and clinical practice}, volume = {227}, number = {}, pages = {112417}, doi = {10.1016/j.diabres.2025.112417}, pmid = {40803509}, issn = {1872-8227}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Diabetes Mellitus/epidemiology/etiology ; Incidence ; *Diabetes Mellitus, Type 2/epidemiology ; *Diabetes Mellitus, Type 1/epidemiology ; SARS-CoV-2 ; Risk Factors ; }, abstract = {AIMS: This systematic review and meta-analysis aimed to determine the relative risk of new-onset diabetes mellitus (NODM) in COVID-19 patients compared to individuals without COVID-19, with subgroup analyses based on diabetes type, age, severity of COVID-19 infection and corticosteroid use.<br><br>METHODS: PubMed, Medline, Embase, and Scopus were systematically searched for peer-reviewed cohort studies comparing NODM incidence in COVID-19 patients against a control group without COVID-19. A random-effects meta-analysis was conducted to determine the relative risk of NODM following COVID-19 infection.<br><br>RESULTS: A total of 12 studies were included, involving over 48 million participants. The risk of developing NODM was 41&#xa0;% higher in patients following COVID-19 infection compared to the control group (RR 1.41; 95&#xa0;% CI 1.07-1.84). Subgroup analysis revealed a higher incidence of type 2 compared to type 1 diabetes mellitus post COVID-19 infection, and increased risk of NODM in adults and patients with higher severity of disease.<br><br>CONCLUSION: COVID-19 infection is associated with a significantly higher risk of NODM. Close monitoring for hyperglycaemia should be considered following COVID-19 infection, especially in adult patients requiring hospital or ICU admission.}, }
@article {pmid40803025, year = {2025}, author = {Makins, A and Mahmood, H and Talbot, K and Hordern, C and Taghinejadi, N and Houlden, R and Bright, S and Arulkumaran, S}, title = {Reverse innovation - South to North learnings in the provision of postpartum contraception: implementation in a high-income setting.}, journal = {Best practice &amp; research. Clinical obstetrics &amp; gynaecology}, volume = {102}, number = {}, pages = {102653}, doi = {10.1016/j.bpobgyn.2025.102653}, pmid = {40803025}, issn = {1532-1932}, mesh = {Humans ; Female ; *Family Planning Services/organization &amp; administration ; *COVID-19/epidemiology ; *Contraception/methods ; *Postpartum Period ; Developing Countries ; United Kingdom ; Pregnancy ; SARS-CoV-2 ; Intrauterine Devices ; Health Services Accessibility ; }, abstract = {This article outlines a unique example of reverse innovation. Lessons from low- and middle-income countries (LMICs) shaped healthcare practices in a high-income setting. We describe how the FIGO Postpartum Intrauterine Device Initiative, implemented across six LMICs, informed the development of a postpartum contraception program in a UK-based NHS trust. Despite the well-documented benefits of postpartum family planning (PPFP), implementing dedicated PPFP services in the UK has been challenging due to fragmented healthcare funding and cross service integration barriers. The COVID-19 pandemic created an urgent need for adaptation, providing a unique opportunity to rapidly establish a comprehensive local PPFP service. We outline how strategies from LMICs - including task-sharing, provider training, and policy advocacy - were directly applied to overcome these barriers and drive successful implementation. This case study highlights the potential of South-to-North knowledge transfer in driving healthcare innovation, improving contraceptive access, and underscores the importance of global collaboration and adaptive learning in reproductive healthcare.}, }
@article {pmid40802311, year = {2025}, author = {Ribeiro, RR and Andrade, RLP and Silva, DCD and Sthal, HC and Oliveira, JA and Regis, IM and Gonzalez, RIC}, title = {[Repercussion of the COVID-19 pandemic on tuberculosis control actions in primary health care: scoping review].}, journal = {Ciencia &amp; saude coletiva}, volume = {30}, number = {7}, pages = {e00992024}, doi = {10.1590/1413-81232025307.00992024}, pmid = {40802311}, issn = {1678-4561}, mesh = {*COVID-19/epidemiology ; Humans ; *Primary Health Care/organization &amp; administration ; *Tuberculosis/prevention &amp; control/epidemiology ; Pandemics ; }, abstract = {This study aimed to map the scientific literature on the impact of the COVID-19 pandemic on the execution of tuberculosis control actions in primary care. It is a scope review, guided by the method proposed by Joanna Briggs Institute Reviewers, developed from five stages. Studies that focused on the analysis of TB control actions were included, considering the studies that contextualize the scenario of the COVID-19 pandemic in the provision, management, and development of tuberculosis services, also, studies that involved the context of APS units were included. The results were classified by categories of conceptual analyses, from the analysis of thematic categorization, presented in frames and tables. The search strategy resulted in a total of 1,014 publications and, after the selection and eligibility process, 21 studies were selected. The mapping of the scientific literature of the study identified the impact of the COVID-19 pandemic in all categories named as TB control actions in APS. Despite the significant impacts pointed out by the studies, it is possible and feasible to recover the response to TB in the post-pandemic period, through accelerated efforts.}, }
@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.<br><br>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&#x200a;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.<br><br>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.}, }
@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.<br><br>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.<br><br>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.}, }
@article {pmid40802031, year = {2025}, author = {Lok, KH and Loo, HL and Chuah, LH}, title = {Topical and transdermal lipid-polymer hybrid nanoparticles (LPN): an integration in advancing dermatological treatments.}, journal = {Drug delivery and translational research}, volume = {15}, number = {11}, pages = {4277-4313}, pmid = {40802031}, issn = {2190-3948}, mesh = {Humans ; *Polymers/chemistry/administration &amp; dosage ; *Nanoparticles/chemistry/administration &amp; dosage ; *Lipids/chemistry/administration &amp; dosage ; Administration, Cutaneous ; *Skin Diseases/drug therapy ; Animals ; Drug Carriers/chemistry ; Drug Delivery Systems/methods ; }, abstract = {Lipid-polymer hybrid nanoparticles (LPN) are an integration or "collaboration" between the two distinct drug delivery platforms of lipid and polymeric carriers. The idea centres on coining the advantages of both materials while attempting to overcome the limitations inherent to each component, thus improving biocompatibility, drug loading, stability, size uniformity, and controlled release properties. Since their emergence over two decades ago, LPN have attracted growing interest in various therapeutic areas such as cancer, neurological disorders, osteoarthritis, and COVID-19 viral infections. Their structural diversity has expanded from the classical polymeric core-lipid shell to its inverse structure of lipid core-polymeric shell and homogeneous lipid-polymer blends, producing nine types of LPN under these structural classes. Correspondingly, preparation strategies have evolved from two-step methods to integrated one-step method of nanoprecipitation, single-emulsification-solvent evaporation, and double-emulsification-solvent evaporation in the early 2010s. More recently, novel methods such as self-assembly, modified ionic gelation, modified ethanolic injection, film rehydration, and hot-melt emulsification have been introduced, with hot-melt emulsification showing particular promise for scalability. In this context, the present review proactively introduces an updated structural classification and proposes a revision of existing formulation strategies by expanding the one-step and two-step framework to incorporate emerging methods tailored for dermatological applications. While LPN are often portrayed as a better version of lipid and polymeric-based nanoparticles, their practical applicability in dermatological treatments remains an open question. Therefore, this review evaluates LPN's clinical and translational potential in dermatology applications such as, wounds, skin infections, dermatitis, psoriasis, skin cancer, pain management, and cosmetic applications.}, }
@article {pmid40801977, year = {2025}, author = {Aboalroub, AA}, title = {Pathogenic Proteins Through the Lens of NMR Spectroscopy: Structural and Functional Insights into Disease.}, journal = {Cell biochemistry and biophysics}, volume = {83}, number = {4}, pages = {4343-4366}, pmid = {40801977}, issn = {1559-0283}, }
@article {pmid40801926, year = {2025}, author = {Anagnostopoulos, I and Lakic, T and Balague, O and Van den Brand, M and Dirnhofer, S and Gasljevic, G and Laurent, C and Ponzoni, M and Quintanilla-Martinez, L and Sander, B and Cook, JR}, title = {Atypical lymphoid proliferations associated with therapeutic intervention: a report of the 2024 EA4HP/SH lymphoma workshop.}, journal = {Virchows Archiv : an international journal of pathology}, volume = {487}, number = {2}, pages = {287-307}, pmid = {40801926}, issn = {1432-2307}, mesh = {Humans ; *Lymphoproliferative Disorders/pathology/diagnosis/etiology/therapy ; COVID-19/prevention &amp; control ; Immunosuppressive Agents/adverse effects ; COVID-19 Vaccines/adverse effects ; Middle Aged ; }, abstract = {The challenging boundaries between neoplastic and reactive lymphoproliferations were discussed during the 2024 European Association for Haematopathology/Society for Hematopathology workshop in Dubrovnik, Croatia. Session 3 focussed on the atypical lymphoid proliferations associated with therapeutic interventions. Forty-four cases were submitted representing a broad spectrum of lymphoproliferative disorders (LPDs) encountered in the settings of immunosuppressive and immunomodulatory therapies, various interventions for solid tumor treatment, drug reaction with eosinophilia and systemic symptoms (DRESS), CAR T-cell therapy for B-cell lymphomas, Bruton tyrosine kinase inhibitors (BTKI) for SLL/CLL treatment, ABL-kinase inhibitor dasatinib, and COVID-19 vaccination. The cases of this session highlighted the importance of having sufficient clinical information including drug history and distribution of disease in order to achieve reliable diagnosis. Among LPDs associated with immunosuppressive and immunomodulatory therapies, the most challenging were T- and NK-derived infiltrates as they ranged from non-clonal to clonal. DRESS-associated lymphadenopathy exhibited variable histologic patterns with the most difficult differential diagnosis being with a T-cell lymphoma. LPDs observed after CAR T-cell therapy for B-cell neoplasms exhibited unexpected phenotypes resulting either from lineage switching/transdifferentiation, or from harvested T-cells already harbouring cancer-associated variants. Temporary interruption of BTKI treatment for CLL/SLL due to surgical procedures led to a "Pseudo-Richter transformation" that disappeared after reintroduction of therapy. Dasatinib led to a lymphadenopathy with a peculiar florid follicular hyperplasia that regressed after discontinuation of therapy. The findings of the few thoroughly studied COVID-19 vaccination associated lymphadenopathy cases reflected a disordered immune response. This report describes the most important features for diagnosis of these challenging cases.}, }
@article {pmid40801614, year = {2025}, author = {Sonkodi, B}, title = {Underlying Piezo2 Channelopathy-Induced Neural Switch of COVID-19 Infection.}, journal = {Cells}, volume = {14}, number = {15}, pages = {}, pmid = {40801614}, issn = {2073-4409}, mesh = {Humans ; *COVID-19/metabolism ; *Ion Channels/metabolism ; SARS-CoV-2 ; Neurons/metabolism/pathology ; *Channelopathies/metabolism ; Pandemics ; Animals ; }, abstract = {The focal "hot spot" neuropathologies in COVID-19 infection are revealing footprints of a hidden underlying collapse of a novel ultrafast ultradian Piezo2 signaling system within the nervous system. Paradoxically, the same initiating pathophysiology may underpin the systemic findings in COVID-19 infection, namely the multiorgan SARS-CoV-2 infection-induced vascular pathologies and brain-body-wide systemic pro-inflammatory signaling, depending on the concentration and exposure to infecting SARS-CoV-2 viruses. This common initiating microdamage is suggested to be the primary damage or the acquired channelopathy of the Piezo2 ion channel, leading to a principal gateway to pathophysiology. This Piezo2 channelopathy-induced neural switch could not only explain the initiation of disrupted cell-cell interactions, metabolic failure, microglial dysfunction, mitochondrial injury, glutamatergic synapse loss, inflammation and neurological states with the central involvement of the hippocampus and the medulla, but also the initiating pathophysiology without SARS-CoV-2 viral intracellular entry into neurons as well. Therefore, the impairment of the proposed Piezo2-induced quantum mechanical free-energy-stimulated ultrafast proton-coupled tunneling seems to be the principal and critical underlying COVID-19 infection-induced primary damage along the brain axes, depending on the loci of SARS-CoV-2 viral infection and intracellular entry. Moreover, this initiating Piezo2 channelopathy may also explain resultant autonomic dysregulation involving the medulla, hippocampus and heart rate regulation, not to mention sleep disturbance with altered rapid eye movement sleep and cognitive deficit in the short term, and even as a consequence of long COVID. The current opinion piece aims to promote future angles of science and research in order to further elucidate the not entirely known initiating pathophysiology of SARS-CoV-2 infection.}, }
@article {pmid40801583, year = {2025}, author = {Williams, JE and Mauya, Z and Walkup, V and Adderley, S and Evans, C and Wilson, K}, title = {Epigenetic Regulation of Neutrophils in ARDS.}, journal = {Cells}, volume = {14}, number = {15}, pages = {}, pmid = {40801583}, issn = {2073-4409}, support = {R00 GM147910/GM/NIGMS NIH HHS/United States ; 1R00GM147910-04/NH/NIH HHS/United States ; }, mesh = {Humans ; *Neutrophils/metabolism/immunology ; *Respiratory Distress Syndrome/genetics/immunology/pathology ; *Epigenesis, Genetic ; Extracellular Traps/metabolism ; MicroRNAs/genetics ; COVID-19/genetics ; Histones/metabolism ; }, abstract = {Acute respiratory distress syndrome (ARDS) is an inflammatory pulmonary condition that remains at alarming rates of fatality, with neutrophils playing a vital role in its pathogenesis. Beyond their classical antimicrobial functions, neutrophils contribute to pulmonary injury via the release of reactive oxygen species, proteolytic enzymes, and neutrophil extracellular traps (NETs). To identify targets for treatment, it was found that epigenetic mechanisms, including histone modifications, hypomethylation, hypermethylation, and non-coding RNAs, regulate neutrophil phenotypic plasticity, survival, and inflammatory potential. It has been identified that neutrophils in ARDS patients exhibit abnormal methylation patterns and are associated with altered gene expression and prolonged neutrophil activation, thereby contributing to sustained inflammation. Histone citrullination, particularly via PAD4, facilitates NETosis, while histone acetylation status modulates chromatin accessibility and inflammatory gene expression. MicroRNAs have also been shown to regulate neutrophil activity, with miR-223 and miR-146a potentially being biomarkers and therapeutic targets. Neutrophil heterogeneity, as evidenced by distinct subsets such as low-density neutrophils (LDNs), varies across ARDS etiologies, including COVID-19. Single-cell RNA sequencing analyses, including the use of trajectory analysis, have revealed transcriptionally distinct neutrophil clusters with differential activation states. These studies support the use of epigenetic inhibitors, including PAD4, HDAC, and DNMT modulators, in therapeutic intervention. While the field has been enlightened with new findings, challenges in translational application remain an issue due to species differences, lack of stratification tools, and heterogeneity in ARDS presentation. This review describes how targeting neutrophil epigenetic regulators could help regulate hyperinflammation, making epigenetic modulation a promising area for precision therapeutics in ARDS.}, }
@article {pmid40801347, year = {2025}, author = {Jin, A and Deng, M and Yang, HS and Li, Z}, title = {Loop-mediated isothermal amplification (LAMP)-based microbial detection: a review of FDA-authorized tests and future perspectives.}, journal = {Critical reviews in clinical laboratory sciences}, volume = {}, number = {}, pages = {1-23}, doi = {10.1080/10408363.2025.2542808}, pmid = {40801347}, issn = {1549-781X}, abstract = {Loop-mediated isothermal amplification (LAMP) has emerged as a rapid and accessible alternative to traditional polymerase chain reactions (PCR) for nucleic acid amplification in research, significantly enhancing pathogen detection in infectious disease diagnostics. This review aims to bridge the gap in the literature regarding the real-world applications of LAMP assays and their potential to improve infectious disease diagnostics across various healthcare settings. We evaluated the current landscape of United States Food and Drug Administration (FDA)-authorized LAMP-based microbial tests, categorizing 30 such tests and detailing their regulatory pathways, such as 510(k) clearance and Emergency Use Authorization (EUA), particularly in response to the COVID-19 pandemic. We comprehensively examine the technical characteristics of LAMP assays, including sample collection, nucleic acid extraction, amplification processes, signal detection, device automation, and their analytical and clinical performance. We highlight the versatility of LAMP assays in diagnostic applications and their growing role in rapid infectious disease. We discuss the advantages and limitations of LAMP technology and identify future directions for its development in infectious disease diagnostics. By analyzing FDA-authorized LAMP-based microbial tests, this review aims to guide healthcare professionals and support future research and product development, ultimately improving patient care.}, }
@article {pmid40801304, year = {2025}, author = {Ellen, A}, title = {From Stagnation to Strategy: Challenges in Advancing Long COVID Research.}, journal = {Journal of evaluation in clinical practice}, volume = {31}, number = {5}, pages = {e70180}, pmid = {40801304}, issn = {1365-2753}, mesh = {Humans ; *COVID-19/physiopathology/complications/epidemiology/therapy ; *Biomedical Research/organization &amp; administration ; SARS-CoV-2 ; Comorbidity ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: Long COVID is a debilitating multisystemic condition and is a major public health burden, yet the pathophysiology remains poorly understood and there are no effective treatments. Despite the urgent need for better management strategies, research into long COVID is losing momentum.<br><br>OBJECTIVES: To help tackle this loss of momentum, this article analyses the major challenges impeding progress and proposes innovative strategies to navigate them and to reinvigorate this research field.<br><br>METHOD: The analysis of the long COVID research domain drew on a broad range of scientific literature to identify major barriers to research and potential pathways forward.<br><br>RESULTS: The research highlighted critical obstacles, including the lack of reliable biomarkers which has necessitated a reliance on symptom reporting that is inherently heterogenous, temporally complex and often confounded by symptoms arising from pre-existing comorbidities. The absence of pre-infection baseline data further complicates the distinction between long COVID-specific pathophysiology and the effects of pre-existing co-morbidities. Additionally, the long COVID patient population has heterogenous multiorgan pathology, and this diversity makes it difficult to identify and interpret clinical findings.<br><br>CONCLUSION: Addressing these methodological and conceptual challenges is essential to accelerate the understanding of long COVID pathophysiology and guide the development of effective interventions.}, }
@article {pmid40800075, year = {2025}, author = {Tlhakanelo, JT and Ataguba, JE and Pagiwa, V and Ramabu, N and Kadimo, K and Molosiwa, D and Muriithi, GN and Achala, DM and Adote, ENA and Mbachu, CO and Beshah, SA and Masuka, N and Nwosu, CO and Akazili, J and Ifeanyi, C}, title = {Equitable access to COVID-19 vaccines in Botswana: a scoping review.}, journal = {Frontiers in health services}, volume = {5}, number = {}, pages = {1609089}, pmid = {40800075}, issn = {2813-0146}, abstract = {INTRODUCTION: Despite global market complexities, Botswana acquired about 2.6 million COVID-19 vaccine doses between March 2021 and March 2022, 76% of which were purchased while 24% were donations. Thus, the study was envisaged to aggregate evidence on the case of Botswana's COVID-19 vaccine access patterns, hesitancy, and uptake.<br><br>MATERIALS AND METHODS: We conducted a scoping reviewof Botswana-based articles using a predetermined search strategy to search databases including Medline, CINAHL, Web of Science, PubMed, Scopus, and Google Scholar. The review included all the English-language written peer-reviewed and grey literature reporting on vaccination in Botswana, to broaden coverage in recognition of limited publications on COVID-19 vaccinartion in Botswana. Non-English articles were excluded due to limited translation resources. Due to the heterogeneity of studies, a narrative synthesis approach was used to collect, synthesize, and map the literature.<br><br>RESULTS: As of 31 December 2021, 80.6% of the Botswana national target of 1,390,856 people over 18 years had received at least one dose of a COVID-19 vaccine, while 71.9% were fully vaccinated. Various vaccine distribution channels were utilized, including public facilities and outreaches, to improve access and uptake of vaccines. COVID-19 vaccine acceptance was considered generally high (73.4% amongst adults), and found positively associated with the male gender, those with comorbidities, those with non-restrictive religious beliefs, and those aged 55-64 years who thought the vaccine was safe for use. COVID-19 vaccine delivery relied on existing Expanded Program on Immunization (EPI) structures and therefore experienced to existing EPI challenges including, lack of transport, shortage of human resources, and vaccine stock-outs.<br><br>CONCLUSIONS: Under-performance of immunization programs at the district level, characterized by declining immunization coverage and inadequate outreach services, exacerbates disparities in vaccine access. Efforts to strengthen healthcare infrastructure and expand outreach services are essential for reaching populations with limited access to healthcare facilities, particularly in rural and hard-to-reach areas. Collaboration with other government entities and the private sector improved vaccine access.}, }
@article {pmid40799952, year = {2025}, author = {Di Micco, P and Siniscalchi, C and Imbalzano, E and Russo, V and Camporese, G and Lodigiani, C and Meschi, T and Perrella, A}, title = {COVID-19: A Disease Driven by Protease/Antiprotease Imbalance? A Specific Review Five Years into the Pandemic.}, journal = {Infection and drug resistance}, volume = {18}, number = {}, pages = {3967-3975}, pmid = {40799952}, issn = {1178-6973}, abstract = {COVID-19, caused by SARS-CoV-2, has profoundly impacted global health since late 2019. Beyond respiratory complications, the disease involves systemic manifestations driven by immune dysregulation, inflammation, and coagulopathy. Among the many mechanisms implicated in severe disease, a growing body of evidence suggests a central role for the imbalance between proteases and antiproteases. This review examines how dysregulated protease activity contributes to viral entry, cytokine activation, vascular injury, and thrombosis. We focus on the integration of proteolytic systems such as the renin-angiotensin system, coagulation cascade, and neutrophil extracellular traps with established pathways like endothelial dysfunction and immune hyperactivation. Furthermore, we highlight therapeutic strategies aimed at restoring proteolytic balance and discuss the potential relevance of this paradigm in the management of long COVID.}, }
@article {pmid40799014, year = {2025}, author = {Ojumu, A and Ibrahim, SA and Seale, AC and Fayehun, O and Gill, P}, title = {Understanding factors influencing the implementation and uptake of less-established adult vaccination programmes: A meta-ethnography of COVID-19 vaccination in Nigeria.}, journal = {Global public health}, volume = {20}, number = {1}, pages = {2544183}, doi = {10.1080/17441692.2025.2544183}, pmid = {40799014}, issn = {1744-1706}, mesh = {Humans ; Nigeria/epidemiology ; *COVID-19/prevention &amp; control/epidemiology ; Adult ; *COVID-19 Vaccines/administration &amp; dosage ; *Immunization Programs/organization &amp; administration ; Anthropology, Cultural ; *Vaccination/statistics &amp; numerical data ; SARS-CoV-2 ; *Patient Acceptance of Health Care ; }, abstract = {Before COVID-19, a few studies examined adult vaccination programmes for disease outbreaks in Nigeria. Recent studies explored vaccine uptake factors, but few examined implementation. We aimed to understand factors influencing the implementation and uptake of adult vaccination programmes in Nigeria, through the COVID-19 example, to support subsequent outbreak interventions. We systematically searched seven databases and conducted a meta-ethnography of eight studies published between 2022 and 2024, involving 207 participants. Through reciprocal and refutational translation, higher-order interpretations, a new line of argument and a conceptual model on factors influencing implementation and uptake of COVID-19 vaccination in Nigeria were developed. We reported findings using eMERGe guidance. We developed eight higher-order interpretations operating at individual, health system and policy levels. Four concerned vaccination uptake: an ethical paradox, self-preservation, socioeconomic characteristics and trust. Another four concerned vaccination implementation and uptake: policy actions, local leadership from government, supply chain challenges and health services information. Our findings suggest that improved vaccination programme implementation during disease outbreaks in Nigeria would support enhanced vaccine uptake by adults. Our findings can inform vaccine implementation strategies for successful rollout and uptake of adult vaccines in future outbreaks.}, }
@article {pmid40797430, year = {2025}, author = {Yang, K and Xie, H and Wan, Z and Zhou, X and Liu, J and Nong, J and Luo, J and Qin, C and Peng, T}, title = {Safety of immune checkpoint inhibitors in cancer patients with COVID-19: A review.}, journal = {Medicine}, volume = {104}, number = {32}, pages = {e43579}, pmid = {40797430}, issn = {1536-5964}, mesh = {Humans ; *Immune Checkpoint Inhibitors/adverse effects/therapeutic use ; *COVID-19/complications ; *Neoplasms/drug therapy/immunology/complications ; SARS-CoV-2 ; Immunotherapy/methods ; }, abstract = {Coronavirus disease 2019 has emerged as a substantial burden to global public health, with cancer patients exhibiting heightened susceptibility to severe complications. Immune checkpoint inhibitors have exhibited noteworthy efficacy in cancer therapy by promoting robust anti-tumor immune responses. Nevertheless, the safety and efficacy during epidemics remain contentious. The extant evidence concerning the persistent administration of immune checkpoint inhibitors in cancer treatment within the context of the coronavirus disease 2019 epidemic has been consolidated in this review, and the significance of rigorous patient screening and vigilant monitoring has been emphasized to equilibrate anticancer efficacy with the risk of immune dysfunction, thereby establishing a foundation for the research in cancer immunotherapy.}, }
@article {pmid40797258, year = {2025}, author = {Kigongo, E and Puleh, SS and Kabunga, A and Akech, SI and Ocen, F and Opollo, MS and Ebong, M}, title = {Community readiness and acceptance for the implementation of the malaria vaccine among caretakers of at-risk children in sub-Saharan Africa: a systematic review and meta-analysis.}, journal = {Malaria journal}, volume = {24}, number = {1}, pages = {259}, pmid = {40797258}, issn = {1475-2875}, mesh = {Africa South of the Sahara ; Humans ; *Malaria Vaccines/administration &amp; dosage ; *Caregivers/psychology/statistics &amp; numerical data ; *Malaria/prevention &amp; control ; *Patient Acceptance of Health Care/statistics &amp; numerical data ; COVID-19/epidemiology ; Child, Preschool ; Infant ; *Vaccination/statistics &amp; numerical data/psychology ; }, abstract = {BACKGROUND: Malaria remains a leading cause of morbidity and mortality in sub-Saharan Africa, particularly among children under five. The introduction of the malaria vaccine presents an opportunity to reduce malaria-related deaths. However, the success of vaccination campaigns depends on community acceptance and willingness to vaccinate. This study aimed to assess the pooled acceptance and willingness to adopt the malaria vaccine in sub-Saharan Africa, with a focus on variations across regions and the impact of the COVID-19 pandemic.<br><br>METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive search of databases, including PubMed, ScienceDirect, Google Scholar, and African Journals Online, was performed. Studies reporting on malaria vaccine acceptance and willingness among caregivers of children under five in sub-Saharan Africa were included. Data were extracted and analysed using STATA, with heterogeneity assessed through the I[2] statistic. Subgroup analyses were performed based on region and pre- and post-COVID periods. Publication bias was assessed using Egger's test.<br><br>RESULTS: A total of 1611 records were identified, and 34 studies met inclusion criteria after screening. Of these, 25 studies with a combined sample of 25,867 participants were included in the meta-analysis. The pooled acceptance rate for the malaria vaccine among caregivers of children under five in sub-Saharan Africa was 82% (95% CI: 73%-90%), while the pooled willingness rate was 80% (95% CI: 70%-90%). Subgroup analyses showed no statistically significant differences in acceptance or willingness by COVID-19 period or region, though the lowest acceptance (53%) was reported in the DRC. High heterogeneity was observed (I[2]&#x2009;>&#x2009;99%), and publication bias was indicated in the willingness outcome (Egger's test, P&#x2009;=&#x2009;0.002).<br><br>CONCLUSION: The findings indicate high levels of acceptance and willingness among caregivers to vaccinate children under five against malaria in sub-Saharan Africa, suggesting strong community readiness for vaccine rollout. However, the observed heterogeneity and potential publication bias highlight the need for context-specific strategies and further high-quality studies to support implementation and uptake across diverse regions. Systematic review registration The protocol has been registered with PROSPERO registration number: CRD42023480528.}, }
@article {pmid40796992, year = {2025}, author = {Mohamed, HM and Elkholy, YY and Mokhtar, YM and Orady, MA and Elmetwaly, HS and Abdelwahab, HM and Abdelrady, YS and Elgohary, MM and Elmahdy, MK}, title = {COVID-19 in comorbid chronic diseased patients, pregnant and lactating women: pathophysiology, available drug treatment, and the most suitable protocol regimen in each group.}, journal = {Inflammopharmacology}, volume = {33}, number = {9}, pages = {4911-4939}, pmid = {40796992}, issn = {1568-5608}, mesh = {Humans ; Pregnancy ; Female ; *Lactation/physiology ; *COVID-19/physiopathology/epidemiology ; Chronic Disease ; *COVID-19 Drug Treatment ; Comorbidity ; *Pregnancy Complications, Infectious/drug therapy/epidemiology/physiopathology ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; }, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Comorbidities such as diabetes, chronic cardiovascular diseases, pulmonary diseases, liver diseases, and renal diseases exacerbate the disease, particularly in older patients, pregnant and lactating women.<br><br>OBJECTIVE: We performed a systematic review to identify all studies reporting on risks associated with these comorbidities to detect the cause of severity of COVID-19 in these diseases and further selection of the most suitable treatment in each disease.<br><br>METHODS: An extensive literature search was performed in the PubMed, Cochrane, and Web of Science databases gathering all available articles. We only selected case-control studies that met inclusion criteria and that focused on high-risk chronic diseased patients, pregnant and lactating women that being infected with COVID-19. Selected studies were grouped into 8 broad categories for review and analysis: (1) pathophysiology of COVID-19, (2) characteristics of COVID-19, (3) common laboratory markers of COVID-19, (4) commonly approved and used treatment of COVID-19, and (5) recommended protocol regimen adjustment in comorbid diseases, pregnant and lactating women.<br><br>CONCLUSION: This review focused on pathophysiology of COVID-19 especially in comorbid chronic diseased patients, pregnant and lactating women with the most suitable protocol regimen adjustment in each group.}, }
@article {pmid40796220, year = {2025}, author = {Kim, J and Ba, Y and Kim, JY and Youn, BY}, title = {Patient perception of physician attire: a systematic review update.}, journal = {BMJ open}, volume = {15}, number = {8}, pages = {e100824}, pmid = {40796220}, issn = {2044-6055}, mesh = {Humans ; *Physician-Patient Relations ; *Clothing/psychology ; *Physicians ; *Patient Preference ; COVID-19 ; }, abstract = {OBJECTIVE: This systematic review aims to update and analyse patient perceptions of physician attire, focusing on its impact on the physician-patient relationship across different medical settings and specialties.<br><br>DESIGN: A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria.<br><br>DATA SOURCES: PubMed, Embase, Cochrane Library and Google Scholar were searched for relevant studies from 1 January 2015 to 1 June 2025.<br><br>ELIGIBILITY CRITERIA: This review examined studies focused on physician attire and its impact on patient perceptions.<br><br>DATA EXTRACTION AND SYNTHESIS: Studies were assessed based on authors, study setting, study design, objective, study population, physician specialty, measures, findings, main conclusion and risk of bias. Then, thematic analysis was employed to synthesise the findings of the articles.<br><br>RESULTS: 28 studies met the inclusion criteria. Patient preferences for physician attire varied significantly by clinical context, medical specialty and physician gender. In outpatient and primary care settings, mixed evidence was reported, with some studies suggesting that a combination of casual attire and white coats may foster approachability and communication, while others showed no clear preference. In contrast, in high-acuity settings such as emergency rooms and operating theatres, scrubs were consistently favoured, indicating moderate to strong evidence for the association with professionalism and preparedness. During the COVID-19 pandemic, patients expressed stronger preferences for scrubs and PPE, emphasising infection prevention and hygiene. Gender-specific findings indicated that male physicians were perceived as more professional when wearing formal attire with white coats, while female physicians in similar attire were often misidentified as nurses or assistants. Specialty-based differences were also observed, with preferences for white coats in dermatology, neurosurgery and ophthalmology, while scrubs were preferred in anaesthesiology and gastroenterology.<br><br>CONCLUSION: This study demonstrates that physician attire consistently and significantly impacts patients' perceptions of professionalism, trust and communication. The collective findings provide robust evidence that these perceptions are highly context-dependent, necessitating adaptable dress codes tailored to clinical environments and patient expectations to enhance trust and patient satisfaction.<br><br>TRIAL REGISTRATION: https://osf.io/kjr4p.}, }
@article {pmid40794529, year = {2025}, author = {Hamidniya, P and Sedighian, H and Farzanehpour, M and Fallah, A and Molaee, H and Mahboobi, M}, title = {The relationship between respiratory tract infections caused by toxin-producing bacteria in burn patients during COVID-19: pathogenesis, diagnostics and novel therapies.}, journal = {Journal of medical microbiology}, volume = {74}, number = {8}, pages = {}, pmid = {40794529}, issn = {1473-5644}, mesh = {Humans ; *COVID-19/complications ; *Burns/complications/microbiology ; SARS-CoV-2 ; *Respiratory Tract Infections/microbiology/therapy/diagnosis ; *Coinfection/microbiology/therapy ; Bacterial Toxins/metabolism ; Pseudomonas aeruginosa/pathogenicity ; Staphylococcus aureus/pathogenicity ; }, abstract = {The COVID-19 pandemic has significantly increased the complexity of managing burn patients, who are particularly susceptible to bacterial co-infections due to their compromised skin barriers and immune dysregulation. Toxin-producing bacteria, such as Staphylococcus aureus and Pseudomonas aeruginosa, pose severe risks by producing virulence factors that impair immune function, delay wound healing and exacerbate systemic inflammation. These challenges are amplified in the presence of SARS-CoV-2, as the viral-induced immune dysregulation and cytokine storms worsen clinical outcomes, leading to higher rates of morbidity and mortality. This review explores the interplay between viral and bacterial infections in burn patients during the COVID-19 pandemic, focusing on the role of bacterial toxins, including superantigens from S. aureus and exotoxins from P. aeruginosa in driving hyperinflammatory responses. These synergistic effects complicate treatment by increasing the likelihood of systemic complications, prolonged hospital stays and MDR infections. To address these challenges, we discuss innovative therapeutic strategies, including endotoxin adsorption therapy to reduce systemic inflammation, immunomodulatory treatments to control cytokine storms and bacteriophage therapy for targeting MDR pathogens. Advanced wound care techniques and rapid diagnostic tools, such as CRISPR-based molecular assays, are highlighted as essential for timely and effective intervention. This review underscores the urgent need for integrated approaches that combine targeted diagnostics, advanced therapeutics and robust infection control measures. These insights aim to improve outcomes for burn patients co-infected with bacterial pathogens and SARS-CoV-2, offering valuable guidance for future pandemic preparedness and burn care protocols.}, }
@article {pmid40794450, year = {2025}, author = {Cartwright, BR and Scherer, PE}, title = {Adipose Tissue as a Target for Precision Medicine Approaches in Childhood Obesity.}, journal = {Diabetes}, volume = {74}, number = {10}, pages = {1710-1719}, pmid = {40794450}, issn = {1939-327X}, support = {R01-DK127274/NH/NIH HHS/United States ; 7-23-JDFT2DY-05//American Diabetes Association/ ; NIDDK-NORC P30-DK127984/NH/NIH HHS/United States ; R01 DK099110/DK/NIDDK NIH HHS/United States ; R01 DK131537/DK/NIDDK NIH HHS/United States ; R01 DK055758/DK/NIDDK NIH HHS/United States ; R01-DK099110/NH/NIH HHS/United States ; P30 DK127984/DK/NIDDK NIH HHS/United States ; R01-DK131537/NH/NIH HHS/United States ; P01 AG051459/AG/NIA NIH HHS/United States ; P01-AG051459/NH/NIH HHS/United States ; R01 DK127274/DK/NIDDK NIH HHS/United States ; R01-DK55758/NH/NIH HHS/United States ; }, mesh = {Humans ; *Precision Medicine/methods ; *Pediatric Obesity/therapy/metabolism ; Child ; *Adipose Tissue/metabolism ; Diabetes Mellitus, Type 2/metabolism ; COVID-19 ; }, abstract = {UNLABELLED: Following the trends of the adult obesity epidemic, and worsened by school disruptions during the coronavirus disease 2019 pandemic, childhood obesity prevalence has reached unprecedented levels. The health implications for this generation are especially concerning, as childhood-onset obesity has more severe health consequences than weight gain that begins in adulthood, including increased risk of type 2 diabetes and diabetes-related complications. The complexity of obesity treatment has been challenging, including remarkable heterogeneity in obesity phenotypes and treatment responses among both adults and children. Many in the field have therefore highlighted a need for precision medicine approaches in obesity treatment across age-groups. This includes a need for precision risk stratification to better target treatment intensity, which will require a better understanding of the earliest stages of metabolic syndrome pathophysiology. The health, function, and distribution of adipose tissue have been established as important determinants of metabolic health in both childhood- and adult-onset obesity, making adipose tissue a promising target for understanding phenotypic heterogeneity in obesity. Here, we provide a brief overview of the current limited understanding of adipose tissue biology during childhood development and discuss opportunities for further research into adipose-centric precision medicine approaches in childhood-onset obesity and type 2 diabetes.<br><br>ARTICLE HIGHLIGHTS: Treatment options for childhood obesity are expanding, but precision medicine approaches, including strategies for precision risk assessment, are needed to appropriately target treatment intensity. Parameters of adipose tissue dysfunction are better predictors of metabolic syndrome than body size, and therefore adipose tissue represents a prime candidate for research approaches in understanding the pathophysiology of insulin resistance and in identifying biomarkers of future prognosis. Expanded developmental research on pediatric adipose tissue in both mice and humans is needed to understand the pathophysiology of childhood-onset obesity and to develop precision treatment approaches.}, }
@article {pmid40792498, year = {2025}, author = {Chilumula, S and Hanchate, P and Patri, SV and Marepally, S}, title = {Influence of structural modifications in synthetic vectors of lipid adjuvants on mRNA vaccine delivery.}, journal = {Biomaterials science}, volume = {13}, number = {18}, pages = {4952-4969}, doi = {10.1039/d5bm00839e}, pmid = {40792498}, issn = {2047-4849}, mesh = {*mRNA Vaccines/administration &amp; dosage ; *Adjuvants, Vaccine/administration &amp; dosage/chemistry ; Humans ; COVID-19 Vaccines/administration &amp; dosage/chemistry ; Animals ; *Liposomes/administration &amp; dosage/chemistry ; *Nanoparticles/administration &amp; dosage/chemistry ; }, abstract = {Lipid adjuvants act as a fundamental element in mRNA vaccine technology by performing as diverse functional parts: augmenting immune responses, assisting genetic payload delivery to target cells, and optimizing antigen presentation. They offer various advantages, such as particle stabilization, targeted delivery, refined endosomal escape mechanisms, and self-adjuvant characteristics that amplify immune activation. The lipid adjuvant structure is crucial for both maximizing delivery accuracy and unlocking tunable immune responses, positioning lipid adjuvants as critical components of next-generation vaccines. Understanding the structural alterations of the lipid adjuvants is necessary for the rational design and synthesis of next-generation novel lipid adjuvants that elicit superior immune responses in mRNA vaccines. To magnify the potency and safety of lipid adjuvants, researchers are investigating the fundamental aspects of designing an innovative lipid that leverages biodegradable linkages. This strategy emphasizes the critical roles of numerous lipids, such as ionizable/cationic lipids, helper lipids, phospholipids, and PEGylated lipids, for enhancing the stability, targeting precision, and immunogenic efficacy of mRNA vaccine delivery. Moreover, it elucidates the structural changes of recently developed cationic/ionizable lipid adjuvants, highlighting how their structure impacts vaccine efficacy, especially linkers. By leveraging these advancements, researchers are exploring the potential for highly effective and targeted mRNA vaccine platforms, paving the way for next-generation immunization strategies.}, }
@article {pmid40792264, year = {2025}, author = {Wu, D and Wang, T and Wu, H and Dong, Y and Huang, Z and Zhang, J and Zhang, W}, title = {Trends and hotspots in global influenza and intestinal flora research based on bibliometrics.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1630924}, pmid = {40792264}, issn = {1664-302X}, abstract = {OBJECTIVE: Influenza (hereinafter referred to as influenza) is a pandemic and seasonal respiratory infectious disease that can lead to a global pandemic, posing a major threat to global public health. Studies have shown that influenza can lead to an imbalance in the intestinal flora, and disruption of the intestinal flora can exacerbate the progression of the disease, suggesting a potential link between influenza and intestinal flora. There is still a lack of systematic summary of bibliometric analysis in this field, therefore, this study aims to reveal the research dynamics, collaborative networks and cutting-edge hotspots in the field of influenza-intestinal flora association through bibliometric methods.<br><br>METHODS: Bibliometric analysis was used to retrieve 554 papers on influenza and intestinal flora from the Web of Science Core Collection (WoSCC) database from 2011 to 2025. After screening, 283 papers were included, and co-occurrence and clustering analyses of countries, authors, institutions, journals, references, and keywords were performed using VOSviewer, CiteSpace, and Bibliometrix; statistical visualization was performed via Microsoft Excel.<br><br>RESULTS: China is the country with the highest number of published papers and the leading CSI in terms of international collaboration intensity. The most popular journal in this field is Frontiers in Microbiology with 20 publications, while the most influential journal is Nature with 605 citations. Zhejiang University was the institution with the highest number of publications and Francois Trottein was the most prolific author. Keyword co-occurrence analysis showed that gut microbiota, influenza, probiotics, intestinal microbiota and COVID-19 were the core research hotspots, and clustering analysis further revealed the "intestinal-pulmonary axis of immunoregulation," such as Cluster analysis further revealed the "intestinal-lung axis immunoregulation," such as Th17/Treg balance, short-chain fatty acids and probiotics, as the cutting edge.<br><br>CONCLUSION: This study is the first to systematically map the bibliometrics of influenza and gut flora. The most influential countries, research institutions and researchers were identified through bibliometric analysis, showing the current research trends and hotspots in influenza and intestinal flora control. The results can provide theoretical guidance for future influenza prevention and control strategies targeting flora.}, }
@article {pmid40791597, year = {2025}, author = {Jung, Y and Grainger, H and Yang, S and Mondal, S and Lukong, KE and Conn, K and Wu, Y}, title = {Catch me if you can: viral nucleic acids to host sensors.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1632283}, pmid = {40791597}, issn = {1664-3224}, mesh = {Humans ; Animals ; *RNA, Viral/immunology ; *Virus Diseases/immunology/virology ; *Host-Pathogen Interactions/immunology ; COVID-19/immunology/virology ; *DNA, Viral/immunology ; *Viruses/immunology/genetics ; SARS-CoV-2/immunology ; }, abstract = {The 2002 movie Catch Me If You Can is a cat-and-mouse story in which Frank Abagnale Jr. successfully conned his way into several high-profile jobs while evading capture by FBI agent Carl Hanratty. Similarly, after entering host cells, viruses interact with or hijack host cellular machinery to replicate their genetical materials and assemble themselves for the next round of infection. Analogous to an FBI agent, host cells have numerous molecular "detectives" that recognize viral nucleic acids (NAs). These include RIG-I, MDA5, LGP2, TLR3, TLR7, TLR8, DHX36, DICER1, PKR, OAS1, ZAP, and NLRP1/6 for viral RNA, as well as cGAS, TLR9, AIM2, IFI16, IFIX, Ku70, MRE11, RNA polymerase III, hnRNPA2B1, LRRFIP1, DAI, DHX9 and DDX41 for viral DNA. However, much like the brilliant Frank Abagnale Jr., viruses have developed various strategies to evade host cellular surveillance-for example, by sequestering or modifying viral NAs and inhibiting or degrading host sensors. In this review, we will summarize the host sensors identified so far, discuss the latest understandings of the various strategies employed by viruses, and highlight the challenges associated with drug development to target virus or host factors. Considering recent global health challenges such as the COVID-19 pandemic and undergoing measles outbreak, understanding virus-host interactions at the molecular and cellular levels remains essential for the development of novel therapeutic strategies.}, }
@article {pmid40791049, year = {2025}, author = {Catapano, P and Di Vincenzo, M and Cipolla, S and Murolo, R and Cirino, A and Boiano, A and Prota, B and Cavaliere, S and Volpicelli, A and Della Rocca, B and Luciano, M and Fiorillo, A and Sampogna, G}, title = {Was the COVID-19 Pandemic a Triggering Factor for PTSD in Adults? Results From A Systematic Review.}, journal = {Actas espanolas de psiquiatria}, volume = {53}, number = {4}, pages = {868-901}, pmid = {40791049}, issn = {1578-2735}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Stress Disorders, Post-Traumatic/epidemiology/etiology ; Risk Factors ; Adult ; Prevalence ; Pandemics ; Female ; }, abstract = {BACKGROUND: The COVID-19 pandemic has represented a traumatic event for the general population, being associated with significant levels of uncertainty for the future, anxiety and depressive symptoms, especially in the first months of the health crisis. The adoption of strict containment measures, lockdown and interruption of all unnecessary activities have had a significant impact on the mental health of the general population. Moreover, the COVID-19 pandemic has been considered a very stressful event (which could be defined as ''traumatic''), being associated with significant morbidity and mortality and being completely unpredictable. Based on such premises, we conducted a systematic review of the available literature in order to identify all studies providing epidemiological data and statistics on the prevalence and characteristics of post-traumatic stress disorder (PTSD) in the general population during the COVID-19 pandemic.<br><br>METHODS: An extensive literature search has been conducted across PubMed, Scopus, and Web of Science from the inception of each database until 15 November 2024.<br><br>RESULTS: Forty-one papers have been included in the review; the majority of the studies have been conducted in Italy and China. A significant heterogeneity in prevalence rates, ranging from 0.5% to 70.2%, and psychometric tool used was found. The most common risk factors for developing PTSD in the framework of the COVID-19 pandemic included: female gender, social isolation, impact on daily routine. The most relevant protective factor includes older age.<br><br>CONCLUSIONS: Future research should aim to standardize assessment tools and criteria to enhance the comparability and reliability of findings in the field of trauma-related research studies.}, }
@article {pmid40790563, year = {2025}, author = {Chandipwisa, C and Uwishema, O and Debebe, A and Abdalmotalib, MM and Barakat, R and Oumer, A and John, M and Taa, L and Onyeaka, H}, title = {Climate change and the global food chain: a catalyst for emerging infectious diseases?.}, journal = {International journal of emergency medicine}, volume = {18}, number = {1}, pages = {149}, pmid = {40790563}, issn = {1865-1372}, abstract = {BACKGROUND: Climate change is disrupting the global food chain, affecting food production, delivery and safety. Extreme weather events disrupt the quality of food and water, while rising temperatures accelerate the spread of microbes. Habitat destruction also forces wildlife in close proximity to people, increasing the risk of zoonotic diseases. Threatening global health seriously, these disturbances also increase the probability of infectious and food-borne diseases.<br><br>METHOD: A narrative review of literature data&#x2002;from WHO publications, Google Scholar and PubMed. The review examines the impacts of climate&#x2002;change on agriculture, food supply systems, and the associated transmission of infectious disease - specifically zoonotic and food-borne diseases.<br><br>RESULTS: As temperatures increase, the germs multiply easily - and the risk of E.&#x2002;coli and Salmonella goes up. Waterborne diseases such as Norovirus and Hepatitis A are more likely to spread in&#x2002;typified extreme weather conditions such as floods. Ecosystem changes push humans and animals into a closer relationship that can lead to zoonotic&#x2002;spillovers, such as the Nipah virus and COVID-19. The growth&#x2002;of animal production and international trade exacerbates antimicrobial resistance (AMR) issues, imposing challenges to disease control.<br><br>CONCLUSION: Climate change is a critical public health&#x2002;emergency with risks of zoonotic and food-borne illnesses alarmingly on the rise. This is an important step toward a One Health approach, which also addresses the integration of&#x2002;human, animal, and environmental health, as well as strengthens food safety regulations and enhances disease surveillance. It needs immediate international cooperation to construct a robust and sustainable food system that reduces health hazards.<br><br>CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid40790389, year = {2025}, author = {Stepanova, G and Ghosal, S}, title = {COVID-19 and dysregulated cholesterol levels in Type I and Type II diabetes: focus on the difference.}, journal = {Biologia futura}, volume = {76}, number = {4}, pages = {497-505}, pmid = {40790389}, issn = {2676-8607}, mesh = {Humans ; *COVID-19/metabolism/complications/epidemiology ; *Diabetes Mellitus, Type 2/metabolism/complications/blood/epidemiology ; *Cholesterol/metabolism/blood ; *Diabetes Mellitus, Type 1/metabolism/complications/blood/epidemiology ; SARS-CoV-2/physiology ; }, abstract = {The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has had a profound global impact on individuals with diabetes mellitus (DM). This review examines the interplay between COVID-19, cholesterol metabolism, and diabetes, focusing on the differences in lipid regulation between Type I (T1DM) and Type II diabetes (T2DM). Diabetes, characterized by impaired glucose regulation and lipid homeostasis, has been identified as a significant risk factor for severe COVID-19 outcomes, including increased rates of hospitalization, ICU admission, and mortality. Dysregulated cholesterol metabolism is often present in diabetic patients and exacerbates the severity of COVID-19. We explore the mechanisms by which SARS-CoV-2 infection affects cholesterol pathways, highlighting the role of cholesterol-rich lipid rafts in viral entry and replication. The review also discusses the potential therapeutic implications of targeting cholesterol metabolism in managing COVID-19 in diabetic populations. Understanding these complex interactions may provide insights into better clinical management strategies and improve outcomes for COVID-19 patients with diabetes.}, }
@article {pmid40788451, year = {2025}, author = {Kumar, V and Martinez-Martin, N and Olson, NW}, title = {Ethical Issues in Rural Health Research: A Scoping Review.}, journal = {Journal of bioethical inquiry}, volume = {}, number = {}, pages = {}, pmid = {40788451}, issn = {1872-4353}, support = {K01 MH118375-01A1/MH/NIMH NIH HHS/United States ; }, abstract = {Rural communities experience well-documented systemic disparities in health access and outcomes in comparison to urban populations. However, the ethical dimensions of these disparities have received only limited attention, and ethical issues related to rural health research have received even less. With the COVID-19 pandemic casting new light on these inequities, we conducted a scoping review to determine how much has been written on ethical issues in rural health research and which ethical issues are most prevalent. Four overarching ethical themes emerged through the search: resource inequity, underrepresentation, the benefits of community-based research, and challenges related to participant autonomy. Additionally, the search revealed a dearth of articles on ethical issues in rural health research, particularly in the United States. Thus, we propose four recommendations to revitalize and guide ethics discussions of research in rural communities, including growing the literature on ethical issues in rural U.S. communities, encouraging collaboration between rural health and bioethics researchers, improving recognition of rural heterogeneity, and addressing new issues in light of COVID-19. Acting on these recommendations would expand and support rural research efforts and ultimately help ameliorate rural-urban health inequities.}, }
@article {pmid40788384, year = {2025}, author = {Silva, TTSD and de Araújo Aguiar, GJ and Machado Santos, S and Florencio, L}, title = {A review on recent developments in sustainable healthcare waste management.}, journal = {Environmental science and pollution research international}, volume = {32}, number = {33}, pages = {19672-19690}, pmid = {40788384}, issn = {1614-7499}, support = {IBPG-0531-3.01/21//Funda&#xe7;&#xe3;o de Amparo &#xe0; Ci&#xea;ncia e Tecnologia do Estado de Pernambuco/ ; }, mesh = {COVID-19/epidemiology ; Humans ; *Medical Waste Disposal/methods ; *Waste Management/methods ; SARS-CoV-2 ; Hazardous Waste ; }, abstract = {This study addresses specific research gaps in the literature regarding HCW management by systematically analyzing the integration of sustainability and material circularity. It employs the PRISMA method and bibliometric analysis with VOSviewer, providing a clear structure for understanding current research trends. In this context, six thematic groups were identified: (i) management for decision-making, (ii) circular economy, (iii) COVID-19 pandemic, (iv) risk analysis, (v) governance, and (vi) disposal and treatment. The COVID-19 pandemic led to a sharp rise in hazardous waste generation, requiring urgent policy adaptations, stricter strategies, and adequate investments to mitigate health risks and environmental impacts. Adopting the circular economy in HCW management requires effective regulation and cross-sector collaboration. To reduce costs, mitigate risks, and enhance resilience in the health sector, reintegrating recoverable HCW into the production cycle is essential. However, challenges remain due to the preference for single-use devices and hazardous waste management.}, }
@article {pmid40788382, year = {2025}, author = {Fernández-Rojas, MA and Salazar, AM and Ostrosky-Wegman, P and Flisser, A and Mendlovic, F}, title = {A feedback loop between DNA damage, genomic instability, and cytoplasmic DNA sensing contributes to cytokine production in COVID-19.}, journal = {Archives of virology}, volume = {170}, number = {9}, pages = {192}, pmid = {40788382}, issn = {1432-8798}, support = {IN216121//DGAPA PAPIIT UNAM/ ; UNAM Postdoctoral Program//Universidad Nacional Autonoma de Mexico/ ; }, mesh = {Humans ; *COVID-19/immunology/genetics/virology ; *SARS-CoV-2/genetics/immunology ; *Genomic Instability ; *DNA Damage ; *Cytokines/metabolism/biosynthesis ; Cytoplasm/metabolism/genetics ; *DNA/immunology ; Cytokine Release Syndrome/immunology ; Signal Transduction ; Inflammation ; }, abstract = {Since the onset of the COVID-19 pandemic, several studies have investigated the inflammatory responses triggered by SARS-CoV-2 infection. In 2021, it was proposed that the cytokine storm observed in patients with severe COVID-19 may be initiated by sensing of cytoplasmic DNA released by micronuclei, which arises as a consequence of virus-induced genomic instability. Subsequent studies have described the presence of micronuclei and other genotoxic and cytotoxic markers in COVID-19 patients. However, the association between the development of a cytokine storm and cytoplasmic DNA sensing remains to be fully elucidated. In this review, we summarize current evidence on the dysregulated cytokine production in response to the detection of genetic material during SARS-CoV-2 infection. We focused mainly on the dysregulated production of cytokines induced by the activation of cytosolic DNA sensing pathways that promote inflammation. We emphasize the need to analyze the contribution of these signaling complexes to COVID-19 pathophysiology. DNA sensing amplifies the inflammatory response and plays a crucial role in the pathogenesis of severe disease manifestations observed in infected patients. Understanding this complex interplay can provide insights into potential therapeutic targets aimed at mitigating the hyper-inflammatory responses seen in severe COVID-19 cases.}, }
@article {pmid40788370, year = {2025}, author = {Wissmann, IB and Coelho, RCD and Baseggio, L and Cardoso, AM}, title = {Adenosine receptors and acute kidney injury: perspectives for future therapy.}, journal = {Purinergic signalling}, volume = {21}, number = {5}, pages = {1115-1133}, pmid = {40788370}, issn = {1573-9546}, support = {154/GR/UFFS/2024 and 73/GR/UFFS/2023//Universidade Federal da Fronteira Sul/ ; }, mesh = {Humans ; *Acute Kidney Injury/metabolism/drug therapy ; *Receptors, Purinergic P1/metabolism ; Animals ; Adenosine/metabolism ; COVID-19/complications/metabolism ; }, abstract = {Adenosine is a key modulator in the pathophysiology of acute kidney injury (AKI), particularly through its influence on inflammatory pathways and renal hemodynamics. This nucleoside exerts its effects via four G protein-coupled receptors-A1, A2A, A2B, and A3-each displaying distinct roles during renal injury. The A1 receptor primarily protects renal tissue under ischemic conditions by reducing metabolic demand, while the A2A receptor promotes anti-inflammatory and vasodilatory effects, improving renal perfusion and attenuating leukocyte infiltration. The A2B receptor, upregulated under hypoxic or injury conditions, is involved in anti-inflammatory actions and vascular integrity, especially in renal tubular and endothelial cells. Conversely, activation of the A3 receptor is generally linked to adverse outcomes, including increased apoptosis and greater tissue damage. Therapeutic strategies targeting adenosine receptors are being actively explored: selective A1 and A2A agonists show potential for promoting renal recovery, while A3 antagonists helped counteract the harmful effects of A3 activation. The review also discusses advances from recent studies (2022-2024), including insights on COVID-19-associated AKI and the nuanced roles of A1 and A3 receptors in different pathological contexts. Additionally, the therapeutic promise of inhibiting adenosine-degrading enzymes, such as ADA and adenosine kinase (ADK), is highlighted. Novel mechanistic insights and recent literature are integrated, providing a comprehensive overview that expands upon previous reviews. Although adenosine receptor modulation holds significant promise as a therapeutic strategy for AKI, further clinical research is necessary to validate efficacy and safety in human populations.}, }
@article {pmid40788115, year = {2025}, author = {Tomeh, MA and Smith, RK and Watkinson, A}, title = {Recent Developments of RNA Vaccines and Therapeutics: Reagents, Formulations, and Characterization.}, journal = {Molecular pharmaceutics}, volume = {22}, number = {9}, pages = {5257-5282}, doi = {10.1021/acs.molpharmaceut.5c00670}, pmid = {40788115}, issn = {1543-8392}, mesh = {Humans ; SARS-CoV-2/immunology ; *COVID-19/prevention &amp; control/immunology ; *COVID-19 Vaccines/immunology/chemistry/therapeutic use ; *mRNA Vaccines/immunology ; RNA, Small Interfering ; Drug Compounding/methods ; Vaccine Development/methods ; Animals ; }, abstract = {The past few years have shown significant clinical success for RNA vaccines in humans. The spread of SARS-CoV-2 into a global pandemic has boosted the transition of many RNAs to clinical trials and accelerated the development process of various types of RNA-based therapeutics, including vaccines, not only for respiratory illnesses but also for a wide range of diseases. Many studies have designed promising RNAs in various forms (small interfering RNA, mRNA, and self-amplifying RNA) or presented novel nanocarriers to maximize the performance of RNA-based therapeutics. There are several crucial aspects that must be covered during RNA vaccine development, including RNA design and synthesis, formulation optimization, and characterization. This paper aims to shed light on RNA vaccines and therapeutics with various properties and applications and provide a comprehensive review of the recent developments of formulation, analytics, and characterization studies.}, }
@article {pmid40787873, year = {2025}, author = {He, JC and Yang, ZX and Chen, JH and Chen, Y}, title = {[Impacts of SARS-CoV-2 on male reproductive health: Etiological principles based on traditional Chinese and Western medicines].}, journal = {Zhonghua nan ke xue = National journal of andrology}, volume = {31}, number = {3}, pages = {246-251}, pmid = {40787873}, issn = {1009-3591}, mesh = {Humans ; Male ; *COVID-19/complications ; Erectile Dysfunction/etiology ; Infertility, Male/etiology ; *Medicine, Chinese Traditional ; *Reproductive Health ; SARS-CoV-2 ; }, abstract = {2019 novel coronavirus pneumonia (COVID-19) is a serious acute infectious disease caused by novel coronavirus (SARS CoV-2) infection, with fever, dry cough and fatigue as the main symptoms. In recent years, studies have suggested that the male reproductive system can be directly invaded by novel coronavirus, with the testis as one of its target organs. Therefore, infection with novel coronavirus can cause the development and aggravation of such diseases as male erectile dysfunction, male infertility, prostatitis, etc. However, no consensus has been reached whether such impacts will be mitigated or remain after recovery from COVID-19, and few reports are available on the mechanism of SARS-CoV-2 inducing male reproductive diseases based on the traditional Chinese medicine (TCM) and Western medicine. This review systematically summarizes the impacts of SARS-CoV-2 on male reproductive health and the etiological principles in the perspective of both TCM and Western medicine.}, }
@article {pmid40787318, year = {2025}, author = {García Ramos, J and de Souza Júnior, RS and Borges, EM}, title = {How Digital Images Are Transforming Chemical Education: A Review of Laboratory-Based Applications.}, journal = {ACS omega}, volume = {10}, number = {30}, pages = {32651-32672}, pmid = {40787318}, issn = {2470-1343}, abstract = {This review explores the transformative role of digital imaging technologies(?)including smartphones, webcams, scanners, and digital cameras(?)in contemporary chemical education and laboratory-based analysis. These tools have emerged as accessible and cost-effective alternatives to traditional spectrophotometric instruments, enabling the capture and quantification of color changes in chemical reactions through RGB value extraction. The review presents a comprehensive overview of the technical principles underlying digital image acquisition, addressing factors such as lighting conditions, device variability, color spaces, and image formats, and examines their impact on analytical accuracy and reproducibility. A wide array of laboratory experiments is discussed, spanning analytical and physical chemistry, with applications in colorimetric assays, fluorescence, flame emission, titrations, and chemical equilibrium studies. Digital imaging has been successfully applied to quantify various analytes, including food dyes, proteins, pharmaceuticals, cations, and anions. The review also emphasizes the pedagogical benefits of these approaches, particularly in remote and resource-limited settings where students can perform meaningful scientific investigations using their own devices. The integration of digital imaging into laboratory instruction promotes student engagement, autonomy, and inquiry-based learning. Its widespread adoption was further accelerated by the COVID-19 pandemic, which demonstrated the feasibility of at-home experimentation. As imaging technologies continue to advance, their potential to democratize access to scientific tools and enhance chemical education is expected to expand, fostering a more inclusive, innovative, and effective approach to laboratory science.}, }
@article {pmid40787016, year = {2025}, author = {Scafe, M and Kanya, M and Flynn, M and Chettiar, R}, title = {Anxiety and Depression in Today's Youth: A Current Look into Assessment and Treatment.}, journal = {Missouri medicine}, volume = {122}, number = {4}, pages = {283-290}, pmid = {40787016}, issn = {0026-6620}, mesh = {Humans ; Adolescent ; *Anxiety/diagnosis/therapy/epidemiology ; *Depression/therapy/diagnosis/epidemiology ; *COVID-19/psychology/epidemiology ; Child ; SARS-CoV-2 ; Mass Screening/methods ; }, abstract = {Following the COVID-19 pandemic, the American Academy of Pediatrics (AAP), the American Academy of Child and Adolescent Psychiatry, and the Children's Hospital Association declared a national emergency in child and adolescent mental health. Rates of anxiety and depression in youth continue at unprecedented levels, contributing to rising numbers of suicide attempts and lowered school attendance. Though many medical providers are trained to assess and provide recommendations for anxiety and depression, many report feeling ill-equipped to address these concerns in a timely, feasible, and effective manner. We review the existing literature on screening for anxiety and depression in the medical setting and provide evidence-based tools for providers to support patients, with acknowledgments of special populations. Additionally, we review multi-disciplinary models of treatment, such as one used by the Depression and Anxiety in Youth (DAY) program at Children's Mercy Kansas City.}, }
@article {pmid40786362, year = {2025}, author = {Chowdhury, A and Bhasin, G and Ganti, L}, title = {Bibliometric Analysis of the Epidemiological Research on Alzheimer's Disease Treatment.}, journal = {Cureus}, volume = {17}, number = {7}, pages = {e87484}, pmid = {40786362}, issn = {2168-8184}, abstract = {Alzheimer's disease presents a complex global health issue. It is characterized by a decline in cognitive function, starting with memory impairment, and extending to impact reasoning, language abilities, and spatial awareness. Despite decades of research, Alzheimer's disease remains a global challenge lacking long-term treatments. Institutions like the Karolinska Institutet, Columbia University, the University of California San Francisco (UCSF), and the University of Pittsburgh contribute significantly to Alzheimer's research, with a growth in publications in 2022 post-COVID-19. While current treatments offer symptomatic relief, there's a need for disease-modifying therapies targeting its mechanisms. This analysis aims to provide a comprehensive overview of the available research and medical literature on Alzheimer's disease by employing bibliometric methods to identify publication trends, leading research institutions, and the evolving focus from symptomatic treatments to disease-modifying therapies. This paper seeks to analyze the research papers on Alzheimer's disease and catalog the metadata associated with each paper.}, }
@article {pmid40786276, year = {2025}, author = {Zahyan, AM and Alhakami, HH and Khormi, AH and Alhufayyan, NS and AlQarni, MA and Alrashidi, AM}, title = {Cardiovascular Complications of COVID-19 in Athletes: A Systematic Review and Meta-analysis.}, journal = {Cureus}, volume = {17}, number = {7}, pages = {e87675}, pmid = {40786276}, issn = {2168-8184}, abstract = {This systematic review and meta-analysis aimed to assess the prevalence of cardiovascular complications associated with coronavirus disease 2019 (COVID-19) infection in athletes. A comprehensive search was conducted across PubMed, Web of Science, Scopus, and the Virtual Health Library using the terms ("COVID-19" OR "SARS-CoV-2") AND ("athletes" OR "athlete") AND ("pericarditis" OR "myocarditis" OR "pericardial effusion" OR "cardiovascular" OR "cardiac"). Of 671 records, 20 studies met the inclusion criteria. The most commonly reported cardiovascular abnormality was pericardial effusion, with a pooled prevalence of 1.9% (95% CI 0.08-4.4), followed by myocarditis (1.5%; 95% CI 0.9-2.7), pericarditis (1.3%; 95% CI 0.8-2.1), and myopericarditis (0.9%; 95% CI 0.2-3.4). No cases of cardiovascular or all-cause mortality were reported among athletes with COVID-19. These findings suggest that cardiovascular complications are rare in athletic populations following COVID-19 infection, potentially reflecting the protective effect of a robust immune system and high baseline cardiovascular fitness.}, }
@article {pmid40786062, year = {2025}, author = {Ibrahim, AU and Pwavodi, PC and Oszoz, M and Duwa, BB and Irkham, I and Hartati, YW}, title = {Nano-modified biosensors for detection of pathogenic diseases: The prospect of smart, multiplex and point-of-care testing.}, journal = {ADMET &amp; DMPK}, volume = {13}, number = {4}, pages = {2799}, pmid = {40786062}, issn = {1848-7718}, abstract = {INTRODUCTION AND BACKGROUND: The world has witnessed several outbreaks, emergence and re-emergence of infectious diseases throughout the 21[st] century as a result of climate change, urbanization and migration. Several infectious diseases caused by pathogens such as SARS-CoV-2, Ebola, Zika, Dengue, Marburg viruses, Mycobacterium tuberculosis, etc. have caused a devastating impact on lives and livelihoods around the world. To counter these diseases, medical experts rely on conventional techniques, which include microscopy and serological testing. However, these conventional methods are hindered by several trade-offs, including high cost, longer processing times, low sensitivity, and a likelihood of false positive results. Biomedical sensors have gained momentum in clinical diagnostics due to their low cost, portability, and sensitivity, among other advantages. To improve their performance, scientists have incorporated nanomaterials. Other techniques used to enhance the performance of nanobiosensors include multiplex testing, point-of-care testing (POCT), and smart sensing.<br><br>METHODOLOGY: Thus, in this review, we present a comprehensive overview of the state-of-the-art nanobiosensors for detecting infectious diseases. The review covers key topics that are centred around the application of nanotechnology in biosensing, multiplex testing, POCT and smart nano-enhanced biosensors.<br><br>FINDINGS: The findings of this review highlighted the advantages of biosensors over conventional approaches, with a limit of detection ranging from nanomolar to attomolar concentrations and a time response ranging from 1 to 3 hours.<br><br>CONCLUSION: Despite the prospect of nanobiosensors, several limitations exist, including complexity, extensive processing time, and others. Moreover, the integration of smart technologies in nanobiosensors can offer several benefits, including high accuracy and faster detection and prediction.}, }
@article {pmid40785780, year = {2025}, author = {Gilmore, NT and Metz, T}, title = {Prevention of Catheter-Related Infections and Complications: A Narrative Literature Review of Vascular Care and Maintenance.}, journal = {International journal of vascular medicine}, volume = {2025}, number = {}, pages = {1427129}, pmid = {40785780}, issn = {2090-2824}, abstract = {Objectives: This review assessed the burden of catheter-related infections (CRI), existing gaps in catheter care, and prevention recommendations for catheter-related bloodstream infections (CRBSIs). The review further discusses how the emergence of coronavirus disease (COVID-19) influenced CRBSI rates and prevention strategies in the post-COVID-19 era. Methods: A targeted literature search was conducted of Embase, Ovid MEDLINE, and EBM Reviews. Where applicable, supplemental hand searches were performed to identify evidence for gaps in the targeted search results. The authors reviewed each study and selected those for inclusion based on the population, intervention, comparison, outcomes, and study design (PICOS) criteria. Relevant studies were assessed for inclusion in the present review. Results: Both "active" methods (scrubbing, flushing, and locking) and "passive" methods (disinfection caps) have consistently been shown to reduce CRBSI risk when assessed individually. These practices have markedly improved CRBSI rates over the past two decades, although there are ongoing gaps in catheter care and adherence to best practices. COVID-19 reversed the trend towards improving CRBSI rates, and persistent challenges for nurse staffing and training have resulted in a failure to return to pre-COVID-19 CRBSI rates in the current post-COVID-19 era. These challenges are further compounded by limited rigorous comparative evidence assessing the relative efficacy of individual CRBSI prevention methods. Conclusions: Improving adherence to hub disinfection, along with catheter care and maintenance protocols, is essential for the prevention of CRIs. Further, innovative approaches for simplifying protocols and "forcing function" may increase compliance with CRBSI prevention strategies. In our practice, we routinely use disinfection caps in addition to standard scrubbing and flushing, alongside increased training and monitoring procedures. Additional studies are needed to assess which individual or combination prevention strategies are most efficacious and feasible in the post-COVID-19 era.}, }
@article {pmid40784940, year = {2025}, author = {Mazzoni, A and Berrueta, M and Pingray, V and Babinska, M and Nigri, C and Ortega, V and Salva, F and Ciapponi, A and Bonet, M}, title = {A systematic review of maternal and perinatal health outcomes in the context of epidemic threats: towards the development of a core outcome set.}, journal = {Maternal health, neonatology and perinatology}, volume = {11}, number = {1}, pages = {23}, pmid = {40784940}, issn = {2054-958X}, support = {001/WHO_/World Health Organization/International ; INV-041181/GATES/Gates Foundation/United States ; INV-041181 WHO//Bill and Melinda Gates Foundation/ ; }, abstract = {OBJECTIVE: To systematically identify and classify maternal and perinatal health outcomes reported in research conducted in the epidemic and pandemic context.<br><br>STUDY DESIGN AND SETTING: We conducted a systematic review following Cochrane Methods. We searched MEDLINE, EMBASE, LILACS, SCI-EXPANDED, CINAHL, Cochrane Central Register of Controlled Trials, PsycINFO, AMED, ClinicalTrials.gov and ICTRP, between January 2015 and March 2023. Experimental, quasi-experimental, observational studies, phase IV trials, and post-marketing studies, published protocols and ongoing registered studies reporting maternal and perinatal health outcomes were included. Studies only reporting coverage of interventions, access to routine health services, clinical presentation of infectious diseases, and reviews were excluded. A sampling strategy was used for COVID-19 studies, due to their very high numbers. Outcome verbatims were extracted and categorized in unique outcome, and further classified into domains and subdomains. Frequency of outcome reporting was calculated.<br><br>RESULTS: 94 maternal and pregnancy and 47 unique neonatal outcomes were identified, from a total of 917 and 657 verbatims, respectively, reported across 440 included studies. At least 20% of included studies reported maternal and pregnancy outcomes of mode of delivery (56.1%), stillbirth (33.0%), preterm birth (28.6%), hypertensive disorders of pregnancy (26.6%), and maternal death (20.7%). These outcomes were identified across all three types of studies identified (epidemiological, product development or post-authorization surveillance). Gestational age at birth (29.8%), congenital malformations of the nervous system (26.1%), birth weight (23.4%), neonatal admission to intensive care unit (23.2%), and neonatal death (19.1%) were the most frequently reported neonatal outcomes.<br><br>CONCLUSIONS: Our study provides the basis for developing a core outcome set to measure maternal and perinatal health during outbreaks, which would help improve data collection of harmonized data, data synthesis, and timely development of informed public health guidance and clinical care responding to the needs of pregnant women.}, }
@article {pmid40781782, year = {2025}, author = {Sahoo, JK and Agrawal, A}, title = {Severe Acute Hepatitis of Unknown Origin in Children: Exploring the Role of Adenovirus and Potential Cofactors.}, journal = {Journal of paediatrics and child health}, volume = {61}, number = {10}, pages = {1566-1572}, doi = {10.1111/jpc.70160}, pmid = {40781782}, issn = {1440-1754}, mesh = {Humans ; Child ; Acute Disease ; *Adenovirus Infections, Human/epidemiology/complications ; *Hepatitis, Viral, Human/epidemiology/virology ; COVID-19/epidemiology ; *Hepatitis/virology/epidemiology ; *Adenoviruses, Human ; }, abstract = {Adenoviruses are a known cause of self-limiting respiratory, ocular, and gastrointestinal infections in children. However, during the recent outbreak in 2021-2022, the identification of human adenoviruses (HAdV), particularly type F41, as a potential cause of severe acute hepatitis in immunocompetent children has sparked global debate. The unusual severity of liver injury and clustering of cases in immunocompetent children have prompted investigations into whether HAdV is truly hepatotropic or merely an incidental finding. Several hypotheses have been proposed, including adenovirus infection, prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or adeno-associated virus-2 (AAV2) with a helper virus (HAdV) co-infection. We aim to review the emerging literature on adenovirus and other cofactors as a potential cause of the recent outbreaks of severe acute hepatitis of unknown origin in children (AHUO).}, }
@article {pmid40781542, year = {2025}, author = {Goyal, A and Thakkar, K and Abbasi, HQ and Shamim, U and Saeed, H and Hurjkaliani, S and Gil, TE and Rangel, DN and Sohail, AH and Daoud, M and Sheikh, AB}, title = {Utilization of telemedicine in healthcare delivery to lesbian, gay, bisexual, transgender, queer, intersex, asexual, other sexual and gender minority (LGBTQIA+) populations: a scoping review.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {29010}, pmid = {40781542}, issn = {2045-2322}, mesh = {Humans ; *Telemedicine ; *Sexual and Gender Minorities/psychology ; *Delivery of Health Care ; Male ; Female ; HIV Infections/diagnosis ; Sexually Transmitted Diseases/diagnosis ; Health Services Accessibility ; }, abstract = {This scoping review examines how telemedicine addresses healthcare needs in the lesbian, gay, bisexual, transgender, queer, intersex, asexual, and other sexual and gender minority (LGBTQIA+) community, focusing on gender-affirming care, mental health, and testing for human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). A literature search of MEDLINE, Embase, Web of Science, and Scopus was conducted to identify studies published until March 2024 focusing on telemedicine services for LGBTQIA + individuals. Data extraction captured study characteristics, telemedicine applications, and patient and provider satisfaction, and was synthesized to map current knowledge and identify gaps. Thirty-eight studies, comprising observational studies and one randomized controlled trial, were included, encompassing 21,774 participants. Telemedicine facilitated access to gender-affirming care, reduced mental health disparities, and supported HIV and STI testing, with high satisfaction reported among patients and providers. It was particularly effective in reducing appointment no-show rates, enabling remote initiation of pre-exposure prophylaxis for HIV, and offering mental health support through virtual counseling. The studies also highlighted increased telemedicine adoption for follow-up visits and medication management. However, challenges like digital privacy concerns, technological accessibility, and cultural competence were identified. Telemedicine holds significant potential to improve healthcare access and outcomes for LGBTQIA + populations, particularly in rural and underserved areas. Future efforts should focus on enhancing provider training, ensuring digital equity, and developing culturally competent telehealth models to fully realize these benefits. The findings can inform the design of inclusive telemedicine policies and services tailored to the needs of LGBTQIA + individuals.}, }
@article {pmid40781029, year = {2025}, author = {Stathopoulos, P and Bousi, SE and Zachiotis, M and Lampropoulos, A and Kakoullis, SA and Michaeloudes, C and Falagas, ME}, title = {Venous thromboembolism associated with infections: a systematic review and meta-analysis.}, journal = {European journal of internal medicine}, volume = {142}, number = {}, pages = {106448}, doi = {10.1016/j.ejim.2025.106448}, pmid = {40781029}, issn = {1879-0828}, mesh = {Humans ; *Venous Thromboembolism/epidemiology/etiology ; Incidence ; Risk Factors ; *Infections/complications/epidemiology ; }, abstract = {BACKGROUND: Venous thromboembolism (VTE) is a disease with complex pathophysiology and a significant cause of morbidity and mortality. Infections have been associated with VTE, but the synthesis of the incidence and strength of this association has not been performed.<br><br>METHODS: A systematic review and meta-analysis were conducted to evaluate the association between infections and VTE. We excluded studies assessing the relationship between VTE and local skin infections, postpartum, malignancies, hypercoagulability syndromes, as well as studies that focused explicitly on orthopedic patients, COVID-19, HIV, and cytomegalovirus.<br><br>RESULTS: Twenty-one studies were included with 3 distinct study designs: 8 case-control, 3 case-crossover, and 10 retrospective cohort studies. 20/21 studies reported a statistically significant increase in VTE incidence among patients with infections compared to patients without infection. Subgroup meta-analyses for each study design showed strong associations: case-control studies [OR 3.35 (95 % CI 2.34-4.79)], case-crossover studies [OR 5.81 (95 % CI 2.12-15.89)], and retrospective cohort studies [OR 2.69 (95 % CI 1.90-3.80)]. The association between infection and VTE was consistent across subgroup meta-analyses, based on the time interval studied, clinical setting, or infection site. Additionally, there was a statistically significant association between bacterial infection and VTE [OR 2.81 (95 % CI: 1.73-4.57)]. None of the studies demonstrated a high risk of bias.<br><br>CONCLUSION: This meta-analysis showed a consistent association between infections and VTE, which is, at least partially, overlooked by the relevant risk assessment scores. Future research should focus on large, prospective studies to evaluate the effectiveness and safety of preventive anticoagulant treatment for patients with infectious diseases.}, }
@article {pmid40780833, year = {2025}, author = {Avendano, EE and Blackmon, SA and Nirmala, N and Chan, CW and Morin, RA and Balaji, S and McNulty, L and Argaw, SA and Doron, S and Nadimpalli, ML}, title = {Race, ethnicity and risk for colonisation and infection with key bacterial pathogens: a scoping review.}, journal = {BMJ global health}, volume = {10}, number = {8}, pages = {}, pmid = {40780833}, issn = {2059-7908}, support = {UM1 AI104681/AI/NIAID NIH HHS/United States ; }, mesh = {Humans ; *Ethnicity/statistics &amp; numerical data ; *Bacterial Infections/ethnology/microbiology ; COVID-19/ethnology/epidemiology ; *Racial Groups/statistics &amp; numerical data ; Community-Acquired Infections/ethnology/microbiology ; Risk Factors ; *Health Status Disparities ; }, abstract = {BACKGROUND: Racial and ethnic disparities in infectious disease burden have been reported in the USA and globally, most recently during the COVID-19 pandemic. It remains unclear whether such disparities also exist for priority bacterial pathogens that are increasingly antimicrobial-resistant. We conducted a scoping review to summarise published studies that report on colonisation or community-acquired infection with pathogens among different races and ethnicities.<br><br>METHODS: We conducted an electronic literature search of MEDLINE, Daily, Global Health, Embase, Cochrane Central and Web of Science from inception to March 2024 for eligible observational studies. Abstracts and full-text publications were screened in duplicate for studies that reported data for race or ethnicity for at least one of the pathogens of interest.<br><br>RESULTS: 62 observational studies in 68 publications met our inclusion criteria. Studies reported results for Staphylococcus aureus (n=61), Escherichia coli (n=9), Pseudomonas aeruginosa (n=2), Enterobacterales (n=1), Enterococcus faecium (n=1) and Klebsiella pneumoniae (n=1) and were conducted in the USA (n=48), Israel (n=6), New Zealand (n=4), Australia (n=3) and Brazil (n=1). US studies most often examined Black and Hispanic minority groups and regularly reported a higher risk of these pathogens in Black persons and mixed results for Hispanic persons. Ethnic minority groups were often reported to be at a higher risk in other countries.<br><br>CONCLUSIONS: Sufficient evidence was identified to justify systematic reviews and meta-analyses evaluating the relationship between race, ethnicity and community-acquired S. aureus and E. coli, although data were rare for other pathogens. We recommend that future studies clarify whether race and ethnicity data are self-reported, collect race and ethnicity data in conjunction with the social determinants of health and make a concerted effort to include non-English speakers and Indigenous populations from the Americas, when possible.}, }
@article {pmid40780723, year = {2025}, author = {Sultani, K and Smeulers, M and de Vries, R and Zonderhuis, BM and Nanayakkara, PWB}, title = {Transforming acute care: a scoping review on the effectiveness, safety and implementation challenges of Hospital-at-Home models.}, journal = {BMJ open}, volume = {15}, number = {8}, pages = {e098411}, pmid = {40780723}, issn = {2044-6055}, mesh = {Humans ; *Home Care Services, Hospital-Based/organization &amp; administration/standards ; Patient Discharge ; Patient Safety ; Randomized Controlled Trials as Topic ; }, abstract = {OBJECTIVES: The hospital-at-home (HaH) model has gained traction as a viable alternative to traditional inpatient care, allowing patients to receive care in their own homes. Despite its growing popularity, there is a lack of comprehensive research addressing effectiveness, safety and factors critical to the successful implementation of HaH programmes. We conducted a scoping review to comprehensively map and summarise the evidence on both admission avoidance and early-supported discharge up until now.<br><br>DESIGN: A scoping review of randomised controlled trials (RCTs), conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: extension for Scoping Reviews (PRISMA-ScR) guidelines.<br><br>DATA SOURCES: Ovid MEDLINE, Embase, CINAHL and Web of Science were systematically searched up to July 2024 ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included English-language RCTs published from 2005 onwards, involving adults (&#x2265;18 years) receiving acute care at home who would otherwise require hospital admission. Eligible studies evaluated admission avoidance or early supported discharge within HaH settings for acutely ill patients. Studies focusing on outpatient care, non-acute conditions or interventions not aligning with the widely accepted HaH definition were excluded. COVID-19-related studies were also excluded to avoid context-specific bias.<br><br>DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data on study characteristics, interventions and outcomes including mortality, length of stay, escalation rates, costs and patient and caregiver satisfaction. Implementation facilitators and barriers were also collected. Discrepancies were resolved by a third reviewer. Results were synthesised descriptively in accordance with PRISMA-ScR guidelines.<br><br>RESULTS: Nine RCTs were identified. The review shows that the HaH model is at least as safe as usual care, with lower or comparable mortality rates. Length of stay varied, with some studies reporting longer stays in the HaH group due to cautious clinical practices. Cost analyses often indicate lower healthcare costs with staffing as the largest expense. Patient and caregiver satisfaction was high, but essential implementation factors were not clearly addressed.<br><br>CONCLUSION: The HaH model represents a promising alternative to acute inpatient care for suitable patients. Future research should focus on conducting larger RCTs, expanding the range of conditions suitable for HaH. Despite favourable clinical outcomes, substantial implementation barriers remain underexplored in current RCTs. This underscores the need to identify strategies for successful implementation, including the integration of technological advancements and qualitative insights into patient and caregiver experiences.}, }
@article {pmid40780538, year = {2025}, author = {Adediran, E and Ikhoyameh, M and Gbadebo, OS}, title = {From inhibition to degradation: Cutting-edge technology in COVID-19 drug discovery.}, journal = {Annales pharmaceutiques francaises}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pharma.2025.08.002}, pmid = {40780538}, issn = {2772-803X}, abstract = {Proteolysis-targeting chimera (PROTAC) molecules are hetero-bifunctional chemical entities with three different units which include a ligand that binds to a protein of interest; a second ligand that binds to the E3 ubiquitin ligase; and a linker that conjugates the two ligands together. The technology utilizes the ubiquitin-proteasome system (UPS) to target a specific protein and induce its degradation in the cell. PROTAC has drawn the interest of researchers in anti-cancer drug discovery and has yielded a better outcome in degrading regulatory proteins, kinases, nuclear receptors, transcription factors, and enzymes. This paper discusses this technology and its application to COVID-19 drug discovery. In 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), an infectious agent emerged from Wuhan resulting in millions of deaths worldwide. The WHO declared it a global pandemic because of its fast transmissibility and infectivity across the continents. To curtail this menace, efforts were made to develop therapeutics and inhibitors very quickly. Vaccines and therapeutics discovery were fast-tracked, and already FDA-approved drug molecules were also repurposed - many of which were protein inhibitors. However, PROTAC technology potentially offers a more direct and sustainable contribution to anti-COVID drug discovery than protein inhibition-based therapeutics.}, }
@article {pmid40780504, year = {2025}, author = {Neumann, JA and Zimmermann, J and Frese, M and Dirksen-Fischer, M and Kleine-Kampmann, S and Harth, V and Heidrich, J and , }, title = {Infectious diseases on passenger ships: Port preparedness and response - A narrative systematic review.}, journal = {Travel medicine and infectious disease}, volume = {67}, number = {}, pages = {102886}, doi = {10.1016/j.tmaid.2025.102886}, pmid = {40780504}, issn = {1873-0442}, mesh = {Humans ; *Ships ; COVID-19/epidemiology/prevention &amp; control/transmission ; *Communicable Diseases/epidemiology/transmission ; SARS-CoV-2 ; Disease Outbreaks/prevention &amp; control ; *Travel ; *Communicable Disease Control/methods ; Influenza, Human/epidemiology/prevention &amp; control ; }, abstract = {BACKGROUND: Ships are environments conducive to the spread of infectious diseases among passengers and crew members. In this context, it is essential to establish effective prevention and control measures to protect the health of passengers and crew members while ensuring that shipping minimizes its contribution to the global spread of disease via ship-to-shore interactions. The aim of this review is to provide knowledge on the impact of infectious diseases on board large passenger ships on the port, the port community and other land-based operations.<br><br>METHODS: A systematic literature review was conducted, searching the PubMed, Scopus and Cochrane Library databases and including additional articles from hand searches up to July 2024. Peer-reviewed studies of infectious disease outbreaks related to large passenger ship travel that described ship-shore interaction, port preparedness and impact on the port community were included. Article selection and data extraction were conducted by two independent reviewers.<br><br>RESULTS: A total of 593 publications were initially identified, with 23 articles included in the analysis. Most studies reported COVID-19 outbreaks on cruise ships; other communicable diseases reported were influenza, gastroenteritis, and varicella. The articles highlighted the importance of comprehensive management plans and proactive risk assessment during infectious disease outbreaks that impact ship-to-shore interactions.<br><br>CONCLUSIONS: Effective stakeholder collaboration, ship-to-shore communication, coordination of diagnostic testing and medical transport, isolation, and quarantine measures are essential components of infectious disease prevention, mitigation, and management in passenger shipping within the port environment.}, }
@article {pmid40779079, year = {2025}, author = {Hemamalani, AU and Thangam, T and Prakashini, RS and Kumar, PA and Parthasarathy, K}, title = {Viral ecology in chiroptera: human-wildlife interactions and pandemic risk.}, journal = {Veterinary research communications}, volume = {49}, number = {5}, pages = {275}, pmid = {40779079}, issn = {1573-7446}, support = {6/9-7(328)/2023/ECD-II, VIR/COVID-19/33/2021/ECD-I//Indian Council of Medical Research/ ; }, mesh = {*Chiroptera/virology ; Animals ; Humans ; *Pandemics/veterinary ; Animals, Wild/virology ; Zoonoses/virology/transmission ; *Virome ; *Virus Diseases/veterinary/transmission/epidemiology/virology ; Disease Reservoirs/virology/veterinary ; }, abstract = {Bats (Order Chiroptera) are ecologically essential and evolutionarily unique mammals, acting as a natural reservoir for innumerable viruses, including several with a high degree of zoonotic significance. The complex and intricate ecology of bat viromes results largely from species diversity, roosting patterns, social structures, immunological adaptations, and their remarkable longevity, especially compared to other small mammals such as rodents. These traits allow bats to carry pathogenic viruses without visible clinical symptoms over extended periods. This review delves into the virome of bat populations focusing on major families like Coronaviridae, Filoviridae, Paramyxoviridae and the evolutionary processes leading to their diversity, persistence within populations, and spill-over. The human-induced environmental disturbance in the form of deforestation, cultivation, urbanization, and wildlife trade has increased direct or indirect contact among bats, humans, and domestic animals, increasing the chances of spill-over. The study of historical events in the form of SARS, MERS, Nipah, Ebola is used for practical implications. We also discuss the behavioral and seasonal variations among intra-colony transmission, the role of intermediate hosts, and the critical need of having an effective One Health-based surveillance system. The understanding of ecological and evolutionary drives behind bat virome is necessary for anticipating zoonotic spill-over events, which can be used as a foundation for public health strategies. Finally, the necessity of integrating virology, ecology, and global health policy perspective in human health policy-making is also discussed, in the context of bat virome research, to prevent future pandemics.}, }
@article {pmid40777633, year = {2025}, author = {Ogundiran, O and Abbate, JL and Kim, S and Diallo, MSK and Muteba, M and Camara, DCP and Bianchi, L and Balde, T and Oyugi, B and Fortin, A and Baykika-Tusiime, J and Williams, GS and Mboussou, F and Okot, C and Mutoka Banza, F and Laundry, K and Ejiofor, EN and Kanyowa, TM and Kamara, R and Atuhebwe, P and Gumede, N and Herring, BL and Woldetsadik, S and Okeibunor, J and Koua, E and Chamla, D and Braka, F and Gueye, AS}, title = {Assessing the utility of the COVID-19 epidemic Situations of Concern classification system in guiding operational responses to the pandemic in the WHO African region: retrospective analysis.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1562525}, pmid = {40777633}, issn = {2296-2565}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *COVID-19/epidemiology ; Retrospective Studies ; World Health Organization ; Africa/epidemiology ; Pandemics ; SARS-CoV-2 ; Public Health ; }, abstract = {During a public health emergency, early implementation of response activities is crucial for saving lives and protecting livelihoods. The COVID-19 pandemic, declared by the World Health Organization (WHO) on March 11, 2020, posed a global public health crisis that required timely decision-making despite limited data and capacity. In this context, WHO's Regional Office for Africa (AFRO) developed the Situations of Concern (SOC) classification system to assess and monitor epidemiological risk across its 47 Member States. We conducted a retrospective analysis to evaluate the performance and operational utility of the SOC system. Using weekly country-level COVID-19 surveillance data, we found that the system demonstrated strong alignment with epidemic wave patterns, with a sensitivity of 83% and specificity of 88%. SOC classifications supported timely operational decision-making in over 70% of documented support instances. Effective management of limited resources through SOC assessments also helped ensure fair distribution of support across communities. Our findings suggest that adaptable classification systems like SOC can provide effective decision-support under conditions of limited data availability, improving outbreak preparedness and response in resource-constrained settings.}, }
@article {pmid40777584, year = {2025}, author = {Yunita, A and Pratama, MI and Almuzakki, MZ and Ramadhan, H and Akhir, EAP and Firdausiah Mansur, AB and Basori, AH}, title = {Performance analysis of neural network architectures for time series forecasting: A comparative study of RNN, LSTM, GRU, and hybrid models.}, journal = {MethodsX}, volume = {15}, number = {}, pages = {103462}, pmid = {40777584}, issn = {2215-0161}, abstract = {Recurrent Neural Networks (RNNs), Long Short-Term Memory (LSTM) networks, and Gated Recurrent Units (GRUs) have gained significant popularity in time series forecasting across diverse domains including healthcare, astronomy, and engineering. However, the inherent variability in model performance due to random weight initialization raises questions about the reliability and consistency of these architectures for time series analysis. This study addresses this concern by conducting a comprehensive benchmark evaluation of nine neural network architectures: vanilla RNN, LSTM, GRU, and six hybrid configurations (RNN-LSTM, RNN-GRU, LSTM-RNN, GRU-RNN, LSTM-GRU, and GRU-LSTM). Performance evaluation was conducted using Monte Carlo simulation with 100 iterations across three real-world datasets: sunspot activity, Indonesian COVID-19 cases, and dissolved oxygen concentration measurements. Statistical analysis employed the Friedman test to assess performance differences across architectures. Results showed no statistically significant differences among the nine architectures. Despite the lack of statistical significance, consistent performance patterns emerged favoring LSTM-based hybrid architectures. The LSTM-GRU and LSTM-RNN configurations demonstrated superior performance across multiple evaluation metrics, with LSTM-RNN excelling in sunspot and dissolved oxygen forecasting, while standalone LSTM showed optimal performance for COVID-19 prediction. These findings provide evidence-based guidance for architecture selection in time series forecasting applications, suggesting that while statistical equivalence exists among architectures, LSTM-based hybrids offer practical advantages in terms of consistency and robustness across diverse temporal patterns.}, }
@article {pmid40776715, year = {2025}, author = {Appel, K and Nackerdien, F and Christian, CS}, title = {Access to tuberculosis care in South Africa during the COVID-19 pandemic: A scoping review.}, journal = {African journal of primary health care &amp; family medicine}, volume = {17}, number = {1}, pages = {e1-e8}, pmid = {40776715}, issn = {2071-2936}, mesh = {Humans ; South Africa/epidemiology ; *COVID-19/epidemiology ; *Health Services Accessibility ; *Tuberculosis/therapy/diagnosis/epidemiology ; SARS-CoV-2 ; Pandemics ; Delivery of Health Care ; }, abstract = {BACKGROUND: Tuberculosis (TB) remains a major public health issue in South Africa, a high-burden TB country. The coronavirus disease 2019 (COVID-19) pandemic has exacerbated challenges in accessing essential TB services. This scoping review explores how access to TB care was impacted during the pandemic.<br><br>AIM: &#xa0;This research aimed to review original studies on access to TB care in South Africa during the COVID-19 pandemic using a scoping review methodology.<br><br>METHOD: &#xa0;A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. Five databases were systematically searched for original peer-reviewed research published between 2020 and 2022. Data were extracted and synthesised using the Penchansky and Thomas framework of healthcare access.<br><br>RESULTS: &#xa0;Three studies met the inclusion criteria. The review identified significant disruptions in TB service delivery during the pandemic, including reduced diagnostic capacity, healthcare facility closures and economic barriers. Patients reported delayed diagnoses and increased stigma, while healthcare workers faced resource shortages and operational challenges.<br><br>CONCLUSION: &#xa0;The COVID-19 pandemic has exacerbated pre-existing barriers to TB care in South Africa, highlighting critical gaps in healthcare delivery. This review provides insights into the challenges faced and emphasises the need for resilient health systems to sustain TB care during future health crises. Contribution:&#xa0;This article highlights the impact of the COVID-19 pandemic on TB care access in South Africa, identifying key barriers across healthcare access dimensions and offering recommendations to improve TB care delivery during public health emergencies.}, }
@article {pmid40776683, year = {2025}, author = {Davies, T and Hampton, T}, title = {Have we made any undergraduate medical education improvements since coronavirus disease 2019? A systematic review of ENT teaching.}, journal = {The Journal of laryngology and otology}, volume = {139}, number = {11}, pages = {1028-1033}, doi = {10.1017/S002221512510296X}, pmid = {40776683}, issn = {1748-5460}, mesh = {Humans ; *COVID-19/epidemiology ; *Education, Medical, Undergraduate/methods/trends/standards ; *Otolaryngology/education ; United Kingdom/epidemiology ; SARS-CoV-2 ; Curriculum ; Pandemics ; }, abstract = {OBJECTIVES: Otolaryngology/ear, nose and throat conditions are common in clinical practice, yet undergraduate exposure in UK medical schools remains limited. The coronavirus disease 2019 pandemic created opportunities to innovate medical education. This review explores the scope of advance in otolaryngology undergraduate education following the coronavirus disease 2019 pandemic.<br><br>METHODS: A search of MEDLINE, Embase, Cochrane, and Education Resources Information Center databases was conducted. Studies that met inclusion criteria were subject to risk-of-bias assessment and narrative analysis.<br><br>RESULTS: Interventions such as mixed reality, cadaveric teaching, and anatomical models improved short-term performance and student satisfaction. Surveys limited advancement in clinical exposure to otolaryngology/ear, nose and throat, when compared to pre-coronavirus-disease literature.<br><br>CONCLUSION: Despite the potential for reform following the pandemic, there has been no significant advancement in the provision of undergraduate medical education in the post-coronavirus-disease era. Standardisation of undergraduate education is needed to mirror recent changes to assessment in undergraduate education in the UK.}, }
@article {pmid40775203, year = {2025}, author = {Stepanenko, OV and Sulatsky, MI and Sulatskaya, AI and Stepanenko, OV}, title = {An unexpected insight into the cause of olfactory dysfunction: fibrillogenesis of odorant-binding proteins.}, journal = {Cell death discovery}, volume = {11}, number = {1}, pages = {370}, pmid = {40775203}, issn = {2058-7716}, support = {NO. 24-24-00247//Russian Science Foundation (RSF)/ ; }, abstract = {Olfactory dysfunction is a common complication of serious pathologies, including neurodegenerative disorders, bacterial and viral infections, including COVID-19, and others. Despite the widespread prevalence of olfactory disorders, the pathophysiological mechanisms of their development, as well as the molecular basis of their association with the underlying disease, remain incompletely understood. The current work formulates a new concept of the origin of olfactory disorders, linking a decrease in the activation of olfactory neurons and their death to the fibrillogenesis of odorant-binding proteins (OBPs), which are the primary participants of olfactory perception. The potential triggers of OBPs' amyloidogenesis in vivo are discussed, such as molecular crowding, components of nasal medications, environmental factors, and cross-seeding with viral and bacterial amyloids. Several ways of impairment of olfactory signaling as a result of fibrillogenesis of OBPs are formulated: complete loss of OBPs functionality following amyloid formation; mechanical blockage of the membranes of sensory neurons and damage to chemoreceptors on their surface, preventing olfactory signaling; cytotoxic effect of OBPs' amyloid on sensory neurons and other cells of the olfactory epithelium. The proposed concept offers a novel perspective on the pathogenesis of olfactory dysfunction, as well as its possible association with amyloidoses, including in neurodegenerations, and infectious diseases. It opens prospects for the development of new therapeutic approaches to the treatment of olfactory disorders.}, }
@article {pmid40774301, year = {2025}, author = {Schwicht, C and von Bergwelt-Baildon, M and Spiekermann, K}, title = {[Immunosuppression in Cancer: Strategies for Infection Prevention].}, journal = {Deutsche medizinische Wochenschrift (1946)}, volume = {150}, number = {17}, pages = {1013-1018}, doi = {10.1055/a-2414-8494}, pmid = {40774301}, issn = {1439-4413}, mesh = {Humans ; COVID-19/prevention &amp; control ; *Immunocompromised Host ; *Neoplasms/immunology/complications/therapy ; }, abstract = {Antimicrobial prophylaxis is an important cornerstone for reducing morbidity and mortality of cancer patients. Important strides have been made in recent years in vaccination, drug prophylaxes and the use of growth-factor support. We detail these changes to the respective recommendations here.Patients with malignant disease are recommended to receive vaccinations against common respiratory pathogens (COVID-19, influenza, pneumococci, and RSV). For both influenza (now trivalent vaccine) and pneumococci (now PCV20), the preferred vaccine has changed. A VZV vaccination using an inactivated virus-subunit is also recommended to prevent reactivations. The profound B-cell depletion caused by CAR-T cell therapy is increasingly being considered in vaccination recommendations.In high-risk situations, antibiotic prophylaxis using fluoroquinolones can be used. However, due to increasing resistance and significant side effects, this approach is being critically evaluated.Posaconazole is recommended as the standard prophylaxis for patients with neutropenia >7 days (<0,5G/L) and hematologic malignancies. Isavuconazole offers an effective alternative for patients who cannot tolerate posaconazole. Interactions between antifungal agents and oncological therapies are becoming increasingly relevant, with particular attention to the CYP-450-enzyme inducing/inhibiting substances. Non-pharmacological measures to prevent fungal infections are now part of the recommendations. These include smoking cessation.Pharmacological prophylaxis for COVID-19 is generally not recommended.The thresholds for primary growth-factor-support have been lowered: G-CSF is generally recommended if the risk of febrile neutropenia is >20%, or, if patient inherent risk factors are present, >10%. A new long-acting, non-PEG-containing G-CSF preparation was approved in 2024.Good collaboration between oncologists and general practitioners is essential to translate these recommendations into clinical practice.}, }
@article {pmid40773381, year = {2025}, author = {Subramaniam, S and Saville, JW and Feng, F and Freiburger, L}, title = {Therapeutic Antibodies for Infectious Diseases: Recent Past, Present, and Future.}, journal = {Biochemistry}, volume = {64}, number = {16}, pages = {3487-3494}, pmid = {40773381}, issn = {1520-4995}, mesh = {Humans ; SARS-CoV-2/immunology ; COVID-19/immunology ; *COVID-19 Drug Treatment ; *Antibodies, Viral/therapeutic use/immunology ; *Antibodies, Monoclonal/therapeutic use ; Antibodies, Neutralizing/therapeutic use/immunology ; Animals ; }, abstract = {A central goal of modern infectious disease research is to discover safe prophylactic vaccines that can prevent infection. When this is not possible, or when preventive vaccines are still in development, it is critical to have interventions that can mitigate the spread of the disease both within infected individuals and in the population. In this short review, we explore the recent history of therapeutic antibody use, highlighting antibodies used over the last five years to treat COVID-19. We outline some of the challenges in developing antibodies rapidly in response to pandemic threats and suggest that emerging technologies for AI-driven design may offer exciting opportunities for the development of a broad class of protein therapies.}, }
@article {pmid40773022, year = {2025}, author = {Castellana, E and Budau, PM and Chiappetta, MR}, title = {Pharmacovigilance: Overview of Italian and European regulations, tools, and perspectives.}, journal = {The International journal of risk &amp; safety in medicine}, volume = {36}, number = {4}, pages = {147-155}, doi = {10.1177/09246479251366836}, pmid = {40773022}, issn = {1878-6847}, mesh = {*Pharmacovigilance ; Humans ; Italy ; *Adverse Drug Reaction Reporting Systems/legislation &amp; jurisprudence/organization &amp; administration ; Europe ; *Drug-Related Side Effects and Adverse Reactions/epidemiology ; }, abstract = {BackgroundThis study provides a concise overview of the Italian and European pharmacovigilance (PV) systems.ObjectiveTo evaluate the regulatory frameworks of above mentioned systems, operational tools, and recent trends in adverse drug reaction (ADR) reporting. The primary objective is to highlight the strengths and critical issues of the current system in improving drug safety and protecting public health.MethodsOur analysis confirms a progressive increase in ADR reporting in Italy over the past decade, with a peak in 2021 during the COVID-19 vaccination campaign, followed by a subsequent decline.ResultsHospital physicians and pharmacists remain the primary reporters, while patient reports account for around 10%. The causality assessment process continues to rely heavily on tools such as the Naranjo algorithm and the WHO-UMC criteria, although no single gold standard exists. Despite regulatory improvements and digital infrastructure development, key limitations persist, notably underreporting, inconsistent report quality, and lack of population exposure data.ConclusionWhile Italy's PV system has evolved considerably, a more integrated, proactive, and technology-enhanced approach is required to improve the sensitivity and timeliness of signal detection. Future directions should include the use of artificial intelligence, electronic health records, and real-world evidence to enhance pharmacovigilance performance.}, }
@article {pmid40772993, year = {2025}, author = {Siqueira, IFB and Figueiredo, LA and Fernandes, CEM and Cintra, LP and de Oliveira, GF and Rios, MA and Maciel, R and Ferretjans, R and Guimarães, NS and Magno, LAV}, title = {Metabolic brain changes in post-acute COVID-19: systematic review and meta-analysis of [18F]-FDG-PET findings.}, journal = {Brain structure &amp; function}, volume = {230}, number = {7}, pages = {128}, pmid = {40772993}, issn = {1863-2661}, mesh = {Humans ; *COVID-19/metabolism/diagnostic imaging/complications ; Positron-Emission Tomography/methods ; Fluorodeoxyglucose F18 ; *Brain/metabolism/diagnostic imaging ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; Radiopharmaceuticals ; Glucose/metabolism ; }, abstract = {Individuals with long COVID exhibit neurological and psychiatric symptoms that often persist well beyond the initial SARS-CoV-2 infection. Studies using [18F]-FDG positron emission tomography (FDG-PET) have revealed diverse abnormalities in brain glucose metabolism during the post-acute phase of COVID-19. We conducted a systematic review and meta-analysis to assess the spatial distribution and heterogeneity of brain metabolic changes in patients in the post-acute phase of COVID-19 relative to controls. We searched the MEDLINE, EMBASE, and CENTRAL databases in June 2025 for studies reporting FDG-PET data in patients with post-acute COVID-19 who have persistent neurological symptoms. Of the 14 eligible studies (584 scans), 13 reported glucose hypometabolism across frontoparietal regions, with the frontal cortex being the most consistently affected. This finding was confirmed by meta-analysis, which revealed a large and significant effect in the frontal cortex (Hedges' g = 1.34; 95% CI: 0.79-1.88; p < 0.001), despite high heterogeneity (I[2] = 93.6%). The systematic review indicates that brain metabolism generally improves over time, with widely varying recovery timelines, and consistently correlates hypometabolism with neurological symptom burden. These findings underscore the clinical relevance of frontoparietal hypometabolism in post-acute COVID-19 and its association with neurocognitive deficits, highlighting the need for longitudinal, quantitative PET studies to elucidate temporal dynamics and inform therapeutic development.}, }
@article {pmid40772671, year = {2025}, author = {Trinh, H and Stevens, N and Adams, G and Chee, R and Ha, T and Knesl, M and Mitchell, J and Nagpal, S and Sia, E and Xing, D and , }, title = {Faculty of Radiation Oncology 2022 Workforce Census.}, journal = {Journal of medical imaging and radiation oncology}, volume = {69}, number = {6}, pages = {687-695}, pmid = {40772671}, issn = {1754-9485}, mesh = {Humans ; *Radiation Oncology/education/statistics &amp; numerical data ; *COVID-19/epidemiology ; New Zealand ; Australia ; Censuses ; Male ; Female ; *Workforce/statistics &amp; numerical data ; *Radiation Oncologists/statistics &amp; numerical data ; Surveys and Questionnaires ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: This paper reports the key findings of the Faculty of Radiation Oncology 2022 workforce census. This is the first census since the COVID-19 pandemic and questions have been updated to assess the impact on RANZCR trainees and fellows. This report focuses on the analysis of respondents from Australia, New Zealand and overseas members, with a separate paper to follow focusing exclusively on New Zealand respondents.<br><br>METHOD: The census was conducted in mid-late 2022 with many questions repeated from previous censuses. New questions were asked about theranostics, working remotely, hypofractionation and the impact of COVID-19 on work practices.<br><br>RESULTS: The census was sent to 591 radiation oncologists with an overall response rate of 52%. Almost half of respondents (n&#x2009;=&#x2009;94/210; 45%) indicated that COVID-19 had no impact on the uptake of hypofractionation. Hypofractionation was most used by respondents in breast and prostate treatment (n&#x2009;=&#x2009;134/200; 67% and n&#x2009;=&#x2009;112/194; 58% respectively). Five respondents (n&#x2009;=&#x2009;5/270; 2%) currently practise in theranostics, with the majority treating thyroid cancers within the public sector. Just under half (n&#x2009;=&#x2009;81/167; 49%) of invited trainees responded. The majority felt that COVID-19 had a negative impact on their training. There has been a decrease in the number of new fellows seeking to complete further fellowships. Employment remains at very high levels for new fellows (>&#x2009;98%).<br><br>CONCLUSION: The impact of COVID-19 on local practices and workloads was not as significant as seen overseas. There continues to be an increasing trend of radiation oncologists working in the private sector. The lack of indigenous representation within our profession continues to be an area that needs further attention.}, }
@article {pmid40772640, year = {2025}, author = {Devigili, G and Marchi, M and Lauria, G}, title = {Small fiber neuropathy: expanding diagnosis with unsettled etiology.}, journal = {Current opinion in neurology}, volume = {38}, number = {5}, pages = {485-495}, pmid = {40772640}, issn = {1473-6551}, mesh = {Humans ; *Small Fiber Neuropathy/diagnosis/etiology/genetics/physiopathology ; COVID-19/complications ; Neuralgia/etiology/diagnosis ; }, abstract = {PURPOSE OF REVIEW: Small fiber neuropathies (SFN) are a heterogeneous group of disorders affecting the thinly myelinated Aδ and unmyelinated C-fibers. The clinical picture is dominated by neuropathic pain, often accompanied by autonomic symptoms of variable severity. The underlying causes encompass metabolic conditions like diabetes mellitus, immuno-mediated disorders, infection, exposure to toxins, and gain-of-function variants in the genes encoding the Nav1.7, Nav1.8, and Nav1.9 sodium channel subunits, though the list of associated diseases continues to grow. Recently, increased attention has focused on immune-mediated forms, which led to the identification of potentially treatable subgroups. These discoveries have advanced our understanding of pathophysiological mechanisms.<br><br>RECENT FINDINGS: Recent studies have broadened the spectrum of underlying conditions associated with SFN, including immune-mediated forms and links to SARS-CoV-2 infection and vaccines. Studies on genetic variants linked to unique clinical presentations have also yielded new insights. Furthermore, emerging perspectives highlighted disorders involving small fiber pathology that lacks typical clinical features of neuropathic pain, challenging traditional diagnostic criteria.<br><br>SUMMARY: Deepening our understanding of the causes underlying SFN advances the identification of potential therapeutic targets. The clinical presentation of SFN can vary significantly and may not consistently correlate with specific underlying conditions. Therefore, a systematic investigation of possible causes through a structured diagnostic assessment is critical to unveil additional contributing factors.}, }
@article {pmid40772015, year = {2025}, author = {Du, S and Chang, J and Zhou, Z}, title = {A Comprehensive Review of Theaflavins: Physiological Activities, Synthesis Techniques, and Future Challenges.}, journal = {Food science &amp; nutrition}, volume = {13}, number = {8}, pages = {e70762}, pmid = {40772015}, issn = {2048-7177}, abstract = {Theaflavins (TFs), which are polyphenolic compounds characterized by a benzotropolone structure, serve as the primary quality and health-promoting components in black tea. Recent investigations have disclosed various health advantages linked to TFs, especially their potential to act as lead compounds in the formulation of therapeutic drugs targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), positioning them as a significant area of focus within food science and nutrition research. This review initially examines the primary physiological activities, mechanisms of action, and challenges related to TFs. It subsequently details the formation mechanism of enzyme-catalyzed TFs from catechins. Building upon this groundwork, this review assesses the recent advancements in two in vitro synthesis methods of TFs: enzymatic oxidation and nonenzymatic synthesis. Finally, the challenges that arise during the large-scale industrial implementation of these synthesis techniques are analyzed, and research strategies aimed at mitigating these issues are suggested. The primary goal of this review was to provide insightful perspectives and guidance for prospective research and industrial utilization of TFs.}, }
@article {pmid40771914, year = {2025}, author = {Wołowiec, &#x141; and Osiak-Gwiazdowska, J and Jaśniak, A and Janiak, M and Wydeheft, L and Łukasiak, M and Pellowska, M and Grześk, G}, title = {Pharmacodynamics, pharmacokinetics, interactions with other drugs, toxicity and clinical effectiveness of proton pump inhibitors.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1507812}, pmid = {40771914}, issn = {1663-9812}, abstract = {The document comprehensively reviews proton pump inhibitors (PPIs), focusing on their pharmacodynamics, pharmacokinetics, drug interactions, toxicity, and clinical efficacy. PPIs irreversibly inhibit the H+/K+-ATPase enzyme in gastric parietal cells, effectively reducing gastric acid secretion. These drugs are widely prescribed for conditions like gastroesophageal reflux disease (GERD), peptic ulcer disease, eradication of Helicobacter pylori and as a prevention against bleeding from gastrointestinal tract. The review article highlights significant drug interactions associated with PPIs. Omeprazole, for instance, can interfere with the metabolism of clopidogrel, reducing its antiplatelet efficacy, which may have clinical implications. The article also discusses other drug interactions, including anticoagulants (e.g., warfarin), selective serotonin reuptake inhibitors (SSRIs), and immunosuppressive and chemotherapeutic drugs, as well as the side effects associated with taking PPIs. Long-term use of PPIs is linked to plenty of adverse effects, such as vitamin B12 and calcium deficiencies, which can lead to bone fractures. An increased risk of infections, including Clostridium difficile and small intestinal bacterial overgrowth (SIBO), is also noted. Cardiovascular risks, such as myocardial infarction and stroke, are observed in some patients on high-dose or prolonged PPI therapy. In rare cases, nephrotoxicity and hepatotoxicity are reported. Additionally, the document examines the potential role of PPIs in exacerbating certain cancers, such as gastric adenocarcinoma, and in influencing the severity of COVID-19 symptoms. PPIs are proven effective in treating GERD and preventing complications from nonsteroidal anti-inflammatory drugs (NSAIDs), particularly in reducing the risk of NSAID-induced ulcers. The document stresses the importance of understanding drug interactions and the need for individualized treatment to minimize adverse effects. Ongoing research into PPIs' long-term safety and efficacy remains essential, particularly given their widespread use in clinical practice.}, }
@article {pmid40771482, year = {2025}, author = {Saxena, SG and Tisdell, E and Farace, E and Godfrey, T and Aumiller, B and Dell, E and Razzak, OP and Kumar, BN and Sznajder, KK}, title = {Achieving equity for International Medical Graduates: a systematic review.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1601492}, pmid = {40771482}, issn = {2296-858X}, abstract = {INTRODUCTION: Foreign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.<br><br>METHODS: Following the PRISMA statement, we searched PubMed, Embase, PsycINFO, CINAHL, Web of Science for all peer-reviewed articles using keywords "international medical graduate", "overseas trained doctor", "overseas trained physician", "foreign trained doctor", "foreign trained physician" (group A); and "discrimination" and "microaggressions" (group B) published between January 1st, 2000 to October 24th, 2021.<br><br>RESULTS: The 46 studies included in this review fall into three groups - acculturation interventions for FIMGs, FIMG's perceptions of what they found useful, and trainers' perspectives on 'what works'. This review also includes interventions that pivoted to the online mode during the Covid-19 pandemic, making the findings relevant, as this is likely to the norm in the future. Acculturation requires training on clinical protocols, host country and health system culture and norms and communication, language and self-awareness skills.<br><br>DISCUSSION: Much work remains to be done. Interventions need to be tailored to suit the unique needs of FIMGs from 150+ countries, trainings require a foundation of theoretical frameworks, additional professional, personal and social support to be provided, life course related changing needs demand attention and the preparedness of host country health systems to accept FIMGs require enhancement.}, }
@article {pmid40770795, year = {2025}, author = {Mostafavi Zadeh, SM and Noroozi, E and Gheytanchi, E and Tajik, F and Madjd, Z and Ahmadvand, D}, title = {The impact of the COVID-19 pandemic on melanoma diagnosis: a systematic review and meta-analysis of global evidence.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {2684}, pmid = {40770795}, issn = {1471-2458}, mesh = {Humans ; *Melanoma/diagnosis/pathology/epidemiology ; *COVID-19/epidemiology ; *Skin Neoplasms/diagnosis ; Pandemics ; Global Health ; }, abstract = {INTRODUCTION: The COVID-19 pandemic significantly disrupted healthcare systems worldwide. Prioritizing emergency responses resulted in the postponement of routine medical care, including melanoma diagnoses. We performed a systematic review and meta-analysis to quantify the pandemic's effect on diagnosis rates, Breslow thickness, stage at presentation, ulceration, histologic subtypes, and patient age.<br><br>METHOD: We performed a systematic review and meta-analysis following PRISMA guidelines. PubMed, Scopus, Web of Science, and Embase were searched up to 10 September 2024 for observational studies comparing melanoma outcomes in the pre-COVID era (before March 2020) with the COVID era (March 2020 onwards). Two reviewers independently screened records, extracted data on diagnostic counts, patient age, Breslow thickness, ulceration, and histopathological subtype, and assessed study quality using the Newcastle-Ottawa Scale (NOS). Random-effects models pooled rate ratios (RRs) or odds ratios (ORs); fixed-effects models pooled mean differences (MDs). Heterogeneity was evaluated with I&#xb2;, and sensitivity analyses were restricted to high-quality studies (NOS&#x2009;&#x2265;&#x2009;7).<br><br>RESULTS: Sixty-two studies (38,676 pre-COVID and 46,846 COVID-era melanomas) met inclusion criteria. New melanoma diagnoses fell by 19% during the pandemic (RR&#x2009;=&#x2009;0.81, 95% CI 0.75-0.86; I&#xb2; = 98%). Mean age at diagnosis rose by 0.86 years (95% CI 0.58-1.14; I&#xb2; = 45%). Tumors were thicker (MD&#x2009;=&#x2009;0.24&#xa0;mm, 95% CI 0.02-0.47; I&#xb2; = 92%) and more frequently ulcerated (OR&#x2009;=&#x2009;1.29, 95% CI 1.15-1.44; I&#xb2; = 31%). Nodular melanoma, an aggressive subtype, became more common (OR&#x2009;=&#x2009;1.34, 95% CI 1.08-1.67; I&#xb2; = 81%), whereas superficial spreading, acral lentiginous, and lentigo-maligna subtypes showed no significant change. All the key findings persisted in good-quality-only analyses.<br><br>CONCLUSION: COVID-19-related service disruptions were associated with fewer melanoma diagnoses but a shift toward older patients and biologically adverse tumor features, signaling delayed detection at the population level. Strengthening resilient, rapid-access skin cancer pathways and integrating tele-dermatology with triaged in-person assessment are public-health priorities for future crises.<br><br>TRIAL REGISTRATION: PROSPERO registration number CRD42022361569.}, }
@article {pmid40770695, year = {2025}, author = {Ali Sheikhi, R and Heidari, M and Doosti, P}, title = {The role of religious leaders in the acceptance of COVID-19 vaccinations: a systematic review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {2683}, pmid = {40770695}, issn = {1471-2458}, support = {6743//Shahrekord University of Medical Sciences, Shahrekord, Iran/ ; 6743//Shahrekord University of Medical Sciences, Shahrekord, Iran/ ; 6743//Shahrekord University of Medical Sciences, Shahrekord, Iran/ ; }, mesh = {Humans ; *COVID-19 Vaccines/administration &amp; dosage ; *COVID-19/prevention &amp; control ; *Leadership ; *Vaccination Hesitancy/psychology ; *Patient Acceptance of Health Care ; *Vaccination/psychology ; }, abstract = {BACKGROUND: The development of COVID-19 vaccines was progressing rapidly, but vaccination acceptance posed many challenges in different communities. This study systematically reviewed the impact of religious leaders on the acceptance of COVID-19 vaccinations. It also examined religious leaders' role in shaping their followers' vaccination decisions and explored the strategies religious organizations use to promote vaccination against COVID-19.<br><br>METHOD: The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary databases used to search the literature were PubMed, Web of Science (WOS), Scopus, ProQuest, ScienceDirect, and Google Scholar. To identify relevant published literature, the title of this systematic review was divided into two key components: keywords related to COVID-19 vaccination and religious leaders, along with their synonyms.<br><br>RESULTS: This review analyzed seven articles using content analysis to explore the diverse roles of religious leaders in COVID-19 vaccination acceptance. The analysis identified two key themes: the positive contributions of religious leaders in promoting vaccination and their negative or neutral roles, highlighting differing perspectives on their influence during the pandemic.<br><br>CONCLUSION: Engaging religious leaders in disseminating and adopting national and global health initiatives, such as capacity building, training, trust building, collaboration with health providers, and dialogue with the community about the COVID-19 vaccination program, is a powerful strategy to advance the World Health Organization (WHO) goals.}, }
@article {pmid40770644, year = {2025}, author = {Shipton, A and Shang, F and Wake, M and Goldfeld, S and Mensah, F}, title = {Lessons for the Next Global Health Crisis: A Qualitative Systematic Review of Women's Experiences of the Perinatal Period During the COVID-19 Pandemic in Australia.}, journal = {The Australian &amp; New Zealand journal of obstetrics &amp; gynaecology}, volume = {}, number = {}, pages = {}, doi = {10.1111/ajo.70054}, pmid = {40770644}, issn = {1479-828X}, support = {//Victorian Government's Operational Infrastructure Support Program/ ; //Murdoch Children's Research Institute/ ; //University of Melbourne/ ; //Royal Australasian College of Physicians/ ; 1160906//National Health and Medical Research Council/ ; 2026263//National Health and Medical Research Council/ ; }, abstract = {BACKGROUND: During the coronavirus disease of 2019 (COVID-19) pandemic, pregnant women and new mothers in Australia experienced extreme pandemic societal responses but low SARS-CoV-2 incidence. This offers one of the few opportunities internationally to learn from the pandemic's indirect effects on maternal health, informing future policy.<br><br>AIMS: To explore women's qualitative experiences of pregnancy to the 12 postpartum months during the COVID-19 pandemic in Australia.<br><br>MATERIALS AND METHODS: A systematic search followed PRISMA guidelines. MEDLINE, Embase, Web of Science and PubMed were searched from 1 January 2020, to 13 August 2023, using four categories of terms: 'COVID-19', 'perinatal', 'qualitative', 'Australia'. Studies were scored using the CASP checklist and common themes identified from thematic synthesis. The ENTREQ reporting statement was followed.<br><br>RESULTS: From eight peer-reviewed studies, four themes were identified: (1) 'No one can give you any answers': Provision of information was inadequate in supporting women to make health-related decisions; (2) 'Very isolated' or 'It brought us closer': Social distancing restrictions caused major changes within women's informal support networks; (3) 'Have they seen enough of me?': Women felt unsupported during disruptions in maternal health services; (4) 'All you want to do is keep safe': Safeguarding family from SARS-CoV-2 added cognitive strain to women's daily decision-making and routine. All studies were of a good or high quality.<br><br>CONCLUSIONS: Three lessons were highlighted. First, women need accurate, accessible health information to make informed decisions. Second, policies should support family bonding and social connections during government restrictions. Finally, health services must be strengthened to ensure continuous, high-quality, accessible care during global crises.}, }
@article {pmid40769733, year = {2025}, author = {Wilson, CM and Boright, LE and Henshaw, AM and Naccarato, A}, title = {Role of rehabilitation in palliative care after the COVID-19 pandemic: a narrative review.}, journal = {Annals of palliative medicine}, volume = {14}, number = {4}, pages = {379-392}, doi = {10.21037/apm-25-6}, pmid = {40769733}, issn = {2224-5839}, mesh = {Humans ; *COVID-19/rehabilitation/epidemiology ; *Palliative Care/organization &amp; administration ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND AND OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic resulted in an historic disruption and transformation of the healthcare system, including the management of individuals with serious illness. Rehabilitation for patients facing serious or life-threatening illness is underutilized and poorly understood, resulting in unwarranted suffering, disability, and poorly coordinated care. This narrative review aims to describe the impact of the COVID-19 pandemic on the role and scope of rehabilitation within the context of serious illness and palliative care.<br><br>METHODS: A focused review of the literature included selected articles identified from three databases published from January 2020 to January 2025. Findings were synthesized narratively, with a focus on identifying themes and gaps in the literature related to two main topics: (I) the evidence related to rehabilitation for those with serious or life-threatening COVID-19 during the pandemic and (II) how rehabilitation for patients with serious illness has been transformed after emerging from the pandemic (including non-COVID diagnoses such as cancer, neurologic conditions, etc.).<br><br>KEY CONTENT AND FINDINGS: The key themes identified during the COVID-19 pandemic emphasized the need for early rehabilitation, interdisciplinary care, and an emphasis on cardiopulmonary principles for rehabilitation. Themes identified during the pandemic also included the emerging role of telerehabilitation, and need for evidence and clinical guidelines for serious illnesses (including long COVID). Themes related to the transformative effect on palliative rehabilitation after the pandemic included an increased importance and focus on coordination of care and interdisciplinary care for those with serious illness and increased focus on mental health and social determinants of health (SDOH). Additionally, there appears to be increased infrastructure and activity related to research, advocacy, and awareness for palliative rehabilitation.<br><br>CONCLUSIONS: The COVID-19 global pandemic highlighted the need for high quality, coordinated palliative care, including rehabilitation services, for patients facing a serious or life-threatening illness. Due to the benefits to a person's quality of life (QoL), dignity, and comfort, there is increasing evidence of the importance of seamless, ongoing access to rehabilitation services for patients with serious illness.}, }
@article {pmid40769663, year = {2025}, author = {Shamoun, R and Asirwatham, A and Leftwich, HK}, title = {From Inflammation to Flooding: COVID-19, Asthma, and Pulmonary Edema.}, journal = {Obstetrics and gynecology clinics of North America}, volume = {52}, number = {3}, pages = {547-563}, doi = {10.1016/j.ogc.2025.05.011}, pmid = {40769663}, issn = {1558-0474}, mesh = {Humans ; *Asthma/therapy/physiopathology/diagnosis ; Pregnancy ; *COVID-19/therapy/physiopathology ; Female ; *Pulmonary Edema/therapy/diagnosis/physiopathology/etiology ; SARS-CoV-2 ; *Pregnancy Complications/therapy/physiopathology/diagnosis ; Risk Factors ; *Pregnancy Complications, Infectious/therapy/physiopathology ; }, abstract = {The respiratory system, like many other body systems, undergoes significant changes during pregnancy to support the needs of the growing fetus. This article begins by providing a detailed overview of these normal physiologic changes, highlighting how the respiratory system adjusts to the increased metabolic demands and altered hormonal environment of pregnancy. The article will then cover updated guidelines for managing asthma, the most common respiratory condition affecting pregnant individuals. Lastly, we will briefly touch on pulmonary edema in pregnancy, reviewing possibly etiologies and risk factors as well as diagnosis and management.}, }
@article {pmid40769605, year = {2025}, author = {Anlacan, VMM and Gabriel, FGC and Jamora, RDG and Villanueva Iii, EQ and Sy, MCC and Lee Yu, MHL and Espiritu, AI}, title = {Association between encephalopathy and clinical outcomes of COVID-19: Findings from the Philippine CORONA Study.}, journal = {Neurologia}, volume = {40}, number = {6}, pages = {567-576}, doi = {10.1016/j.nrleng.2025.06.009}, pmid = {40769605}, issn = {2173-5808}, mesh = {Humans ; *COVID-19/complications/mortality/therapy/epidemiology ; Philippines/epidemiology ; Female ; Male ; Retrospective Studies ; Middle Aged ; *Brain Diseases/epidemiology/mortality ; Intensive Care Units/statistics &amp; numerical data ; Length of Stay/statistics &amp; numerical data ; Aged ; Respiratory Insufficiency/epidemiology/etiology ; Severity of Illness Index ; Respiration, Artificial/statistics &amp; numerical data ; Adult ; SARS-CoV-2 ; Hospitalization/statistics &amp; numerical data ; }, abstract = {INTRODUCTION: This study aimed to determine whether encephalopathy is associated with such COVID-19 outcomes as disease severity, mortality, respiratory failure, intensive care unit (ICU) admission, duration of ventilator dependence, and length of ICU and hospital stay.<br><br>METHODS: We performed a subgroup analysis comparing outcomes in patients with and without encephalopathy, based on data from a nationwide retrospective cohort study among adult patients hospitalized with COVID-19 at 37 hospital sites in the Philippines. The patient outcomes included for analysis were disease severity, mortality, respiratory failure, ICU admission, duration of ventilator dependence, and length of ICU and hospital stay.<br><br>RESULTS: Of a total of 10881 COVID-19 admissions, 622 patients had encephalopathy. The adjusted hazard ratios (aHR) for mortality among mild and severe cases were 9.26 and 1.63 times greater (P<.001), respectively, in the encephalopathy group compared to the no-encephalopathy group. Encephalopathy was associated with increased risk of severe COVID-19 (adjusted odds ratio [aOR]: 7.95; P<.001), respiratory failure (aHR: 5.40; P<.001), longer hospital stays (aOR: 1.36; P<.001), and admission to the ICU (aOR: 4.26; P<.001). We found no sufficient evidence that encephalopathy was associated with length of ICU stay (aOR: 1.11; P=.522) or duration of ventilator dependence (aOR: 0.88; P=.428).<br><br>CONCLUSIONS: Encephalopathy was associated with COVID-19 severity, mortality, respiratory failure, ICU admission, and longer hospital stays.}, }
@article {pmid40769540, year = {2025}, author = {Liu, Y and Su, S and Wang, Z and Wu, J and Chen, H and Yang, H}, title = {[Research progress in active substances and their mechanisms of action against porcine epidemic diarrhea virus].}, journal = {Sheng wu gong cheng xue bao = Chinese journal of biotechnology}, volume = {41}, number = {7}, pages = {2519-2533}, doi = {10.13345/j.cjb.250129}, pmid = {40769540}, issn = {1872-2075}, mesh = {*Porcine epidemic diarrhea virus/drug effects/immunology ; Animals ; Swine ; *Swine Diseases/virology/prevention &amp; control ; *Antiviral Agents/pharmacology ; *Coronavirus Infections/veterinary/prevention &amp; control/virology ; Viral Vaccines/immunology ; Humans ; Signal Transduction ; }, abstract = {Porcine epidemic diarrhea virus (PEDV) is an intestinal coronavirus that can cause porcine epidemic diarrhea, leading to diarrhea, vomiting, weight loss, and even death in piglets. Due to the diversity of PEDV strains, traditional vaccines are difficult to sustainably and effectively prevent and control PEDV. This article reviews the strategies and mechanisms of active substances in regulating intracellular signaling pathways, viral proteins, and microbial metabolites to enhance the host immune function against PEDV. It emphasizes the prevention of PEDV resistance and the potential harm of PEDV breaking through interspecies barriers to the human society, aiming to provide reliable theoretical support for the development of new antiviral drugs or vaccines.}, }
@article {pmid40769234, year = {2025}, author = {Sterpetti, AV and Miceli, F and Di Girolamo, A and Bozzani, A and Arici, V and Ascione, M and Marzo, LD}, title = {Inflammation, abdominal aortic aneurysm enlargement and rupture. Lessons learned from the Covid19 pandemic.}, journal = {Current problems in cardiology}, volume = {50}, number = {10}, pages = {103151}, doi = {10.1016/j.cpcardiol.2025.103151}, pmid = {40769234}, issn = {1535-6280}, mesh = {Humans ; *COVID-19/complications/epidemiology ; *Aortic Aneurysm, Abdominal/epidemiology/etiology/pathology ; *Aortic Rupture/epidemiology/etiology ; SARS-CoV-2 ; *Inflammation ; Risk Factors ; Pandemics ; Disease Progression ; }, abstract = {Patients with moderate-severe COVID19 infection suffer from several cardiovascular diseases: heart failure (3 %-33 %), myocardial ischemia (0.9 %-11 %), ventricular dysfunction (10 %-47 %), arrhythmias (9 %-17 %), venous thrombo-embolism (25 %) and arterial thrombosis (1 %-3 %). Although intracranial and coronary arterial aneurysms have been described in adults and children with COVID19, few reports have correlated COVID19 infection and sudden degeneration of aortic aneurysms and dissections. We analyzed the risk factor for enlargement and rupture of aortic aneurysms in patrients with moderate-severe COVID19 infection. Several COVID19 related mechanisms may impact aortic aneurysm progression: increased elastin and collagen digestion by enzymes triggered by viral spike proteins in ACE2-negative myeloid cells and/or by inflammatory cytokines; hypoxemia related to thrombosis of micro vessels of the aneurismal wall; dysregulation of the immune system. Patients with known arterial aneurysm may be at risk for sudden increase of dimensions and rupture during moderate-severe COVID19 infection.}, }
@article {pmid40769229, year = {2025}, author = {Amrani, BL and Zawari, NS and Abd Rahman, NZA and Azman, AS and Nor Rashid, N and Khairat, JE}, title = {Unlocking nature's hidden treasures: Actinomycetota's arsenal of potent antiviral compounds against human viral infections.}, journal = {Microbial pathogenesis}, volume = {208}, number = {}, pages = {107953}, doi = {10.1016/j.micpath.2025.107953}, pmid = {40769229}, issn = {1096-1208}, mesh = {Humans ; *Antiviral Agents/pharmacology/therapeutic use/chemistry/isolation &amp; purification ; *Virus Diseases/drug therapy/virology ; Animals ; *Viruses/drug effects ; }, abstract = {The global emergence of infectious diseases, including COVID-19, Mpox, MERS, Ebola, dengue, Zika, and avian influenza, alongside the escalation of antimicrobial resistance, has made the discovery of novel antiviral agents an urgent priority. Actinomycetota, a diverse group of microorganisms known for their medicinal properties and antibiotic production, stand out as a promising source of antiviral compounds. Since the 20th century, studies on the antiviral potential of Actinomycetota-derived secondary metabolites have shown efficacy against various human viruses, such as influenza viruses (IVs), human coronaviruses (hCoVs), respiratory syncytial virus (RSV), human immunodeficiency virus (HIV), herpes simplex virus (HSV), mosquito-borne viruses such as Zika virusZIKV), dengue virus (DENV), West Nile virus (WNV), Chikungunya virus (CHIKV)), and monkeypox virus (MPXV). This review provides a comprehensive summary of key findings from the literature, emphasizing the theurapeutic potential of these compounds and the importance of further research to elucidate their mechanisms of action and enhance their production. Unlocking the antiviral arsenal of Actinomycetota may pave the way for the development of novel and effective antiviral therapies to combat human viral diseases.}, }
@article {pmid40768894, year = {2025}, author = {Ding, J and Liu, Z and Chao, M}, title = {The association between problematic social media use and attention deficit/hyperactivity disorder symptomatology: a systematic review and meta-analysis.}, journal = {Journal of psychiatric research}, volume = {189}, number = {}, pages = {544-553}, doi = {10.1016/j.jpsychires.2025.07.009}, pmid = {40768894}, issn = {1879-1379}, mesh = {Humans ; *Attention Deficit Disorder with Hyperactivity/epidemiology/psychology ; *Social Media/statistics &amp; numerical data ; COVID-19 ; *Internet Addiction Disorder/epidemiology ; }, abstract = {BACKGROUND: Problematic social media use (PSMU) is becoming increasingly common, with various studies highlighting a notable correlation with Attention Deficit/Hyperactivity Disorder (ADHD) symptomatology.<br><br>METHODS: A comprehensive search strategy was employed to identify relevant studies from the following databases: PubMed, Web of Science, EBSCO, and ProQuest. Meta-analysis was performed using Comprehensive Meta Analysis software with a random effects model.<br><br>RESULTS: The meta-analysis included 15 studies with a total of 35,223 participants. The analysis revealed a moderate positive correlation between ADHD symptomatology and PSMU (r&#xa0;=&#xa0;0.361, 95&#xa0;% CI [0.297, 0.421]). Subgroup analyses identified several significant moderators: data collection timing (rAfter-COVID-19>rBefore-COVID-19), assessment tools for PSMU (rBSMAS&#xa0;>&#xa0;rSMDS&#xa0;>&#xa0;rOthers), and assessment tools for ADHD (rASRS&#xa0;>&#xa0;rOthers). Additionally, the mean age of participants emerged as a significant moderator in the meta-regression analysis.<br><br>CONCLUSIONS: The evidence supports a significant association between ADHD symptomatology and PSMU. These findings have implications for future research and clinical practice.}, }
@article {pmid40767628, year = {2025}, author = {Luo, J and Luo, J and Fang, Z and Fu, Y and Xu, BB}, title = {Insights Into Effects of Natural Bioactive Components on Inflammatory Diseases in Respiratory Tract.}, journal = {Phytotherapy research : PTR}, volume = {39}, number = {9}, pages = {4199-4229}, pmid = {40767628}, issn = {1099-1573}, support = {UICR0400016-24//BNU-HKBU United International College/ ; 2023VPPC-R10//Open Research Project of the Key Laboratory of Viral Pathogenesis &amp; Infection Prevention and Control of the Ministry of Education/ ; }, mesh = {Humans ; *Inflammation/drug therapy ; *Respiratory Tract Diseases/drug therapy ; *Anti-Inflammatory Agents/pharmacology/therapeutic use ; *Phytochemicals/therapeutic use/pharmacology ; Animals ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Signal Transduction/drug effects ; Cystic Fibrosis/drug therapy ; COVID-19 ; }, abstract = {The increasing prevalence of inflammatory diseases in the respiratory tract worldwide has raised concerns, and due to its high prevalence and poor prognosis, it remains a clinical focus and research hotspot. These inflammatory diseases include airway inflammation, asthma, bacterial antigens-induced tonsil epithelial inflammation, chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), COVID-19, acute lung injury, and lung cancer. This review summarizes the relevant molecular mechanisms of inflammatory diseases in the respiratory tract and the progress of natural bioactive components in inflammatory diseases in the respiratory tract. The natural bioactive components have good therapeutic or intervention effects on inflammatory airway diseases in vitro, in vivo, and in clinical trials. The information on inflammatory diseases in the respiratory tract and natural bioactive ingredients in anti-inflammatory diseases were collected from famous literature databases such as Web of Science, PubMed, and Google Scholar, with keywords including bioactive components, inflammatory diseases, respiratory tract, and so forth. The bioactive phytochemicals, such as curcumin, ginsenoside, safranal, melatonin, could improve inflammatory diseases through the regulation of PI3K/Akt, NF-κB, NRF2/HO-1, MAPK, cAMP-PKA, and MEK/ERK Signaling pathways. Further high-quality studies are still needed to firmly establish the clinical efficacy of bioactive ingredients. This review provides new insight for future research on functional food or drug-lead compound development on natural products improving inflammatory diseases in the respiratory tract.}, }
@article {pmid40767402, year = {2025}, author = {Prasannan, A and Venkatachalam, K and Binesh, A}, title = {Factor VIII beyond haemophilia: a hidden regulator of venous thrombosis and endothelial dysfunction.}, journal = {Blood coagulation &amp; fibrinolysis : an international journal in haemostasis and thrombosis}, volume = {36}, number = {7}, pages = {335-346}, doi = {10.1097/MBC.0000000000001385}, pmid = {40767402}, issn = {1473-5733}, mesh = {Humans ; *Factor VIII/metabolism/genetics/physiology ; *Hemophilia A/blood/complications ; *Venous Thrombosis/blood/etiology/metabolism ; COVID-19/complications/blood ; *Endothelium, Vascular/metabolism/physiopathology/pathology ; SARS-CoV-2 ; Thrombin/metabolism ; Sepsis/blood ; Animals ; }, abstract = {Factor VIII (FVIII), a critical cofactor protein traditionally acknowledged for its deficiency in haemophilia A (HA), has been attracting interest for its substantial role in vascular disease. Recent data highlights its essential role beyond haemostasis, in the development of venous thrombosis (VT) and endothelial dysfunction influenced by genetic and acquired factors. This review summarizes the biology, synthesis, and activation of FVIII, emphasizing its role in thrombin generation and endothelial dysfunction. FVIII is implicated in inflammatory and thrombotic disorders, such as COVID-19, sepsis, and cancer-associated thrombosis. Although anticoagulant medication indirectly reduces elevated FVIII levels, direct intervention is constrained by the associated bleeding risks. Novel approaches like RNA interference, gene editing, and endothelial-specific modulation might offer compelling opportunities for the regulation of FVIII. This study highlights the potential of FVIII as a diagnostic and therapeutic target in thrombosis by integrating molecular insights with clinical data, hence promoting future precision-based therapies.}, }
@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.<br><br>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.<br><br>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.}, }
@article {pmid40767138, year = {2025}, author = {Pinte, L and Dumitru, AC and Usurelu, AC and Niculae, CM and Draghici, A and Cotet, MA and Baicus, C}, title = {Low eosinophils and their dynamic as a predictor of death in patients with infections: a systematic review and meta-analysis of cohort studies.}, journal = {Annals of medicine}, volume = {57}, number = {1}, pages = {2541084}, pmid = {40767138}, issn = {1365-2060}, mesh = {Humans ; *Eosinophils ; *COVID-19/mortality/blood ; Prognosis ; *Sepsis/mortality/blood ; SARS-CoV-2 ; Cohort Studies ; Leukocyte Count ; Clostridium Infections/mortality/blood ; Pulmonary Disease, Chronic Obstructive/mortality/blood ; }, abstract = {BACKGROUND: Eosinophils prognostic significance in predicting mortality has become particularly notable during the COVID-19 pandemic. We aimed to evaluate the prognostic value of peripheral low eosinophil (eosinopenia) with focus on their dynamics (eosinophil recovery) in patients with infections.<br><br>METHODS: We searched databases (MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library) and additional sources from inception to 1 December 2023. Cohort studies involving adult patients hospitalized with infections were evaluated using dual-reviewer methodology.<br><br>RESULTS: Out of 15,066 screened papers, 151 studies met the inclusion criteria, with 107 focused on COVID-19, 14 on sepsis, 9 on Clostridioides difficile, 6 on acute COPD exacerbations, and 17 on other infections. The majority of studies reported significantly lower admission eosinophil levels in non-survivors compared to survivors. Random-effects model meta-analysis showed mean eosinophil difference between deceased and survivors -15.31 (95% CI: -18.72 to -11.90) for COVID-19 and -44.6 (95% CI: -95.62 to 6.41) for sepsis (I[2]&#xa0;>&#xa0;90%). Mortality with eosinopenia showed low certainty of evidence for C. difficile (0 cells/mm&#xb3; cut-off: RR 2.35; 95% CI: 1.84-2.99) and very low for COVID-19 when considering different cut-offs (0 cells/mm&#xb3;: RR 2.37; 95% CI: 1.86-3.01; 20 cells/mm&#xb3;: RR 2.90; 95% CI: 1.59-5.28; 50 cells/mm&#xb3;: RR 2.70; 95% CI: 1.33-5.49). Survivors generally showed an increase in eosinophil counts within the first 2-5 days of hospitalization, while the deceased had persistently low levels.<br><br>CONCLUSIONS: Eosinopenia, particularly the trajectory of eosinophil recovery, may serve as a cost-effective and accessible prognostic marker for mortality in patients with infections.}, }
@article {pmid40765543, year = {2025}, author = {Reddy, M and Kulkarni, M and Kanakalakshmi, ST and Shenoy, L and KrishnaBhat, RR}, title = {Non-invasive SpO2/FiO2 ratio (SFR) as surrogate for PaO2/FiO2 ratio (PFR): A scoping review.}, journal = {Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)}, volume = {11}, number = {3}, pages = {221-232}, pmid = {40765543}, issn = {2393-1809}, abstract = {Patient oxygenation significantly impacts clinical outcomes, and continuous monitoring is essential, especially in critical care settings where hypoxia is the leading cause of mortality. PFR (PaO2/FiO2 ratio or P/F ratio) is an invasive method for measuring oxygenation requiring arterial blood gas (ABG) sampling, however it carries complications making non-invasive methods more desirable. SFR (SpO2/FiO2 ratio or S/F ratio), a non-invasive tool based on pulse oximetry, provides a cost-effective and rapid way to monitor oxygenation status, especially in settings where advanced methods are unavailable. A total of 575 articles were screened from databases including Web of Science, Scopus, PubMed, and CINAHL, with 32 articles meeting the inclusion criteria for this scoping review wherein SFR was used as a surrogate for PFR and a diagnostic tool for acute lung injury and ARDS. A total of 81,637 patient records were analyzed, including ABG values, pulse oximetry readings, mechanical ventilator settings, and patient diagnoses. The study population included adults, pediatric patients, and neonates admitted to critical care units, with common diagnoses including acute hypoxemic respiratory failure, ARDS, and COVID-19. In the context of COVID-19, SFR was used to predict the need for mechanical ventilation, with a cut-off of 300 indicating a threshold for imminent ventilation requirement. The studies demonstrated statistically significant sensitivity and specificity for SFR, highlighting its utility as a non-invasive tool for assessing oxygenation status. SFR has shown potential as a reliable non-invasive surrogate for determining oxygenation status across all populations.}, }
@article {pmid40765331, year = {2025}, author = {Chavda, VP and Mehta, AA and Zafar, H and Raza, F and Paiva-Santos, AC and Balar, PC and Apostolopoulos, V and Vora, L}, title = {Adenovirus-Based Single-Dose Vaccines for SARS-CoV-2: A Review.}, journal = {Frontiers in bioscience (Landmark edition)}, volume = {30}, number = {7}, pages = {25094}, doi = {10.31083/FBL25094}, pmid = {40765331}, issn = {2768-6698}, mesh = {Humans ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; *COVID-19/prevention &amp; control/immunology ; *SARS-CoV-2/immunology ; *Adenoviridae/genetics/immunology ; Genetic Vectors ; }, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has many unexpected implications, but the scientific community remains optimistic about overcoming these obstacles. Adenoviruses (Ad) are considered the most suitable vectors for transferring specific antigens to mammalian cells since they can induce both innate and adaptive immune responses. Ad-based coronavirus disease 2019 (COVID-19). vaccines were granted emergency use authorization in the COVID-19 pandemic. Many features of the Ad vector render it an appealing vaccine carrier for contagious diseases, including high titer, ease of processing, high effectiveness, low immunogenicity in clinical trials, and consistency in pharmaceutical packaging and shipment processes. Ad-based vaccines are generally effective and have few side effects since Ad induces minor infections in humans, and genetic modifications can block viral replication. These single-dose vaccines are effective not only in young individuals but also in adults. Clinical trials of these single-dose vaccines are commendable and have shown excellent safety and efficacy profiles. This review provides a summary of the development of single-dose vaccines against SARS-CoV-2.}, }
@article {pmid40764711, year = {2025}, author = {Blackmur, JP and Re, C and Stewart, GD}, title = {What has the COVID-19 pandemic taught us about safety of surgical wait times in urological oncology?.}, journal = {BJU international}, volume = {136}, number = {5}, pages = {781-787}, pmid = {40764711}, issn = {1464-410X}, mesh = {Humans ; *COVID-19/epidemiology ; *Time-to-Treatment ; *Urologic Neoplasms/surgery ; SARS-CoV-2 ; *Urologic Surgical Procedures ; *Waiting Lists ; Pandemics ; Male ; }, abstract = {OBJECTIVES: To review papers assessing the impact of surgical delay in relation to the COVID-19 pandemic, and evaluate what has been learnt about the safety of surgical waiting times in urological oncology.<br><br>PATIENTS AND METHODS: Medline and Web of Science were searched for studies published between 1 January 2020 and 1 November 2024. Studies included were those reporting treatment delay effects on surgical or oncological outcomes, or patient experience with reference to COVID-19. Priority was given to studies deriving their cohort after the start of the pandemic. Studies were also included in which the cohort was derived before the pandemic, but where recommendations were made on COVID-19 treatment delay. Data were extracted regarding duration of delay and authors' reported impact of delay on outcome (quantified, and simplified as negative/neutral/positive).<br><br>RESULTS: A total of 35 studies met the inclusion criteria. Fourteen studies included data collected after the start of the pandemic and 21 exclusively included cohorts derived prior to the pandemic but made recommendations about COVID-19-related treatment delays. Six studies on urothelial cancer reported negative clinical outcomes for delays between 2&#x2009;weeks and 3&#x2009;months, while three reported a neutral impact. Four studies on kidney cancer reported negative outcomes with 1-3-month delay, while two reported a neutral impact. Eleven studies on prostate cancer reported that a 3-12-month delay had neutral effects, while one reported negative outcomes. One study on penile cancer reported worse survival with delays in treatment. No studies on testicular cancer were identified. Five studies reported negative patient experience with delays, while one reported a positive patient experience.<br><br>CONCLUSIONS: Few studies have reported the impacts of COVID-19-related delayed treatment; this was a missed opportunity. While most prostate cancer treatment can be deferred up to 180&#x2009;days, diagnostic cystoscopy, transurethral resection of bladder tumour and nephrectomy for cT2+ renal masses should be expedited to occur within 30&#x2009;days. Treatment of cT1 renal masses, carcinoma invading bladder muscle, upper tract urothelial carcinoma and high-risk prostate cancer should commence within 90&#x2009;days.}, }
@article {pmid40764277, year = {2025}, author = {Pimenta, PDC and de Aquino Lima, TC and Geraldine, VGS and Tourinho, FS and do Nascimento, MC and Novaes, RD and Dias, LMRP}, title = {COVID-19 Vaccine Adverse Events by Country Income Level: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.}, journal = {American journal of health promotion : AJHP}, volume = {}, number = {}, pages = {8901171251365229}, doi = {10.1177/08901171251365229}, pmid = {40764277}, issn = {2168-6602}, abstract = {PurposeTo synthesize evidence on the incidence of COVID-19 vaccine-related adverse events across countries by income level.DesignSystematic review and meta-analysis of randomized trials.SettingStudies published 2020-2025, retrieved from EMBASE, PubMed/MEDLINE, and Scopus.SampleEleven trials with 7841 participants; seven from high-income and four from upper-middle-income countries.MeasuresIncidence per 100 vaccinated. Countries by income: low (≤$1145), lower-middle ($1146-4515), upper-middle ($4516-14,005), high (>$14,005). Inter-reviewer agreement assessed by kappa (0.684). Risk of bias evaluated with Cochrane RoB 2.AnalysisMantel-Haenszel random-effects models estimated relative risks (RR) with 95% confidence intervals. Heterogeneity assessed by I[2]. Subgroup analyses by income and dose.ResultsAEFI incidence was consistently higher in high-income vs upper-middle-income countries, especially after dose 2. Injection-site pain (68.1 vs 26.3 per 100), headache (45.7 vs 14.1), myalgia (42.5 vs 9.2), and fatigue (33.8 vs 11.4) were most common. Meta-analyses showed higher pooled RR in high-income settings: any AEFI after dose 1, RR = 1.83 (95% CI: 1.39-2.42); local, RR = 3.15; systemic, RR = 2.05. After dose 2, overall RR reached 2.94; local, 4.37; systemic, 2.48. All subgroup differences were significant.ConclusionHigher-income countries showed a greater incidence of mostly mild adverse events, particularly after the second dose. mRNA vaccines had the highest rates. Findings reveal income-based disparities and inform equitable post-vaccination monitoring.}, }
@article {pmid40763909, year = {2025}, author = {Zhao, P and Chen, Y and Zhou, S and Li, F}, title = {Microbial modulation of tryptophan metabolism links gut microbiota to disease and its treatment.}, journal = {Pharmacological research}, volume = {219}, number = {}, pages = {107896}, doi = {10.1016/j.phrs.2025.107896}, pmid = {40763909}, issn = {1096-1186}, mesh = {Humans ; *Tryptophan/metabolism ; *Gastrointestinal Microbiome/drug effects ; Animals ; COVID-19/metabolism/microbiology ; Anti-Bacterial Agents/therapeutic use/pharmacology ; }, abstract = {Emerging studies have demonstrated that tryptophan (Trp) metabolism plays a critical role in maintaining intestinal and systemic homeostasis. Trp metabolism is involved in diseases such as metabolic syndrome, gastrointestinal cancers, neurological disorders, and viral diseases. The gut microbiota is crucial for regulating Trp metabolism, thereby influencing host health. Conversely, Trp metabolism can also modulate the composition and function of the gut microbiota. In this review, we summarize the mechanisms through which gut microbiota-regulated Trp metabolism contributes to disease development. We also discuss how external factors, such as antibiotics and diet, influence Trp metabolism and may offer protective effects against disease, including Covid-19. These advances have facilitated the development of novel therapeutic strategies targeting Trp metabolic dysfunction.}, }
@article {pmid40763823, year = {2026}, author = {Xu, L and Wu, X}, title = {Viral detection using Clustered Regularly Interspaced Short Palindromic Repeats/CRISPR-associated protein and Argonaute nucleases.}, journal = {Clinica chimica acta; international journal of clinical chemistry}, volume = {578}, number = {}, pages = {120526}, doi = {10.1016/j.cca.2025.120526}, pmid = {40763823}, issn = {1873-3492}, mesh = {Humans ; *SARS-CoV-2/isolation &amp; purification/genetics ; *CRISPR-Cas Systems/genetics ; *Argonaute Proteins/genetics/metabolism ; COVID-19/diagnosis ; *CRISPR-Associated Proteins/genetics/metabolism ; *Clustered Regularly Interspaced Short Palindromic Repeats ; }, abstract = {Viral pandemics pose severe threats to human health and societal stability, exemplified by the COVID-19 outbreak in 2019. Conventional viral detection methods such as Polymerase chain reaction (PCR) typically require trained personnel, expensive equipment, and 2-4 h for processing. Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRISPR-associated protein (Cas) and Argonaute (Ago) system-based detection methods achieve attomolar sensitivity or single-copy detection limits with single-base specificity within 1 h, without requiring complex or costly instruments. This review firstly introduces the mechanisms and functions of CRISPR/Cas systems (Cas9, Cas12, Cas13) and Ago systems. It also introduces viruses with significant social impact, and continued with reviewing applications of these systems in single and multiplex virus detection. Single viral detection includes recently developed DNA/RNA-activated Cas9 detection (DACD/RACD) using Cas9 trans-cleavage activity, Cas12-based DNA Endonuclease-targeted CRISPR Trans Reporter (DETECTR) with attomolar sensitivity, CRISPR/Cas13a-based Fluorescent Nanoparticle SARS-CoV-2 (CFNS) achieving 1 copy/mL sensitivity with quantum dot reporters, and amplification-free mobile phone detection detecting 31 copies/μL without amplification. Multiplex viral detection includes Microfluidic Device Integrated with CRISPR/Cas12a and Multiplex Recombinase Polymerase Amplification (MiCaR) enabling 30-plex detection through microfluidic chips with spatial discrimination, PfAgo-mediated Nucleic acid Detection (PAND) utilizing Ago-produced guide sequences for 5-plex detection, Specific High-Sensitivity Enzymatic Reporter UnLOCKing v2 (SHERLOCKv2) achieving 4-plex detection with multi-enzyme single-reaction systems, and Multiplexed Evaluation of Nucleic acids (CARMEN) supporting over 100 target assays. Finally, this review discusses challenges in CRISPR/Cas and Ago-based detection methods, including Protospacer Adjacent Motif (PAM) sequence requirements for Cas9/12, prolonged reaction times due to nucleic acid extraction/amplification, and instability of core components like nucleases and crRNAs. Detection specificity and multiplex capabilities could be further improved. Future directions are outlined for improving detection specificity, developing multiplex capabilities and advancing POCT. Developing diagnostic tools using CRISPR/Cas and Ago systems could transform molecular diagnostics, such tools promise to be easily accessible worldwide. They are essential for precise identification and strategic containment of infectious disease transmission.}, }
@article {pmid40762988, year = {2025}, author = {Gusmão, ACS and Scaléa, ACR and Uehara, SCDSA}, title = {Symptoms of long COVID in children and adolescents: a scoping review.}, journal = {Revista da Escola de Enfermagem da U S P}, volume = {59}, number = {}, pages = {e20240435}, pmid = {40762988}, issn = {1980-220X}, mesh = {Humans ; Adolescent ; Child ; *COVID-19/complications/diagnosis/epidemiology/physiopathology ; Age Factors ; }, abstract = {OBJECTIVE: To map the symptoms of Long Covid (LC) presented by children and adolescents.<br><br>METHOD: This is a scoping review, using the search engines Web of Science, Scopus, Virtual Health Library, and PUBMED, following the principles of the Joanna Briggs Institute.<br><br>RESULTS: Sixteen studies were selected, which showed that fatigue, headache, dyspnea, and cough were the most frequent symptoms of LC. There is a tendency for the development of child-adolescent LC related to the increase in age range, and the correlation between LC and predominant sex proved to be inconclusive. The presence of comorbidities, such as obesity, respiratory, neurological and renal diseases, was the most reported and a study showed an association between Covid-19 vaccine protection and LC.<br><br>CONCLUSION: This review points to a plurality of symptomatic manifestations of LC in children and adolescents, changing according to age group and health history.}, }
@article {pmid40762948, year = {2025}, author = {Palmer, M and Seekins, D and Avigan, M and Marcinak, J and Rockey, DC and Regev, A and Shastri, VK and Lewis, JH and Dash, A}, title = {The Impact of COVID-19 and COVID-19 Vaccination on Detection, Assessment, and Management of Suspected Acute Drug-Induced Liver Injury Occurring during Clinical Trials: Consensus Recommendations from the IQ DILI Initiative.}, journal = {Drug safety}, volume = {}, number = {}, pages = {}, pmid = {40762948}, issn = {1179-1942}, abstract = {While the acute impact of the coronavirus disease 2019 (COVID-19) pandemic has waned, implications for clinical trials remain. In particular, guidance for evaluation of elevated liver tests due to COVID-19, its treatments, and COVID-19 vaccination is lacking. The IQ DILI Initiative, composed of experts from academia, regulatory agencies, and industry herein propose recommendations to address this gap. Extensive literature review was conducted and structured discussions were held between IQ DILI industry members, regulators, and academic experts in hepatology and DILI. Liver-related manifestations in nonhospitalized patients with COVID-19 are highly varied. Evidence of liver injury may occur after COVID-19 symptoms resolve and testing is negative. Treatments for COVID-19 may cause liver injury or alter pharmacokinetics. COVID-19 vaccination has been associated with rare but clear hepatotoxicity, typically consistent with drug-induced autoimmune-like hepatitis, although other presentations, severity, latency, and time to resolution have been reported. Liver injury occurred with mRNA and viral vector vaccines, and in individuals with and without underlying autoimmune or liver diseases. Drug developers and investigators should be aware of the potential liver-related manifestations related to COVID-19, its treatments, and COVID-19 vaccination, as this may impact study eligibility and causality assessment during a trial. COVID-19 testing should be considered part of DILI causality assessment, as a positive test may prevent premature termination of the investigational drug. Since clinical trial participants may not consider vaccinations in their medical history, specific inquiry about their receipt is important when liver tests are abnormal during screening and as part of DILI causality assessment.}, }
@article {pmid40761748, year = {2025}, author = {Usher, S and Allin, S and Gautier, L and Fierlbeck, K and Sriram, V and Bodner, A and Trapé, C and Shipton, L and Montecalvo, A and Berman, P}, title = {The influence of public health organization on response to the COVID-19 pandemic in four Canadian provinces: A comparative qualitative analysis.}, journal = {Health policy OPEN}, volume = {9}, number = {}, pages = {100146}, pmid = {40761748}, issn = {2590-2296}, abstract = {BACKGROUND: Studies of COVID-19 pandemic responses reveal shortcomings that may relate to the organization of public health systems.<br><br>OBJECTIVE: This study uncovers the organizational factors that may strengthen pandemic responses in high-income countries through a comparative analysis of four Canadian provinces.<br><br>METHODS: We undertook a qualitative multiple case study, collecting data through document review and 103 interviews with government and non-governmental actors involved in pandemic response. Analysis explored how differences in the organization of provincial public health systems influenced decision-making, advisory, coordination and adaptation processes.<br><br>RESULTS: The scale of the pandemic positioned the Premier as legitimate decision-maker in all provinces regardless of the distribution of authority in their public health systems. Capacity for generating public health advice was increased through existing or new organizations and highlighted the advantage of links to university expertise. All public health systems relied on healthcare resources for testing programs despite differences in the integration of public health under healthcare governance structures; centralization of healthcare governance was a facilitator. Adapting pandemic control measures to population needs was supported by linkages between organizations capable of apprehending needs and organizations that made decisions.<br><br>CONCLUSIONS: This study builds on the literature of pandemic responses across high-income countries and uncovers organizational factors that may enhance agility to rapidly expand capacities, connect actors for emergency responses, and strengthen public health systems.}, }
@article {pmid40760496, year = {2025}, author = {Rae, JD and Chen, W and Diarra, S and Nghiem, N and Chisholm, RH and Tran-Duy, A and Shearer, F and Devine, A}, title = {Web-based models to inform health policy: A scoping review.}, journal = {Health research policy and systems}, volume = {23}, number = {1}, pages = {99}, pmid = {40760496}, issn = {1478-4505}, support = {2025362//Australian National Health and Medical Research Council of Australia (NHMRC)/ ; }, mesh = {Humans ; *Health Policy ; *Internet ; COVID-19/epidemiology ; SARS-CoV-2 ; Malaria/epidemiology ; *Models, Theoretical ; *Policy Making ; }, abstract = {Health policies must be continually updated as new evidence is generated to ensure the optimal delivery of health interventions and prevention measures. Models are often used to study health problems, but their complexity limits their use by policy-makers. One way to facilitate their use among non-modellers is to develop user-friendly interfaces and make them available online. We conducted a scoping review of journal articles to identify and describe the currently available, interactive, freely available web-based health models that aim to inform health policy relevant to any disease or health issue affecting human populations. This scoping review included 16 web-based models covering 13 diseases or health issues, of which the most common were coronavirus disease 2019 (COVID-19) and malaria. The most common model outputs were epidemiological indicators (14/16), such as case numbers, incidences, or results from diagnostic screening, followed by the cost of implementing the intervention or health measure of interest (10/16). Model validation was performed in 6 of the 16 studies by comparing the model results with the previously published evidence or comparing simulated outcomes with observed data. Sensitivity and scenario analyses were conducted for 62.5% of models (10/16); however, in most cases, the user can perform these analyses by changing the model parameters in the user interface. This review explores the potential of web-based models to support health policy decisions and resource allocation. Despite their limited number, the 16 interactive web-based health models provide valuable insights into various health issues, primarily infectious diseases. The usability of the currently available web-based health models is impacted by the accuracy of the model description, the ability of the user to alter parameter values and the model assumptions that limit their generalizability. Such models must be validated and incorporate appropriate sensitivity analyses to be reliable and helpful to policy-makers.}, }
@article {pmid40760361, year = {2025}, author = {Alshehri, S and Almutawif, YA and Khan, NU}, title = {Impact of COVID-19 vaccination on cancer patients: safety, efficacy, and long-term effects.}, journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer}, volume = {33}, number = {8}, pages = {753}, pmid = {40760361}, issn = {1433-7339}, mesh = {Humans ; *Neoplasms/immunology/complications ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage/immunology/therapeutic use ; *COVID-19/prevention &amp; control ; SARS-CoV-2/immunology ; Vaccination ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to a worldwide pandemic in 2020. Cancer patients represent a highly vulnerable group for COVID-19 infection and are associated with poor outcomes due to their immunosuppressive status, owing to malignancy itself or anticancer therapies. Several approved COVID-19 vaccines were assessed for their effectiveness in the general population. However, initially, cancer patients were excluded from large landmark trials, leading to a paucity of data. This article presents a narrative review that synthesizes findings from peer-reviewed clinical trials, real-world cohort studies, and expert guidelines to assess the current evidence. This review assesses the safety, efficacy, and long-term effectiveness of COVID-19 vaccination in patients with cancer. Accumulated evidence from multiple clinical trials and real-world data suggests that COVID-19 vaccines are generally well-tolerated, safe, and efficacious in patients with both solid and hematologic types of cancer, eliciting moderate adverse reactions and rare severe reactions, including immune-related adverse events, thrombotic events, and anaphylaxis. Vaccine-induced humoral response and cellular response are often weakened in cancer patients, especially those with hematologic malignancies, compared to those of non-cancerous individuals. However, the immunogenicity in cancer patients improves significantly with booster doses. Further, seroresponse against SARS-CoV-2 variants increases with additional booster doses, signifying the importance of personalized booster approaches. Despite this, vaccinated cancer patients develop breakthrough infections, which are associated with hospitalization and higher mortality compared to the general population. Moreover, long-term follow-up of vaccinated cancer patients suggests that they demonstrate durable immune responses, with rare reports of cancer recurrence or remission that require further evaluation. Collectively, COVID-19 vaccination is a practical and valuable approach for alleviating risk and improving outcomes in patients with cancer.}, }
@article {pmid40759382, year = {2025}, author = {Wu, J and Qian, X and Bai, S and Wu, L and Zhao, X}, title = {Lesser-known non-apoptotic programmed cell death in viral infections.}, journal = {Virus research}, volume = {359}, number = {}, pages = {199612}, pmid = {40759382}, issn = {1872-7492}, mesh = {Humans ; Pyroptosis ; *Virus Diseases/immunology/pathology/virology ; SARS-CoV-2/immunology/physiology ; *COVID-19/immunology/virology/pathology ; Apoptosis ; Necroptosis ; Immunity, Innate ; Animals ; Ferroptosis ; Extracellular Traps/immunology ; Macrophages/immunology ; Cell Death ; Host-Pathogen Interactions ; *Regulated Cell Death ; Virus Replication ; }, abstract = {Non-apoptotic programmed cell death (NAPCD) represents a diverse set of cell death mechanisms that differ from classical apoptosis and have recently gained attention in the context of viral infections. This review focuses on four key NAPCD types, including ferroptosis, cuproptosis, NETosis (neutrophil extracellular trap formation), and PANoptosis (a combination of pyroptosis, apoptosis, and necroptosis), and summarizes their distinct molecular pathways and roles during viral infections. We emphasize their functional relevance in SARS-CoV-2 infection, revealing how they significantly impact viral replication, host immune responses, and tissue damage. Furthermore, we explore the interaction between NAPCDs and specific immune responses. Specifically, ferroptosis influences macrophage polarization. Cuproptosis activates innate immunity via the cGAS-STING pathway. NETosis contributes to Th17 responses, and PANoptosis interacts with Th1, Th22, and Thαβ pathways. Understanding the interplay among these cell death pathways provides new insights into host-virus dynamics and uncovers potential therapeutic targets for viral diseases.}, }
@article {pmid40759007, year = {2025}, author = {Baduashvili, A and Radonovich, L and Leslie, L and Pease, S and Brickson, C and Chockalingam, L and Banacos, N and Fitzgerald, B and Wagner, J and Bahnfleth, WP and Cox-Ganser, J and Mead, KR and Olsiewski, P and Gregory, CO and Stone, E and Taliano, J and Weissman, DN and Bero, L}, title = {Engineering Infection Controls to Reduce Indoor Transmission of Respiratory Infections : A Scoping Review.}, journal = {Annals of internal medicine}, volume = {178}, number = {9}, pages = {1314-1325}, doi = {10.7326/ANNALS-25-00577}, pmid = {40759007}, issn = {1539-3704}, mesh = {*Respiratory Tract Infections/prevention &amp; control/transmission ; Humans ; *Air Pollution, Indoor/prevention &amp; control ; *Infection Control/methods ; Air Microbiology ; }, abstract = {BACKGROUND: Engineering infection controls include a wide range of interventions used indoors to reduce occupants' exposure to respiratory pathogens.<br><br>PURPOSE: To identify and describe primary studies evaluating the effects of engineering infection control interventions designed to reduce the spread of respiratory infections transmitted through indoor air.<br><br>DATA SOURCES: MEDLINE, Embase, Global Health, Cochrane Central Register of Controlled Trials, CINAHL, Scopus, and Environmental Science Collection from database inception to 12 December 2023.<br><br>STUDY SELECTION: English-language primary research articles evaluating engineering infection control interventions.<br><br>DATA EXTRACTION: Publication information, population characteristics, intervention details, and all relevant outcomes were abstracted by a reviewer and verified by a second, senior reviewer.<br><br>DATA SYNTHESIS: A total of 672 studies published between 1929 and 2024 were identified. Most (n = 606) evaluated environmental samples only, 57 included human participants, and 9 included sentinel animal subjects. About half of the studies included at least 1 intervention classified as pathogen inactivation (n = 405), with fewer involving pathogen removal (n = 200) or air exchange or dilution (n = 143). Across all studies, about half (n = 332) measured the quantity of viable nonpathogenic organisms from air samples, followed by the quantity of nonbiological particulates (n = 197) or viable pathogenic organisms (n = 149). Harms, such as toxic byproducts, were rarely measured.<br><br>LIMITATION: Exclusion of non-English-language publications and gray literature.<br><br>CONCLUSION: There is substantial heterogeneity in the available evidence. Gaps in evidence include studies measuring efficacy outcomes that are highly relevant for human infection transmission or harms. Refinements in classification of interventions and outcomes could strengthen reporting of these evaluations.<br><br>PRIMARY FUNDING SOURCE: National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention. (Registered on Open Science Framework [https://osf.io/5zmhd]).}, }
@article {pmid40757741, year = {2025}, author = {Butterfield, JA and Gunn, KJ and Sweitzer, K and Catanzaro, M and McHenry, L and Ketonis, C}, title = {Parsonage-Turner Syndrome Following COVID-19 Exposures: A Systematic Review.}, journal = {Hand (New York, N.Y.)}, volume = {}, number = {}, pages = {15589447251352003}, pmid = {40757741}, issn = {1558-9455}, abstract = {BACKGROUND: Parsonage-Turner syndrome (PTS) is an uncommon neuropathy classically characterized by acute onset shoulder pain followed by muscle weakness and usually eventual resolution. In the post-COVID-19 era with large portions of the population experiencing viral infection and vaccination, multiple case reports of PTS surfaced in medical literature, with only 1 case report in hand literature.<br><br>METHODS: A systematic review was performed using PubMed, Embase, Scopus, Web of Science, and Google Scholar to identify all reported cases of PTS related to COVID-19 infection or vaccination. Trends in diagnostic modalities and treatment options were recorded.<br><br>RESULTS: Thirty-two reports on 54 patients were identified detailing PTS cases following COVID-19 vaccination, and 21 reports on 26 patients following COVID-19 infection. Patients presented an average of 9.5 days following vaccination versus 18.8 days postinfection. Magnetic resonance imaging (MRI) was performed on 82.5% of patients, with the most common findings being normal, hourglass-like constrictions, intramuscular edema on T2-weighted images, and enlargement of regional lymph nodes. Seventy-nine percent (79%) of patients had nerve conductive study (NCS) and electromyography (EMG) performed an average of 6.6 weeks following musculoskeletal symptom onset.<br><br>CONCLUSIONS: As more patients are routinely vaccinated against and/or contract COVID-19, an increase of these patients presenting to hand clinics is possible. Electrodiagnostic studies and MRI may best be obtained 2 and 3 weeks, respectively, after symptom onset. In addition, repeat EMG/NCX should be obtained 9 to 12 months after symptom onset to assess if surgical interventions are indicated. Hand surgeons should be prepared to diagnose and institute therapies to optimize recovery.}, }
@article {pmid40757657, year = {2025}, author = {Kavruk, M and Ercan, M and Borsa, BA and Özalp, VC and Hernandez, FJ}, title = {Biotechnological Preparedness for Novel Pandemics: Diagnostic Performance of IVDS Against SARS-CoV-2.}, journal = {MicrobiologyOpen}, volume = {14}, number = {4}, pages = {e70042}, pmid = {40757657}, issn = {2045-8827}, support = {//This study was supported by the Diputacion Foral de Gipuzkoa (EB-EP-BI-2024-0280), the Swedish Research Council (VR-2024-016121), and HORIZON-MSCA-2022-COFUND-101126600-SmartBRAIN3./ ; }, mesh = {Humans ; *COVID-19/diagnosis ; *SARS-CoV-2/isolation &amp; purification ; *Biotechnology/methods ; Pandemics/prevention &amp; control ; Reagent Kits, Diagnostic ; COVID-19 Testing/methods ; }, abstract = {Although the COVID-19 pandemic has created many challenges and negative impacts around the world, some of which will persist into the future, its technological challenge has created a unique opportunity in a globalized world. It is a rare event that almost all of humanity to be directed towards a single goal and to try to produce solutions, but the necessity of a similar global action in the future has begun to enter the agenda again. The predictions made on the basis of countries and institutions against the possibility of a pandemic, which is defined as Disease X, are shaped by the experience of the COVID-19 pandemic. Technologically, one of the know-how we have gained in this pandemic is the performance of IVD and test systems in terms of quality and quantity. A comprehensive analysis of the products produced by combining biotechnology with different strategies has not been conducted. In this context, we have analyzed the technical preferences, limitations, and other performance parameters of IVDs and test kits that could be developed against a future Disease X. The performance parameters of 2,882 biotechnological products listed for use in the European Union have been analyzed, and areas that could be targeted for increased effectiveness have been identified. Our study is the first of its kind in this field and can serve as a guide for those who want to work on detection methods, diagnostics, and novel technologies for deployment in future pandemics.}, }
@article {pmid40757469, year = {2025}, author = {Sui, Y and Hou, X and Zhang, J and Hong, X and Wang, H and Xiao, Y and Zeng, X}, title = {Lipid nanoparticle-mediated targeted mRNA delivery and its application in cancer therapy.}, journal = {Journal of materials chemistry. B}, volume = {13}, number = {33}, pages = {10085-10117}, doi = {10.1039/d5tb01556a}, pmid = {40757469}, issn = {2050-7518}, mesh = {Humans ; *RNA, Messenger/administration &amp; dosage/chemistry/therapeutic use ; *Nanoparticles/chemistry ; *Neoplasms/therapy/drug therapy ; *Lipids/chemistry ; Animals ; Cancer Vaccines ; *Drug Delivery Systems ; Liposomes ; }, abstract = {mRNA technology has gained significant attention due to its successful application in COVID-19 vaccines, becoming a vital research area in disease treatment. Achieving therapeutic efficacy requires mRNA to efficiently enter target cells and express functional proteins, highlighting the urgent need for effective delivery systems. Lipid nanoparticles (LNPs) have emerged as a crucial enabler for the clinical translation of mRNA therapies, thanks to their remarkable delivery capabilities. Several mRNA-based therapies have now been approved or are in clinical trials, underscoring the vast potential of mRNA technology. This review provides a comprehensive overview of the application of mRNA-LNP in cancer therapy. It systematically summarizes strategies for optimizing LNP composition, introduces innovative synthesis methods and AI-driven formula optimization, and explores targeted delivery strategies. Additionally, it delves into the various applications of mRNA in cancer treatment, including mRNA tumor vaccines, adoptive cell transfer therapies, restoration of tumor suppressors, immunomodulatory factors, combination therapies, and other emerging treatments. By addressing current challenges and future directions, this review aims to offer valuable insights for further research in this field.}, }
@article {pmid40756880, year = {2025}, author = {Mithen, R and Todd, J and Madden, H and Brown, T and Surtida, BE and Mullaney, J}, title = {The High-Value Nutrition National Science Challenge programme: facilitating collaboration between academia and the food and beverage industry to develop healthier foods.}, journal = {Journal of the Royal Society of New Zealand}, volume = {55}, number = {6}, pages = {2513-2525}, pmid = {40756880}, issn = {1175-8899}, abstract = {The High-Value Nutrition | Ko Ngā Kai Whai Painga National Science Challenge (HVN NSC) was the first of the 11 National Science Challenges (NSCs) to be launched in April 2014. We provide an overview of the background to the Challenge, its overarching objective, a summary of the evolution of the research programme over its 10-year duration, its resilience and adaptation of its research programme during and after the Covid19 pandemic, and its potential impact. We consider the HVN NSC to be an exemplar of how to facilitate constructive engagement between academia and the Food and Beverage (F&amp;B) industry for the benefit of scientists, businesses and consumers.}, }
@article {pmid40756606, year = {2025}, author = {Sofroniou, A and Ridley, A}, title = {A Systematic Review of Clinical Trials Using mRNA Vaccines for Infectious Diseases other than COVID-19.}, journal = {British journal of biomedical science}, volume = {82}, number = {}, pages = {14557}, pmid = {40756606}, issn = {2474-0896}, mesh = {Humans ; Clinical Trials as Topic ; *mRNA Vaccines/therapeutic use ; *Vaccines, Synthetic/therapeutic use ; COVID-19/prevention &amp; control ; *Communicable Diseases/immunology ; RNA, Messenger/immunology ; COVID-19 Vaccines ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Although mRNA-based vaccines have been in development for over two decades, their widespread use only emerged during the COVID-19 pandemic. The success of these vaccines has brought mRNA technology to the forefront of efforts to develop novel vaccines. However, as this is a rapidly evolving field, there is a need for a comprehensive and up-to-date overview of the current evidence base to guide further research and development. This study, therefore, systematically reviewed the literature on clinical trials using mRNA vaccines for infectious diseases other than COVID-19.<br><br>METHODS: A systematic review of the literature, following the PRISMA 2020 guidelines, identified clinical trials in infectious diseases other than COVID-19. PubMed and ClinicalTrials.gov were screened for such clinical trials using search terms related to mRNA vaccines, and the results of the two independent searches were combined. Clinical trials using mRNA vaccines against either COVID-19 or non-communicable diseases were removed, as were duplicated studies. The remaining clinical trials were then stratified based on pathogen, status, and phase.<br><br>RESULTS: Nine hundred and seventy-six clinical trials were identified, of which 83 met the inclusion criteria. These included candidate mRNA vaccines against 14 viral, two bacterial and one protozoan infection. Of these, 43 trials have concluded, 21 are active, and a further 12 are recruiting, with the remaining not yet recruiting, enrolling by invitation, or withdrawn. Of the 43 completed clinical trials, 26 were phase I trials, eight were phase I/II trials, three were phase II trials, and six were phase III trials. The clinical trials captured in this systematic review included combined vaccines, with two or more vaccines administered at the same time, and mRNA vaccines designed to encode pathogen structural components, in addition to pathogen-specific antibodies.<br><br>CONCLUSION: This systematic review identified clinical trials investigating mRNA vaccine candidates against multiple infectious diseases, other than COVID-19, with the majority targeting viral infections. Despite the lack of long-term data, this systematic review suggests that these mRNA vaccine candidates are safe and effective with the potential to shape the field of preventive medicine. Beyond the prevention of infectious diseases, mRNA vaccines are showing promise against cancer and potential applications in autoimmune and other diseases.}, }
@article {pmid40756549, year = {2025}, author = {Ruth Saunders, N and Kawamura, A and MacLeod, O and Nieuwesteeg, A and De Souza, C}, title = {Somatic symptom and related disorders: Guidance on assessment and management for paediatric health care providers.}, journal = {Paediatrics &amp; child health}, volume = {30}, number = {4}, pages = {331-337}, pmid = {40756549}, issn = {1205-7088}, abstract = {Somatic symptom and related disorders (SSRDs) pose significant challenges in paediatric health care due to their impacts on child and adolescent well-being, functioning, and family systems. This statement offers comprehensive guidance to health care providers on the assessment and management of SSRDs as well as communication strategies for clinical encounters. Specific SSRD diagnoses are outlined along with common clinical presentations and recommended approaches to medical investigations and patient/family communication early in the diagnostic journey. Evidence-based treatments for SSRDs once a diagnosis has been established are delineated. Psychoeducational approaches that help to shift the onus of care from unnecessary medical testing and procedures, thereby shortening the diagnostic journey and promoting more functional, rehabilitative care therapies, are reviewed. Specific strategies to support patients and their families and validate their perspectives are outlined.}, }
@article {pmid40756213, year = {2025}, author = {El-Khoury, G and Hajjar, C and Geitani, R and Karam Sarkis, D and Butel, MJ and Barbut, F and Abifadel, M and Kapel, N}, title = {Gut microbiota and viral respiratory infections: microbial alterations, immune modulation, and impact on disease severity: a narrative review.}, journal = {Frontiers in microbiology}, volume = {16}, number = {}, pages = {1605143}, pmid = {40756213}, issn = {1664-302X}, abstract = {Respiratory viral infections are a major public health concern, accounting for millions of infections annually and contributing significantly to global morbidity and mortality. Influenza and respiratory syncytial virus (RSV) have long been recognized as critical pathogens, while the recent emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the COVID-19 pandemic. These viruses typically affect both the upper and lower respiratory tracts and can cause a broad spectrum of clinical manifestations, ranging from mild symptoms to severe respiratory failure and multi-organ dysfunction. Gastrointestinal symptoms are also frequently reported, suggesting a potential link between respiratory viruses and gut microbiota alterations. This connection highlights the role of the gut microbiota in disease pathophysiology. This narrative review summarizes current evidence on gut microbiota changes associated with SARS-CoV-2, influenza, and RSV infections. It further explores the microbiota's role in immune regulation and host homeostasis, and discusses the potential of microbiota-targeted strategies in the prevention and management of acute respiratory syndromes.}, }
@article {pmid40755283, year = {2025}, author = {Ward, M and Richardson, M and Metkar, M}, title = {mRNA folding algorithms for structure and codon optimization.}, journal = {Briefings in bioinformatics}, volume = {26}, number = {4}, pages = {}, pmid = {40755283}, issn = {1477-4054}, mesh = {*Algorithms ; *RNA, Messenger/chemistry/genetics ; *Codon/genetics ; Humans ; SARS-CoV-2/genetics ; *RNA Folding ; Nucleic Acid Conformation ; COVID-19 ; }, abstract = {mRNA technology has revolutionized vaccine development, protein replacement therapies, and cancer immunotherapies, offering rapid production and precise control over sequence and efficacy. However, the inherent instability of mRNA poses significant challenges for drug storage and distribution, particularly in resource-limited regions. Co-optimizing RNA structure and codon choice has emerged as a promising strategy to enhance mRNA stability while preserving efficacy. Given the vast sequence and structure design space, specialized algorithms are essential to achieve these qualities. Recently, several effective algorithms have been developed to tackle this challenge that all use similar underlying principles. We call these specialized methods mRNA folding algorithms as they generalize classical RNA folding algorithms. Initial laboratory testing of mRNA folding optimized mRNA vaccines, such as those encoding SARS-CoV-2 spike and VZV gE, has shown promising improvements in both in-solution stability and immunogenicity. While these biological properties are beginning to be evaluated experimentally, a comprehensive in silico analysis of the underlying principles, performance, and limitations of these design algorithms is equally essential. Thus, this review aims to provide an in-depth understanding of these algorithms, identify opportunities for improvement, and benchmark existing software implementations in terms of scalability, correctness, and feature support.}, }
@article {pmid40755019, year = {2025}, author = {Liang, J and Horvath, D and Luz, S and Li, Y and Nair, H}, title = {Respiratory viral infections: when and where? A scoping review of spatiotemporal methods.}, journal = {Journal of global health}, volume = {15}, number = {}, pages = {04213}, pmid = {40755019}, issn = {2047-2986}, mesh = {Humans ; *Respiratory Tract Infections/epidemiology/virology/transmission ; *Spatio-Temporal Analysis ; *Virus Diseases/epidemiology/transmission ; COVID-19/epidemiology/transmission ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Respiratory viral infections pose a substantial disease burden worldwide. Spatiotemporal techniques help identify transmission patterns of these infections, thereby supporting timely control and prevention efforts. We aimed to synthesise the current state of evidence on quantitative methodologies for investigating the spatiotemporal characteristics of respiratory viral infections.<br><br>METHODS: We conducted a scoping review using the PRISMA-ScR guidelines. We searched three biomedical bibliographic databases, EMBASE, MEDLINE, and Web of Science, identifying studies that analysed spatiotemporal transmission of viral respiratory infectious diseases (published before 1 March 2023).<br><br>RESULTS: We identified 8466 articles from database searches, of which 152 met our inclusion criteria and were qualitatively synthesised. Most included articles (n&#x2009;=&#x2009;140) were published during the COVID-19 pandemic, with 131 articles specifically analysing COVID-19. Exploratory research (n&#x2009;=&#x2009;77) investigated the spatiotemporal transmission characteristics of respiratory infectious diseases, focussing on transmission patterns (n&#x2009;=&#x2009;16), and influencing factors (n&#x2009;=&#x2009;61). Forecasting research (n&#x2009;=&#x2009;75) aimed to predict the disease trends using either univariate (n&#x2009;=&#x2009;57) or multivariate models (n&#x2009;=&#x2009;18), predominantly using machine learning methods (n&#x2009;=&#x2009;41). The application of advanced deep learning models (n&#x2009;=&#x2009;20) in disease forecasting analysis was often constrained by the quality of the available disease data.<br><br>CONCLUSIONS: There is a growing body of research on spatiotemporal analyses of respiratory viral infections, particularly during the COVID-19 pandemic. The acquisition of high-quality data remains important for effectively leveraging sophisticated models in disease forecasting research. Concurrently, although advanced modelling techniques are widely applied, future studies should consider capturing the complex spatiotemporal interactions in disease trajectory modelling.}, }
@article {pmid40754154, year = {2025}, author = {Schamoni-Kast, K and Uetrecht, C}, title = {From Science to Fiction - Connecting In Vivo and In Vitro Results in Polyprotein Processing of Coronaviruses.}, journal = {Journal of molecular biology}, volume = {437}, number = {22}, pages = {169370}, doi = {10.1016/j.jmb.2025.169370}, pmid = {40754154}, issn = {1089-8638}, mesh = {*Polyproteins/metabolism/genetics ; *Coronavirus/genetics/metabolism/physiology ; Humans ; Virus Replication ; *Protein Processing, Post-Translational ; *Viral Proteins/metabolism/genetics ; Animals ; Genome, Viral ; }, abstract = {Polyprotein processing is a common strategy in many positive sense single-stranded RNA ((+)ssRNA) viruses. This highly regulated process is crucial for viral progeny and ensures the release of functional replicase proteins in the correct location and at the right time. Coronaviruses (CoVs) have one of the largest genomes on average among (+)ssRNA viruses requiring a unique replication-transcription complex (RTC) with proofreading function that prevents error catastrophe. Two thirds of the CoV genome encode for the non-structural proteins (nsps) that drive replication. These are directly synthesized by RNA genome translation after infection as two large polyproteins pp1a and pp1ab. A regulated polyprotein proteolytic auto-processing is essential for viral growth and always has been an interesting target for therapeutics. Here, we present an overview of polyprotein processing and RTC research in CoVs in vitro and in vivo over the last 30 years. We highlight cutting-edge methodologies such as super resolution microscopy or structural mass spectrometry approaches and demonstrate how these have contributed to polyprotein research, e.g. by providing comprehensive structural models. We illustrate exciting examples of polyprotein processing in other viruses that could be transferred to CoVs, too. Additionally, we identify critical knowledge gaps in polyprotein processing and RTC assembly, proposing future perspectives to address these limitations.}, }
@article {pmid40754067, year = {2025}, author = {Peine, C and Stoliaroff-Pepin, A and Reinacher, U and Heldt, K and Sarganas, G and Piechotta, V and Mikolajewska, A and Pilic, A and Barkowski, N and Bleve, D and Giebeler, MH and Poser, S and Searle, L and Kißner, E and Nitsche, L and Bayram, F and Siemens, W and Ziegler, A and Meerpohl, JJ and Sandmann, F and Wichmann, O and Harder, T}, title = {Effectiveness of COVID-19 vaccines against post-COVID-19 condition/long COVID: systematic review and meta-analysis.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {31}, number = {12}, pages = {1961-1971}, doi = {10.1016/j.cmi.2025.07.026}, pmid = {40754067}, issn = {1469-0691}, mesh = {Humans ; *COVID-19/prevention &amp; control/complications ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; *Vaccine Efficacy ; SARS-CoV-2/immunology ; Vaccination ; Post-Acute COVID-19 Syndrome ; }, abstract = {BACKGROUND: Persons infected with SARS-CoV-2 can develop long-term symptoms known as postCOVID-19 condition (PCC; symptoms ≥3 months after infection) or long COVID (LC; symptoms ≥1 month after infection). Vaccination against COVID-19 might prevent PCC/LC, but the extent of protection is unclear.<br><br>OBJECTIVES: The aim of this systematic review was to evaluate the vaccine efficacy/effectiveness (VE) of COVID-19 vaccines given prior to SARS-CoV-2 infection in preventing PCC or LC.<br><br>METHODS DATA SOURCES: Studies were identified in Embase, MEDLINE, PreView, COVID-19 L.OVE repository, and Cochrane Library up to August 1, 2024.<br><br>Randomized controlled trials and nonrandomized studies of interventions (NRSI) that investigated immunization with a COVID-19 vaccine before SARS-CoV-2 infection were eligible, irrespective of participant age and sex.<br><br>ASSESSMENT OF RISK OF BIAS: Risk of bias was assessed using the ''Risk Of Bias In Nonrandomized Studies-of Interventions'' tool.<br><br>METHODS OF DATA SYNTHESIS: Primary outcome was PCC, secondary outcomes were LC, time until reconvalescence, limitations in everyday activity, and quality of life. Meta-analyses were primarily conducted using the random-effects model.<br><br>RESULTS: A total of 6423 records were screened, and 65 NRSI reporting adjusted estimates were included, comprising >5.7 mio.<br><br>PARTICIPANTS: VE for &#x2265;1 vaccine dose against PCC was 41.0% (95% CI 27.8%; 51.7%; 22 NRSI, certainty of evidence: low). VE after 1, 2, or 3 doses versus unvaccinated was 19.1% (-119.4%; 70.2%, 3 NRSI), 43.2% (4.5%; 66.2%; 4 NRSI), and 70.0% (30.0%; 87.0%; 1 NRSI), respectively. In <18 years old, VE against PCC was 26% for &#x2265;1 dose (-4%; 48%, 1 NRSI) and in >60 years old 41% (17%; 59%, 1 NRSI). VE after pre-Omicron-SARS-CoV-2 infection was 32.1% (-54.3%; 70.1%, 3 NRSI) and 20.9% (-10.1%; 43.3%, 2 NRSI) after Omicron infection. Sensitivity analyses indicated no influence of risk of bias and effect measure.<br><br>CONCLUSIONS: COVID-19 vaccines may be moderately effective in preventing PCC/LC. VE may increase with the number of vaccine doses administered.}, }
@article {pmid40753657, year = {2025}, author = {Fan, ZR and Chong, MC and Zhang, L and Ren, Y and Liu, Y and Che, CC}, title = {Mental health challenges and associated factors among nursing home caregivers: A scoping review.}, journal = {Geriatric nursing (New York, N.Y.)}, volume = {65}, number = {}, pages = {103598}, doi = {10.1016/j.gerinurse.2025.103598}, pmid = {40753657}, issn = {1528-3984}, mesh = {Humans ; *Caregivers/psychology ; *Nursing Homes ; *Mental Health ; *Stress, Psychological/epidemiology ; *COVID-19/epidemiology ; Depression/epidemiology ; Anxiety/epidemiology ; }, abstract = {BACKGROUND: Mental health challenges, such as anxiety, depression, perceived stress, and low subjective well-being, are prevalent among nursing home caregivers. However, comprehensive reviews addressing these issues are lacking.<br><br>AIM: To identify the prevalence of these psychological conditions and their associated factors among nursing home caregivers across various countries.<br><br>METHODS: A scoping review followed Arksey and O'Malley's methodology and PRISMA-ScR guidelines were conducted, including 26 articles identified through databases such as CINHAL, MEDLINE, Web of Science, PubMed, WANFANG, VIP, and CNKI.<br><br>RESULTS: Caregivers face significant mental health challenges exacerbated by workplace conditions, demographic factors, and the COVID-19 pandemic. Anxiety, depression, and stress interact, whereas stress and subjective well-being exhibit bidirectional relationships.<br><br>CONCLUSION: Comprehensive policies are urgently needed to address the mental health needs of nursing home caregivers and enhance their subjective well-being, thereby ensuring quality long-term care.}, }
@article {pmid40752767, year = {2025}, author = {Davido, B and Loubet, P}, title = {The silent surge: the under-recognised burden of respiratory syncytial virus, human metapneumovirus, and parainfluenza viruses in adults.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {159}, number = {}, pages = {108006}, doi = {10.1016/j.ijid.2025.108006}, pmid = {40752767}, issn = {1878-3511}, mesh = {Humans ; *Paramyxoviridae Infections/diagnosis/epidemiology ; *Respiratory Syncytial Virus Infections/diagnosis/epidemiology ; Metapneumovirus/isolation &amp; purification ; Adult ; Respiratory Syncytial Virus, Human ; COVID-19/epidemiology/diagnosis ; Aged ; }, abstract = {Respiratory syncytial virus (RSV), human metapneumovirus (HMPV), and parainfluenza viruses (PIV) drive substantial morbidity in adults, yet remain underdiagnosed due to diagnostic gaps. While influenza and COVID-19 benefit from rapid triplex antigenic tests and PCR, HMPV and PIV lack routine diagnostics, and RSV testing is underutilised in adults, leading to frequent misdiagnosis as common colds or bacterial infections. This opinion paper highlights the burden of these "forgotten viruses" in elderly and comorbid populations, where RSV and HMPV cause significant hospitalizations. Misdiagnosis fuels cardiovascular complications and antimicrobial resistance through inappropriate antibiotic use. Recent RSV vaccine successes offer a blueprint for HMPV and PIV, but improved diagnostics are critical to guide vaccine strategies and inform prevention efforts. Addressing these gaps can reduce healthcare costs and protect vulnerable populations from these hidden respiratory threats.}, }
@article {pmid40752304, year = {2025}, author = {Campanaro, G and Centini, FR and Sicca, C and Davico, J and Musella, E and Chebaro, K and Totis, F and Cannizzaro, D}, title = {Spinal neurosurgery: Trends in female authorship contribution over 5-Year publication history.}, journal = {Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia}, volume = {140}, number = {}, pages = {111523}, doi = {10.1016/j.jocn.2025.111523}, pmid = {40752304}, issn = {1532-2653}, mesh = {Humans ; *Authorship ; Female ; Bibliometrics ; *Neurosurgery/trends ; Male ; *Gender Equity ; }, abstract = {In the last few years, more efforts have been made to increase gender equity in medical specialties. Nevertheless, spinal neurosurgery continues to be one of the most male-dominated subspecialties in neurosurgery. This bibliometric analysis sought to explore the representation of female authors in major neurosurgical publications between September 2017 and August 2022, with a focus on first and last authorship roles across journals and countries. The paper analyzed 3171 unique publications within a framework of 93 high-impact neurosurgery-related journals. Results showed that female authors were 14,25 % of first authors and 7,88 % of last authors, and that only 2,11 % of articles had both female first and last authors. Country of affiliation and the journal of publication significantly influenced the author's gender representations, with Scandinavian states and certain journals, like Neurocritical Care, showing relatively high percentages of female authorship. Even if there has been minor progress over the recent past, disparities nowadays persist, potentially limiting diversity in perspectives and advancements in this field. These disparities underline the presence and the influence of systemic and cultural factors impeding gender equity, and underscoring the critical need for proactive measures to foster it, including mentorship programs, institutional support, and policies for balanced opportunities. The COVID-19 pandemic amplified inequities in this field, disproportionately impacting female academics due to increased domestic responsibilities without the corresponding implementation of support systems. The significant role of mentorship in improving female representation was also highlighted by this analysis: our data indicated higher collaboration rates between female first and last authors in the field of spinal neurosurgery. To address these challenges, efforts must be made starting during residency, with the aim of targeting systemic barriers and cultural biases. The implementation of inclusive policies, like on-site childcare programs, and fostering international collaboration, might help to reduce these disparities and to ensure that diversity drives innovation in spinal neurosurgery. Such an approach is essential for addressing inequity, which is not merely a matter of fairness but is central to advancing the field. This would ensure that only talent and hard work are what determine success in spinal neurosurgery, which is imperative for the progress of the speciality, enabling diverse perspectives to shape the future of patient care, research, and academic leadership.}, }
@article {pmid40751192, year = {2025}, author = {Mulumba, M and Oga, J and Koomson, N and Kara, TA and Cynthia, AN and Forman, L}, title = {Decolonizing global health: Africa's pursuit of pharmaceutical sovereignty.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {1015}, pmid = {40751192}, issn = {1472-6963}, mesh = {Humans ; Africa ; *Global Health ; COVID-19/prevention &amp; control ; *COVID-19 Vaccines/supply &amp; distribution/economics ; *Drug Industry/legislation &amp; jurisprudence ; }, abstract = {BACKGROUND: Africa's continued reliance on imported medicines, vaccines, and active pharmaceutical ingredients is the direct legacy of colonial extraction, intensified by the structural-adjustment era's dismantling of state-owned drug plants and cemented by intellectual-property regimes that keep critical know-how offshore. The COVID-19 vaccine scramble exposed the full cost of this vulnerability and has triggered a continent-wide push for pharmaceutical sovereignty-an explicit, decolonizing agenda to localize research, regulation, and production. This review distils the latest evidence on the barriers that still block that transition and maps the regulatory, financial, technological, and civic opportunities most likely to accelerate it.<br><br>METHODOLOGY: A critical narrative literature review was conducted. Six databases (PubMed, Scopus, ProQuest, Google Scholar, BMJ Global Health and the Institute for Economic Justice repository) were searched for English-language records published January 2000-May 2025 using the terms Africa AND (pharmaceutic OR vaccine OR API) AND (sovereign OR manufactur OR decoloni). Grey literature from AU agencies, Africa CDC, WHO and UNIDO was added. Forty-five documents met inclusion criteria and were included in the article. Reflexive thematic analysis identified recurrent barriers and enabling pathways; intercoder reliability was ensured through independent coding and consensus meetings.<br><br>RESULTS: Four structurally reinforcing barriers dominate the evidence base: (i) TRIPS-based patent exclusivities that restrict technology transfer; (ii) fragmented and immature regulatory capacity (iii) chronic under-investment; and (iv) import-biased procurement. The countervailing opportunities center on (i) AMA-led regulatory harmonization, (ii) pooled-demand instruments (iii) technology-transfer partnerships and (iv) civic-sector mobilization.<br><br>CONCLUSION: Africa now possesses the regulatory blueprint, pooled-demand incentives, and emerging technology platforms to localize production of medicines and vaccines. However, its realization is dependent on synchronizing these levers by easing IP constraints, completing AMA-led regulatory convergence, mobilizing concessional finance for API and bulk-drug capacity, and reforming procurement to reward local value. If pursued in concert, these steps can convert pharmaceutical sovereignty from a political slogan into a resilient, continent-wide industrial reality- anchoring Africa's wider agenda to decolonize global health.}, }
@article {pmid40750563, year = {2025}, author = {Bhiman, JN and Serwanga, J and Ugwu, CA and Vigan-Womas, I and Quashie, PK and Bhattacharya, J and Sande, C and Bonomo, A and Markey, FB and Awandare, GA and Garg, PK and Kaleebu, P and Happi, C and Rennergarbe, A and Woods, C and Kirchner, J and Aguilar, AO and Makar, K and Moore, PL and , }, title = {Retaining African networks is urgent for global health.}, journal = {Trends in microbiology}, volume = {33}, number = {11}, pages = {1150-1154}, doi = {10.1016/j.tim.2025.07.002}, pmid = {40750563}, issn = {1878-4380}, mesh = {Humans ; *COVID-19/epidemiology/immunology/prevention &amp; control/virology ; *Global Health ; *SARS-CoV-2/genetics/immunology ; Africa/epidemiology ; Pandemics/prevention &amp; control ; }, abstract = {The Global Immunology and Immune Sequencing for Epidemic Response (GIISER) network, established in 2021, exemplifies the power of South-South collaboration in pandemic preparedness and response. Emerging from the COVID-19 crisis, GIISER integrated genomic surveillance, immunology, and capacity building across African, Asian, and South American sites, enabling rapid detection and characterization of SARS-CoV-2 variants. Through technology transfer, standardized protocols, and coordinated training, GIISER informed public health policy, advanced monoclonal antibody discovery, and strengthened local expertise. As COVID-19 research subsides and in the context of profound funding constraints, GIISER's scientific successes highlight the urgent need to sustain and expand regional networks to address current and future infectious disease threats, while championing diversity and scientific leadership in low- and middle-income countries (LMICs).}, }
@article {pmid40749962, year = {2025}, author = {Shao, Q and Liu, T and Hu, B and Chen, L}, title = {Interplay between autophagy and apoptosis in human viral pathogenesis.}, journal = {Virus research}, volume = {359}, number = {}, pages = {199611}, pmid = {40749962}, issn = {1872-7492}, mesh = {Humans ; *Autophagy ; *Apoptosis ; *Host-Pathogen Interactions ; *Virus Diseases/virology/pathology ; *Viruses/pathogenicity ; RNA Viruses/pathogenicity ; DNA Viruses/pathogenicity ; }, abstract = {Autophagy and apoptosis are two pivotal programmed cell death pathways that regulate vital physiological processes, ranging from cellular development to intracellular homeostasis. These pathways also act as key battlegrounds in host-pathogen interactions during viral infection. This comprehensive review explores the dual regulatory mechanisms controlling autophagy and apoptosis triggered by clinically significant human viruses. These include DNA viruses-such as herpes simplex virus (HSV), Epstein-Barr virus (EBV), hepatitis viruses, human papillomavirus (HPV), and human bocavirus (HBoV)-and RNA viruses, including human immunodeficiency virus type 1 (HIV-1), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), enterovirus 71 (EV71), influenza viruses, respiratory syncytial virus (RSV), Coxsackievirus B (CVB), rabies virus (RABV), and dengue virus serotype 2 (DENV2). We specifically highlight the dynamic crosstalk between autophagic and apoptotic pathways during viral pathogenesis, analyzing how viruses strategically co-opt both cellular processes to facilitate infection. By systematically elucidating these viral manipulation strategies, this review aims to provide a reference for developing targeted antiviral strategies and identifying novel therapeutic interventions.}, }
@article {pmid40749835, year = {2025}, author = {Cattoir, V and Dinh, A and Jarraud, S and Monnier, AL and Loubet, P}, title = {Value of molecular biology tests in community-acquired acute pneumonia.}, journal = {Infectious diseases now}, volume = {55}, number = {6S}, pages = {105128}, doi = {10.1016/j.idnow.2025.105128}, pmid = {40749835}, issn = {2666-9919}, mesh = {Humans ; *Community-Acquired Infections/diagnosis/virology/microbiology ; COVID-19/diagnosis ; Multiplex Polymerase Chain Reaction/methods ; SARS-CoV-2/genetics/isolation &amp; purification ; *Pneumonia/diagnosis/virology/microbiology ; *Molecular Diagnostic Techniques/methods ; }, abstract = {For patients hospitalized with community-acquired acute pneumonia (CAP), molecular tools (especially multiplex PCR syndromic panels) are associated with a significant improvement of microbiological diagnosis yield, compared with conventional methods. Two main families of tests are currently available: targeted viral PCR tests (influenza, SARS-CoV-2, RSV) performed on nasopharyngeal swabs and adapted to epidemic situations; and "upper respiratory tract" (nasopharyngeal) or "lower respiratory tract" (deep swabs) syndromic panels to detect a broad spectrum of viral and bacterial agents, sometimes including resistance genes. These tests are not recommended for routine use in CAP patients treated in ambulatory settings. In hospitalized CAP patients, their use must be guided by severity, epidemic context, and therapeutic implications. "Upper respiratory tract" panels can be useful when an atypical agent or a virus undetected by targeted PCR tests is suspected. "Lower respiratory tract" panels must only be used in case of severe forms or complex situations. Clinical trials showed real diagnostic value but variable clinical impact, which is often limited in the absence of an optimization strategy for the antibiotic therapy. Multiplex PCR syndromic panels represent a promising step forward in the management of patients hospitalized with CAP, but their clinical value still depends on several factors: type of panel and swab, quick results, presence of mobile teams of infectious diseases specialists, and capacity to correctly interpret results to guide treatment decisions.}, }
@article {pmid40749771, year = {2025}, author = {Choi, H and Kwon, BR and Cole, AR and Brooks, BW}, title = {Global occurrence and hazards of benzodiazepines in water resources: Knowledge gaps and future directions.}, journal = {Environmental pollution (Barking, Essex : 1987)}, volume = {384}, number = {}, pages = {126921}, doi = {10.1016/j.envpol.2025.126921}, pmid = {40749771}, issn = {1873-6424}, mesh = {*Benzodiazepines/analysis ; *Water Pollutants, Chemical/analysis ; *Environmental Monitoring ; *Water Resources ; COVID-19 ; }, abstract = {Benzodiazepines (BZDs) are a group of psychoactive pharmaceuticals that are used to treat a variety of medical conditions. Due to the widespread usage of this class of medicines, BZDs have been frequently reported in aquatic systems. We performed a critical review of the refereed literature to better understand the prevalence of BZDs in aquatic matrices and associated water quality hazards. Forty-five BZDs were included in this study, of which 20 compounds have been detected in 5 different aquatic matrices ranging across 6 continents. Most of the aquatic monitoring observations for BZDs were available from Europe, with 1434 maximum measured environmental concentration data points, while 428 and 144 data points were reported from Asia and North America, respectively. Monitoring data gaps were identified in Antarctica, South America, Oceania, and Africa. We identified a temporal change in which BZDs occurrence in sewage, effluents and surface waters increased after initiation of the global COVID-19 pandemic, which appears related to increased prescription rates of these medications to treat mental health conditions. Probabilistic environmental hazard assessments were then performed for compounds with sufficient data using therapeutic hazard values (THVs) and predicted no effect concentrations (PNECs). Over 81 % exceedances of traditional morphometric and behavior PNECs were observed for temazepam and diazepam in African surface waters. Here again, increased exeedances were identified post-COVID-19. Numerous ecotoxicity data gaps were present for almost all BZDs; in fact, sufficient toxicity data to calculate both morphometric and behavioral PNECs was only available for diazepam, oxazepam, and temazepam. Our findings highlight important water quality hazards among global regions and aquatic matrices, which can inform future research efforts to understand and manage BZDs in the environment.}, }
@article {pmid40749507, year = {2026}, author = {Alape, JMR and Bandeira, CCS and Bonano, G and Nogueira, JJ and da Silva Martinho, H}, title = {Vibrational and electronic spectral analysis of Hepcidin-25 hormone: Perspectives for hyperinflammation diagnosis.}, journal = {Spectrochimica acta. Part A, Molecular and biomolecular spectroscopy}, volume = {344}, number = {Pt 2}, pages = {126717}, doi = {10.1016/j.saa.2025.126717}, pmid = {40749507}, issn = {1873-3557}, mesh = {*Hepcidins/blood/chemistry/analysis ; Humans ; *Spectrum Analysis, Raman/methods ; Spectroscopy, Fourier Transform Infrared/methods ; Molecular Dynamics Simulation ; *Inflammation/diagnosis/blood ; Vibration ; Density Functional Theory ; }, abstract = {The hormone hepcidin-25 is a molecule that regulates iron metabolism. It is present in biofluids and it is a hyperinflammation marker for critical pathological states such as anaphylaxis, acute respiratory distress syndrome, autoimmune diseases, sepsis, and COVID-19, among others. Its fast detection and quantification are of key importance in health strategies for fatality prediction. Vibrational spectroscopy techniques such as Fourier-transform infrared (FTIR) and Raman spectroscopies are potential options for point-of-care detection of this key hormone. Here, we present FTIR and Raman experimental and spectral simulation data for hepcidin-25. Vibrational calculations were computed by static Gaussian plane-wave density functional theory (DFT) and molecular dynamics (MD) simulations. The agreement between experimental and calculated by static Gaussian plane-wave DFT calculations for hepcidin-25 in the fingerprint region enabled the assignment of all experimental observed bands. We also determined the limit of detection of hepcidin-25 in FTIR and Raman which enabled us to concluded that its hormone detection in serum using FTIR or Raman is a viable option. On the other hand for its determination in saliva, a ∼1000× enhancement is needed.}, }
@article {pmid40748111, year = {2025}, author = {Frey, J}, title = {Tourette Syndrome and Tic Disorders.}, journal = {Continuum (Minneapolis, Minn.)}, volume = {31}, number = {4}, pages = {1120-1151}, doi = {10.1212/cont.0000000000001595}, pmid = {40748111}, issn = {1538-6899}, mesh = {Humans ; *Tourette Syndrome/therapy/diagnosis/physiopathology ; *Tic Disorders/therapy/diagnosis/physiopathology ; Male ; Female ; Behavior Therapy/methods ; Deep Brain Stimulation/methods ; Adult ; }, abstract = {OBJECTIVE: This article describes the clinical features of Tourette syndrome and its diagnostic criteria, etiology, and pathophysiology, as well as common myths associated with tic disorders. It discusses the behavioral, pharmacologic, neuromodulation, and alternative treatment approaches to tic disorders.<br><br>LATEST DEVELOPMENTS: With the significant increase in functional ticlike behavior, especially during the COVID-19 pandemic, diagnostic criteria for functional ticlike behavior have been delineated to separate these ticlike movements from the tics observed in Tourette syndrome. Although behavioral therapy such as comprehensive behavioral intervention for tics remains the first-line treatment for tics, modifications to comprehensive behavioral intervention for tics have been developed to make this type of treatment more accessible. Pharmacologic trials for vesicular monoamine transporter 2 inhibitors have failed to meet the primary endpoint of tic reduction; however, they may still be helpful as add-on therapy for select individuals. A first-in-class compound called ecopipam met the primary endpoint for tic reduction and was well-tolerated, and may be a promising new treatment for Tourette syndrome. Deep brain stimulation may be considered for tics refractory to more conservative approaches.<br><br>ESSENTIAL POINTS: Tourette syndrome and tic disorders can substantially affect quality of life. Educating patients about the natural history and expected course of the disease is the most important first step in management. Choosing a treatment based on comorbidities, tic severity, and patient preference is crucial for a beneficial outcome.}, }
@article {pmid40748057, year = {2025}, author = {Foley, DA and Smith, DW and Barr, I and Moore, HC and Nicol, M and Blyth, CC}, title = {Determinants of respiratory syncytial virus and human metapneumovirus transmission.}, journal = {Clinical microbiology reviews}, volume = {38}, number = {3}, pages = {e0020324}, pmid = {40748057}, issn = {1098-6618}, mesh = {Humans ; *Metapneumovirus/physiology/genetics ; *Respiratory Syncytial Virus Infections/transmission/prevention &amp; control/virology ; *Paramyxoviridae Infections/transmission/virology/prevention &amp; control ; *Respiratory Syncytial Virus, Human/physiology/genetics ; COVID-19/transmission ; SARS-CoV-2 ; Virus Shedding ; }, abstract = {SUMMARYRespiratory syncytial virus and human metapneumovirus are major causes of respiratory illness globally, particularly affecting children and older adults. Despite their clinical significance, substantial gaps persist in understanding the determinants of their transmission. This review examines the multifaceted factors shaping RSV and hMPV transmission, including viral structure and evolution, host behaviors and viral shedding dynamics, the influence of environmental conditions on viral survival, the roles of population- and community-level transmission networks, and the impact of SARS-CoV-2. Additionally, we explore prevention strategies, including immunizations and non-pharmaceutical interventions, to reduce transmission in high-risk settings.}, }
@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}, pmid = {40748012}, issn = {1473-6527}, support = {ZIA HG200417/ImNIH/Intramural NIH HHS/United States ; }, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; 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.<br><br>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.<br><br>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.}, }
@article {pmid40747829, year = {2025}, author = {Kakehbaraei, S and Arab-Zozani, M and Kakebaraei, S}, title = {Emerging trends in viral infection inhibition using a chitosan-based drug delivery system.}, journal = {Journal of drug targeting}, volume = {}, number = {}, pages = {1-16}, doi = {10.1080/1061186X.2025.2540858}, pmid = {40747829}, issn = {1029-2330}, abstract = {Viral diseases damage the host's cells and weaken the host's immunity, leading to multiple relapses or lasting a long time. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a prevalent infection that can cause immunostimulation, serious medical complications or even promote the risk of side effects and fatality, especially among older adults. Due to the replication process of the viral genome, it is significant to design and develop new pharmaceuticals to alleviate the illness and global death rates attributed to infection. Chitosan, a versatile biopolymer derived from natural sources, possesses cationic properties and has been employed to produce nanoparticles (NPs). These NPs exhibit biocompatibility, biodegradability, antimicrobial and anticancer properties, non-toxicity, ready availability, and the ability to function as drug delivery systems (DDSs). The physicochemical attributes of chitosan and its NPs in the transfer of bioactive agents are detected in nanotechnology, which can enhance anti-viral efficacy. This review highlights progressions in nanoscience for chitosan-based drug delivery in treating viral diseases. New research is expected to suggest new strategies in the field of DDS for the therapeutics of infectious diseases.}, }
@article {pmid40747640, year = {2025}, author = {DeVuono, IR and Posa, S and Lafond, NMC and Woodley, BD and Coroiu, A and Chaiton, MO and Evans, WK and Veldhuizen, S and Zawertailo, LA and Melamed, OC and Eng, L and George, MM and Halligan, MH and Silverman, CB and Stewart, A and Krames, L and Bradley, M and Hussain, S and Selby, P and Minian, N}, title = {Exploring Practices for Implementing Smoking Cessation in Oncology Settings: A Rapid Systematic Review Update.}, journal = {Cancer control : journal of the Moffitt Cancer Center}, volume = {32}, number = {}, pages = {10732748251359835}, pmid = {40747640}, issn = {1526-2359}, mesh = {Humans ; *Smoking Cessation/methods/statistics &amp; numerical data ; *Neoplasms/therapy ; *Medical Oncology/methods ; Ontario ; }, abstract = {IntroductionSmoking cessation among individuals with cancer increases the effectiveness of cancer treatments and reduces the risks of death. However, individuals receiving cancer treatments in Ontario's 14 regional cancer centres are provided advice on the benefits of quitting smoking and referrals to smoking cessation treatments at different rates. This rapid systematic review was conducted, with funding from the Canadian Cancer Society, to update a published systematic review (Young et al, 2023) and to (1) identify implementation strategies and related implementation outcomes used in oncology settings; (2) describe the characteristics of these implementation strategies and implementation outcomes; and (3) determine whether specific implementation strategies are associated with increased smoking cessation efforts, referred to as the 3As (Ask, Advise, and Act) approach to smoking cessation.MethodsThis rapid systematic review was registered in The International Prospective Register of Systematic Reviews (registration number CRD42023491391). Three databases were searched for relevant studies: MEDLINE, Embase, and Cochrane Library. The quality of included studies was assessed based on their study design and narrative synthesis was used to summarize the data extracted.Results3158 studies were found, and eighteen new studies met our inclusion criteria. All eighteen studies had a low to moderate risk of bias. The implementation strategies training and educating stakeholders, using evaluative and iterative strategies, providing interactive assistance, supporting clinicians, and developing stakeholder interrelationships were associated with increased asking, advising, and acting, although these associations do not imply causality. Only 5 studies measured implementation outcomes; however, heterogeneity in the measurement tools used prevented analysis.ConclusionAlthough abundant data on implementation strategies was found, implementation outcomes were sparse and connections between the implementation strategies and implementation outcomes could not be drawn. Future studies should pilot the implementation strategies associated with increased asking, advising, and acting, and measure their success, considering both implementation strategies and implementation outcomes, as this information is lacking in the current literature.}, }
@article {pmid40746857, year = {2025}, author = {Zhang, T and Zhang, L and Ma, X and Song, W}, title = {The tiny giants of regeneration: MSC-derived extracellular vesicles as next-generation therapeutics.}, journal = {Frontiers in cell and developmental biology}, volume = {13}, number = {}, pages = {1612589}, pmid = {40746857}, issn = {2296-634X}, abstract = {Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) are revolutionizing the field of regenerative medicine, becoming the core carriers of next-generation acellular therapeutic strategies. In contrast to traditional mesenchymal stem cell therapy, these nanoscale "regenerative tiny giants" offer significant advantages, including low immunogenicity, efficient biological barrier penetration, and stable storage. As natural bioactive molecular carriers, MSC-EVs precisely regulate the inflammatory response, angiogenesis, and tissue repair processes in target tissues by delivering functional RNA, proteins, and other signaling elements. They have demonstrated multidimensional therapeutic potential in diseases such as bone and joint regeneration, nerve function reconstruction, myocardial repair, and skin wound healing. Worldwide, 64 registered clinical trials have preliminarily validated the safety and applicability of MSC-EVs across various diseases. Notably, they have shown significant progress in treating severe coronavirus disease 2019 (COVID-19), ischemic stroke, and complex wound healing. However, the lack of standardization in production processes, insufficient targeting for in vivo delivery, and the scarcity of long-term biodistribution data remain core bottlenecks limiting the clinical translation of MSC-EVs. Future interdisciplinary technologies, including 3-dimensional (3D) dynamic culture, genetic engineering, and intelligent slow-release systems, are expected to facilitate the transition of MSC-EVs from the lab to large-scale applications. This shift may transform "injectable regenerative factors" into "programmable nanomedicines", offering new solutions for precision medicine.}, }
@article {pmid40745633, year = {2025}, author = {Sales, TLS and Pereira, DN and Gomes, VMR and de Aguiar, GG and Marcolino, MS}, title = {Efficacy of tenofovir on clinical outcomes of COVID-19 patients: a systematic review.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {965}, pmid = {40745633}, issn = {1471-2334}, mesh = {Humans ; *Tenofovir/therapeutic use ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; COVID-19/mortality ; *Antiviral Agents/therapeutic use ; SARS-CoV-2/drug effects ; Treatment Outcome ; Hospitalization/statistics &amp; numerical data ; Intensive Care Units/statistics &amp; numerical data ; }, abstract = {BACKGROUND: Pharmacological treatments for COVID-19 remain limited, particularly for severe outcomes. Tenofovir, an inhibitor of the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp), has been proposed as a therapeutic agent to reduce hospitalization, intensive care unit (ICU) admissions, and mortality.<br><br>OBJECTIVE: To assess the efficacy of tenofovir in COVID-19 patients based on randomized controlled trials (RCTs).<br><br>METHODS: A systematic review of RCTs assessing tenofovir in COVID-19 was conducted. Searches in PubMed/MEDLINE, Scopus, Cochrane Library, LILACS, SciELO, and COVID-19 LOVE databases were last updated on April 16, 2025. Risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. As a meta-analysis was not feasible, a qualitative analysis was performed. The review protocol was registered in PROSPERO (CRD42023465336).<br><br>RESULTS: Among 1241 retrieved trials, three met the inclusion criteria. These trials, conducted in 32 hospitals across Colombia, Spain and Iran included 1048 patients. In the Colombian study, the combination of tenofovir disoproxil/emtricitabine with colchicine and rosuvastatin was associated with reduced 28-day mortality (risk difference [RD] = -0.05; 95% CI: -0.07 to -0.04) and lower need for invasive mechanical ventilation (RD = -0.08; 95% CI: -0.11 to -0.04). However, randomization bias and small sample size limit the interpretation of these results. Conversely, the Spanish study was classified as having a low risk of bias, but found no significant benefit of tenofovir disoproxil/emtricitabine in reducing 28-day mortality (risk ratio [RR]&#x2009;=&#x2009;1.76; 95% CI: 0.52 to 5.91) or for the composite outcome of ICU admission, disease progression, and mortality (RR&#x2009;=&#x2009;0.95; 95% CI: 0.66 to 1.40). The Iranian study, in turn, demonstrated that tenofovir alafenamide, when combined with standard treatment, significantly reduced the need for mechanical ventilation (0.0% vs. 13.3%, p&#x2009;=&#x2009;0.038) and ICU length of stay (3.3 days vs. 14.5 days; p&#x2009;=&#x2009;0.04). However, the presence of a high risk of bias, with major concerns regarding co-interventions and statistical analyses, precludes a definitive conclusion regarding these results.<br><br>CONCLUSIONS: This review identified three clinical trials evaluating the efficacy of tenofovir in COVID-19, with conflicting results. One study suggested a potential benefit in reducing mortality and the need for invasive mechanical ventilation in mild to moderate cases but methodological limitations, including risk of bias and small sample size, weaken its conclusions. The second study found no significant impact on mortality or disease progression. In the third study, no deaths were reported, but he significant reduction in the need for mechanical ventilation and ICU length of stay is extremely limited due to the high risk of bias. Given these inconsistencies and the limitations of available evidence, tenofovir cannot be recommended for COVID-19 treatment.}, }
@article {pmid40745248, year = {2025}, author = {Self, M and Coupland, LA and Aneman, A}, title = {Utility of fibrinolysis enhanced viscoelastic assays to evaluate fibrinolysis disorders in critically ill adults with severe infection: a scoping review.}, journal = {Annals of intensive care}, volume = {15}, number = {1}, pages = {110}, pmid = {40745248}, issn = {2110-5820}, abstract = {BACKGROUND: Acutely infected critically ill patients develop coagulopathies and perturbations to the fibrinolysis system that manifest as immunothrombosis. Whole blood viscoelastic testing, using an exogenous fibrinolytic agent to enhance fibrinolysis (FE-VET) can assess both processes of coagulation and fibrinolysis at the bedside. This scoping review aimed to illustrate clinical applicability, knowledge gaps and unmet needs for this emerging technology.<br><br>METHODS: A systematic search of bibliographic databases and the grey literature was performed between the 10th October 2024 and the 14th January 2025 using a pre-published protocol and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guideline for scoping reviews (PRISMA-ScR). Studies reporting FE-VET to investigate fibrinolysis in acutely infected patients admitted to the intensive care unit were assessed, including associations with disease severity and clinical outcomes.<br><br>RESULTS: The search identified 297 studies with 24 included in this review. Fifteen studies were observational (12 prospective, 3 retrospective), 4 case reports and series, 2 validation studies, 2 letters, and 1 poster abstract. No randomised controlled trials were identified. Most studies used varying concentrations of tissue plasminogen activator (tPA) to enhance fibrinolysis, with FE-VET performed at a single time point and the lysis time to achieve 50% reduction of maximum clot firmness being the most frequently reported variable. Fibrinolysis resistance was the prevailing state reported in acute sepsis or COVID-19 infections and associated with increased disease severity and worse clinical outcomes.<br><br>CONCLUSION: Viscoelastic testing using a fibrinolysis enhancing agent demonstrated a spectrum of fibrinolysis resistance in acutely infected critically ill patients, associated with increased disease severity and mortality. Standardisation of the concentrations of fibrinolysis enhancing agents and the reporting of clot lysis parameters across testing devices are needed to establish reference values. This would improve future clinical studies of fibrinolysis, including trials of fibrinolytic therapies using a personalised medicine approach.}, }
@article {pmid40744548, year = {2025}, author = {Casia, PF and Liu, F and Richmond, MM and Adams, C}, title = {The challenges and experiences of New Graduate Registered Nurses (NGRNs) during the Covid-19 pandemic: An integrative review.}, journal = {Applied nursing research : ANR}, volume = {84}, number = {}, pages = {151977}, doi = {10.1016/j.apnr.2025.151977}, pmid = {40744548}, issn = {1532-8201}, mesh = {*COVID-19/nursing/epidemiology ; Humans ; Pandemics ; SARS-CoV-2 ; Female ; }, abstract = {AIM: This study aimed to attain a comprehensive understanding of the challenges and experiences of New Graduate Registered Nurses (NGRNs) who cared for patients with COVID-19 during the COVID-19 pandemic.<br><br>BACKGROUND: During the COVID-19 pandemic, NGRNs quickly adapted to demanding clinical roles, showing resilience, initiative, and commitment to growth. Through mentorship and teamwork, they developed stronger professional identities. These experiences, though crisis-driven, underscore the lasting value of flexible training, emotional support, and structured transitions in all healthcare settings.<br><br>METHOD: An integrative review method by Whittemore and Knafl (2005).<br><br>RESULTS: An initial pool of 836 records was identified, with 22 articles meeting the criteria for review. From these, four main themes and ten subthemes emerged: Pandemic-Specific Conditions Faced by NGRNs - educational/training conditions, working conditions, and physical/psychological conditions; Pandemic-Related Concerns Raised by NGRNs -proficiency/experience concerns and safety concerns; Pandemic-Related Positive Responses by NGRNs - proactivity, staying positive, and advocating for nurses; Pandemic-Related Growth Among NGRNs -professional and personal development and pandemic-fostered commitment and advocacy.<br><br>CONCLUSION: The experiences of NGRNs during the pandemic revealed their capacity for resilience, adaptability, and leadership under pressure. Each theme-ranging from proactive learning to advocacy and professional growth-highlights both the challenges faced, and the strengths developed. These insights extend beyond crisis response, offering practical guidance for building supportive, flexible, and future-ready systems that empower NGRNs in both pandemic and non-pandemic healthcare settings.}, }
@article {pmid40744443, year = {2025}, author = {Kamra, K and Xia, Z and Zucker, IH and Schultz, H and Wang, HJ}, title = {Chemoreflex function in pulmonary diseases - A review.}, journal = {The Journal of physiology}, volume = {603}, number = {16}, pages = {4461-4482}, pmid = {40744443}, issn = {1469-7793}, support = {R01HL126796-01//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; R01 HL152160/HL/NHLBI NIH HHS/United States ; R21 HL170127-01//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; R21 HL170127/HL/NHLBI NIH HHS/United States ; R01HL171602-01//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; R01HL152160-01//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; R01 HL126796/HL/NHLBI NIH HHS/United States ; R01HL172029-01A1//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; R01 HL172029/HL/NHLBI NIH HHS/United States ; R01 HL171602/HL/NHLBI NIH HHS/United States ; R01HL-169205-01//HHS | NIH | National Heart, Lung, and Blood Institute (NHLBI)/ ; }, mesh = {Humans ; COVID-19/physiopathology ; *Chemoreceptor Cells/physiology ; *Lung Diseases/physiopathology ; *Reflex/physiology ; Animals ; SARS-CoV-2 ; Carotid Body/physiopathology ; }, abstract = {The chemoreflex is a vital protective reflex that is crucial in restoring normal blood gas and pH levels. The carotid bodies are peripheral chemoreceptors activated by hypoxia (primarily), hypercapnia, acidaemia, temperature, lactate and potassium fluctuations. They are crucial for maintaining physiological conditions based on underlying causes and blood gas abnormalities. Central chemoreceptors in the brain stem are responsive to hypercapnia and contribute to blood gas regulation. Chemoreceptors regained attention during the SARS-CoV-2 (COVID-19) pandemic, potentially contributing to disease severity. In conditions like chronic intermittent hypoxia, chemoreflex sensitization may lead to respiratory disorders, impacting quality of life. There has been substantial research/evidence linking chemoreflex dysfunction to cardiovascular illnesses such as heart failure and hypertension. However, little emphasis has been placed on the role of the chemoreflex in mediating cardiopulmonary dysfunction during and after pulmonary disorders such as acute lung injury. The current review summarizes recent advances in the study of chemoreflex malfunction and the underlying mechanisms in acute and chronic lung diseases such as COVID-19 infection, chronic obstructive pulmonary disease, asthma, obstructive sleep apnoea and acute lung injury.}, }
@article {pmid40744021, year = {2025}, author = {Komaroff, AL and Dantzer, R}, title = {Causes of symptoms and symptom persistence in long COVID and myalgic encephalomyelitis/chronic fatigue syndrome.}, journal = {Cell reports. Medicine}, volume = {6}, number = {8}, pages = {102259}, pmid = {40744021}, issn = {2666-3791}, support = {P30 CA016672/CA/NCI NIH HHS/United States ; R21 NS130712/NS/NINDS NIH HHS/United States ; R01 CA193522/CA/NCI NIH HHS/United States ; U54 AI138370/AI/NIAID NIH HHS/United States ; R01 NS073939/NS/NINDS NIH HHS/United States ; }, mesh = {Humans ; *Fatigue Syndrome, Chronic/pathology/etiology/physiopathology ; *COVID-19/complications/pathology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Gastrointestinal Microbiome ; }, abstract = {Debilitating symptoms for many years can follow acute COVID-19 ("long COVID"), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and various post-acute infection syndromes (PAISs). Together, long COVID and ME/CFS affect 60-400 million individuals, globally. Many similar underlying biological abnormalities have been identified in both conditions including autoantibodies against neural targets, endothelial dysfunction, acquired mitochondrial dysfunction, and a pro-inflammatory gut microbiome. Each of these abnormalities may directly cause some of the symptoms. In addition, the symptoms also may be caused by ancient, evolutionarily conserved symptomatic and metabolic responses to vital threats-sickness behavior and torpor-responses mediated by specific, recently discovered neural circuits. These neural circuits constitute a symptom-generating pathway, activated by neuroinflammation, which may be targeted by therapeutics to quell neuroinflammation. Many factors cause the symptoms to become chronic, including persistent infectious agents (and/or their nucleic acids and antigens) and the fact that many of the underlying biological abnormalities reinforce each other, creating ongoing physiological vicious cycles.}, }
@article {pmid40742669, year = {2025}, author = {Van Holle, L}, title = {Observed Versus Expected Analysis-How Does It Fit in the Pharmacovigilance Toolkit?.}, journal = {Drug safety}, volume = {48}, number = {12}, pages = {1325-1330}, pmid = {40742669}, issn = {1179-1942}, mesh = {*Pharmacovigilance ; Humans ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/adverse effects/administration &amp; dosage ; Algorithms ; *Adverse Drug Reaction Reporting Systems ; *Mass Vaccination/adverse effects ; SARS-CoV-2 ; }, abstract = {Observed versus expected (O/E) analyses have been used in an unprecedented scale for the safety monitoring of the COVID-19 mass vaccination. The extent of their usage changed its nature, which consisted of a mixture of medical expertise and epidemiology, into something more algorithmic and automated. By doing so, the observed versus expected analysis became closer to disproportionality analysis (DPA), which is also a type of observed versus expected analysis that differs in the way the expected is calculated. A qualitative assessment of the strengths and limitations of both methods concludes that the algorithmic O/E is more likely to underestimate under-reporting, is more likely to be sensitive to asymmetrical differences in the definition of the condition of interest, and is more dependent on a greater variety of data sources or medical knowledge that might not be accurate for emerging safety issues (exposure, background incidence rate, and risk window). Provided some adjustment (stratification and/or subgrouping) of the routine disproportionality into a targeted disproportionality occurs, which would account for the epidemiological specifics of the vaccine and event-of-interest, the targeted DPA has the potential to be promoted from a signal detection method into a signal evaluation method that could advantageously replace the algorithmic O/E analysis. Research on the setup of a sensitivity analysis framework integrating several standardized choices of disproportionality settings, along with measures (qualitative or quantitative) of the biases for each choice, could be more beneficial for the pharmacovigilance field than studies designed to estimate the background incidence rates of adverse events of special interest for the sole purpose of being used in O/E analyses.}, }
@article {pmid40742623, year = {2025}, author = {Joshi, A and Gawey, L and Rahman, M and Ghanshani, R and Tran, KA and Friedman, A and Hsiao, JL and Shi, VY}, title = {Factors Influencing Treatment Adherence in Chronic Spontaneous Urticaria: A Systematic Review.}, journal = {Clinical reviews in allergy &amp; immunology}, volume = {68}, number = {1}, pages = {74}, doi = {10.1007/s12016-025-09092-9}, pmid = {40742623}, issn = {1559-0267}, mesh = {Humans ; *Chronic Urticaria/drug therapy/epidemiology ; *Medication Adherence ; Omalizumab/therapeutic use ; Quality of Life ; }, abstract = {Chronic spontaneous urticaria (CSU) is characterized by recurrent wheals and/or angioedema without an identifiable trigger. Despite advances in therapy-including biologics such as omalizumab-suboptimal treatment adherence remains a major challenge, often resulting in poor symptom control and diminished quality of life. The objective of this study is to evaluate the existing literature on adherence in CSU and identify evidence-based strategies for improving long-term treatment engagement. A systematic literature search of PubMed and EMBASE was performed for articles published between 2000 and 2024 using the terms "chronic spontaneous urticaria," "chronic urticaria," "chronic idiopathic urticaria," "compliance," and "adherence." Eligible studies reported original data on adherence-related factors in CSU. Each study was categorized to World Health Organization (WHO) adherence dimensions: social/economic, healthcare system, condition-related, therapy-related, and patient-related. Risk of bias assessment was conducted for each study included in the final selection. The search followed PRISMA guidelines, and the protocol was registered with PROSPERO (ID: CRD42024627967). Twenty-one studies (totaling 18,500 patients) met inclusion criteria. Common barriers included lack of preventative medication use, inconvenience, forgetfulness, dissatisfaction with healthcare providers, and logistical challenges in accessing in-office biologic administration. Patients previously treated with immunosuppressants had a poorer response to omalizumab, which may contribute to nonadherence due to perceived lack of efficacy. External factors such as the COVID-19 pandemic also contributed to nonadherence by reducing clinic visits and access to specialist referrals. Higher education level and employment were significantly associated with improved adherence. Proposed strategies include simplifying treatment regimens, enhancing patient education about CSU chronicity, providing telehealth or home medication administration options, and offering financial or social support programs. Multiple interrelated barriers contribute to treatment nonadherence in patients with CSU, underscoring the need for multifaceted, patient-centered interventions. Clear communication, simplified regimens, and supportive resources may enhance adherence and help achieve improved long-term clinical outcomes.}, }
@article {pmid40742497, year = {2025}, author = {Ul Haq, MZ and Ashraf, S and Shah, MSU and Sulaiman, SA and Shaukat, A and Ansari, MA and Basaria, AAA and Fatima, L and Saeed, H and Goyal, A and Daoud, M}, title = {Efficacy and safety of Ensitrelvir in asymptomatic or mild to moderate COVID-19: a systematic review and meta-analysis of randomized controlled trials.}, journal = {Infection}, volume = {53}, number = {5}, pages = {1645-1661}, pmid = {40742497}, issn = {1439-0973}, mesh = {Humans ; Randomized Controlled Trials as Topic ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/adverse effects ; SARS-CoV-2/drug effects ; COVID-19/virology ; Treatment Outcome ; Indazoles ; Triazines ; Triazoles ; }, abstract = {INTRODUCTION: Since late 2019, COVID-19 has had a catastrophic impact on public health. Ensitrelvir, a new antiviral targeting the SARS-CoV-2 main protease, has reduced viral replication and disease severity. This meta-analysis and systematic review assessed Ensitrelvir's efficacy and safety in patients with mild-to-moderate COVID-19 symptoms.<br><br>METHODS: A comprehensive search was conducted in PubMed (Medline), Scopus, Embase, and CENTRAL up to July 2024 to retrieve randomized controlled trials (RCTs) comparing Ensitrelvir to placebo in adults with mild to moderate, RT-PCR-confirmed COVID-19. Outcomes were assessed at standardized time points, with viral RNA measured at day 4. Mean differences (MD) for continuous outcomes and risk ratios (RR) for binary outcomes, both with 95% confidence intervals (CIs), were calculated using the Mantel-Haenszel random-effects model. Efficacy outcomes included SARS-CoV-2 viral RNA, while safety outcomes included HDL, triglycerides, bilirubin, AST, headache, diarrhea, TEAEs, TRAEs, serious TEAEs, and treatment discontinuation. The quality of the included RCTs was assessed with the Cochrane Risk of Bias 2 (ROB2) tool.<br><br>RESULTS: The analysis included six RCTs with 2,793 participants: 1,860 received Ensitrelvir and 933 were given a placebo. Ensitrelvir gave significant results for reduced viral RNA levels of SARS-CoV-2 [MD: -&#x2009;1.35; 95% CI -&#x2009;1.58 to -&#x2009;1.13; p&#x2009;<&#x2009;0.01] and the incidence of lower cholesterol levels [RR: 8.83; 95% CI 4.05 to 19.27; p&#x2009;<&#x2009;0.01] compared to the placebo group. However, it was associated with increased risks of decreased HDL levels, elevated triglycerides, increased bilirubin, more headaches, and a higher overall occurrence of treatment-emergent adverse events.<br><br>CONCLUSION: Ensitrelvir effectively reduces viral load in COVID-19 patients, but its safety profile raises concerns due to significant adverse effects. The benefits must be carefully weighed against the risks, and further research is needed to confirm its role in treatment and to find ways to mitigate these adverse effects.}, }
@article {pmid40742145, year = {2025}, author = {Li, J and Cheng, G and Qin, X and Liu, J}, title = {Streptococcus pneumoniae β-lactam resistance: epidemiological trends, molecular drivers, and innovative control strategies in the post-pandemic era.}, journal = {Clinical microbiology reviews}, volume = {38}, number = {3}, pages = {e0008225}, pmid = {40742145}, issn = {1098-6618}, mesh = {Humans ; *Streptococcus pneumoniae/drug effects/genetics ; *Pneumococcal Infections/epidemiology/microbiology/drug therapy/prevention &amp; control ; *Anti-Bacterial Agents/pharmacology/therapeutic use ; *beta-Lactam Resistance/genetics ; COVID-19/epidemiology ; beta-Lactams/pharmacology ; Pandemics ; }, abstract = {SUMMARYStreptococcus pneumoniae (S. pneumoniae) is a major human pathogen that can cause severe diseases such as meningitis and bacteremia. β-lactam antibiotics are the most essential antimicrobial agents for treating S. pneumoniae infections, but the resistance has become a significant challenge in clinical therapy. Analyses reveal notable regional disparities in the prevalence of β-lactam resistance in S. pneumoniae. The use of pneumococcal conjugate vaccines effectively reduces the spread of highly resistant clones, indirectly improving resistance patterns. Interestingly, resistance is inversely correlated with bacterial invasiveness, suggesting mutual selective pressures. Additionally, the COVID-19 pandemic may have influenced the evolution of S. pneumoniae resistance by altering host immune states and healthcare resource allocation. Immunocompromised patients face a higher risk of invasive pneumococcal disease, driving increased antimicrobial use that fuels the rise of resistance. Beyond the single-molecular mechanism, the resistance gene acquisition order plays a critical role in the successful resistance evolution. Analyzing the dynamic principles and key nodes involved in the evolution of drug resistance could offer novel insights for developing precise antibacterial treatment strategies. Current research efforts focus on the development of novel antibiotics, antimicrobial peptides, lysins, and other innovative therapeutic agents. Artificial intelligence shows immense potential in the screening of antimicrobial drugs and the prediction of resistance mechanisms. This review synthesizes recent advances in the epidemiology, molecular mechanisms, and management of β-lactam resistance in S. pneumoniae, with the aim of informing evidence-based antimicrobial stewardship and accelerating the development of innovative therapeutics to combat this evolving public health threat.}, }
@article {pmid40740941, year = {2025}, author = {Wang, Q and Tan, S and Fu, X and He, J and Ma, Q and You, F and You, L and Ren, Y}, title = {Advancing lung organoids toward clinical applications: a global perspective on research focus and future directions.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1611304}, pmid = {40740941}, issn = {2296-858X}, abstract = {BACKGROUND: Lung organoids have emerged as a promising tool for studying lung development, function, and disease pathology. The present study aimed to analyze the current status and development trends of lung organoid research over the past years, present visual representations, and provide references for future research directions using bibliometric analysis.<br><br>METHODS: Information on articles on lung organoids extracted from the Web of Science Core Collection, such as year of publication, journal, country, institution, author, and keywords, was analyzed. R, VOSviewer, and SCImago Graphica were used to visualize publication trends, co-authorship analysis, co-occurrence analysis, and hotspot evolution.<br><br>RESULTS: The number of global publications has increased from 1 in 2011 to 929 in 2024. The Nature produced the highest number of citations (2,675 citations). The United States (8,155 citations and 281 publications), University Medical Center Utrecht (2083 citations and 11 publications), and Clevers H (2,711 citations and 21 publications) were the most influential countries, institutions, and authors, respectively. Co-occurrence cluster analysis of the top 54 keywords formed four clusters: (1) idiopathic pulmonary fibrosis, (2) lung cancer, (3) cystic fibrosis, (4) COVID-19.<br><br>CONCLUSION: Overall, research on lung organoids continues to increase. The United States of America and the Netherlands dominated global studies. The analysis of pulmonary fibrosis, lung cancer and COVID-19 occupied a prominent position of research in this area. The research hotspots for lung organoids are disease model and microphysiological systems. Standardization, accurate disease modeling, and ethics and safety remain pressing challenges that need to be addressed in this field.}, }
@article {pmid40740387, year = {2025}, author = {Øvretveit, J}, title = {Applying implementation science to infectious disease emergency preparedness and response.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1622618}, pmid = {40740387}, issn = {2296-2565}, mesh = {Humans ; *Implementation Science ; COVID-19 ; *Disaster Planning/organization &amp; administration ; *Disease Outbreaks/prevention &amp; control ; *Civil Defense/organization &amp; administration ; }, abstract = {Some infectious disease outbreaks present an emergency and a potential disaster scenario. Examples include a new virus similar to or more infectious and deadly than COVID-19 or Ebola, such as the 2025 MERS-like virus. Although good practices for general emergency preparedness and management can be used to plan, there are different and less-known preparations and responses needed for some infectious disease outbreaks and continuing and evolving crises. The objectives of this article are to provide guidance about how to plan and respond to these types of emergencies more effectively by using implementation science knowledge as well as lessons from COVID-19 and other infectious disease emergencies. This narrative review gives guidance for healthcare service delivery leaders at different levels of a healthcare system and easy to understand and use resources for leaders to improve their infectious disease emergency preparedness and operational actions in a disaster scenario. The implementation science guidance covers: interventions, adaptation to context, iteration, coordination for alignment, facilitation, and how to use behavior and organization change models and theories. It also provides researchers with an overview of issues and frameworks to help focus their research designs and data collection to study intervention implementation processes and outcomes for infectious disease outbreaks.}, }
@article {pmid40738542, year = {2025}, author = {Adhikary, K and Paul, A and Madan, A and Islam, A and Ashique, S and Ramzan, M}, title = {Personalized precision: Revolutionizing cancer treatment with mRNA-based vaccines in melanoma therapy.}, journal = {Advances in immunology}, volume = {166}, number = {}, pages = {137-167}, doi = {10.1016/bs.ai.2024.10.011}, pmid = {40738542}, issn = {1557-8445}, mesh = {Humans ; *Melanoma/therapy/immunology ; *Cancer Vaccines/immunology/therapeutic use/genetics ; *Precision Medicine/methods ; *RNA, Messenger/immunology/genetics ; Antigens, Neoplasm/immunology/genetics ; Immunotherapy/methods ; COVID-19/prevention &amp; control/immunology ; mRNA Vaccines/immunology ; SARS-CoV-2/immunology ; Vaccines, Synthetic/immunology ; Animals ; Antibodies, Monoclonal, Humanized ; }, abstract = {Biological and societal issues are involved when we refer to a condition as cancer, which connotes loss, complexity, and uncertainty. In recent decades, the number of melanomas has climbed. Cancer treatment vaccines have induced immune responses against tumor-associated but not tumor-specific antigens. Cancer therapy may use mRNA vaccines after COVID-19 pandemic regulation advancements. Therapy mRNA cancer vaccines as advanced immunotherapies gain prominence. Using messenger RNA, the mRNA-4157/V940 cancer vaccine encodes 34 patient-specific tumor euroantigens. mRNA-4157/V940, like the COVID-19 vaccination, instructs the immune system to distinguish healthy and malignant cells using messenger RNA. T cell responses are tailored to a patient's tumor mutational pattern using this unique immunization. The drug suppresses PD-1, PD-L1, and PD-L2. T lymphocytes activated by pembrolizumab may affect cancer and non-cancerous cells. Early clinical trials suggest pembrolizumab and mRNA-4157/V940 may boost T cell-mediated cancer killing. Knowing the status and problems of melanoma therapeutic mRNA cancer vaccines in clinical trials is critical. In this chapter, we have focused on preclinical and clinical advances that have revealed mRNA melanoma vaccine manufacturing issues and solutions.}, }
@article {pmid40736895, year = {2025}, author = {Sung, WJ and Baaijens, JA}, title = {Algorithms for Short-Read Viral Haplotype Reconstruction: Challenges, Solutions, and Perspectives.}, journal = {Methods in molecular biology (Clifton, N.J.)}, volume = {2955}, number = {}, pages = {89-109}, doi = {10.1007/978-1-0716-4702-8_6}, pmid = {40736895}, issn = {1940-6029}, mesh = {Humans ; *Algorithms ; Computational Biology/methods ; COVID-19/virology ; Genetic Variation ; *Genome, Viral ; *Haplotypes ; High-Throughput Nucleotide Sequencing/methods ; Mutation ; SARS-CoV-2/genetics ; }, abstract = {RNA viruses, such as HIV, HCV, and SARS-CoV-2, show high levels of intrahost genetic diversity. Many different haplotypes can be present in a single infection, which can be studied using next-generation sequencing. However, full-length haplotype reconstruction from short reads is computationally challenging due to the presence of low-frequency mutants, as well as sequencing errors. Moreover, reads may not be long enough to span regions between neighboring mutations. Finally, the sequencing depths needed to discover such low-frequency mutants result in large datasets, which require highly efficient algorithms. In this review, we provide an overview of current strategies to address these challenges and identify potential directions for increasing the accuracy and efficiency of viral haplotype reconstruction. Such developments will be key to advancing our understanding of viral evolution, improving treatment strategies, and informing public health interventions.}, }
@article {pmid40736492, year = {2025}, author = {Grad, R and Ebell, MH}, title = {Top 20 Research Studies of 2024 for Primary Care Physicians.}, journal = {American family physician}, volume = {112}, number = {1}, pages = {34-41}, pmid = {40736492}, issn = {1532-0650}, mesh = {Humans ; Anti-Bacterial Agents/therapeutic use ; *Physicians, Primary Care ; COVID-19 ; *Primary Health Care ; SARS-CoV-2 ; }, abstract = {This article summarizes the top 20 research studies of 2024 identified as POEMs (patient-oriented evidence that matters). Based on a network meta-analysis, the oral antibiotics most likely to be effective for community-acquired pneumonia are telithromycin (not available in the United States), azithromycin, amoxicillin-clavulanate, and the quinolones levofloxacin and nemonoxacin (not available in the United States). The oral antivirals molnupiravir and nirmatrelvir-ritonavir reduce hospitalizations in immunocompromised patients with COVID-19. In average-risk infants, a single dose of nirsevimab reduces hospitalizations due to respiratory syncytial virus. Amoxicillin with or without clavulanate is more effective than placebo for children with symptoms of acute sinusitis. Benzyl benzoate 25% is highly effective for scabies in adolescents and adults. Lactobacillus-containing probiotics reduce the incidence of recurrent urinary tract infections (UTIs) in premenopausal women with frequent UTIs. Low-dose amitriptyline is effective as second-line therapy for irritable bowel syndrome. For patients with uncomplicated gallstones, conservative management is a reasonable option. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists are better than older drugs at improving patient-oriented outcomes for type 2 diabetes. Continuous or intermittent glucose monitoring is minimally effective for control of type 2 diabetes and can be harmful. Phentermine-topiramate and GLP-1 receptor agonists are the most effective drugs for promoting weight loss. Semaglutide is effective for secondary prevention of cardiovascular disease in people with obesity and no diabetes. SGLT-2 inhibitors and GLP-1 receptor agonists decrease cardiovascular death in older adults with type 2 diabetes and heart failure. Beta blockers do not prevent subsequent events after myocardial infarction in patients with preserved ejection fraction. For patients who do not quit smoking after a trial of varenicline or combined nicotine replacement therapy, a higher dose of either drug can increase quit rates. e-Cigarettes increase abstinence from smoking, but long-term vaping is a consequence for some. Oral naltrexone and acamprosate are safe and effective treatments for alcohol use disorder. Cognitive behavior therapy can reduce fatigue attributed to long COVID. New monoclonal antibodies for Alzheimer disease are harmful, expensive, and minimally effective. Clinicians may choose to deliver bad news in person or by telephone, using their judgment or patient preference to decide which is best for the patient.}, }
@article {pmid40736451, year = {2025}, author = {Yfantopoulos, J and Chantzaras, A}, title = {The economics of prevention and quality of care: policy insights from the EU's COVID-19 response.}, journal = {Expert review of pharmacoeconomics &amp; outcomes research}, volume = {25}, number = {8}, pages = {1129-1142}, doi = {10.1080/14737167.2025.2542294}, pmid = {40736451}, issn = {1744-8379}, mesh = {Humans ; *COVID-19/prevention &amp; control/economics/epidemiology ; *Health Policy/economics ; European Union ; *Quality of Health Care/economics ; Cost-Benefit Analysis ; *Delivery of Health Care/economics/organization &amp; administration ; Health Expenditures ; }, abstract = {INTRODUCTION: Prevention and quality of care are increasingly recognized as fundamental drivers of sustainable, high-performing health systems. Both have demonstrated cost-effectiveness and long-term benefits, yet remain underfunded and fragmented across many European Union Member States. The COVID-19 pandemic offered a natural stress test, revealing significant variation in investment patterns, system responsiveness, and outcome efficiency.<br><br>AREAS COVERED: This article integrates economic theory, empirical evidence, and policy analysis to explore how prevention and quality jointly shape system value. It includes analyses of prevention expenditure trends, elasticity to GDP and health spending, and cross-country efficiency indicators across EU Member States (2019-2022). The findings draw from Eurostat data and a targeted review of economic literature on cost-effectiveness and value-based care.<br><br>EXPERT OPINION: Empirical results confirm that prevention is income- and budget-elastic, but efficiency and impact depend on institutional capacity and governance. The underuse of economic tools in quality planning and prevention prioritization hampers performance. Embedding efficiency metrics, dynamic modeling, and performance-based allocation into policy frameworks is essential to enhance value and resilience. In the coming years, prevention and quality should be better embedded in fiscal planning and system performance, not just as public health imperatives - but as economic necessities.}, }
@article {pmid40735200, year = {2025}, author = {Jiang, Z and Zhou, Q and Shu, H and Jiang, L}, title = {Impact of COVID-19 on physical activity patterns in non-professional populations in Asia: a mini review of pre-, during, and post-pandemic periods.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1604185}, pmid = {40735200}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology ; *Exercise ; Asia/epidemiology ; SARS-CoV-2 ; Pandemics ; }, abstract = {This mini-narrative review examines the impact of the COVID-19 pandemic on physical activity (PA) patterns across Asian countries, including regions such as Hong Kong, South Korea, Japan, and Southeast Asia. Pre-pandemic (before 2019), Asia experienced gradually increasing PA participation rates, characterized predominantly by outdoor activities, gym workouts, and organized group exercises, driven by growing fitness awareness and the availability of facilities for exercise. During the pandemic (2020-2022), widespread declines in regular exercise occurred due to restrictions, causing a substantial shift toward indoor, home-based, and online-based PA. Low PA adversely affects cardiovascular health, immune function, obesity, metabolic conditions, and psychological well-being. Although home-based exercise modalities partially mitigated these impacts, their effectiveness remained limited compared to pre-pandemic routines. In the post-pandemic period (2022-2025), PA in Asia partially recovered, with some regions, such as Hong Kong and South Korea, reporting PA levels surpassing pre-pandemic baselines due to widespread adoption of hybrid exercise models. This recovery has fostered lasting changes toward hybrid exercise models, combining traditional and digital modalities, resulting in positive health outcomes across the cardiovascular, immune, metabolic, and psychological domains. Future public health strategies should emphasize flexible, diverse, and accessible exercise options, and further research should explore the sustainability and implications of these evolving exercise behaviors.}, }
@article {pmid40735053, year = {2025}, author = {SeyedAlinaghi, S and Afzalian, A and Mojdeganlou, H and Varshochi, S and Paranjkhoo, P and Shahbazi, P and Hajizadeh, M and Lotfi, S and Hajei, A and Nasiri, K and Afsahi, AM and Afroughi, F and Heidaresfahani, L and Karimi, A and Farizani Gohari, NS and Mehraeen, E and Hackett, D}, title = {COVID-19 and its association with meteorological, climate, and environmental factors: A systematic review.}, journal = {Journal of public health research}, volume = {14}, number = {3}, pages = {22799036251358298}, pmid = {40735053}, issn = {2279-9028}, abstract = {COVID-19 transmission can be influenced by various factors, including weather and climate conditions, population density, and the availability of medical facilities. To gain a deeper understanding of this topic, an in-depth analysis of recent studies is needed. Our objective was to investigate previous systematic reviews that have examined the seasonal variation of COVID-19 and the impact of climate on its transmission and mortality. Online databases that included PubMed, Scopus, Web of Science, and Cochrane were searched using relevant keywords up to November 2021. Negative associations were found between temperature and COVID-19 spread and mortality (6/9 studies, 66.6%). These negative correlations imply a decrease in the spread and mortality of COVID-19 with an increase in temperature. Similarly, seven systematic reviews reported a negative correlation between humidity and transmission or mortality of COVID-19 (7/9 studies, 77.7%). COVID-19 spread was not associated with precipitation (three studies) but was negatively correlated with sunlight or UV radiation (two studies), COVID-19 incidence and mortality were positively associated with wind speed (one study). One study reported that the effect of air pressure and UV radiation on COVID-19 activity was unknown. The effects of air pollution, seasonal changes, wind speed, precipitation, and UV radiation on COVID-19 incidence or mortality remain unclear. However, factors proposed as having the greatest influence on COVID-19 incidence or mortality include air pollution, wind speed, and wastewater. Sunlight exposure and warm climates likely assist with reducing COVID-19 incidence or mortality, with the infection having a winter seasonality.}, }
@article {pmid40735024, year = {2025}, author = {Haile, SR and Kronthaler, D}, title = {Potential for Bias in Prevalence Estimates when Not Accounting for Test Sensitivity and Specificity: A Systematic Review of COVID-19 Seroprevalence Studies.}, journal = {International journal of public health}, volume = {70}, number = {}, pages = {1608343}, pmid = {40735024}, issn = {1661-8564}, mesh = {Humans ; *COVID-19/epidemiology/diagnosis ; Seroepidemiologic Studies ; Sensitivity and Specificity ; Bias ; Prevalence ; SARS-CoV-2 ; }, abstract = {OBJECTIVES: The COVID-19 pandemic has led to many studies of seroprevalence. A number of methods exist in the statistical literature to correctly estimate disease prevalence or seroprevalence in the presence of diagnostic test misclassification, but these methods seem to be not routinely used in the public health literature. We aimed to examine how widespread the problem is in recent publications, and to quantify the magnitude of bias introduced when correct methods are not used.<br><br>METHODS: A systematic review was performed to estimate how often public health researchers accounted for diagnostic test performance in estimates of seroprevalence.<br><br>RESULTS: Of the seroprevalence studies sampled, 77% (95% CI 72%-82%) failed to account for sensitivity and specificity. In high impact journals, 72% did not correct for test characteristics, and 34% did not report sensitivity or specificity. The most common type of correction was the Rogen-Gladen formula (57%, 45%-69%), followed by Bayesian approaches (32%, 21%-44%). Rates of correction increased slightly over time, but type of correction did not change.<br><br>CONCLUSION: Researchers conducting studies of prevalence should report sensitivity and specificity of the diagnostic test and correctly account for these characteristics.}, }
@article {pmid40734681, year = {2025}, author = {Duff, E and Pijl, E and Fehr, C and Gudi, SK}, title = {The Impact of Post-COVID-19 Condition on Frontline Healthcare Workers: A Scoping Review.}, journal = {The Canadian journal of infectious diseases &amp; medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2025}, number = {}, pages = {1790795}, pmid = {40734681}, issn = {1712-9532}, abstract = {The main goal of this integrative scoping review was to address the knowledge gap and inform policy and research regarding the impact of post-COVID-19 conditions on frontline healthcare workers (HCWs). An integrative scoping review using Arksey and O'Malley's framework examined post-COVID-19 conditions in frontline HCWs. We searched CINAHL, EMBASE, APA PsycINFO, PubMed, Social Science Database, ProQuest, Social Science Journals, and Web of Science, including dissertations, conference proceedings, and government publications for gray literature. A preestablished data extraction tool was developed to capture relevant information about post-COVID-19 conditions in HCWs. Of the total 42 studies, the majority were cross-sectional in design (29) and conducted mainly in countries such as Italy (4), India (3), and Brazil (3). Study findings reveal that a substantial proportion of HCWs in various countries were diagnosed with post-COVID-19 condition, which included persistent symptoms affecting physical and mental well-being. Persistent symptoms, particularly fatigue and anxiety, were associated with a poorer quality of life, decreased work ability, and impaired health-related quality of life among HCWs. Fatigue was a frequently reported symptom in many studies, often accompanied by weakness, muscle pain, shortness of breath, anxiety, depression, and sleep disturbances. The evidence generated through this research examining post-COVID-19 conditions among HCWs is a foundation for informing policy in the healthcare workforce. These findings also address the gap in research on the broader impacts of the COVID-19 pandemic on employers and the healthcare workforce.}, }
@article {pmid40734171, year = {2025}, author = {Passmore, H and Craft, S and Krieger, R and Tang, S and Sacerdote, S and Lumbis, E and Blaufarb, S and Doran, KM}, title = {Innovations at the intersection of homelessness and substance use during the COVID-19 pandemic: a scoping review.}, journal = {Harm reduction journal}, volume = {22}, number = {1}, pages = {132}, pmid = {40734171}, issn = {1477-7517}, mesh = {Humans ; *Ill-Housed Persons ; *COVID-19/epidemiology ; *Substance-Related Disorders/therapy/epidemiology ; *Harm Reduction ; Telemedicine ; SARS-CoV-2 ; Pandemics ; }, abstract = {BACKGROUND: The COVID-19 pandemic led to disruptions in substance use and harm reduction services for people experiencing homelessness (PEH) as well as opportunities to innovate. Pandemic-era innovations may offer insights on more effective approaches to the intertwined issues of homelessness and substance use beyond the pandemic. We present findings from a scoping literature review of articles describing interventions related to substance use and homelessness that emerged during the pandemic.<br><br>METHODS: We conducted a scoping literature review to identify articles on pandemic-era innovations related to substance use and homelessness. We completed a comprehensive search for articles in nine academic and grey literature databases in November 2022, and a second database search in September 2023. We screened titles, abstracts, and full text using predefined inclusion and exclusion criteria. We extracted data on study design, location, participants, and outcomes.<br><br>RESULTS: Database searches yielded 812 unique articles; 68 met inclusion criteria. Most articles discussed interventions addressing opioid use (n&#x2009;=&#x2009;60). Commonly described interventions included telemedicine-based prescribing of medications for opioid use disorder (MOUD), homeless services site-based MOUD provision, managed alcohol programs, supervised consumption services, and safer supply prescribing. Articles reported few intervention-related adverse effects, though study designs (e.g., non-experimental, observational studies lacking comparison groups) presented limitations to effectiveness outcome assessment. Surmountable challenges associated with interventions included inequitable access to technology for PEH.<br><br>CONCLUSIONS: Innovations in programs that provide substance use treatment and harm reduction services to PEH were observed during the COVID-19 pandemic. Further evidence is needed to determine which COVID-19 pandemic-related innovations were most impactful and how they should be prioritized and continued post-pandemic.}, }
@article {pmid40733750, year = {2025}, author = {Hernandez-Ruiz, YG and Lopatynsky-Reyes, EZ and Ulloa-Gutierrez, R and Avila-Agüero, ML and Rodriguez-Morales, AJ and Basa, JE and Nikiema, FW and Chacon-Cruz, E}, title = {100-Day Mission for Future Pandemic Vaccines, Viewed Through the Lens of Low- and Middle-Income Countries (LMICs).}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733750}, issn = {2076-393X}, abstract = {The 100-Day Mission, coordinated by the Coalition for Epidemic Preparedness Innovations (CEPI) and endorsed by significant international stakeholders, aims to shorten the timeframe for developing and implementing vaccines to 100 days after the report of a new pathogen. This ambitious goal is outlined as an essential first step in improving pandemic preparedness worldwide. This review highlights the mission's implementation potential and challenges by examining it through the lens of low- and middle-income countries (LMICs), which often face barriers to equitable vaccine access. This article explores the scientific, economic, political, and social aspects that could influence the mission's success, relying on lessons learned from previous pandemics, such as the Spanish flu, H1N1, and COVID-19. We also examined important cornerstones like prototype vaccine libraries, accelerated clinical trial preparedness, early biomarkers identification, scalable manufacturing capabilities, and rapid pathogen characterization. The review also explores the World Health Organization (WHO) Pandemic Agreement and the significance of Phase 4 surveillance in ensuring vaccine safety. We additionally evaluate societal issues that disproportionately impact LMICs, like vaccine reluctance, health literacy gaps, and digital access limitations. Without intentional attempts to incorporate under-resourced regions into global preparedness frameworks, we argue that the 100-Day Mission carries the risk of exacerbating already-existing disparities. Ultimately, our analysis emphasizes that success will not only rely on a scientific innovation but also on sustained international collaboration, transparent governance, and equitable funding that prioritizes inclusion from the beginning.}, }
@article {pmid40733738, year = {2025}, author = {Gulova, SM and Veselkina, US and Astrakhantseva, IV}, title = {Adaptation of the Vaccine Prophylaxis Strategy to Variants of the SARS-CoV-2 Virus.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733738}, issn = {2076-393X}, support = {24-25-20139//Russian Science Foundation/ ; }, abstract = {The emergence of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus closely related to SARS-CoV and officially known as Betacoronavirus pandemicum precipitated a substantial surge in vaccine development that culminated during the global COVID-19 pandemic. At present, there are dozens of vaccines for the prevention of SARS-CoV-2 being utilized across the globe. However, only 10 of these vaccines have been authorized by the World Health Organization (WHO). These include mRNA-based, viral vector, subunit and whole-virion inactivated vaccines. At the current end of the pandemic, there has been a decline in the global vaccination rate, both for the general population and for those most at risk of severe illness from the virus. This suggests that the effectiveness of the vaccines may be waning. The decline occurs alongside a decrease in testing and sequencing for SARS-CoV-2. Furthermore, the process of tracking viruses becomes increasingly complex, thereby providing a selective advantage for SARS-CoV-2 and allowing it to evolve stealthily. In this review, we provide a comprehensive overview of viral evolution and vaccine development. We also discuss ways to overcome viral variability and test universal vaccines for all SARS-CoV-2 variants.}, }
@article {pmid40733725, year = {2025}, author = {Wang, C and Peng, L and Huang, X and Tsang, TK}, title = {Impact of Vaccination and Public Health Measures on the Severity of SARS-CoV-2 Omicron Infections in China: A Systematic Review and Meta-Regression Analysis.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733725}, issn = {2076-393X}, support = {Project No. T11-705/21-N//Research Grants Council of the Hong Kong SAR Government/ ; }, abstract = {Background: Starting in early 2022, SARS-CoV-2 Omicron has driven large outbreaks in China, a predominantly infection-naive population with high inactivated vaccine coverage. This unique context provided a substantially less-confounded opportunity to evaluate how vaccination, public health, and social measures influenced severity. Methods: We systematically reviewed 86 studies (224 severity estimates) published from 2022 to 2024, reporting symptom and clinical severity outcomes (fever, cough, and sore throat; symptomatic, severe/critical, and fatal illness) of Omicron infections in China. Using meta-regression, we evaluated the associations of study setting, age group, vaccination status, predominant subvariants, and Oxford COVID-19 Government Response Tracker (OxCGRT) indices, including the Government Response Index (GRI), Containment and Health Index (CHI), and the Stringency Index (SI), with infection outcomes, adjusting for key confounders. Results: We found the primary or booster series of inactivated vaccines conferred strong protection against severe/critical illness (pooled relative risk (RR) 0.17 [95% CI: 0.09-0.33]) but did not reduce symptom frequency (RR 0.99 [95% CI: 0.95-1.02]). Each 10-unit increase in GRI or CHI was associated with 7% (95% CI: 1-12%) and 6% (95% CI: 1-10%) lower odds of symptomatic infection and 3% (95% CI: 1-4%) lower odds of severe/critical illness. Later subvariants (BA.5, BF.7, and XBB) showed 24-38% higher odds of upper respiratory symptoms versus BA.1. Conclusions: The data collection context significantly impacted severity estimates, with higher estimates from emergency hospitals. Overall, inactivated vaccines provided strong protection against severe/critical outcomes while stringent public health measures were associated with lower severity. Our findings underscore the importance of consistent and standardized protocols to produce reliable estimates of SARS-CoV-2 severity in evolving epidemiological contexts.}, }
@article {pmid40733710, year = {2025}, author = {Zhang, Y and Zhang, H and Lv, K and Lin, X and Chen, F and Cao, H and Chen, C}, title = {Retinal Vascular Occlusion Following COVID-19 Vaccination: A Comprehensive Review of Observational Study and Pathophysiological Mechanisms.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733710}, issn = {2076-393X}, support = {82271096//National Natural Science Foundation of China/ ; }, abstract = {Background: Retinal vascular occlusion (RVO) and retinal artery occlusion (RAO) have been reported as rare adverse events following COVID-19 vaccination, raising concerns about vaccine safety. This review synthesizes cohort and case-control studies assessing the association between COVID-19 vaccines and RVO/RAO, while exploring potential pathophysiological mechanisms. Methods: We analyzed large-scale population-based studies from South Korea, Europe, and the TriNetX database, focusing on odds ratios (OR), hazard ratios (HR), and relative risks (RR) across mRNA and adenoviral vector vaccines. Pathological processes were hypothesized based on molecular and clinical evidence. Results: Studies investigating the association between COVID-19 vaccination and retinal vascular occlusion show conflicting results; some studies report no association (e.g., OR 0.93, 95% CI 0.60-1.45), others suggest reduced risk (e.g., OR 0.80, 95% CI 0.64-0.99), and one indicates increased risk over two years (HR 2.19, 95% CI 2.00-2.39). Adenoviral vector vaccines, particularly ChAdOx1, show higher RAO incidence in specific cohorts. Proposed mechanisms include vaccine-induced immune thrombotic thrombocytopenia (VITT) via anti-PF4 antibodies, spike protein-mediated endothelial dysfunction, and adjuvant-driven inflammation. Conclusions: While causality remains unproven, temporal heterogeneity and vaccine type-specific risks warrant further investigation. Longitudinal studies with robust controls are needed to clarify these associations in the post-pandemic context.}, }
@article {pmid40733700, year = {2025}, author = {Baralić, M and Stojanović, N and Gajić, S and Sič, A and Manzar, A and Bontić, A and Pavlović, J and Bojić, MN and Kezić, A}, title = {Kidney Involvement in SARS-CoV-2 Infection: Peritoneal Dialysis as the Preferred Modality.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733700}, issn = {2076-393X}, abstract = {Patients undergoing peritoneal dialysis (PD) represent a uniquely vulnerable population due to intrinsic immunological dysfunction and a high prevalence of comorbid conditions. This review examines the complex interplay between natural and vaccine-induced immune responses to SARS-CoV-2 in this group, focusing on viral entry, immune activation, and immune evasion mechanisms. Particular attention is given to the impaired cellular and humoral responses seen in PD patients, including reduced T-cell function, diminished antibody production, and abnormal cytokine signaling, all of which contribute to an elevated risk of severe COVID-19 outcomes. The immunogenicity and clinical efficacy of various vaccine platforms, including inactivated, vector-based, and mRNA formulations, are critically assessed, with an emphasis on the role of booster doses in enhancing protection amid waning immunity and evolving viral variants. Furthermore, the review highlights the advantages of PD as a home-based modality that is compatible with telemedicine and may reduce the risk of viral exposure. These insights underscore the importance of developing individualized vaccination strategies, maintaining close immunological surveillance, and implementing innovative dialysis care approaches to improve clinical outcomes during the ongoing pandemic and future public health crises. Tailored booster strategies and telemedicine-integrated care models are essential for improving outcomes in this high-risk population.}, }
@article {pmid40733692, year = {2025}, author = {Thöne, P and Egger, M and Gruber, MS and Gruber, G and Kasassov, C and Nyiri, D and Weis, E and Werl, H and Trinkl, L and Lilleby, W and Clodi, M and Bräutigam, E and Dieplinger, B and Aigner, A and Geinitz, H}, title = {Safety, Immunogenicity, and Efficacy of COVID-19 Vaccines in Radiation-Oncology Patients: A Systematic Review and Meta-Analysis.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733692}, issn = {2076-393X}, abstract = {Background/Objectives: The COVID-19 pandemic significantly threatened cancer patients and oncologic care. The rollout of vaccines emerged as a critical milestone, despite the initial lack of evidence regarding their safety and efficacy in this population. This systematic review and meta-analysis evaluate the current evidence on COVID-19 vaccination in patients undergoing radiotherapy (RT). Methods: PubMed, Livivo, Scopus, and Cochrane Library were systematically reviewed for relevant publications on COVID-19 vaccination in the context of radiation oncology, published by 19 April 2024. The treatment effects were calculated as the proportion of seroconverted individuals. Results: A total of 22 studies published between 2021 and 2024 were included, covering various aspects of vaccination, including safety, tolerability, qualitative and quantitative humoral responses, cellular responses, vaccination efficacy, and booster vaccinations. Notably, patients undergoing RT exhibited a high willingness to receive vaccination. Vaccination was overall well tolerated and safe, with a low incidence of side effects, which were primarily mild. The primary meta-analysis showed a seroconversion proportion of 91% [95% CI: 84-96%] overall, with a somewhat higher proportion of 93% in patients receiving RT alone, compared to 90% in patients receiving either RT or RT combined with chemotherapy. Furthermore, immunization during RT led to a sustained increase in antibody titers, with a notable long-term persistence of IgG. Conclusions: COVID-19 vaccines demonstrate excellent safety, immunogenicity, and efficacy in patients receiving RT, who also exhibit a high willingness to be vaccinated. The outcomes observed are comparable to those in healthy controls and superior to those seen in patients receiving other cancer treatments, such as chemotherapy. The vaccination of radiation oncology patients in future pandemics or epidemics is strongly advocated even during active treatment.}, }
@article {pmid40733664, year = {2025}, author = {Nguyen, HN and Vanderzee, IO and Wen, F}, title = {The Application of Single-Cell Technologies for Vaccine Development Against Viral Infections.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733664}, issn = {2076-393X}, support = {S10OD020053, P30CA046592//National Institutes of Health (NIH)/ ; CAREER Award 1653611//National Science Foundation (NSF)/ ; Taubman Institute Innovation Projects program//A. Alfred Taubman Medical Research Institute/ ; }, abstract = {The development of vaccines against viral infections has advanced rapidly over the past century, propelled by innovations in laboratory and molecular technologies. These advances have expanded the range of vaccine platforms beyond live-attenuated and inactivated vaccines to include recombinant platforms, such as subunit proteins and virus-like particles (VLPs), and more recently, mRNA-based vaccines, while also enhancing methods for evaluating vaccine performance. Despite these innovations, a persistent challenge remains: the inherent complexity and heterogeneity of immune responses continue to impede efforts to achieve consistently effective and durable protection across diverse populations. Single-cell technologies have emerged as transformative tools for dissecting this immune heterogeneity, providing comprehensive and granular insights into cellular phenotypes, functional states, and dynamic host-pathogen interactions. In this review, we examine how single-cell epigenomic, transcriptomic, proteomic, and multi-omics approaches are being integrated across all stages of vaccine development-from infection-informed discovery to guide vaccine design, to high-resolution evaluation of efficacy, and refinement of cell lines for manufacturing. Through representative studies, we highlight how insights from these technologies contribute to the rational design of more effective vaccines and support the development of personalized vaccination strategies.}, }
@article {pmid40733649, year = {2025}, author = {Dong, C and Li, Z and Tan, D and Sun, H and Liang, J and Wei, D and Zheng, Y and Zhang, L and Liu, S and Zhang, Y and Wang, J and He, Q}, title = {Research and Clinical Progress of Therapeutic Tumor Vaccines.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733649}, issn = {2076-393X}, abstract = {Therapeutic cancer vaccines are a new growth point of biomedicine with broad industrial prospects in the post-COVID-19 era. Many large international pharmaceutical companies and emerging biotechnology companies are deploying different tumor therapeutic cancer vaccine projects, focusing on promoting their clinical transformation, and the vaccine industry has strong momentum for development. Such vaccines are also the core engine and pilot site for the development of new vaccine targets, new vectors, new adjuvants, and new technologies, which play a key role in promoting the innovation and development of vaccines. Various therapeutic cancer vaccines, such as viral vector vaccines, bacterial vector vaccines, cell vector vaccines, peptide vaccines, and nucleic acid vaccines, have all been applied in clinical research. With the continuous development of technology, therapeutic cancer vaccines are evolving towards the trends of precise antigens, efficient carriers, diversified adjuvants, and combined applications. For instance, the rapidly advancing mRNA-4157 vaccine is a typical representative that combines personalized antigens with efficient delivery vectors (lipid nanoparticles, LNPs), and it also shows synergistic advantages in melanoma patients treated in combination with immune checkpoint inhibitors. In this article, we will systematically discuss the current research and development status and clinical research progress of various therapeutic cancer vaccines.}, }
@article {pmid40733647, year = {2025}, author = {Al Hashimi, F and Shuaib, SE and Bragazzi, NL and Chen, S and Wu, J}, title = {COVID-19 Vaccine Timing and Co-Administration with Influenza Vaccines in Canada: A Systematic Review with Comparative Insights from G7 Countries.}, journal = {Vaccines}, volume = {13}, number = {7}, pages = {}, pmid = {40733647}, issn = {2076-393X}, abstract = {BACKGROUND/OBJECTIVES: Despite significant advancements in vaccine development and distribution, the optimal timing and integration of COVID-19 vaccination in Canada remain crucial to public health. As the SARS-CoV-2 virus continues to evolve, determining effective timing strategies for booster doses is necessary to sustain immunity, especially in high-risk populations. This systematic review aims to critically evaluate the timing and co-administration strategies of COVID-19 vaccines in Canada, comparing them with approaches in other G7 nations.<br><br>METHODS: The review seeks to identify best practices to inform national vaccination policies, with a particular focus on synchronizing COVID-19 and seasonal influenza vaccinations. We systematically searched Scopus, PubMed, Medline, and Web of Science (17 August 2021 to 7 July 2024) using the PECOS framework. Two independent reviewers screened titles/abstracts, extracted key data on immunogenicity, efficacy, and safety, and performed a narrative synthesis on timing and co-administration outcomes.<br><br>RESULTS: Evidence summarized across G7 countries reveals that most nations are converging on annual or flexible booster schedules tailored to high-risk groups, often aligning COVID-19 vaccination with influenza campaigns. Countries like Canada, the UK, and the US have integrated these efforts, while others maintain more independent or heterogeneous approaches. In addition, timely booster doses, whether administered annually or more frequently in high-risk settings, consistently reduce infection rates and hospitalizations.<br><br>CONCLUSIONS: These findings collectively support the continued evolution of COVID-19 vaccination programs toward integrated, seasonally aligned strategies. Future public health efforts can build on these lessons not only to sustain protection against SARS-CoV-2 but also to strengthen preparedness for other respiratory infections.}, }
@article {pmid40733602, year = {2025}, author = {Aljabali, AAA and Lundstrom, K and Hromić-Jahjefendić, A and El-Baky, NA and Nawn, D and Hassan, SS and Rubio-Casillas, A and Redwan, EM and Uversky, VN}, title = {The XEC Variant: Genomic Evolution, Immune Evasion, and Public Health Implications.}, journal = {Viruses}, volume = {17}, number = {7}, pages = {}, pmid = {40733602}, issn = {1999-4915}, mesh = {Humans ; *Immune Evasion ; *COVID-19/virology/immunology/epidemiology/prevention &amp; control ; *SARS-CoV-2/genetics/immunology/classification ; Public Health ; *Evolution, Molecular ; Spike Glycoprotein, Coronavirus/genetics/immunology ; Genome, Viral ; Mutation ; }, abstract = {Narrative review synthesizes the most current literature on the SARS-CoV-2 XEC variant, focusing on its genomic evolution, immune evasion characteristics, epidemiological dynamics, and public health implications. To achieve this, we conducted a structured search of the literature of peer-reviewed articles, preprints, and official surveillance data from 2023 to early 2025, prioritizing virological, clinical, and immunological reports related to XEC and its parent lineages. Defined by the distinctive spike protein mutations, T22N and Q493E, XEC exhibits modest reductions in neutralization in vitro, although current evidence suggests that mRNA booster vaccines, including those targeting JN.1 and KP.2, retain cross-protective efficacy against symptomatic and severe disease. The XEC strain of SARS-CoV-2 has drawn particular attention due to its increasing prevalence in multiple regions and its potential to displace other Omicron subvariants, although direct evidence of enhanced replicative fitness is currently lacking. Preliminary analyses also indicated that glycosylation changes at the N-terminal domain enhance infectivity and immunological evasion, which is expected to underpin the increasing prevalence of XEC. The XEC variant, while still emerging, is marked by a unique recombination pattern and a set of spike protein mutations (T22N and Q493E) that collectively demonstrate increased immune evasion potential and epidemiological expansion across Europe and North America. Current evidence does not conclusively associate XEC with greater disease severity, although additional research is required to determine its clinical relevance. Key knowledge gaps include the precise role of recombination events in XEC evolution and the duration of cross-protective T-cell responses. New research priorities include genomic surveillance in undersampled regions, updated vaccine formulations against novel spike epitopes, and long-term longitudinal studies to monitor post-acute sequelae. These efforts can be augmented by computational modeling and the One Health approach, which combines human and veterinary sciences. Recent computational findings (GISAID, 2024) point to the potential of XEC for further mutations in under-surveilled reservoirs, enhancing containment challenges and risks. Addressing the potential risks associated with the XEC variant is expected to benefit from interdisciplinary coordination, particularly in regions where genomic surveillance indicates a measurable increase in prevalence.}, }
@article {pmid40733600, year = {2025}, author = {Debat, H and Bejerman, N}, title = {An Update on RNA Virus Discovery: Current Challenges and Future Perspectives.}, journal = {Viruses}, volume = {17}, number = {7}, pages = {}, pmid = {40733600}, issn = {1999-4915}, mesh = {*RNA Viruses/genetics/isolation &amp; purification/classification ; Humans ; Animals ; *RNA Virus Infections/virology/transmission/epidemiology ; Communicable Diseases, Emerging/virology ; Zoonoses/virology ; Public Health ; }, abstract = {The relentless emergence of RNA viruses poses a perpetual threat to global public health, necessitating continuous efforts in surveillance, discovery, and understanding of these pathogens. This review provides a comprehensive update on recent advancements in RNA virus discovery, highlighting breakthroughs in technology and methodologies that have significantly enhanced our ability to identify novel viruses across diverse host organisms. We explore the expanding landscape of viral diversity, emphasizing the discovery of previously unknown viral families and the role of zoonotic transmissions in shaping the viral ecosystem. Additionally, we discuss the potential implications of RNA virus discovery on disease emergence and pandemic preparedness. Despite remarkable progress, current challenges in sample collection, data interpretation, and the characterization of newly identified viruses persist. Our ability to anticipate and respond to emerging respiratory threats relies on virus discovery as a cornerstone for understanding RNA virus evolution. We address these challenges and propose future directions for research, emphasizing the integration of multi-omic approaches, advanced computational tools, and international collaboration to overcome barriers in the field. This comprehensive overview aims to guide researchers, policymakers, and public health professionals in navigating the intricate landscape of RNA virus discovery, fostering a proactive and collaborative approach to anticipate and mitigate emerging viral threats.}, }
@article {pmid40733577, year = {2025}, author = {Tan, BEK and Tham, SK and Poh, CL}, title = {mRNA Vaccine Development in the Fight Against Zoonotic Viral Diseases.}, journal = {Viruses}, volume = {17}, number = {7}, pages = {}, pmid = {40733577}, issn = {1999-4915}, mesh = {Humans ; Animals ; *Vaccine Development ; *Zoonoses/prevention &amp; control/virology ; *Viral Zoonoses/prevention &amp; control/immunology ; *Viral Vaccines/immunology ; COVID-19/prevention &amp; control ; *Virus Diseases/prevention &amp; control ; Vaccines, Synthetic/immunology ; SARS-CoV-2/immunology ; *RNA, Messenger/immunology/genetics ; mRNA Vaccines/immunology ; COVID-19 Vaccines/immunology ; Communicable Diseases, Emerging/prevention &amp; control ; }, abstract = {Zoonotic diseases are transmitted from animals to humans, and they impose a significant global burden by impacting both animal and human health. It can lead to substantial economic losses and cause millions of human deaths. The emergence and re-emergence of zoonotic diseases are heavily influenced by both anthropogenic and natural drivers such as climate change, rapid urbanization, and widespread travel. Over time, the unprecedented rise of new and re-emerging zoonotic diseases has prompted the need for rapid and effective vaccine development. Following the success of the COVID-19 mRNA vaccines, mRNA-based platforms hold great promise due to their rapid design, swift development and ability to elicit robust immune responses, thereby highlighting their potential in combating emerging and pre-pandemic zoonotic viruses. In recent years, several mRNA vaccines targeting emerging and re-emerging zoonotic viral diseases, such as rabies, Nipah, Zika, and influenza, have advanced to clinical trials, demonstrating promising immunogenicity. This review explores recent advances, challenges, and future directions in developing mRNA vaccines against emerging and re-emerging zoonotic viral diseases.}, }
@article {pmid40733537, year = {2025}, author = {Elsharabassi, YK and Swaidan, NT and Emara, MM}, title = {Potential Resistance Mechanisms Exhibited by Cystic Fibrosis Patients Against SARS-CoV-2.}, journal = {Viruses}, volume = {17}, number = {7}, pages = {}, pmid = {40733537}, issn = {1999-4915}, mesh = {Humans ; *Cystic Fibrosis/immunology/genetics/virology/complications ; *COVID-19/immunology/genetics/virology ; *SARS-CoV-2/physiology ; Angiotensin-Converting Enzyme 2/genetics/metabolism ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics/metabolism ; Serine Endopeptidases/metabolism/genetics ; *Disease Resistance ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the 2019 coronavirus disease pandemic. The virus primarily spreads through person-to-person contact via aerosols and droplets, contributing to high case numbers and related morbidities. SARS-CoV-2 targets the respiratory tract, causing acute respiratory distress syndrome, particularly in immunocompromised individuals such as those with cystic fibrosis (CF). CF is a life-threatening genetic disorder caused by mutations in the CF transmembrane conductance regulator (CFTR) gene, leading to impaired respiratory function and recurrent severe respiratory symptoms. Despite their potential vulnerability, CF patients have shown a lower incidence of severe COVID-19, suggesting protective factors against SARS-CoV-2. Differential expression of the ACE2 receptor, crucial for viral entry, and other host factors, such as TMPRSS2, may play a role in this resistance to SARS-CoV-2. Analyzing the genomics and transcriptomics profiles of CF patients could provide insights into potential resistance mechanisms. The potential resistance mechanisms include blood and extracellular ATP levels, a deleted/dysfunctional CFTR gene, ACE and ACE2 regulation and expression, ACE and ACE2 polymorphism effects, host proteins and SARS-CoV-2 interactions, and SMN1 and ACE/ACE2 interactions. This review discusses the underlying factors and potential resistance mechanisms contributing to CF patients' responses to SARS-CoV-2 infection. The review provides an opportunity to further investigate future therapy and research through understanding the underlying potential resistance mechanisms exhibited by CF patients against SARS-CoV-2, including ACE and ACE2 polymorphisms.}, }
@article {pmid40733521, year = {2025}, author = {Mahajan, S and Mahajan, S and Patgiri, S}, title = {Association and Interaction of Epstein-Barr Virus with SARS-CoV-2 Infection-A Review.}, journal = {Viruses}, volume = {17}, number = {7}, pages = {}, pmid = {40733521}, issn = {1999-4915}, mesh = {Humans ; *COVID-19/virology/complications/immunology ; *Herpesvirus 4, Human/physiology ; *Epstein-Barr Virus Infections/virology/complications/drug therapy ; *SARS-CoV-2/physiology ; Virus Activation ; }, abstract = {Despite the significant decrease in SARS-CoV-2-related mortality, COVID-19 continues to impose a high public health burden due to the high rate of post-COVID-19 pathological conditions, broadly termed Long COVID, that continue for any period of time and are generally multisystemic. However, recent studies have strengthened the evidence that the reactivation of the Epstein-Barr virus (EBV) in the post-COVID-19 era has significantly contributed to the exacerbation and prolongation of Long COVID symptoms. The mechanism and pathophysiology of EBV reactivation in Long COVID patients still need further exploration due to limited studies. This review summarises the various studies linking EBV reactivation in Long COVID along with its pathophysiology and novel therapeutics for EBV in a post-COVID-19 era.}, }
@article {pmid40733499, year = {2025}, author = {Triggle, CR and MacDonald, R}, title = {COVID-19 and a Tale of Three Drugs: To Repurpose, or Not to Repurpose-That Was the Question.}, journal = {Viruses}, volume = {17}, number = {7}, pages = {}, pmid = {40733499}, issn = {1999-4915}, mesh = {Humans ; *Drug Repositioning ; *COVID-19 Drug Treatment ; *Antiviral Agents/therapeutic use/pharmacology ; Hydroxychloroquine/therapeutic use ; Ivermectin/therapeutic use ; SARS-CoV-2/drug effects ; Adenosine Monophosphate/analogs &amp; derivatives/therapeutic use ; Alanine/analogs &amp; derivatives/therapeutic use ; Antimalarials/therapeutic use ; COVID-19 ; }, abstract = {On 11 March 2020, the World Health Organisation (WHO) declared a global pandemic caused by the SARS-CoV-2 coronavirus that earlier in February 2020 the WHO had named COVID-19 (coronavirus disease 2019). There were neither drugs nor vaccines that were known to be effective against the virus, stimulating an urgent worldwide search for treatments. An evaluation of existing drugs by 'repurposing' was initiated followed by a transition to de novo drug discovery. Repurposing of an already approved drug may accelerate the introduction of that drug into clinical use by circumventing early, including preclinical studies otherwise essential for a de novo drug and reducing development costs. Early in the pandemic three drugs were identified as repurposing candidates for the treatment of COVID-19: (i) hydroxychloroquine, an anti-malarial also used to treat rheumatoid arthritis and lupus; (ii) ivermectin, an antiparasitic approved for both human and veterinary use; (iii) remdesivir, an anti-viral originally developed to treat hepatitis C. The scientific evidence, both for and against the efficacy of these three drugs as treatments for COVID-19, vied with public demand and politicization as unqualified opinions clashed with evidence-based medicine. To quote Hippocrates, "There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance".}, }
@article {pmid40733290, year = {2025}, author = {Pawłowska, M and Nuszkiewicz, J and Jarek, DJ and Woźniak, A}, title = {Ferroptosis and Metabolic Dysregulation: Emerging Chemical Targets in Cancer and Infection.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {14}, pages = {}, pmid = {40733290}, issn = {1420-3049}, mesh = {*Ferroptosis/drug effects ; Humans ; *Neoplasms/metabolism/drug therapy/pathology ; Lipid Peroxidation ; Animals ; COVID-19/metabolism ; Oxidative Stress ; Iron/metabolism ; SARS-CoV-2 ; }, abstract = {The distinctive nature of ferroptosis is that it is induced chemically and signifies a regulated cell death dependent on iron-dependent lipid peroxidation. The mechanism of ferroptosis involves oxidative damage to the membrane lipids. It differs from apoptosis and necroptosis, triggering metabolic changes in the iron-lipid homeostasis and antioxidant defense, such as glutathione (GSH) and glutathione peroxidase 4 (GPX4). Herein, the molecular mechanisms of ferroptosis and its role in the tumorigenesis process and infection-related diseases are presented. It also discusses metabolic reprogramming as a factor that modifies the levels of cell-sensitizing polyunsaturated fatty acids (PUFAs), iron dysregulation, and oxidative stress in aggressive cancers and inflammatory diseases such as sepsis, tuberculosis, and COVID-19. Particular attention is given to chemical modulators of ferroptosis, including synthetic inducers and inhibitors, as well as bioactive natural compounds. Our focus is on the significance of analytical tools, such as lipidomics and metabolomics, in understanding the phenomenon of ferroptosis. Finally, we explore novel therapeutic approaches targeting ferroptosis in cancer and infectious diseases, while navigating both the opportunities and challenges in drug development. The review then draws on chemical biology and disease pathology to propose promising areas of study for ferroptosis-related therapies.}, }
@article {pmid40733111, year = {2025}, author = {Tufeu, M and Herkenne, C and Kalia, YN}, title = {Trends and Commonalities of Approved and Late Clinical-Phase RNA Therapeutics.}, journal = {Pharmaceutics}, volume = {17}, number = {7}, pages = {}, pmid = {40733111}, issn = {1999-4923}, abstract = {Background/Objectives: After many years of research and the successful development of therapeutic products by a few industrial actors, the COVID-19 vaccines brought messenger RNAs, as well as other nucleic acid modalities, such as antisense oligonucleotides, small interfering RNA, and aptamers, into the spotlight, eliciting renewed interest from both academia and industry. However, owing to their structure, relative "fragility", and the (usually) intracellular site of action, the delivery of these therapeutics has frequently proven to be a key limitation, especially when considering endosomal escape, which still needs to be overcome. Methods: By compiling delivery-related data on approved and late clinical-phase ribonucleic acid therapeutics, this review aims to assess the delivery strategies that have proven to be successful or are emerging, as well as areas where more research is needed. Results: In very specific cases, some strategies appeared to be quite effective, such as the N-acetylgalactosamine moiety in the case of liver delivery. Surprisingly, it also appears that for some modalities, efforts in molecular design have led to more "drug-like" properties, enablingthe administration of naked nucleic acids, without any form of encapsulation. This appears to be especially true when local administration, i.e., by injection, is possible, as this provides de facto targeting and a high local concentration, which can compensate for the small proportion of nucleic acids that reach the cytoplasm. Conclusions: Nucleic acid-based therapeutics have come a long way in terms of their physicochemical properties. However, due to their inherent limitations, targeting appears to be crucial for their efficacy, even more so than for traditional pharmaceutical modalities.}, }
@article {pmid40733041, year = {2025}, author = {Shen, Y and Eades, W and Dinh, L and Yan, B}, title = {Carboxylesterase Factors Influencing the Therapeutic Activity of Common Antiviral Medications Used for SARS-CoV-2 Infection.}, journal = {Pharmaceutics}, volume = {17}, number = {7}, pages = {}, pmid = {40733041}, issn = {1999-4923}, support = {R01AI172959//National Institute of Allergy and Infectious Diseases/ ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19, remains a major global health threat. The virus enters host cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. Several small-molecule antiviral drugs, including molnupiravir, favipiravir, remdesivir, and nirmatrelvir have been shown to inhibit SARS-CoV-2 replication and are approved for treating SARS-CoV-2 infections. Nirmatrelvir inhibits the viral main protease (M[pro]), a key enzyme for processing polyproteins in viral replication. In contrast, molnupiravir, favipiravir, and remdesivir are prodrugs that target RNA-dependent RNA polymerase (RdRp), which is crucial for genome replication and subgenomic RNA production. However, undergoing extensive metabolism profoundly impacts their therapeutic effects. Carboxylesterases (CES) are a family of enzymes that play an essential role in the metabolism of many drugs, especially prodrugs that require activation through hydrolysis. Molnupiravir is activated by carboxylesterase-2 (CES2), while remdesivir is hydrolytically activated by CES1 but inhibits CES2. Nirmatrelvir and remdesivir are oxidized by the same cytochrome P450 (CYP) enzyme. Additionally, various transporters are involved in the uptake or efflux of these drugs and/or their metabolites. It is well established that drug-metabolizing enzymes and transporters are differentially expressed depending on the cell type, and these genes exhibit significant polymorphisms. In this review, we examine how CES-related cellular and genetic factors influence the therapeutic activities of these widely used COVID-19 medications. This article highlights implications for improving product design, targeted inhibition, and personalized medicine by exploring genetic variations and their impact on drug metabolism and efficacy.}, }
@article {pmid40732950, year = {2025}, author = {Coşkun, N and Demir, R and Canbolat, AA and Sarıtaş, S and Pekdemir, B and Bechelany, M and Karav, S}, title = {Polyphenols as Antiviral Agents: Their Potential Against a Range of Virus Types.}, journal = {Nutrients}, volume = {17}, number = {14}, pages = {}, pmid = {40732950}, issn = {2072-6643}, mesh = {*Polyphenols/pharmacology/therapeutic use ; *Antiviral Agents/pharmacology/therapeutic use ; Humans ; Virus Replication/drug effects ; *Virus Diseases/drug therapy/virology ; SARS-CoV-2/drug effects ; Animals ; *Viruses/drug effects ; }, abstract = {Polyphenols are structurally diverse plant metabolites that have attracted significant interest. Their compositions are versatile, depending on their structures, including the number of rings in the polyphenol composition. Based on these attributes, polyphenols can be classified as flavanols, anthocyanins, flavones, phenolic acids, stilbenes, and lignans. Polyphenols mainly possess inhibition of viral replication, interference with viral protein synthesis, and modulation of immune responses, providing significant antiviral effects against several viruses, including herpes simplex virus, hepatitis C virus, and influenza. They are crucial for medical compounds in diverse, versatile treatments, namely in diabetes, cardiovascular disorders, cancer, and neurodegenerative problems. Plants are the primary source of bioactive molecules, which are valued for their anti-inflammatory, antioxidant, anticancer, and antiviral activities. Especially, polyphenols are extracted as the most abundant bioactive compounds of plants. Moreover, viral infections are one of the major factors in illnesses and diseases, along with bacteria and fungi. Numerous in vitro and in vivo studies report antiviral activity against SARS-CoV-2, Mayaro virus, dengue virus, herpesvirus, and influenza A virus, though clinical validation remains limited. Additionally, inhibition of viral entry, interference with viral replication, modulation of host immune response, and direct virucidal effects were examined.}, }
@article {pmid40732763, year = {2025}, author = {Gokalsing, E and Ferrolho, J and Gibson, MS and Vilhena, H and Anastácio, S}, title = {Efficacy of GS-441524 for Feline Infectious Peritonitis: A Systematic Review (2018-2024).}, journal = {Pathogens (Basel, Switzerland)}, volume = {14}, number = {7}, pages = {}, pmid = {40732763}, issn = {2076-0817}, mesh = {Animals ; Cats ; *Antiviral Agents/therapeutic use ; *Feline Infectious Peritonitis/drug therapy/virology ; Treatment Outcome ; *Adenosine/analogs &amp; derivatives/therapeutic use ; Drug Therapy, Combination ; }, abstract = {Feline infectious peritonitis (FIP) is a severe viral disease with a very high fatality rate. GS-441524 is an adenosine analogue that acts as an antiviral and has shown promise in FIP treatment. However, its commercialization in some regions is not yet authorized. To evaluate the efficacy of GS-441524 based on the published literature, a systematic review was conducted. This systematic review was conducted using PubMed, ScienceDirect, and Google Scholar for studies published from 2018 onwards. Following PRISMA guidelines, 11 studies (totaling 650 FIP cases treated with GS-441524 alone or in combination) were included. Therapeutic efficacy was assessed by FIP form, clinical signs, and dosage. The overall treatment success rate was 84.6%. This rate was higher when GS-441524 was combined with other antivirals and lower in cases of wet FIP or those with neurological complications. Combination therapy with other antivirals may improve outcomes in complicated FIP cases, although further studies are needed. The GS-441524 dosages associated with the best outcomes were 5-10 mg/kg once daily (or equivalent subcutaneous dose), adjusted for FIP type, severity, and presence of neurological/ocular signs. Higher dosages can be used for severe cases or to prevent relapse, but splitting into twice-daily dosing may be necessary to avoid absorption issues. In summary, this synthesis indicates that GS-441524 is a highly promising treatment for FIP, with a high success rate among treated cases. Nevertheless, randomized controlled trials are needed to establish evidence-based therapeutic protocols tailored to different FIP presentations.}, }
@article {pmid40732065, year = {2025}, author = {Anugu, A and Singh, P and Kashyap, D and Joseph, J and Naik, S and Sarkar, S and Zaman, K and Dhaliwal, M and Nagar, S and Gupta, T and Honnavar, P}, title = {PROTAC-Based Antivirals for Respiratory Viruses: A Novel Approach for Targeted Therapy and Vaccine Development.}, journal = {Microorganisms}, volume = {13}, number = {7}, pages = {}, pmid = {40732065}, issn = {2076-2607}, abstract = {The global burden of respiratory viral infections is notable, which is attributed to their higher transmissibility compared to other viral diseases. Respiratory viruses are seen to have evolved resistance to available treatment options. Although vaccines and antiviral drugs control some respiratory viruses, this control is limited due to unexpected events, such as mutations and the development of antiviral resistance. The technology of proteolysis-targeting chimeras (PROTACs) has been emerging as a novel technology in viral therapeutics. These are small molecules that can selectively degrade target proteins via the ubiquitin-proteasome pathway. PROTACs as a therapy were initially developed against cancer, but they have recently shown promising results in their antiviral mechanisms by targeting viral and/or host proteins involved in the pathogenesis of viral infections. In this review, we elaborate on the antiviral potential of PROTACs as therapeutic agents and their potential as vaccine components against important respiratory viral pathogens, including influenza viruses, coronaviruses (SARS-CoV-2), and respiratory syncytial virus. Advanced applications of PROTAC antiviral strategies, such as hemagglutinin and neuraminidase degraders for influenza and spike proteins of SARS-CoV-2, are detailed in this review. Additionally, the role of PROTACs in targeting cellular mechanisms within the host, thereby preventing viral pathogenesis and eliciting an antiviral effect, is discussed. The potential of PROTACs as vaccines, utilizing proteasome-based virus attenuation to achieve a robust protective immune response, while ensuring safety and enhancing efficient production, is also presented. With the promises exhibited by PROTACs, this technology faces significant challenges, including the emergence of novel viral strains, tissue-specific expression of E3 ligases, and pharmacokinetic constraints. With advanced computational design in molecular platforms, PROTAC-based antiviral development offers an alternative, transformative path in tackling respiratory viruses.}, }
@article {pmid40730911, year = {2025}, author = {Aernout, I and Verbeke, R and Thery, F and Willems, P and Elia, U and De Smedt, SC and Rappuoli, R and Peer, D and Impens, F and Lentacker, I}, title = {Challenges and opportunities in mRNA vaccine development against bacteria.}, journal = {Nature microbiology}, volume = {10}, number = {8}, pages = {1816-1828}, pmid = {40730911}, issn = {2058-5276}, support = {Baxerna 2.0 (101080544)//EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020)/ ; Expert (825828)//EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020)/ ; 1S40923N//Fonds Wetenschappelijk Onderzoek (Research Foundation Flanders)/ ; 1275023N//Fonds Wetenschappelijk Onderzoek (Research Foundation Flanders)/ ; 12T1722N//Fonds Wetenschappelijk Onderzoek (Research Foundation Flanders)/ ; 12AN524N//Fonds Wetenschappelijk Onderzoek (Research Foundation Flanders)/ ; ERC Adv. Grant # 101055029//EC | EU Framework Programme for Research and Innovation H2020 | H2020 Priority Excellent Science | H2020 European Research Council (H2020 Excellent Science - European Research Council)/ ; 2012/20//Israel Science Foundation (ISF)/ ; }, mesh = {Humans ; *Vaccine Development/methods ; *Bacterial Vaccines/immunology/genetics ; *Bacterial Infections/prevention &amp; control/immunology ; Vaccines, Synthetic/immunology ; *Bacteria/immunology/genetics ; Animals ; mRNA Vaccines/immunology ; COVID-19/prevention &amp; control ; RNA, Messenger/immunology/genetics ; Antigens, Bacterial/immunology/genetics ; }, abstract = {The global surge in antimicrobial resistance presents a critical threat to public health, emphasizing the urgent need for the development of new and more effective bacterial vaccines. Since the success of mRNA vaccines during the COVID-19 pandemic, this vaccine strategy has rapidly advanced, with most efforts focused on cancer immunotherapy and targeting viral pathogens. Recently, mRNA vaccines have entered the early phases of clinical development for bacterial diseases. However, bacteria present greater biological complexity compared with viruses, posing additional challenges for vaccine design, such as antigen selection, immune response and mRNA construct design. Here, we discuss critical aspects in the development of bacterial mRNA vaccines, from antigen selection to construct design. We also highlight the current preclinical landscape and discuss remaining translational challenges and future potential for mRNA vaccines against bacterial infections.}, }
@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 &amp; 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.<br><br>OBJECTIVE: To systematically review and synthesize the evidence from RCTs evaluating the effect of NAC on mortality in patients with COVID-19.<br><br>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).<br><br>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]&#x2009;=&#x2009;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.<br><br>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.}, }
@article {pmid40726934, year = {2025}, author = {Castro, MC and Ponmattam, J and FitzGerald, EA}, title = {Shocks and health care in Latin America and the Caribbean.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1604424}, pmid = {40726934}, issn = {2296-2565}, mesh = {Humans ; Latin America/epidemiology ; Caribbean Region/epidemiology ; *COVID-19/epidemiology ; *Delivery of Health Care/organization &amp; administration ; *Health Services Accessibility ; *Disasters ; }, abstract = {BACKGROUND: The Latin American and the Caribbean (LAC) is one of the most disaster-prone regions worldwide, and the frequency and intensity of disasters is expected to increase. We propose typologies of shocks considering healthcare resilience to examine how the risk of shocks varies across LAC and how previous shocks and their impacts in LAC fit into these categories.<br><br>METHODS: We classify shocks into natural, anthropogenic and climate-related, and build on the literature to develop a 2&#xd7;2 classification considering health care resilience and trust in government. Using the INFORM risk we categorize countries into risk groups considering indicators of governance and access to healthcare as proxies for trust in government and health care resilience, respectively. We discuss the 2&#xd7;2 classification considering examples of health impacts of shocks, highlighting strengths and weaknesses of national responses, and use excess death ratios during the COVID-19 pandemic to demonstrate how health impacts correspond to the 2&#xd7;2 typology.<br><br>RESULTS: Based on the available literature, the proposed 2&#xd7;2 classification reflects the recent consequences of shocks in LAC countries. Overall, areas where healthcare access and trust in government were weak had the most devastating impacts. However, strong access to healthcare is not a sufficient condition determining the impact of a shock, as evidenced during the COVID-19 pandemic. For the most part, countries lack a detailed shock management plan.<br><br>DISCUSSION: Countries in the LAC region have historically been unprepared to manage shocks. In the absence of a comprehensive and multisectoral shock management plan, countries will continue to act in a reactive way, after a shock, as most of the examples discussed in our analysis illustrate. A shock management plan is an important step to build resilient health systems.}, }
@article {pmid40725228, year = {2025}, author = {Li, J and Zhang, C and Li, B and Wu, Y}, title = {New Advances in Small Molecules Targeted at Viral Capsid-Genome Binding.}, journal = {International journal of molecular sciences}, volume = {26}, number = {14}, pages = {}, pmid = {40725228}, issn = {1422-0067}, support = {No. 20230204040YY//the Jilin Province Science and Technology Development Plan Project/ ; No. 21875085//project of NSFC/ ; No//the Innovation &amp; Opening Program of the State Key Laboratory of Supramolecular Structure and Materials, Jilin University/ ; }, mesh = {*Antiviral Agents/pharmacology/chemistry ; *Genome, Viral/drug effects ; Humans ; *Capsid Proteins/metabolism/chemistry/genetics ; SARS-CoV-2/drug effects/genetics/metabolism ; *Capsid/metabolism/drug effects ; Protein Binding/drug effects ; Dengue Virus/drug effects/genetics/metabolism ; Virus Replication/drug effects ; Hepatitis B virus/drug effects/genetics/metabolism ; *Small Molecule Libraries/pharmacology ; Binding Sites/drug effects ; Animals ; COVID-19 Drug Treatment ; }, abstract = {The capsid protein plays a crucial role in the viral life cycle. By interacting with the viral genome, it facilitates the assembly of the nucleocapsid, ultimately leading to the formation of the viral particle. Therefore, interfering with or disrupting the interaction between the capsid protein and viral genome can effectively inhibit viral replication and infection. This review focuses on elucidating the binding mechanisms between the capsid protein and the viral genome, as well as their potential applications as therapeutic targets. In particular, it summarizes the research progress on small-molecule drugs targeting the capsid-genome binding sites of dengue virus, HBV, and SARS-CoV-2. Notably, this review provides a detailed discussion on the mechanisms by which these small-molecule inhibitors interfere with the capsid-genome interaction, aiming to offer inspiration for the future development of novel antiviral drugs targeting the capsid-genome binding.}, }
@article {pmid40725130, year = {2025}, author = {Vail, KJ and Macha, BN and Hellmers, L and Fischer, T}, title = {Modeling Virus-Associated Central Nervous System Disease in Non-Human Primates.}, journal = {International journal of molecular sciences}, volume = {26}, number = {14}, pages = {}, pmid = {40725130}, issn = {1422-0067}, support = {P51OD011104//NIH ORIP/ ; K01OD036106//NIH ORIP/ ; }, mesh = {Animals ; *Disease Models, Animal ; Primates/virology ; Humans ; *Central Nervous System Diseases/virology ; Central Nervous System/virology ; *Virus Diseases/virology ; *Central Nervous System Viral Diseases/virology ; }, abstract = {While viral pathogens are often subdivided into neurotropic and non-neurotropic categories, systemic inflammation caused by non-neurotropic viruses still possesses the ability to alter the central nervous system (CNS). Studies of CNS disease induced by viral infection, whether neurotropic or not, are presented with a unique set of challenges. First, because brain biopsies are rarely necessary to diagnose viral-associated neurological disorders, antemortem tissue samples are not readily available for study and human pathological studies must rely on end-stage, postmortem evaluations. Second, in vitro models fail to fully capture the nuances of an intact immune system, necessitating the use of animal models to fully characterize pathogenesis and identify potential therapeutic approaches. Non-human primates (NHP) represent a particularly attractive animal model in that they overcome many of the limits posed by more distant species and most closely mirror human disease pathogenesis and susceptibility. Here, we review NHP infection models of viruses known to infect and/or replicate within cells of the CNS, including West Nile virus, the equine encephalitis viruses, Zika virus, and herpesviruses, as well as those known to alter the immune status of the brain in the absence of significant CNS penetrance, including human immunodeficiency virus (HIV) in the current era of combination antiretroviral therapy (cART) and the coronavirus of severe acute respiratory syndrome (SARS)-CoV-2. This review focuses on viruses with an established role in causing CNS disease, including encephalitis, meningitis, and myelitis and NHP models of viral infection that are directly translatable to the human condition through relevant routes of infection, comparable disease pathogenesis, and responses to therapeutic intervention.}, }
@article {pmid40724980, year = {2025}, author = {Szataniak, I and Packi, K}, title = {Melatonin as the Missing Link Between Sleep Deprivation and Immune Dysregulation: A Narrative Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {14}, pages = {}, pmid = {40724980}, issn = {1422-0067}, mesh = {*Melatonin/metabolism/pharmacology ; *Sleep Deprivation/complications/drug therapy/physiopathology ; *Immune System ; COVID-19/complications ; Inflammation ; *Oxidative Stress ; Mitochondria/metabolism ; NF-kappa B/metabolism ; Circadian Rhythm ; Humans ; Animals ; Mice ; Sleep/physiology ; Cytokines/metabolism ; }, abstract = {Sleep deprivation impairs immune function, and melatonin has emerged as a key mediator in this process. This narrative review analyzes 50 studies published between 2000 and 2025 to determine the extent to which reduced melatonin synthesis contributes to immune dysregulation. Consistent sleep loss lowers melatonin levels, which correlates with elevated proinflammatory cytokines (e.g., IL-6 and TNF-α), increased oxidative stress, and reduced immune cell activity, including that of natural killer (NK) cells and CD4+ lymphocytes. Melatonin regulates immune pathways, including NF-κB signaling. It also supports mitochondrial health and helps maintain gut barrier integrity. These effects are particularly relevant in vulnerable populations, including older adults and shift workers. Experimental findings also highlight melatonin's therapeutic potential in infections like SARS-CoV-2, where it modulates inflammatory responses and viral entry mechanisms. Despite the heterogeneity of study methodologies, a consistent correlation emerges between circadian disruption, melatonin suppression, and immune imbalance. These findings underscore melatonin's dual role as a chronobiotic and immunomodulator. Addressing sleep loss and considering melatonin-based interventions may help restore immune homeostasis. More clinical trials are needed to determine the best dosing, long-term efficacy, and population-specific strategies for supplementation. Promoting healthy sleep is crucial for preventing chronic inflammation and diseases associated with immune dysfunction.}, }
@article {pmid40724691, year = {2025}, author = {Pennisi, F and Borlini, S and Cuciniello, R and D'Amelio, AC and Calabretta, R and Pinto, A and Signorelli, C}, title = {Improving Vaccine Coverage Among Older Adults and High-Risk Patients: A Systematic Review and Meta-Analysis of Hospital-Based Strategies.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {14}, pages = {}, pmid = {40724691}, issn = {2227-9032}, abstract = {Background/Objectives: Adult vaccination remains suboptimal, particularly among older adults and individuals with chronic conditions. Hospitals represent a strategic setting for improving vaccination coverage among these high-risk populations. This systematic review and meta-analysis evaluated hospital-based interventions aimed at enhancing vaccine uptake in adults aged ≥60 years or 18-64 years with at-risk medical conditions. Methods: We conducted a systematic review and meta-analysis following PRISMA and MOOSE guidelines. Searches in PubMed, EMBASE, and Scopus identified studies published in the last 10 years evaluating hospital-based interventions reporting vaccination uptake. The risk of bias was assessed using validated tools (NOS, RoB 2, ROBINS-I, QI-MQCS). A meta-analysis was conducted for categories with ≥3 eligible studies reporting pre- and post-intervention vaccination coverage in the same population. Results: We included 44 studies. Multi-component strategies (n = 21) showed the most consistent results (e.g., pneumococcal uptake from 2.2% to 43.4%, p < 0.001). Reminder-based interventions (n = 4) achieved influenza coverage increases from 31.0% to 68.0% and a COVID-19 booster uptake boost of +38% after SMS reminders. Educational strategies (n = 11) varied in effectiveness, with one study reporting influenza coverage rising from 1.6% to 12.2% (+662.5%, OR 8.86, p < 0.01). Standing order protocols increased pneumococcal vaccination from 10% to 60% in high-risk adults. Hospital-based catch-up programs improved DTaP-IPV uptake from 56.2% to 80.8% (p < 0.001). For patient education, the pooled OR was 2.11 (95% CI: 1.96-2.27; p < 0.001, I[2] = 97.2%) under a fixed-effects model, and 2.47 (95% CI: 1.53-3.98; p < 0.001) under a random-effects model. For multi-component strategies, the OR was 2.39 (95% CI: 2.33-2.44; p < 0.001, I[2] = 98.0%) with fixed effects, and 3.12 (95% CI: 2.49-3.92; p < 0.001) with random effects. No publication bias was detected. Conclusions: Hospital-based interventions, particularly those using multi-component approaches, effectively improve vaccine coverage in older and high-risk adults. Embedding vaccination into routine hospital care offers a scalable opportunity to reduce disparities and enhance population-level protection. Future policies should prioritize the institutional integration of such strategies to support healthy aging and vaccine equity.}, }
@article {pmid40724506, year = {2025}, author = {Kostorz-Nosal, S and Kowaliński, M and Spyra, A and Gałuszka, B and Skoczyński, S}, title = {The Application of Ultrasonography in the Detection of Airway Obstruction: A Promising Area of Research or Unnecessary Gadgetry?.}, journal = {Life (Basel, Switzerland)}, volume = {15}, number = {7}, pages = {}, pmid = {40724506}, issn = {2075-1729}, support = {BNW-1-118/N/4/K//Medical University of Silesia/ ; }, abstract = {Since the COVID-19 pandemic, the utilization of transthoracic ultrasonography (TTU) in the evaluation of pulmonary field artefacts has become standard practice among clinicians. However, there is a considerable lack of knowledge regarding the assessment of diaphragm mobility in the context of various lung diseases. Although numerous conditions are known to affect diaphragm mobility, including neurological, cardiovascular, and infectious diseases, it appears that pulmonary diseases may also limit the mobility of this major respiratory muscle. Despite the evidence of diaphragm mobility disorders in patients diagnosed with lung cancer, there is a discrepancy in the literature regarding the function of the diaphragm in individuals with chronic obstructive pulmonary disease (COPD). A shared aetiological factor frequently results in the co-occurrence of the aforementioned diseases. It is, however, possible to detect patients whose obstructive airway disease is caused only by the compression of infiltrative and nodal lesions rather than COPD. Bilateral TTU of diaphragmatic mobility in correlation with other available pulmonary function tests and radiological imaging may prove to be a valuable approach to isolating lung cancer patients with COPD overdiagnosis. Conversely, the overdiagnosis of COPD has been implicated in the potentially unnecessary and harmful use of inhaled medications with their adverse effects (e.g., cardiac arrhythmias, limb tremor, cough, and pneumonia), the failure to decrease obstruction in cases of other lung disorders, and the potential to contribute to the delayed diagnosis of the underlying condition responsible for the respiratory symptoms. This paper aims to provide a comprehensive overview of the utilization of ultrasound in the evaluation of diaphragm movement impairments for the detection of obstructions while also delineating the underlying limitations of this technique. Moreover, we propose a diagnostic algorithm for the purpose of excluding unilateral obstruction resulting from infiltrative neoplastic masses based on the ultrasound assessment of diaphragmatic mobility.}, }
@article {pmid40724216, year = {2025}, author = {Liu, Q}, title = {Early Warning Signs for Monitoring Airborne Respiratory Virus Transmission.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {7}, pages = {}, pmid = {40724216}, issn = {1660-4601}, mesh = {Humans ; SARS-CoV-2/isolation &amp; purification ; *Air Microbiology ; COVID-19/transmission ; Aerosols/analysis ; *Environmental Monitoring/methods ; }, abstract = {Airborne respiratory viruses (e.g., influenza, respiratory syncytial virus (RSV), and SARS-CoV-2) continue to pose a serious threat to global public health due to their ability to spread through multiple transmission pathways. Among these, aerosol transmission stands out as a key route, particularly in enclosed environments. However, current monitoring systems have major limitations in sensitivity, standardization, and high time resolution. This study provides a summary of the latest information on the monitoring technologies for respiratory virus aerosols. It discusses the technical and ethical challenges in real-world applications. In addition, this study proposes practical solutions and future development pathways. The aim of this study is to provide theoretical support for building a dynamic, precise, and effective early warning system for monitoring variants of airborne respiratory viruses.}, }
@article {pmid40724171, year = {2025}, author = {Liscano, Y and Anillo Arrieta, LA and Montenegro, JF and Prieto-Alvarado, D and Ordoñez, J}, title = {Early Warning of Infectious Disease Outbreaks Using Social Media and Digital Data: A Scoping Review.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {7}, pages = {}, pmid = {40724171}, issn = {1660-4601}, support = {Direcci&#xf3;n General de Investigaciones of Universidad Santiago de Cali under call No. DGI-01-2025//Universidad Santiago de Cali/ ; }, mesh = {*Social Media ; Humans ; *Disease Outbreaks ; *Communicable Diseases/epidemiology ; }, abstract = {Background and Aim: Digital surveillance, which utilizes data from social media, search engines, and other online platforms, has emerged as an innovative approach for the early detection of infectious disease outbreaks. This scoping review aimed to systematically map and characterize the methodologies, performance metrics, and limitations of digital surveillance tools compared to traditional epidemiological monitoring. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute and PRISMA-SCR guidelines. Scientific databases including PubMed, Scopus, and Web of Science were searched, incorporating both empirical studies and systematic reviews without language restrictions. Key elements analyzed included digital sources, analytical algorithms, accuracy metrics, and validation against official surveillance data. Results: The reviewed studies demonstrate that digital surveillance can provide significant lead times (from days to several weeks) compared to traditional systems. While performance varies by platform and disease, many models showed strong correlations (r > 0.8) with official case data and achieved low predictive errors, particularly for influenza and COVID-19. Google Trends and X (formerly Twitter) emerged as the most frequently used sources, often analyzed using supervised regression, Bayesian models, and ARIMA techniques. Conclusions: While digital surveillance shows strong predictive capabilities, it faces challenges related to data quality and representativeness. Key recommendations include the development of standardized reporting guidelines to improve comparability across studies, the use of statistical techniques like stratification and model weighting to mitigate demographic biases, and leveraging advanced artificial intelligence to differentiate genuine health signals from media-driven noise. These steps are crucial for enhancing the reliability and equity of digital epidemiological monitoring.}, }
@article {pmid40724121, year = {2025}, author = {Komeiha, M and Artyukh, I and Ogundele, OJ and Zhao, QJ and Massaquoi, N and Straus, S and Razak, F and Hosseini, B and Persaud, N and Mishra, S and Eissa, A and Isabel, M and Pinto, AD}, title = {Unveiling the Impact: A Scoping Review of the COVID-19 Pandemic's Effects on Racialized Populations in Canada.}, journal = {International journal of environmental research and public health}, volume = {22}, number = {7}, pages = {}, pmid = {40724121}, issn = {1660-4601}, support = {N/A//Emerging and Pandemic Infections Consortium - Institute for Pandemics, University of Toronto/ ; }, mesh = {*COVID-19/epidemiology/ethnology ; Humans ; Canada/epidemiology ; SARS-CoV-2 ; Pandemics ; *Racial Groups/statistics &amp; numerical data ; Health Status Disparities ; }, abstract = {OBJECTIVES: The objective of this study was to examine the impact of the COVID-19 pandemic on racialized communities and individuals in Canada.<br><br>METHODS: This review followed the Joanna Briggs Institute (JBI) methodology and the PRISMA-ScR guidance on reporting scoping reviews. Ovid MEDLINE ALL, Embase Classic + Embase, CINAHL (Ebsco platform), PsycINFO, and Cochrane were searched for documents that were published after March 2020 and that reported on the social and economic impacts and health outcomes of the COVID-19 pandemic on generally healthy racialized populations that reside in Canada.<br><br>SYNTHESIS: A total of 39 documents were included in this review. Our results show racialized communities faced greater social, economic, and health impacts from the pandemic. These impacts were manifested in the form of high COVID-19 morbidity and mortality rates, increased discrimination, worsening mental health, difficulty in accessing healthcare, and challenges related to accessing food and basic necessities.<br><br>CONCLUSION: Canadian racialized groups have been inequitably affected by the COVID-19 pandemic due to pre-existing inequalities and emerging discrimination. Responsive policy action and robust pandemic preparedness efforts are indispensable in adopting a proactive stance to prevent racialized populations from bearing a disproportionate burden of negative health crises in the future. This necessitates addressing pre-existing disparities and targeting social and economic vulnerability areas. By doing so, we can mitigate the reported social, economic, and health impacts experienced by racialized groups, including challenges related to accessing basic necessities, deteriorating mental health, and barriers to healthcare access.}, }
@article {pmid40723962, year = {2025}, author = {Eke, SM and Cua, A}, title = {Invisible Engines of Resistance: How Global Inequities Drive Antimicrobial Failure.}, journal = {Antibiotics (Basel, Switzerland)}, volume = {14}, number = {7}, pages = {}, pmid = {40723962}, issn = {2079-6382}, abstract = {Antimicrobial resistance (AMR) is considered a global healthcare emergency in the 21st century. Although the evolution of microorganisms through Darwinian mechanisms and antibiotic misuse are established drivers, the structural socioeconomic factors of AMR remain insufficiently explored. This review takes on an analytical perspective, drawing upon a wide spectrum of evidence to examine the extent to which socioeconomic factors contribute to the global proliferation of AMR, with an emphasis on low- and middle-income countries (LMICs). The analytical review at hand was carried out through a search for relevant articles and reviews on PubMed, Google Scholar, the Centers for Disease Control and Prevention, and the World Health Organization database using combinations of the keywords "antimicrobial resistance," "socioeconomic factors," "low- and middle-income countries," "surveillance," "healthcare access," and "agriculture." Preference was given to systematic reviews, high-impact primary studies, and policy documents published in peer-reviewed journals or by reputable global health organizations. Our analysis identifies a complex interplay of systemic vulnerabilities that accelerate AMR in resource-limited settings. A lack of regulatory frameworks regarding non-prescription antibiotic use enables the proliferation of multi-drug-resistant microorganisms. Low sewer connectivity facilitates the environmental dissemination of resistance genes. Proper antibiotic selection is hindered by subpar healthcare systems and limited diagnostic capabilities to deliver appropriate treatment. Additionally, gender disparities, forced migration, and climate-driven zoonotic transmission compound the burden. During the COVID-19 pandemic, antimicrobial misuse surged, further amplifying resistance trends. AMR is not solely a biological phenomenon, but a manifestation of global inequity. Mitigation requires a transformation of policy directed toward a "One Health" strategy that incorporates socioeconomic, environmental, and health system reforms. Strengthening surveillance, investing in infrastructure, regulating pharmaceutical practices, and promoting health equity are essential to curb the rising tide of resistance.}, }
@article {pmid40723899, year = {2025}, author = {Camps, J and Iftimie, S and Jiménez-Franco, A and Castro, A and Joven, J}, title = {Metabolic Reprogramming in Respiratory Viral Infections: A Focus on SARS-CoV-2, Influenza, and Respiratory Syncytial Virus.}, journal = {Biomolecules}, volume = {15}, number = {7}, pages = {}, pmid = {40723899}, issn = {2218-273X}, mesh = {Humans ; *SARS-CoV-2/metabolism ; *COVID-19/metabolism/virology ; *Respiratory Syncytial Virus Infections/metabolism/virology ; *Influenza, Human/metabolism/virology ; Respiratory Syncytial Viruses/metabolism ; Orthomyxoviridae/metabolism ; Metabolic Reprogramming ; }, abstract = {Respiratory infections caused by severe acute respiratory syndrome coronavirus 2, influenza virus, and respiratory syncytial virus pose significant global health challenges, leading to high morbidity and mortality, particularly in vulnerable populations. Despite their distinct virological characteristics, these viruses exploit host cellular metabolism to support replication, modulate immune responses, and promote disease progression. Emerging evidence shows that they induce metabolic reprogramming, shifting cellular energy production toward glycolysis to meet the bioenergetic demands of viral replication. Additionally, alterations in lipid metabolism, including enhanced fatty acid synthesis and disrupted cholesterol homeostasis, facilitate viral entry, replication, and immune evasion. The dysregulation of mitochondrial function and oxidative stress pathways also contributes to disease severity and long-term complications, such as persistent inflammation and immune exhaustion. Understanding these metabolic shifts is crucial for identifying new therapeutic targets and novel biomarkers for early disease detection, prognosis, and patient stratification. This review provides an overview of the metabolic alterations induced by severe acute respiratory syndrome coronavirus 2, influenza virus, and respiratory syncytial virus, highlighting shared and virus-specific mechanisms and potential therapeutic interventions.}, }
@article {pmid40723879, year = {2025}, author = {Chrostek, L and Cylwik, B}, title = {Hyaluronic Acid in Immune Response.}, journal = {Biomolecules}, volume = {15}, number = {7}, pages = {}, pmid = {40723879}, issn = {2218-273X}, mesh = {*Hyaluronic Acid/immunology/metabolism ; Humans ; Signal Transduction ; Animals ; COVID-19/immunology ; Cytokines/metabolism/immunology ; Inflammation/immunology ; SARS-CoV-2/immunology ; }, abstract = {This review summarizes the available evidence on hyaluronic acid's (HA's) role in immune response. HA is one of many components in the extracellular matrix that transmits signals from the extracellular microenvironment to cellular effector systems in immune cells. The final effect of these interactions depends on the type of cells and receptors used and the size of HA particles. HA's activation of intracellular signaling pathways leads to an immune response involving the release of pro- or anti-inflammatory cytokines and chemokines. These play a crucial role in defense mechanisms, such as protecting against pathogens and tissue healing after injuries. HA, as a signaling particle, is also involved in the intensification of the cytokine storm during COVID-19. Multifold increases in HA content in the lungs and the strength of its impact on the immune system define an "HA storm". The molecular mechanisms involved in inflammation and initiation, including the promotion of cancer, also begin in the microenvironment, and hyaluronic acid is a key element. In this paper, we focus on intra- and intercellular signaling pathways using HA participation rather than injection preparation based on HA use for esthetic treatment.}, }
@article {pmid40723876, year = {2025}, author = {Richardson, E and Mo, CC and Calabretta, E and Corrado, F and Kocoglu, MH and Baron, RM and Connors, JM and Iacobelli, M and Wei, LJ and Benjamin, EJ and Rapoport, AP and Díaz-Ricart, M and Martínez-Mellado, AJ and Carlo-Stella, C and Richardson, PG and Moraleda, JM}, title = {Defibrotide for Protecting Against and Managing Endothelial Injury in Hematologic Malignancies and COVID-19.}, journal = {Biomolecules}, volume = {15}, number = {7}, pages = {}, pmid = {40723876}, issn = {2218-273X}, mesh = {Humans ; *Hematologic Neoplasms/drug therapy/complications/pathology ; *Polydeoxyribonucleotides/therapeutic use/pharmacology ; *COVID-19/complications/pathology/virology ; SARS-CoV-2 ; Hepatic Veno-Occlusive Disease/drug therapy ; *COVID-19 Drug Treatment ; Graft vs Host Disease/drug therapy ; Cytokine Release Syndrome/drug therapy ; *Fibrinolytic Agents/therapeutic use/pharmacology ; }, abstract = {Defibrotide, which is approved for treating hepatic veno-occlusive disease (VOD)/sinusoidal obstruction syndrome (SOS), exhibits pleiotropic anti-inflammatory, anti-thrombotic, and fibrinolytic properties, conferring broad endothelial protective effects. Given these mechanisms, defibrotide has potential utility in various conditions involving endothelial injury or activation. In this review we outline the endothelial-protective mechanisms of defibrotide and comprehensively summarize current evidence supporting its applications in hematologic malignancies, including the prevention and treatment of hepatic VOD/SOS, graft-versus-host disease, and transplant-associated thrombotic microangiopathy. Additionally, we discuss its role in mitigating key toxicities linked to chimeric antigen receptor (CAR) T-cell therapies and bispecific antibodies, such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). We also explore emerging evidence on defibrotide's potential in SARS-CoV-2 infection-associated endotheliopathies, including acute COVID-19 and post-acute sequelae of SARS-CoV-2 infection ("long-COVID"), and the endothelial protective activity of defibrotide in these settings. Finally, we highlight potential future applications of defibrotide in hematologic malignancies and viral infections, emphasizing its multimodal mechanism of action.}, }
@article {pmid40723102, year = {2025}, author = {Rizzo, R and Fusto, G and Marino, S and Castagnola, I and Parano, C and Pappalardo, XG and Parano, E}, title = {Molecular and Neurobiological Imbalance from the Use of Technological Devices During Early Child Development Stages.}, journal = {Children (Basel, Switzerland)}, volume = {12}, number = {7}, pages = {}, pmid = {40723102}, issn = {2227-9067}, abstract = {Background/Objectives: Digital technologies have become increasingly integrated into the daily lives of children and adolescents, largely because their interactive and visually engaging design is particularly suited to the younger users. The COVID-19 pandemic further accelerated this trend, significantly lowering the average age of access to the digital devices. However, scientific consensus remains divided regarding the developmental impact of digital media use-particularly its cognitive, motor, and emotional consequences-depending on whether the use is passive or active. This review aims to explore these effects across developmental stages, focusing on both behavioral and neurobiological dimensions, and to identify emerging risks and protective factors associated with digital engagement. Methods: A PRISMA review was conducted on the impact of digital media use among pre-school children and adolescents. Behavioral, psychosocial, and neurobiological aspects were examined, with specific attention to epigenetic changes, techno-stress, digital overstimulation, and immersive technologies (e.g., virtual and augmented reality). Results: The findings suggest that passive digital consumption is more often associated with negative outcomes, such as impaired attention and emotional regulation, especially in younger children. Active and guided use may offer cognitive benefits. Neurobiological research indicates that chronic exposure to digital stimuli may affect stress regulation and neural development, possibly via epigenetic mechanisms. Effects vary across developmental stages and individual vulnerabilities. Conclusions: A nuanced understanding of digital engagement is essential. While certain technologies can support development, excessive or unguided use may pose risks. This review provides age-specific recommendations to foster balanced and healthy technology use in children and adolescents.}, }
@article {pmid40722944, year = {2025}, author = {Cárdenas-Rodríguez, N and Ignacio-Mejía, I and Mejía-Barradas, CM and Ortega-Cuellar, D and Muñoz-González, F and Vargas-Hernández, MA and Albores-Méndez, EM and Ibáñez-Cervantes, G and Medina-Santillán, R and Hernández-Ortiz, A and Herrera-López, E and Bandala, C}, title = {Post-COVID Condition and Neuroinflammation: Possible Management with Antioxidants.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {14}, number = {7}, pages = {}, pmid = {40722944}, issn = {2076-3921}, abstract = {Post-COVID condition (PCC) is a complex syndrome characterized by the persistence of diverse symptoms-including respiratory, neurological, and psychiatric manifestations-that last for weeks or months after acute Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. Epidemiological data indicate a higher prevalence among women and older adults, with significant impacts on daily functioning. The pathophysiology of PCC is multifactorial, involving immune dysregulation, viral persistence, mitochondrial dysfunction, and oxidative stress, all of which contribute to sustained neuroinflammation. This narrative review examines the clinical features, risk factors, and current evidence on antioxidant-based interventions as potential therapeutic strategies for PCC. A wide range of compounds-including vitamins, polyphenols, and endogenous antioxidants-have shown promise in mitigating neuroinflammation and oxidative damage in both clinical and experimental settings. Antioxidants may help restore redox balance and improve neurological outcomes in affected patients. However, further clinical research is essential to determine their efficacy, safety, and optimal therapeutic protocols.}, }
@article {pmid40722812, year = {2025}, author = {Kim, B and Han, N}, title = {Periodontal Pathobionts and Respiratory Diseases: Mechanisms of Interaction and Implications for Interdisciplinary Care.}, journal = {Biomedicines}, volume = {13}, number = {7}, pages = {}, pmid = {40722812}, issn = {2227-9059}, support = {NSFC No. 81500844//National Natural Science Foundation of China/ ; }, abstract = {Periodontitis is a prevalent chronic inflammatory disease that has been increasingly recognized for its systemic impacts, including its connection to respiratory diseases such as pneumonia, chronic obstructive pulmonary disease (COPD), Obstructive Sleep Apnea (OSA), asthma, lung cancer, and COVID-19. This review explores the potential role of periodontal pathobionts, particularly Porphyromonas gingivalis (Pg), Treponema denticola (Td), Fusobacterium nucleatum (Fn), Aggregatibacter actinomycetemcomitans (Aa), and Tannerella forsythia (Tf), in respiratory health. These pathobionts contribute to respiratory diseases by facilitating pathogen adhesion, inducing epithelial cell apoptosis, and promoting inflammation. The review also highlights the beneficial effects of periodontal treatment in reducing pathobiont burden and systemic inflammation, thereby mitigating the risk of respiratory complications. This interdisciplinary approach underscores the need to consider oral health as a critical component in managing and preventing respiratory diseases, with future research needed to further clarify these associations and develop targeted interventions.}, }
@article {pmid40722579, year = {2025}, author = {Caliman Sturdza, OA and Filip, F and Terteliu Baitan, M and Dimian, M}, title = {Deep Learning Network Selection and Optimized Information Fusion for Enhanced COVID-19 Detection: A Literature Review.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {15}, number = {14}, pages = {}, pmid = {40722579}, issn = {2075-4418}, abstract = {The rapid spread of COVID-19 increased the need for speedy diagnostic tools, which led scientists to conduct extensive research on deep learning (DL) applications that use chest imaging, such as chest X-ray (CXR) and computed tomography (CT). This review examines the development and performance of DL architectures, notably convolutional neural networks (CNNs) and emerging vision transformers (ViTs), in identifying COVID-19-related lung abnormalities. Individual ResNet architectures, along with CNN models, demonstrate strong diagnostic performance through the transfer protocol; however, ViTs provide better performance, with improved readability and reduced data requirements. Multimodal diagnostic systems now incorporate alternative methods, in addition to imaging, which use lung ultrasounds, clinical data, and cough sound evaluation. Information fusion techniques, which operate at the data, feature, and decision levels, enhance diagnostic performance. However, progress in COVID-19 detection is hindered by ongoing issues stemming from restricted and non-uniform datasets, as well as domain differences in image standards and complications with both diagnostic overfitting and poor generalization capabilities. Recent developments in COVID-19 diagnosis involve constructing expansive multi-noise information sets while creating clinical process-oriented AI algorithms and implementing distributed learning protocols for securing information security and system stability. While deep learning-based COVID-19 detection systems show strong potential for clinical application, broader validation, regulatory approvals, and continuous adaptation remain essential for their successful deployment and for preparing future pandemic response strategies.}, }
@article {pmid40722282, year = {2025}, author = {Abdul Manan, H and de Jesus, R and Thaploo, D and Hummel, T}, title = {Mapping the Olfactory Brain: A Systematic Review of Structural and Functional Magnetic Resonance Imaging Changes Following COVID-19 Smell Loss.}, journal = {Brain sciences}, volume = {15}, number = {7}, pages = {}, pmid = {40722282}, issn = {2076-3425}, support = {Deutsche Forschungsgemeinschaft (DFG CA 893/22-1, Project number 504505452)//Deutsche Forschungsgemeinschaft (DFG CA 893/22-1, Project number 504505452)/ ; }, abstract = {BACKGROUND: Olfactory dysfunction (OD)-including anosmia and hyposmia-is a common and often persistent outcome of viral infections. This systematic review consolidates findings from structural and functional MRI studies to explore how COVID-19 SARS-CoV-2-induced smell loss alters the brain. Considerable heterogeneity was observed across studies, influenced by differences in methodology, population characteristics, imaging timelines, and OD classification.<br><br>METHODS: Following PRISMA guidelines, we conducted a systematic search of PubMed/MEDLINE, Scopus, and Web of Science to identify MRI-based studies examining COVID-19's SARS-CoV-2 OD. Twenty-four studies were included and categorized based on imaging focus: (1) olfactory bulb (OB), (2) olfactory sulcus (OS), (3) grey and white matter changes, (4) task-based brain activation, and (5) resting-state functional connectivity. Demographic and imaging data were extracted and analyzed accordingly.<br><br>RESULTS: Structural imaging revealed consistent reductions in olfactory bulb volume (OBV) and olfactory sulcus depth (OSD), especially among individuals with OD persisting beyond three months, suggestive of inflammation and neurodegeneration in olfactory-associated regions like the orbitofrontal cortex and thalamus. Functional MRI studies showed increased connectivity in early-stage OD within regions such as the piriform and orbitofrontal cortices, possibly reflecting compensatory activity. In contrast, prolonged OD was associated with reduced activation and diminished connectivity, indicating a decline in olfactory processing capacity. Disruptions in the default mode network (DMN) and limbic areas further point to secondary cognitive and emotional effects. Diffusion tensor imaging (DTI) findings-such as decreased fractional anisotropy (FA) and increased mean diffusivity (MD)-highlight white matter microstructural compromise in individuals with long-term OD.<br><br>CONCLUSIONS: COVID-19's SARS-CoV-2 olfactory dysfunction is associated with a range of cerebral alterations that evolve with the duration and severity of smell loss. Persistent dysfunction correlates with greater neural damage, underscoring the need for longitudinal neuroimaging studies to better understand recovery dynamics and guide therapeutic strategies.}, }
@article {pmid40722204, year = {2025}, author = {Thiha, N and Soe, PP and Win, HH and Delorme, L and Clevenbergh, PA and Babin, FX}, title = {Exploring the psychological impact on children and adolescents during the initial period of the COVID-19 pandemic-a systematic review.}, journal = {BMC psychology}, volume = {13}, number = {1}, pages = {842}, pmid = {40722204}, issn = {2050-7283}, abstract = {The impact of the COVID-19 pandemic on the mental well-being of children and teenagers has gained increased recognition, but a systematic review to assess its effects on their mental health has not yet been conducted using the PRISMA and PICOS framework. Therefore, this review aimed to evaluate global changes in psychological well-being among young people by analysing longitudinal and repeated cross-sectional studies conducted before and during the pandemic. The review analysed data from 21 studies in 10 countries, involving 87,486 participants under the age of 19. The majority of the research found a long-term decline in young people’s psychological health, including higher levels of depression, anxiety, and psychological distress during the pandemic. Studies highlighted that factors such as confinement, stress, environmental hazards, and financial crises significantly impacted household dynamics, which in turn affected children’s development and psychological well-being. Emerging studies from various regions worldwide suggest a potential decline in the mental health of school-aged adolescents during the COVID-19 pandemic. This review underscores the need for further research to understand the severe and long-term consequences of the pandemic on children’s mental health.}, }
@article {pmid40721817, year = {2025}, author = {Yogendra, R and Perlowski, A and Johng, B and Dahshan, H and Orr, C and Jeffers, D and Husain, K and Patterson, BK}, title = {Perioperative and anesthetic considerations for post-acute sequelae of COVID (PASC)/long COVID.}, journal = {Perioperative medicine (London, England)}, volume = {14}, number = {1}, pages = {80}, pmid = {40721817}, issn = {2047-0525}, abstract = {Post-acute sequelae of COVID (PASC), commonly known as long COVID, presents with a broad spectrum of medical conditions and symptoms persisting beyond 3 months post-SARS-CoV-2 infection, affecting over 18 million Americans and 65 million people worldwide. Despite its prevalence, to date, there are no specific clinical guidelines for the perioperative management of PASC patients. PASC is a complex, multisystemic condition leading to neurological, respiratory, and endocrine sequelae, potentially resulting from persistent viral presence, immune dysregulation, and/or end-organ damage. This manuscript discusses the implications of these sequelae on anesthesia practice, emphasizing the need for vigilance in pre-operative assessments to identify PASC and associated conditions through detailed patient history, understanding of off-label medication use, and familiarity with medical terminologies like POTS, MCAS, and brain fog. Key perioperative considerations include cautious use of anesthetics, especially in patients with neurological and cardiovascular complications. Pulmonary management strategies for PASC patients, such as lung-protective ventilation and non-invasive post-operative support, could mitigate any perioperative respiratory complications. Finally, we underscore the importance of a multidisciplinary approach to manage PASC patients effectively during surgery, advocating for personalized anesthetic plans and calling for more evidence-driven guidelines for this emerging patient group as research progresses.}, }
@article {pmid40721512, year = {2025}, author = {Xiang, C and Park, AY and Weber, SE and Lenardo, MJ and Ozen, A and Cui, J}, title = {The impact of genetic immune disorders on infections including COVID-19, inflammatory bowel disease and cancer.}, journal = {Nature immunology}, volume = {26}, number = {9}, pages = {1440-1452}, pmid = {40721512}, issn = {1529-2916}, mesh = {Humans ; *Inflammatory Bowel Diseases/genetics/immunology ; *COVID-19/immunology/genetics ; *Neoplasms/immunology/genetics ; *SARS-CoV-2/immunology ; *Genetic Diseases, Inborn/immunology/genetics ; Genetic Predisposition to Disease ; }, abstract = {Inborn errors of immunity (IEIs) are rare genetic anomalies that cause defective immune function. Over 500 IEIs have been identified to date, affecting millions of patients globally. These IEIs reveal the complex interplay between genetics, the environment and microorganisms that determine immune disease phenotypes. Progress in understanding the molecular and cellular mechanisms of IEIs provides a genetic framework for a functional understanding of the human immune system, disease pathogenesis and successful therapeutic interventions. This Review describes how IEIs impact infectious diseases, particularly coronavirus disease 2019, inflammatory bowel disease and cancer.}, }
@article {pmid40721118, year = {2025}, author = {Cao, YF and Zhong, H and Liu, ZP and Guo, Q and Zeng, KW}, title = {Lonicera japonica Thunb. in acute lung injury: A systematic review of bioactive components and multi-target mechanisms.}, journal = {Fitoterapia}, volume = {185}, number = {}, pages = {106764}, doi = {10.1016/j.fitote.2025.106764}, pmid = {40721118}, issn = {1873-6971}, mesh = {*Lonicera/chemistry ; *Acute Lung Injury/drug therapy ; Humans ; *Anti-Inflammatory Agents/pharmacology ; Animals ; *Phytochemicals/pharmacology ; Chlorogenic Acid/pharmacology ; COVID-19 Drug Treatment ; Phytotherapy ; }, abstract = {BACKGROUND: Acute lung injury (ALI), characterized by dysregulated host-pathogen interactions and hyperinflammatory responses, poses a critical clinical burden in viral infections such as influenza and COVID-19. Lonicera japonica Thunb. (LJT), a cornerstone herb in traditional medicine for respiratory ailments exhibits multi-component synergy with documented anti-ALI properties. However, its phytochemical determinants and polypharmacological mechanisms remain underexplored.<br><br>PURPOSE: This review aims to systematically decode the bioactive phytoconstituents of LJT driving ALI protection and establish their multi-target mechanisms through integrative pharmacology.<br><br>METHODS: The information was compiled from major scientific databases such as the Chinese National Knowledge Infrastructure (CNKI), Elsevier, ScienceDirect, PubMed, and Web of Science. Relevant literature was extracted from the above databases using the keywords "acute lung injury," "Lonicera japonica," "anti-inflammatory," and "chlorogenic acid."<br><br>RESULTS: LJT's bioactive matrix orchestrates ALI mitigation via: 1) TLR4/MyD88/NF-&#x3ba;B axis suppression, reducing TNF-&#x3b1;, IL-6, and NLRP3 inflammasome activation; 2) Nrf2/HO-1-mediated oxidative stress resolution; 3) direct antiviral effects against influenza.<br><br>CONCLUSION: This mechanistic elucidation positions LJT as a promising multi-target phytotherapeutic against the cytokine storm phase of ALI.}, }
@article {pmid40720942, year = {2025}, author = {Ulsamer, A and Pomarè Montin, D and Bocciero, V and Parra Morales, TJ and Tofani, L and di Girolamo, L and Romagnoli, S and Villa, G and Cecchi, M}, title = {Interleukin-6 Removal and Clinical Effects of Oxiris: A Systematic Review and Meta-Analysis.}, journal = {Blood purification}, volume = {}, number = {}, pages = {1-10}, doi = {10.1159/000547587}, pmid = {40720942}, issn = {1421-9735}, abstract = {INTRODUCTION: Sepsis is a life-threatening condition associated with high mortality due to an unregulated host immune response. Extracorporeal blood purification (EBP) therapies have been proposed as adjunctive treatments to immunomodulate patients; however, none have been consistently shown to be effective in reducing mortality. In several observational studies, Oxiris has been associated with cytokine reduction and a potential benefit in influencing inflammatory diseases. This meta-analysis explores the association between cytokine removal and clinical efficacy of the Oxiris membrane using interleukin-6 (IL-6) as a biomarker.<br><br>METHODS: This review includes articles on EBP with Oxiris membranes in adult patients with sepsis/septic shock or COVID-19. No time or language restrictions were applied to the systematic literature search. Data extraction and statistical analysis were limited to the cytokines and clinical data reported in the included articles. The most representative cytokine was IL-6 and the selected outcomes included Vasoactive-Inotropic Score (VIS), SOFA score, procalcitonin (PCT) and C-reactive protein (CRP). The review used meta-analysis and unpaired t test to estimate differences between groups of patients treated with or without Oxiris.<br><br>RESULTS: The study found no significant differences in demographics between the intervention and control groups at baseline. Intervention group showed a significant reduction in vasoactive inotropic score, norepinephrine dose, SOFA score, PCT, and CRP.<br><br>CONCLUSION: We reviewed 8 studies in which IL-6 was significantly reduced in the Oxiris group compared to the control. This meta-analysis found that the use of the Oxiris membrane resulted in significant clinical improvement during treatment.}, }
@article {pmid40716716, year = {2025}, author = {Inguva, PK and Mukherjee, S and Walker, PJ and Tenberg, V and Devos, C and Shin, S and Wu, Y and Santra, S and Wang, J and Singh, S and Kanso, MA and Kim, SH and Trout, BL and Bazant, MZ and Myerson, AS and Braatz, RD}, title = {Mechanistic modeling of lipid nanoparticle formation for the delivery of nucleic acid therapeutics.}, journal = {Biotechnology advances}, volume = {84}, number = {}, pages = {108643}, doi = {10.1016/j.biotechadv.2025.108643}, pmid = {40716716}, issn = {1873-1899}, mesh = {*Nanoparticles/chemistry ; *Lipids/chemistry ; *Nucleic Acids/administration &amp; dosage/therapeutic use/chemistry ; Humans ; SARS-CoV-2 ; COVID-19/prevention &amp; control ; *Drug Delivery Systems ; COVID-19 Vaccines ; Liposomes ; }, abstract = {Nucleic acids such as mRNA have emerged as a promising therapeutic modality with the capability of addressing a wide range of diseases. Lipid nanoparticles (LNPs) as a delivery platform for nucleic acids were used in the COVID-19 vaccines and have received much attention. While modern manufacturing processes which involve rapidly mixing an organic stream containing the lipids with an aqueous stream containing the nucleic acids are conceptually straightforward, detailed understanding of LNP formation and structure is still limited and scale-up can be challenging. Mathematical and computational methods are a promising avenue for deepening scientific understanding of the LNP formation process and facilitating improved process development and control. This article describes strategies for the mechanistic modeling of LNP formation, starting with strategies to estimate and predict important physicochemical properties of the various species such as diffusivities and solubilities. Subsequently, a framework is outlined for constructing mechanistic models of reactor- and particle-scale processes. Insights gained from the various models are mapped back to product quality attributes and process insights. Lastly, the use of the models to guide development of advanced process control and optimization strategies is discussed.}, }
@article {pmid40716141, year = {2025}, author = {Cuevas, FI}, title = {Commentary: Processes of pre-clinical and clinical vaccine development public data sharing within the NIAID collaborative influenza vaccine innovation centers (CIVICs).}, journal = {Vaccine}, volume = {62}, number = {}, pages = {127547}, doi = {10.1016/j.vaccine.2025.127547}, pmid = {40716141}, issn = {1873-2518}, mesh = {Humans ; *Information Dissemination/methods ; *Influenza Vaccines/immunology ; United States ; *COVID-19/prevention &amp; control ; National Institute of Allergy and Infectious Diseases (U.S.) ; *Influenza, Human/prevention &amp; control ; *Vaccine Development/methods ; SARS-CoV-2/immunology ; Pandemics/prevention &amp; control ; COVID-19 Vaccines ; }, abstract = {The 2019 coronavirus disease (COVID-19) pandemic increased efforts for rapid data sharing and dissemination among researchers as well as to data repositories. Researchers and studies prioritized data sharing, which increased understanding of SARS-CoV-2's pathology. Eventually, this effort to maximize collaboration and data dissemination, led to the development of mRNA vaccines. This successful effort has highlighted the importance of data sharing and the implementation of data management policies, including the National Institutes of Health's (NIH) Data Sharing Policy of 2023. Moreover, programs such as the National Institute of Allergy and Infectious Diseases (NIAID) funded Collaborative Influenza Vaccine Innovation Centers (CIVICs), have beta-tested this policy, with the help of the Statistical, Data Management and Coordination Center (SDMCC) and its data standards, and deemed it useful. However, the process has also initiated pertinent discussion on potential improvements and optimizations for the future of data sharing. Here, I use the CIVICs data sharing reporting standards and process as a data sharing example, and suggest logistical improvements to propose a better-equipped model for the vaccinology community.}, }
@article {pmid40716013, year = {2025}, author = {Martino, EA and Vigna, E and Bruzzese, A and Amodio, N and Lucia, E and Olivito, V and Labanca, C and Caserta, S and Mendicino, F and Morabito, F and Gentile, M}, title = {Vaccination in Multiple Myeloma: Challenges and Strategies.}, journal = {European journal of haematology}, volume = {115}, number = {4}, pages = {334-343}, pmid = {40716013}, issn = {1600-0609}, mesh = {Humans ; *Multiple Myeloma/immunology/therapy/complications ; *Vaccination/methods ; COVID-19/prevention &amp; control/immunology ; SARS-CoV-2/immunology ; COVID-19 Vaccines/immunology/administration &amp; dosage ; Pneumococcal Vaccines/administration &amp; dosage/immunology/therapeutic use ; Influenza Vaccines/immunology/administration &amp; dosage/therapeutic use ; }, abstract = {BACKGROUND: Multiple myeloma (MM) is a hematological malignancy characterized by profound immunosuppression resulting from both disease-related mechanisms and treatment-induced immune dysfunction. This compromised immune status markedly increases susceptibility to infections, a leading cause of morbidity and mortality in MM patients. While vaccination represents a cornerstone of infection prevention, standard immunization strategies often yield suboptimal responses in this population.<br><br>OBJECTIVES: This review synthesizes current evidence on the immunological barriers and clinical effectiveness of vaccination in MM. We evaluate vaccines targeting influenza, Streptococcus pneumoniae, SARS-CoV-2, and other relevant pathogens, and explore determinants influencing vaccine efficacy, including optimal timing, formulation, and patient-specific immune parameters.<br><br>METHODS: A comprehensive literature review was conducted, encompassing clinical trials, retrospective cohort studies, expert consensus guidelines, and population-based data. Extracted outcomes included serological responses, infection-related events, and vaccine safety in MM patients.<br><br>RESULTS: Patients with MM exhibit impaired vaccine responses due to hypogammaglobulinemia, T- and B-cell dysfunction, and therapy-induced lymphodepletion. Despite modest immunogenicity, influenza and pneumococcal vaccines reduce respiratory infections and hospitalizations. Sequential administration of PCV13 followed by PPSV23, as well as post-autologous stem cell transplantation (ASCT) three-dose regimens, is associated with reduced pneumonia incidence. COVID-19 vaccines elicit variable responses, particularly in patients on anti-CD38 or BCMA-targeted therapies, highlighting the need for booster doses and, in selected cases, prophylactic monoclonal antibodies. Vaccines against herpes zoster, hepatitis B, and Haemophilus influenzae type B are also recommended, particularly around ASCT. Immunophenotypic markers such as CD19+ B-cell and CD4+ T-cell counts are predictive of vaccine responsiveness, supporting immune profiling as a tool for individualized vaccination planning.<br><br>CONCLUSIONS: Vaccination remains a critical component of infection prevention in MM. Although immunogenicity may be attenuated, clinical benefits-namely, reduced infection burden and healthcare utilization-support broad vaccine implementation. A personalized approach, considering the treatment phase, disease control, and immune status, is essential to optimize vaccine effectiveness. Ongoing research into high-dose, adjuvanted, and next-generation vaccines is critical to enhance protection in this vulnerable population.}, }
@article {pmid40720171, year = {2025}, author = {Banerjee, B and Halder, S and Kumar, S and Chaddha, M and Ali, R and Mohite, R and Bano, M and Pandey, R}, title = {Genomic insights into bacteriophages: a new frontier in AMR detection and phage therapy.}, journal = {Briefings in functional genomics}, volume = {24}, number = {}, pages = {}, pmid = {40720171}, issn = {2041-2657}, support = {INV-033578/GATES/Gates Foundation/United States ; 2021 HTH 018//Rockefeller Foundation/ ; GAP0276//AIDS Healthcare Foundation/ ; }, mesh = {*Bacteriophages/genetics ; *Phage Therapy/methods ; Humans ; *Genomics/methods ; *Genome, Viral ; Bacteria/virology/genetics/drug effects ; Bacterial Infections/therapy/microbiology ; }, abstract = {The misuse and overprescription of antibiotics have accelerated the rise of antimicrobial resistance (AMR), rendering many antibiotics ineffective and leading to significant clinical challenges. The conventional treatment methods have become progressively challenging, posing a threat of evolving into an impending silent pandemic. The long track record of bacteriophages combating bacterial infections has renewed hope into the potential therapeutic benefits of bacteriophages. Bacteriophage therapy offers a promising alternative to antibiotics, particularly against multidrug-resistant (MDR) pathogens. This article explores the promise of phages as a potential means to combat superbugs from the perspective of the genomic and transcriptomic landscape of the phages and their bacterial host. Advances in bacteriophage genomics have expedited the detection of new phages and AMR genes, enhancing our understanding of phage-host interactions and enabling the identification of potential treatments for antibiotic-resistant bacteria. At the same time, holo-transcriptomic studies hold potential for discovering disease and context-specific transcriptionally active phages vis-à-vis disease severity. Holo-transcriptomic profiling can be applied to investigate the presence of AMR-bacteria, highlighting COVID-19 and Dengue diseases, in addition to the globally recognized ESKAPE pathogens. By simultaneously capturing phage, bacterial and host transcripts, this approach enables a better comprehension of the bacteriophage dynamics. Moreover, insight into these defence and counter-defence interactions is essential for augmenting the adoption of phage therapy at scale and advancing bacterial control in clinical settings.}, }
@article {pmid40720045, year = {2025}, author = {Balakrishnan, R and Subbarayan, R and Shrestha, R and Chauhan, A}, title = {Intersection of COVID-19 and Alzheimer's Disease: Genetic Insights and Neuropathological Consequences.}, journal = {Biochemical genetics}, volume = {}, number = {}, pages = {}, pmid = {40720045}, issn = {1573-4927}, abstract = {The potential link between viral infections and the onset of Alzheimer's disease (AD) has been debated for several years. The emergence of the SARS-CoV-2 pandemic has raised concerns regarding its potential role in predisposing individuals to AD or aggravating its progression. The widespread transmission of SARS-CoV-2 has introduced novel aspects to AD research, driving comprehensive investigations into the possible correlation between COVID-19 and neuropathological manifestations observed in patients with AD. This review explores the complex connection between COVID-19 and Alzheimer's disease by examining both the direct effects of SARS-CoV-2 on the brain and the indirect impacts of the infection on the overall health of individuals with Alzheimer's disease. An overview of COVID-19 is provided, followed by a detailed discussion of Alzheimer's disease, including its clinical presentation and neuropathological consequences. Moreover, our review aimed to identify key candidate genes, such as ACE2, TMPRSS2, OAS1, and APOE4, which have been implicated in COVID-19 and AD. We analyzed data from multiple genomic and transcriptomic databases to elucidate the genetic factors underlying the association between these two conditions. Furthermore, with advancements in contemporary genomic technologies, this review highlights potential genetic mutations and variations that may serve as crucial biomarkers, risk predictors, and therapeutic targets. Elucidating these molecular interactions could offer critical insights for advancing future research and formulating innovative therapeutic interventions for Alzheimer's disease within the framework of SARS-CoV-2 infection.}, }
@article {pmid40719006, year = {2025}, author = {Oleszkiewicz, A and Croy, I and Hummel, T}, title = {The impact of olfactory loss on quality of life: a 2025 review.}, journal = {Chemical senses}, volume = {50}, number = {}, pages = {}, pmid = {40719006}, issn = {1464-3553}, support = {20 #2020/39/B/HS6/01533//National Science Center (Poland)/ ; 101046369//European Innovation Council/ ; }, mesh = {Humans ; *Quality of Life ; *COVID-19/complications/epidemiology ; *Olfaction Disorders/psychology/physiopathology ; Smell/physiology ; }, abstract = {For a long time, the sense of smell was considered the neglected stepbrother of human sensory abilities, and the loss of smell has received little attention. This perception changed dramatically with the COVID-19 pandemic, which led to millions of people losing their sense of smell, and some never recovering. COVID-19 not only increased general awareness of olfactory disorders but also accelerated research into the role of smell in nonverbal communication and mental health. This review aims to summarize the literature on the impact of olfactory disorders on quality of life. Starting from the functions of olfaction in healthy individuals, we will briefly describe the most common olfactory disorders and their effect on an individual's life, including nutrition and eating behaviors, social and psychological well-being, and exposure to environmental hazards. Consequences of olfactory loss permeate many spheres of daily life. On average, dysosmia has a moderate impact on quality of life, though for some patients the effects can be severe.}, }
@article {pmid40718973, year = {2025}, author = {Manes, MT and Giubilato, S and Francese, M and Mannarini, A and Ciliberti, G and Pavan, D and Di Fusco, SA and Rossini, R and Khoury, G and Aschieri, D and Scardovi, B and Bruno, N and Cocozza, S and Gulizia, MM and Geraci, G and Gabrielli, D and Colivicchi, F and Grimaldi, M and Oliva, F}, title = {[Individual's eHealth literacy: an update].}, journal = {Giornale italiano di cardiologia (2006)}, volume = {26}, number = {8}, pages = {604-610}, doi = {10.1714/4531.45336}, pmid = {40718973}, issn = {1972-6481}, mesh = {Humans ; *Telemedicine ; *Health Literacy ; *COVID-19/epidemiology ; Age Factors ; Socioeconomic Factors ; Sex Factors ; }, abstract = {The escalation in demand for digital health services, particularly highlighted by recent global health crises, has emphasized the significance of eHealth literacy (eHL). This concept encompasses the skills necessary to effectively search for, comprehend, evaluate, and apply online health information to solve health-related issues. eHL not only facilitates navigation through the digital health landscape but also broadens the understanding of the digital divide within the context of health information accessibility. In this review, we encompassed individual eHL definitions and tools, focusing on the role of eHL during the COVID-10 outbreak, and with regard to gender, age and social inequalities.}, }
@article {pmid40718283, year = {2025}, author = {Mathew, A and Dongre, R and Kim, SH and Turner, J and Mathew, A and Cherryholmes, E and Mehrinfar, M and Kamprath, S}, title = {The Clinical Applications of Psilocybin Therapies and Post-COVID Syndrome: A Comprehensive Narrative Review.}, journal = {Cureus}, volume = {17}, number = {6}, pages = {e86659}, pmid = {40718283}, issn = {2168-8184}, abstract = {The coronavirus variant (causing the COVID-19 disease) that led to a pandemic sent global shockwaves, resulting in long-term effects on physical, mental, and social well-being and impacting both individuals and communities. With the pandemic's notable impact on mental health, one such potential treatment discussed in recent literature is psilocybin. Psilocybin is a naturally occurring prodrug compound found in select mushrooms shown to reduce clinical symptoms of certain mental health disorders. In this study, we review the status and usage of psilocybin in clinical practice preceding and following the COVID-19 pandemic. The search criteria for the study included psilocybin or psychedelics or psychedelic-therapy psychiatry and long-haul COVID. The search spanned English articles from January 2020 to April 2024, utilizing the PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and PubMed databases. Two reviewers independently screened each record to decide if a study met the inclusion criteria and to account for bias. Each article researched different pathologies, including depression, anxiety, post-traumatic stress disorder, and COVID-19. The manuscripts collectively emphasize that there is evidence that psilocybin has a role in the treatment of said pathologies, with relatively safe outcomes if administered under proper medical supervision. Psilocybin use was followed up for a relatively long period after some trials, but further research is warranted to draw a more definitive conclusion regarding the therapeutic uses of psilocybin. Our review reflects that barriers to using psilocybin therapeutically for long-haul COVID-19 exist, which significantly impacts the scope of our research. While evidence suggests its efficacy in mental health conditions such as depression and mood disorders, more robust clinical trials are needed. Current literature supports the pharmacological basis that psilocybin may be effective in treating COVID-19 sequelae. Psilocybin's role in inhibiting SARS-Cov-2 protease shows promise, but ultimately, in vitro validation will be necessary before wider approval of the drug. Lastly, large clinical trials comparing psilocybin to standard care and assessing symptom relief in long-term COVID patients may help validate the findings seen in much of the current literature.}, }
@article {pmid40717731, year = {2025}, author = {Joodaki, M and Seif, F and Afzalnia, A and Emtiazi, N and Shirazi, MM and Ashtari, B and Hosseinian, SM and Hosseini, N}, title = {COVID-19 vaccines and neurological disorders: A narrative review of immune responses and adverse reactions.}, journal = {AIMS neuroscience}, volume = {12}, number = {2}, pages = {222-249}, pmid = {40717731}, issn = {2373-7972}, abstract = {COVID-19 vaccines have been effective in providing strong immunity within a relatively short time frame, significantly reducing both the severity of the disease and associated mortality. However, post-vaccination complications, particularly neurological disorders, have been reported. Among the more frequently documented neurological complications are acute disseminated encephalomyelitis (ADEM), multiple sclerosis (MS), transverse myelitis (TM), optic neuritis (ON), Bell's palsy (BP), and Guillain-Barré syndrome (GBS). The precise role of COVID-19 vaccines in triggering the onset or relapse of these conditions remains uncertain. Immunological processes involving cytokines, chemokines, antibodies, and immune cells are believed to contribute to the pathogenesis of these neurological side effects. This review examines the immune responses triggered by COVID-19 vaccines and their potential role in the development of such complications. Despite reports of neurological side effects, these cases remain rare, and the overall benefits of vaccination in curbing the pandemic and preventing severe illness far exceed the risks. It is vital to sustain the progress of global vaccination efforts while continuously evaluating the risk-benefit ratio, particularly for individuals with underlying conditions. Ongoing research and surveillance are crucial for creating safer vaccines and identifying individuals who may be more susceptible to adverse reactions, ensuring broader protection against COVID-19.}, }
@article {pmid40717478, year = {2025}, author = {Bajić, D and Todorović, N and Popović, ML and Plazačić, M and Mihajlović, A}, title = {Immunity's core reset: Synbiotics and gut microbiota in the COVID-19 era.}, journal = {Innate immunity}, volume = {31}, number = {}, pages = {17534259251362023}, pmid = {40717478}, issn = {1753-4267}, mesh = {Humans ; *COVID-19/immunology/microbiology ; *Gastrointestinal Microbiome/immunology ; *Synbiotics/administration &amp; dosage ; *SARS-CoV-2/immunology ; *Dysbiosis/immunology/microbiology ; Probiotics/therapeutic use ; Prebiotics/administration &amp; dosage ; Inflammation/immunology ; }, abstract = {The gut microbiome plays a crucial role in shaping immune responses, and its connection to immunity has never been more relevant than in the COVID-19 era. The interaction between gut microbes and the immune system, known as microbiome-immunity crosstalk, influences both how the body responds to infections and how well it recovers. COVID-19, whether in its acute phase or lingering as long COVID, has been linked to disturbances in the gut microbiome. During infection, many patients experience dysbiosis-an imbalance in gut bacteria-that can contribute to immune dysfunction and excessive inflammation. This imbalance may not only worsen the severity of the disease but also prolong recovery, leading to persistent symptoms like fatigue, brain fog, and digestive issues. Long COVID, in particular, has been associated with ongoing immune dysregulation, where the body's defense system remains in a state of heightened activation, causing chronic inflammation. Given the strong link between gut health and immunity, there is growing interest in strategies to restore microbial balance. Synbiotics-combinations of probiotics (beneficial bacteria) and prebiotics (nutrients that support them)-are being explored as a potential therapeutic approach. By replenishing beneficial gut microbes, synbiotics may help regulate immune responses, reduce inflammation, and support overall recovery from COVID-19. Emerging research suggests that improving gut health could enhance the body's ability to fight infections and recover more efficiently. As we continue to understand the long-term impact of COVID-19, focusing on the gut microbiome offers a promising path forward. Supporting a balanced and diverse microbiome through diet, lifestyle, and targeted interventions like synbiotics may provide a natural way to strengthen immunity and improve health outcomes in both acute and long COVID cases.}, }
@article {pmid40714940, year = {2025}, author = {Zhang, J and Guo, J and Li, J and Gao, J and Liu, J and Shen, S and Zhu, J}, title = {The Role of Emerging/Re-Emerging RNA Viruses in Bone-Related Diseases With a Focus on DENV, CHIKV, and SARS-CoV-2.}, journal = {Reviews in medical virology}, volume = {35}, number = {4}, pages = {e70053}, doi = {10.1002/rmv.70053}, pmid = {40714940}, issn = {1099-1654}, support = {20222A146//Zhejiang Traditional Chinese Medicine Science and Technology Project/ ; LGF22H060032//Zhejiang Provincial Basic Public Welfare Research Program/ ; A20210086//Hangzhou Health and Family Planning Science and Technology Program/ ; }, mesh = {Humans ; *SARS-CoV-2/pathogenicity ; *COVID-19/complications/virology ; *Dengue Virus/pathogenicity ; *Chikungunya virus/pathogenicity ; *Bone Diseases/virology ; *Dengue/virology/complications ; Animals ; *Chikungunya Fever/virology/complications ; }, abstract = {Emerging and re-emerging RNA viruses represent a persistent and evolving global health threat. While primarily recognized for their acute systemic or respiratory illnesses, a growing body of evidence implicates several of these pathogens in the development or exacerbation of bone-related diseases. This review critically describes the multifaceted roles of selected major RNA viruses-Dengue Virus (DENV), Chikungunya Virus (CHIKV), and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)- in bone-related diseases. It discusses the current understanding of the clinical manifestations, ranging from arthralgia and arthritis to more severe outcomes such as osteopenia, osteoporosis, and bone erosions. The review describes the potential pathogenic mechanisms, including direct viral infection of bone cells (osteoblasts, osteoclasts, and osteocytes), as well as virus-induced dysregulation of host immune responses that lead to pro-inflammatory cytokine storms and altered signalling pathways, collectively driving aberrant bone remodelling. By discussing current knowledge, this review aims to highlight the significant, yet often underappreciated, impact of these RNA viruses on bone health, identify existing knowledge gaps, and underscore the need for further mechanistic research to inform targeted therapeutic and preventive strategies that reduce bone morbidity in affected populations.}, }
@article {pmid40714772, year = {2025}, author = {Amlaev, KR and Abdullah, A}, title = {[THE RISK AND PROTECTIVE FACTORS FOR NONCOMMUNICABLE DISEASES].}, journal = {Problemy sotsial'noi gigieny, zdravookhraneniia i istorii meditsiny}, volume = {33}, number = {3}, pages = {445-447}, doi = {10.32687/0869-866X-2025-33-3-445-447}, pmid = {40714772}, issn = {0869-866X}, mesh = {Humans ; *Noncommunicable Diseases/epidemiology/prevention &amp; control ; Risk Factors ; Protective Factors ; COVID-19/epidemiology ; Air Pollution/adverse effects ; }, abstract = {The article presents modern data on non-communicable diseases (NCDs) and their risk factors. The tendency of increasing mortality from NCDs due to increase in the number and aging of the population is noted. The data is presented testifying that, in addition to biological risk factors, influence of environmental factors is increasing, including atmospheric and household air pollution, the levels of which are high in a significant number of countries. It is emphasized that green spaces (e.g., trees, grass, forests and parks) and blue spaces (e.g., lakes, rivers, ponds, etc.) provide beneficial effect on human health, being in fact protective factors for NCDs. The NCD risk factors are found to interact closely with each other: air pollution, depression, tobacco smoking, high blood pressure and obesity have been linked to all NCDs. The evidence is provided that presence of behavioral risk factors for NCDs exacerbates severity of infectious pathology, particularly COVID-19 and other infectious diseases (influenza, HIV, tuberculosis, hepatitis, etc.). Given that NCD risk factors can occur in early childhood, promoting healthy lifestyles among expectant mothers and adolescents should be a priority to reduce NCD risks, especially in low- and middle-income countries.}, }
@article {pmid40713974, year = {2025}, author = {Morgenstern, C and Rawson, T and Routledge, I and Kont, M and Imai-Eaton, N and Skarp, J and Doohan, P and McCain, K and Johnson, R and Unwin, HJT and Naidoo, T and Dee, DP and Parchani, K and Cracknell Daniels, BN and Vicco, A and Drake, KO and Christen, P and Sheppard, RJ and Leuba, SI and Hicks, JT and McCabe, R and Nash, RK and Santoni, CN and Cuomo-Dannenburg, G and van Elsland, S and Bhatia, S and Cori, A and , }, title = {Severe acute respiratory syndrome (SARS) mathematical models and disease parameters: a systematic review.}, journal = {The Lancet. Microbe}, volume = {6}, number = {9}, pages = {101144}, doi = {10.1016/j.lanmic.2025.101144}, pmid = {40713974}, issn = {2666-5247}, mesh = {Humans ; *Severe Acute Respiratory Syndrome/transmission/epidemiology/mortality/virology ; COVID-19/transmission/epidemiology ; *Models, Theoretical ; Risk Factors ; SARS-CoV-2 ; Disease Outbreaks ; Seroepidemiologic Studies ; }, abstract = {SARS-CoV-1 was the first documented coronavirus to cause an acute epidemic in humans and remains a priority pathogen owing to the risk of re-emergence. Robust estimates of key epidemiological parameters are essential to guide outbreak responses and inform mathematical models. Existing systematic reviews have been limited in scope, warranting a comprehensive and up-to-date review. We conducted a systematic review (PROSPERO CRD42023393345) of studies of severe acute respiratory syndrome (SARS) transmission models and parameters characterising the transmission, evolution, natural history, severity, risk factors, and seroprevalence of SARS-CoV-1. Information was extracted using a custom database and quality assessment tool. We extracted data on 519 parameters, 243 risk factors, and 112 models from 289 papers. We found that SARS is characterised by high lethality (case-fatality ratio, 10·9%), transmissibility (R0 range, 1·1-4·59), and superspreading events (approximately 91% of SARS-CoV-1 infections can be attributed to 20% of individuals who were most infectious). Infection risk was the highest among health-care workers and close contacts of infected individuals. Severe disease and death were associated with age and existing comorbidities. The natural history of SARS was poorly characterised, except for the incubation and mean onset-to-hospitalisation delays. The extracted data were compiled into our associated R package, epireview, which can be updated to incorporate novel findings, thus providing a key resource for informing response to future coronavirus outbreaks. By making data accessible through an updatable database, we support rapid, evidence-informed responses to potential re-emergence of SARS-CoV-1 or related coronaviruses.}, }
@article {pmid40712614, year = {2025}, author = {Chen, J and Deng, S and Xu, X and Chen, S and Abo, YN and Bassat, Q and Deng, J and Komissarov, AB and Liu, E and Muñoz-Almagro, C and Ren, L and Stolyarov, K and Tomlinson, J and Cai, Z and Qiao, M and Li, Y and Wang, X and , }, title = {Regional and type-specific variations in the global seasonality of human parainfluenza viruses and the influence of climatic factors: a systematic review and meta-analysis.}, journal = {The Lancet. Global health}, volume = {13}, number = {8}, pages = {e1425-e1435}, doi = {10.1016/S2214-109X(25)00188-3}, pmid = {40712614}, issn = {2214-109X}, mesh = {Humans ; *Seasons ; *Climate ; *Global Health ; *Paramyxoviridae Infections/epidemiology/virology ; }, abstract = {BACKGROUND: Human parainfluenza viruses (hPIVs) are common viral causes of acute respiratory infections, resulting in substantial global disease burden. Seasonal patterns of hPIV epidemics can vary by geographical region and viral type, although these patterns are not well understood at a global level. We aimed to characterise regional and type-specific variations in hPIV seasonality and assess the potential role of climatic factors in explaining these variations.<br><br>METHODS: In this systematic review and meta-analysis, we collected monthly aggregated seasonal activity data for hPIV and its four types (hPIV-1, hPIV-2, hPIV-3, and hPIV-4) from various sources, including a systematic search of Embase, MEDLINE, and Ovid Global Health, for literature published between Jan 1, 2000, and Dec 31, 2024; unpublished data contributed by an established collaborative network; and public viral surveillance datasets from online platforms. We included studies that continuously tested hPIVs throughout their study period and reported seasonal activity in defined geographical locations on a monthly basis (or if monthly data could be derived from reports). We excluded published studies if they had fewer than 20 cases, focused on specific medical conditions, or contained duplicate data from published literature or publicly available datasets. A prespecified collection template was used to collect data from members in the collaborative network. We extracted site-specific monthly case counts of combined hPIVs and each viral type and used the annual average percentage approach to assess relative circulating strength, epidemic onset and peak month, and epidemic duration by virus type and latitude. We identified type-specific transmission zones of countries with similar circulating patterns with the k-means method. A local regression model (selected by leave-one-out cross-validation) was used to explore climatic factors associated with variations in hPIV monthly circulating activity. The study was registered with PROSPERO, CRD42023370261.<br><br>FINDINGS: We included 115 records in total: 103 studies identified from the published literature, five studies contributed by collaborators, and data from seven public surveillance datasets. We included 306&#x2008;719 cases from 141 sites in 64 countries. We found that hPIV-3 exhibited distinctive seasonal patterns compared with the other three hPIV types. In temperate regions, hPIV-3 seasons typically occurred in spring, summer, and winter, with a median onset in April (IQR April-May) in the northern temperate region and July (July-July) in the southern temperate region. hPIV-1, hPIV-2, and hPIV-4 seasons typically occurred in autumn, winter, and summer, with median onsets between August and October in the northern temperate region and between April and May in the southern temperate region. Both epidemic onset and peak timing for hPIV-1, hPIV-2, and hPIV-4 were less consistent in tropical and subtropical regions than in temperate regions, whereas the seasonality of hPIV-3 remained generally consistent across regions. Northern temperate and subtropical countries typically clustered in shared transmission zones for hPIV-1, hPIV-2, and hPIV-3 with a few exceptions, as did countries in the southern hemisphere. Nevertheless, hPIV-1 and hPIV-4 peak timings were delayed as latitude increased in the northern hemisphere (Pearson's r=0&#xb7;62 [p=0&#xb7;0012] for hPIV-1 and r=0&#xb7;53 [p=0&#xb7;049] for hPIV-4). Type-specific climate models yielded better fits (with greater area under the receiver operating characteristic curve values) than models for combined hPIVs. In temperate regions, higher hPIV-1, hPIV-2, and hPIV-4 activity correlated with declining temperature and increasing relative humidity (all p values <0&#xb7;0001), whereas higher hPIV-3 activity was correlated with rising temperature (rs=0&#xb7;61; p<0&#xb7;0001). In subtropical and tropical regions, the climate models showed suboptimal performance. Exploratory analyses showed differential timing shifts in hPIV epidemics across six included countries following the lifting of COVID-19 non-pharmacological interventions.<br><br>INTERPRETATION: Our results characterise both between-type and regional variations in hPIV seasonality and the differential effects of monthly temperature variability and relative humidity on the global seasonality of different hPIV types. These findings have important implications for development of global hPIV surveillance and epidemic prediction in diverse locations. Substantial gaps in hPIV type-specific seasonality data remain in many countries, highlighting the need to expand surveillance to improve characterisation and prediction of hPIV epidemics.<br><br>FUNDING: National Natural Science Foundation of China.}, }
@article {pmid40711525, year = {2025}, author = {Buchrits, S and Trieman, G and Giladi, O and Hofstetter, L and Gurion, R and Granot, G and Shacham-Abulafia, A and Raanani, P and Gafter-Gvili, A}, title = {Infectious complications in CLL/SLL patients receiving Bruton's Tyrosine Kinase inhibitors - systematic review and meta-analysis of randomized controlled trials.}, journal = {Annals of hematology}, volume = {104}, number = {8}, pages = {3903-3915}, pmid = {40711525}, issn = {1432-0584}, mesh = {Humans ; *Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy/complications/epidemiology ; *Agammaglobulinaemia Tyrosine Kinase/antagonists &amp; inhibitors ; Randomized Controlled Trials as Topic ; *Protein Kinase Inhibitors/adverse effects/therapeutic use ; *Infections/epidemiology/etiology ; Bridged Bicyclo Compounds, Heterocyclic/adverse effects/therapeutic use ; Sulfonamides/adverse effects/therapeutic use ; COVID-19/epidemiology ; Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use ; Tyrosine Kinase Inhibitors ; }, abstract = {The development of Bruton Tyrosine Kinase inhibitors (BTKis) has revolutionized the management of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). However, increased infection rates have been reported in patients receiving BTKis in multiple clinical trials. This study aimed to evaluate the risk of infections associated with BTKis compared to other therapeutic regimens in CLL/SLL patients. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. We included trials comparing BTKi-containing regimens (e.g., BTKi alone or combined with anti-CD20 or venetoclax) to other therapeutic regimens, as well as studies comparing different BTKis or BTKi combinations. Primary outcomes were the risk of any infection and grade 3-4 infections. Secondary outcomes included pneumonia, sepsis, septic shock, COVID-19, fungal infections, fatal infections, bacteremia, and febrile neutropenia. Pooled risk ratios (RR) with 95% confidence intervals (CIs) were estimated using fixed or random effects models based on heterogeneity. Eighteen trials encompassing 8,324 patients were included. BTKi-containing regimens, either as monotherapy or combined with anti-CD20 or venetoclax, were not associated with a significantly increased risk of any infection compared to other regimens [BTKi + anti-CD20 or venetoclax: RR 0.93 (95% CI: 0.79-1.09, I[2] = 46%), 3 trials; BTKi monotherapy: RR 1.12 (95% CI: 0.94-1.34, I[2] = 73%), 3 trials]. Similarly, BTKi monotherapy was not associated with an increased risk of grade 3-4 infections [RR 1.05 (95% CI: 0.76-1.44, I[2] = 61%), 5 trials]. The risk of sepsis was not significantly increased with BTKi regimens [BTKi + anti-CD20: RR 0.48 (95% CI: 0.12-1.84, I[2] = 69%), 4 trials; BTKi monotherapy: RR 0.50 (95% CI: 0.25-1.01, I[2] = 0%), 5 trials]. However, pneumonia risk was increased in the BTKi + anti-CD20 vs other regimens, [RR 2.18; 95% CI 1.29-3.70; I[2] = 3%, 4 trials]. The risk of febrile neutropenia was reduced in trials comparing BTKi-containing regimens to other therapies. BTKi-containing regimens were not associated with an increased risk of overall infections or grade 3-4 infections compared to other regimens. However, an elevated risk of pneumonia was observed with BTKi combinations, highlighting the need for careful consideration when selecting treatment regimens for CLL/SLL patients.}, }
@article {pmid40711310, year = {2025}, author = {Mir, S and Peters, M and Penny, G and Agsaoa, A and Mir, M}, title = {From Challenge to Cure: A Look at Feline Infectious Peritonitis and Emerging Treatment Strategies and Breakthroughs.}, journal = {Veterinary sciences}, volume = {12}, number = {7}, pages = {}, pmid = {40711310}, issn = {2306-7381}, abstract = {BACKGROUND: Feline infectious peritonitis (FIP) is a complex and devastating viral disease in cats caused by feline coronavirus (FCoV). While FCoV is commonly encountered and typically innocuous, the emergence of a mutated variant can lead to the development of FIP, a severe and often fatal condition.<br><br>METHOD AND RESULTS: This review article provides a comprehensive overview of the etiological factors, epidemiology, clinical manifestations, and challenges associated with FIP. Additionally, it underscores the critical need for further research to enhance diagnostic capabilities and develop effective therapeutic interventions.<br><br>CONCLUSION: By shedding light on the intricate dynamics of FIP, this review paper aims to contribute to a deeper understanding of the disease via fostering therapeutic advancements that can improve outcomes for afflicted felines.}, }
@article {pmid40711104, year = {2025}, author = {Orr, R and Canetti, EFD and Gough, S and Macdonald, K and Dulla, J and Lockie, RG and Dawes, JJ and Blacker, SD and Milligan, GS and Schram, B}, title = {Police Fitness: An International Perspective on Current and Future Challenges.}, journal = {Sports (Basel, Switzerland)}, volume = {13}, number = {7}, pages = {}, pmid = {40711104}, issn = {2075-4663}, abstract = {Poor officer fitness can lead to decreased occupational task performance, injuries, increased absenteeism, and a variety of negative health sequalae further adding to the challenges of staffing law enforcement agencies. Optimizing the physical fitness for both serving officers and new recruits is critical as their loss is, and will increasingly be, difficult to replace. However, maintaining and recruiting a physically fit workforce faces several challenges. For serving officers, shiftwork is known to decrease motivation to exercise and negatively impact sleep and diet. Additional factors impacting their fitness includes age-related declines in fitness, increasing obesity, long periods of sedentarism, and negative COVID-19 effects. Concurrently, recruiting physically fit recruits is challenged by declining levels of fitness, reduced physical activity, and increasing obesity in community youth. Ability-based training (ABT), individualizing physical conditioning training based on the existing fitness levels of individuals within a group, offers a potential solution for delivering physical conditioning to groups of applicants, recruits, and officers with a range of physical fitness capabilities. Law enforcement agencies should consider implementing ABT during academy training and ongoing fitness maintenance to minimize injury risk and optimize task performance.}, }
@article {pmid40711073, year = {2025}, author = {Appiah, GA and Babason, JJ and Dziworshie, AY and Abankwa, A and Bonney, JHK}, title = {Is Ghana Prepared for Another Arboviral Outbreak? Evaluating the 2024 Dengue Fever Outbreak in the Context of Past Yellow Fever, Influenza, and COVID-19 Outbreaks.}, journal = {Tropical medicine and infectious disease}, volume = {10}, number = {7}, pages = {}, pmid = {40711073}, issn = {2414-6366}, abstract = {Arboviruses are a growing concern in many nations. Several reports of arboviral outbreaks have been recorded globally in the past decade alone. Repeated arboviral outbreaks in developing countries have consistently highlighted vulnerabilities in disease surveillance and response systems, exposing critical gaps in early detection, contact tracing, and resource allocation. The 2024 Dengue fever outbreak in Ghana, which recorded 205 confirmed cases out of 1410 suspected cases, underscored the urgent need to evaluate the country's preparedness for arboviral outbreaks, given the detection of competent vectors in the country. A retrospective analysis of Ghana's 2009-2013 pandemic influenza response plan revealed significant deficiencies in emergency preparedness, raising concerns about the country's ability to manage emerging arboviral threats. This review assessed Ghana's current arboviral outbreak response and preparedness by examining (a) the effectiveness of vector control measures, (b) the role of early warning systems in mitigating outbreaks, (c) laboratory support and diagnostic capabilities, and (d) community engagement strategies. It highlights the successes made in previous outbreaks and sheds light on several gaps in Ghana's outbreak response efforts. This review also provides recommendations that can be implemented in many countries across Africa as they brace themselves for any arboviral outbreak.}, }
@article {pmid40710333, year = {2025}, author = {Shiozawa, S}, title = {Pathogenesis of Autoimmunity/Systemic Lupus Erythematosus (SLE).}, journal = {Cells}, volume = {14}, number = {14}, pages = {}, pmid = {40710333}, issn = {2073-4409}, support = {Grant-in-aid 25515003, 17659301, 13204059, 11557026, 12204074 and 0003 of Center of Excellence (CEO)//Institute for Rheumatic Diseases, Ministry of Education, Culture, Sports, Science and Technology of Japan, and Japan Science and Technology Agency/ ; }, mesh = {*Lupus Erythematosus, Systemic/immunology/pathology/etiology ; Humans ; Animals ; *Autoimmunity/immunology ; B-Cell Activating Factor/metabolism ; Autoantibodies/immunology ; Mice ; }, abstract = {SLE is characterized by the generation of a variety of autoantibodies including anti-dsDNA autoantibodies, causing damage in various organs. If autoimmunity is defined by the generation of a variety of autoantibodies against the self, SLE is the only disease to qualify. Identification of the SLE-causing factor must fulfill the following criteria: (i) the factor induces SLE, (ii) the factor is operating in active SLE and (iii) SLE heals after removal of the factor. All candidate factors are reviewed from this viewpoint in this review. As to the cause of SLE, high levels of interferon α can induce SLE; however, interferon α in most patients did not reach this high level. BAFF (B cell activating factor of the TNF family) is increased in SLE. BAFF itself induced some manifestation of SLE, whereas removal of interferon α or BAFF by an antibody (Ab) did not heal SLE. BXSB male mice with a duplicated TLR7 gene develop SLE; however, the gene Sle1 is also required for the development of SLE. In addition, sanroque mice develop a variety of autoantibodies and SLE; the sanroque mutation, which disrupts one of the repressors of ICOS, results in increased CCR7[lo] CXCR5[+]Tfh cells, IL-21 and SLE. ICOS[+]T follicular helper (Tfh) cells increase in SLE and SLE-model (NZBxNZW)F1 mice, and the blockade of Tfh development ameliorated SLE, indicating the importance of Tfh cells in the pathogenesis of SLE. Self-organized criticality theory shows that SLE is caused by repeated infection, wherein SLE-inducing pathogens can vary individually depending on one's HLA; however, the pathogen presented on HLA stimulates the T cell receptor (TCR) strongly beyond self-organized criticality. This stimulation generates TCR-revised, autoreactive DOCK8[+]Tfh cells, which induced a variety of autoantibodies and SLE. The SARS-CoV-2 virus is an example pathogen because SLE occurs after SARS-CoV-2 infection and vaccination. DOCK8[+]Tfh cells and SLE decreased after conventional or anti-DOCK Ab therapies. Thus, DOCK8[+]Tfh cells newly generated after repeated infection fulfill the criteria (i), (ii) and (iii) as the cause of SLE.}, }
@article {pmid40710086, year = {2025}, author = {Van Zant, W and Ray, P}, title = {Democratization of Point-of-Care Viral Biosensors: Bridging the Gap from Academia to the Clinic.}, journal = {Biosensors}, volume = {15}, number = {7}, pages = {}, pmid = {40710086}, issn = {2079-6374}, mesh = {*Biosensing Techniques/methods ; Humans ; *Point-of-Care Systems ; *COVID-19/diagnosis ; *SARS-CoV-2/isolation &amp; purification ; Academia ; }, abstract = {The COVID-19 pandemic and recent viral outbreaks have highlighted the need for viral diagnostics that balance accuracy with accessibility. While traditional laboratory methods remain essential, point-of-care solutions are critical for decentralized testing at the population level. However, a gap persists between academic proof-of-concept studies and clinically viable tools, with novel technologies remaining inaccessible to clinics due to cost, complexity, training, and logistical constraints. Recent advances in surface functionalization, assay simplification, multiplexing, and performance in complex media have improved the feasibility of both optical and non-optical sensing techniques. These innovations, coupled with scalable manufacturing methods such as 3D printing and streamlined hardware production, pave the way for practical deployment in real-world settings. Additionally, software-assisted data interpretation, through simplified readouts, smartphone integration, and machine learning, enables the broader use of diagnostics once limited to experts. This review explores improvements in viral diagnostic approaches, including colorimetric, optical, and electrochemical assays, showcasing their potential for democratization efforts targeting the clinic. We also examine trends such as open-source hardware, modular assay design, and standardized reporting, which collectively reduce barriers to clinical adoption and the public dissemination of information. By analyzing these interdisciplinary advances, we demonstrate how emerging technologies can mature into accessible, low-cost diagnostic tools for widespread testing.}, }
@article {pmid40709747, year = {2025}, author = {Robles-Aguilar, P and Ruiz-Fernández, MD and Bermudo-Fuenmayor, S}, title = {Digital Health Experiences of Primary Care Nurses: A Qualitative Meta-synthesis.}, journal = {International nursing review}, volume = {72}, number = {3}, pages = {e70069}, pmid = {40709747}, issn = {1466-7657}, mesh = {Humans ; Qualitative Research ; *COVID-19/nursing/epidemiology ; *Primary Care Nursing ; *Telemedicine ; Primary Health Care ; Attitude of Health Personnel ; Digital Health ; }, abstract = {AIM: To analyze primary care nurses' experiences of integrating and using digital health in their daily practice.<br><br>BACKGROUND: The integration of digital health in primary care, accelerated by the COVID-19 pandemic, has transformed nursing practices with a view to provide better support and services to patients.<br><br>INTRODUCTION: The World Health Organization defines "digital health" as the use of electronic technologies to improve health. Its 2020-2025 strategy seeks to integrate these technologies into health systems to facilitate communication between professionals, patients, and authorities. Tools such as telehealth, electronic records, artificial intelligence, and big data are transforming the role of nurses, who must become familiar with them for their performance.<br><br>METHODS: Qualitative studies on digital health in primary care nursing were reviewed following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guidelines and using the Joanna Briggs Institute for Qualitative Research (JBI-QARI) criteria.<br><br>RESULTS: Eleven articles were analyzed using thematic coding according to Thomas and Harden's approach, identifying three main themes: adaptation to digital health, nurses' perspective on digital health, and nurse-patient digital interaction.<br><br>DISCUSSION: The integration of digital health has required nurses to adapt quickly. They have expressed both benefits and challenges, highlighting the importance of adequate training, personalization in the use of digital tools, information security, and optimization of technological infrastructure.<br><br>It is essential to assess the current competencies of nurses in digital health in order to meet their needs. Health systems should incorporate new technologies into clinical practice guidelines and health programs to improve and update the continuity and quality of care in primary care. Health policies should support the continuing education of nurses and the effective integration of technology.}, }
@article {pmid40709592, year = {2025}, author = {Menon, S and Koura, KG}, title = {Artificial intelligence for tuberculosis control: a scoping review of applications in public health.}, journal = {Journal of global health}, volume = {15}, number = {}, pages = {04192}, pmid = {40709592}, issn = {2047-2986}, mesh = {Humans ; *Artificial Intelligence ; *Public Health ; *Tuberculosis/prevention &amp; control/diagnosis ; Global Health ; }, abstract = {BACKGROUND: Artificial intelligence (AI) has become an important tool in global health, improving disease diagnosis and management. Despite advancements, tuberculosis (TB) remains a public health challenge, particularly in low- and middle-income countries where diagnostic methods are limited. In this scoping review, we aim to examine the potential role of AI in TB control.<br><br>METHODS: We conducted a search on 25 August 2024 for the past five years, in the PubMed database using keywords related to AI and TB. We included laboratory-based and observational studies focussing on AI applications in TB, excluding non-original research.<br><br>RESULTS: There were 34 eligible studies, identifying eight overarching aspects associated with TB control, including active case finding (ACF), triage, pleural effusion diagnosis, multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB, differential diagnosis distinguishing active TB from TB infection and other pulmonary communicable diseases, TB and other pulmonary communicable and non-communicable diseases (NCDs), treatment outcome prediction, pleural effusion, and predictions of regional and national trends. AI may transform TB control through enhanced ACF methods and triage, improving detection rates in high-burden regions. With high accuracy, AI may diagnose pleural diagnosis, differentiate TB active and TB infection, TB and non-tuberculous mycobacterial lung disease, COVID-19, and pulmonary NCDs. AI applications may facilitate the prediction of treatment success and adverse effects. Furthermore, AI-driven hotspot mapping may identify undiagnosed TB cases at rates surpassing traditional notification methods. Lastly, predictive modelling and clinical decision support systems may improve the management of MDR-TB.<br><br>CONCLUSIONS: This scoping review highlights the potential of AI-driven predictions in national TB programmes to enhance diagnostics, track trends, and strengthen public health surveillance. While promising for reducing transmission and supporting TB care in low-resource settings, these models require large-scale validation to ensure real-world applicability, especially for high-risk groups.}, }
@article {pmid40709582, year = {2025}, author = {Dai, D and Gois, PF and Simpson, D and Hedfi, S and Shrapnel, S and Pole, JD}, title = {Global geographic and socioeconomic disparities in COVID-associated acute kidney injury: a systematic review and meta-analysis.}, journal = {Journal of global health}, volume = {15}, number = {}, pages = {04166}, pmid = {40709582}, issn = {2047-2986}, mesh = {Humans ; *Acute Kidney Injury/epidemiology/etiology ; *COVID-19/complications/epidemiology ; *Global Health/statistics &amp; numerical data ; Socioeconomic Factors ; Prevalence ; *Health Status Disparities ; SARS-CoV-2 ; Socioeconomic Disparities in Health ; }, abstract = {BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of COVID-19, which significantly increases the risk of mortality. There has been a wide range of AKI prevalence reported throughout the pandemic, reflecting differences in geographic location, patient characteristics, and health care resources. We aimed to provide a global overview of the COVID-19 AKI prevalence reported in published studies to uncover geographic and socioeconomic disparities.<br><br>METHODS: We undertook a systematic review and meta-analysis, searching PubMed, Embase, Scopus, Web of Science, and Cochrane Library for full-text articles published in English reporting the prevalence of AKI from January 2020 to November 2023. All studies defined AKI according to the Kidney Disease Improving Global Outcomes criteria. Clinical characteristics were extracted and examined from 334 studies that met the inclusion criteria. With significant study heterogeneity, random-effect models were estimated. We reported pooled AKI prevalence by country, region, and income level. Meta-regression further examined the relationship between COVID-associated AKI and geographic location.<br><br>RESULTS: After removing studies that utilised the same data, 345&#x2009;796 patients from 246 studies were included, covering 49 countries. Of 246 studies, 137 came from high-income countries, whereas only three were conducted in low-income countries. Among non-intensive care unit (ICU) patients, low-income countries had the lowest COVID-19 AKI prevalence (14.1%; 95% confidence interval (CI)&#x2009;=&#x2009;11.4-17.2). Among ICU patients, lower-middle-income countries had the lowest COVID-19 AKI prevalence (27.9%;95% CI&#x2009;=&#x2009;19.4-38.4).<br><br>CONCLUSIONS: Our study shows significant geographic and socioeconomic disparities in the prevalence of COVID-associated AKI, with a higher prevalence in high-income countries and a lower prevalence in low- and lower-middle-income countries. This study is the most comprehensive systematic review and meta-analysis highlighting global disparities in COVID-associated AKI prevalence. Further studies are needed to explain the reasons behind these differences.}, }
@article {pmid40709071, year = {2025}, author = {Khorramnia, S and Navidi, Z and Sarkoohi, A and Iravani, MM and Orandi, A and Orandi, A and Ghazi, SF and Fallah, E and Malekabad, ES and Moghadam, SHP}, title = {Remdesivir Versus Sotrovimab in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis.}, journal = {Health science reports}, volume = {8}, number = {7}, pages = {e71118}, pmid = {40709071}, issn = {2398-8835}, abstract = {BACKGROUND AND AIM: Remdesivir and Sotrovimab have emerged as potential treatment options for patients diagnosed with coronavirus disease 2019 (COVID-19). This systematic review and meta-analysis sought to evaluate and compare the effectiveness and safety of these two drugs in the context of COVID-19 management.<br><br>METHODS: A systematic search was conducted in PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar up to July 2024. The effectiveness outcomes examined included mortality rate, hospitalization rate, emergency department visits, ICU admission, and adverse events. The risk of bias in nonrandomized studies of interventions was evaluated using a standardized tool, and data from the identified studies were meticulously analyzed using Comprehensive Meta-Analysis (CMA) software.<br><br>RESULTS: The analysis incorporated a total of 9 studies involving 7841 patients. The meta-analysis findings indicated no significant disparity between the Remdesivir and Sotrovimab groups concerning mortality rate (odds ratio [OR]&#x2009;=&#x2009;3.49, 95% confidence interval [CI]: 0.50-24.11, p&#x2009;=&#x2009;0.20), hospitalization rate (OR&#x2009;=&#x2009;2.11, 95% CI: 0.85-5.22, p&#x2009;=&#x2009;0.10), emergency department visit (OR&#x2009;=&#x2009;0.80, 95% CI: 0.11-5.62, p&#x2009;=&#x2009;0.82), and intensive care unit (2.37, 95% CI: 0.18-29.90, p&#x2009;=&#x2009;0.50). Moreover, comparable rates of adverse events were observed across both groups (OR&#x2009;=&#x2009;0.98, 95% CI: 0.39-2.47, p&#x2009;=&#x2009;0.97). The certainty of evidence for these findings was rated as low or moderate.<br><br>CONCLUSION: The study findings suggest that there is no significant difference in effectiveness between Remdesivir and Sotrovimab in the treatment of COVID-19 patients. Further research is needed to provide a more comprehensive comparison of these interventions for COVID-19.}, }
@article {pmid40708428, year = {2025}, author = {Aoki, A and Sugiura, K and Akiyama, T}, title = {Overview of the Japanese mental health services through legislation, policies and recent initiatives: a narrative review.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {3-4}, pages = {397-408}, doi = {10.1080/09540261.2025.2462318}, pmid = {40708428}, issn = {1369-1627}, mesh = {Humans ; *Community Mental Health Services/legislation &amp; jurisprudence ; COVID-19 ; *Health Policy/legislation &amp; jurisprudence ; Japan ; *Mental Disorders/therapy ; *Mental Health Services/legislation &amp; jurisprudence/organization &amp; administration ; }, abstract = {In Japan, mental health legislation and policies have evolved, and mental health services have progressively developed in the post-World War II era. This review introduces two essential laws: the Act on Mental Health and Welfare for Persons with Mental Disorders or Disabilities and the Act on Providing Comprehensive Support for the Daily Life and Life in Society of Persons with Disabilities. It also outlines the changes in mental health policy over the past decades, beginning with the Vision for the Reform of Mental Health and Medical Welfare of 2004, which advocated for a 'transition from hospital-centered care to community-centered care'. The article further presents current practices in mental health-related areas under the community-based integrated care system that also addresses mental disorders-the latest approach to the care of individuals with mental disorders. The changes in the past few decades aimed at promoting community-based care. As a result, while outpatient and home-based services have flourished, the number of psychiatric beds remains high, which is a persisting challenge. Finally, the article discusses the impact of COVID-19 on mental health and mental health services, a policy shift and the necessity of considering mental health in related policies raised by the pandemic in Japan.}, }
@article {pmid40708426, year = {2025}, author = {Okasha, T and Shaker, NM and El-Gabry, DA}, title = {Mental health services in Egypt, the Middle East, and North Africa.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {3-4}, pages = {306-314}, doi = {10.1080/09540261.2024.2400143}, pmid = {40708426}, issn = {1369-1627}, mesh = {Humans ; *Mental Health Services/organization &amp; administration ; Egypt ; Africa, Northern ; Middle East ; *COVID-19 ; *Health Services Accessibility ; Child ; Refugees ; Adolescent ; *Healthcare Disparities ; }, abstract = {This review provides insight into the contemporary challenges and initiatives in mental health care across Egypt, the Middle East, and North Africa (MENA) region. It examines the structural barriers, including fragmented public health systems and inadequate resource allocation, which hinder access to mental health services. The COVID-19 pandemic exacerbated these challenges, prompting innovative approaches like telepsychiatry and the establishment of specialized psychiatric hospitals. Despite advancements in psychiatric education and research, disparities persist, particularly in rural mental health care. Limited funding, workforce shortages, and barriers to accessing medications and post-hospitalization support further compound the issue. International and local efforts aim to address these challenges, with a focus on enhancing child and adolescent mental health services and supporting populations affected by the refugee crisis. Policy reforms, increased financial allocation, and workforce development are essential for overcoming these obstacles and ensuring equitable access to quality mental health care throughout the MENA region. This review underscores the urgent need for collaborative action to improve mental health outcomes and reduce disparities in the region.}, }
@article {pmid40708415, year = {2025}, author = {Rojnic Kuzman, M and Medved, S}, title = {Mental health services in Croatia-current perspectives and future challenges.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {3-4}, pages = {221-228}, doi = {10.1080/09540261.2024.2434576}, pmid = {40708415}, issn = {1369-1627}, mesh = {Croatia ; Humans ; *Mental Health Services/trends/organization &amp; administration ; *COVID-19/epidemiology ; Telemedicine ; Stress Disorders, Post-Traumatic/therapy ; Health Services Accessibility ; }, abstract = {We examine the current state and challenges of mental health services in the Republic of Croatia, a Central European country with a population of 3.87 million. Croatia's healthcare system delivers mental health services across primary, secondary, and tertiary levels, largely supported by the Croatian Health Insurance Fund, which administers the country's universal healthcare system, ensuring wide accessibility. Key policy frameworks include the Strategic Framework for the Development of Mental Health until 2030 and the Action Plan in Addictions. However, challenges persist, including a lack of community-based approaches, underfunding, and workforce shortages, particularly in child and adolescent psychiatry. The paper also highlights the impact of the COVID-19 pandemic and Croatia's 2020 earthquake on mental health services, emphasizing a transition toward telepsychiatry and mobile psychiatric teams. Additionally, post-traumatic stress disorder (PTSD) is underscored as a significant public health issue in Croatia.}, }
@article {pmid40708413, year = {2025}, author = {Richter, D and Hepp, U and Jäger, M and Adorjan, K}, title = {Mental health care services in Switzerland - the post-pandemic state.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {3-4}, pages = {315-321}, doi = {10.1080/09540261.2025.2479596}, pmid = {40708413}, issn = {1369-1627}, mesh = {Humans ; Switzerland/epidemiology ; *COVID-19/epidemiology ; *Mental Health Services/organization &amp; administration ; *Mental Disorders/therapy/epidemiology ; *Health Policy ; }, abstract = {Mental health care in Switzerland is at a relatively high level worldwide. Nevertheless, as in many other countries, the COVID-19 pandemic has had a significant impact on the entire healthcare system and psychiatry in particular. In addition, the care of people with mental disorders in Switzerland is characterised by numerous special features that distinguish the country from most Western systems. The article provides an overview of the following aspects of mental health care: Epidemiology, pandemic-related developments, health policy and funding, as well as the structure and specific aspects of outpatient, intermediate and inpatient care. Finally, it analyses numerous challenges facing mental health care in Switzerland.}, }
@article {pmid40708412, year = {2025}, author = {Wiegand, HF and Hölzel, L and Tüscher, O and Lieb, K and Falkai, P and Adorjan, K}, title = {Mental health services in Germany - Structures, outcomes and future challenges.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {37}, number = {3-4}, pages = {253-270}, doi = {10.1080/09540261.2025.2479601}, pmid = {40708412}, issn = {1369-1627}, mesh = {Humans ; *Mental Health Services/organization &amp; administration/economics ; Germany ; *COVID-19 ; *Mental Disorders/therapy ; }, abstract = {This narrative review provides an overview of the structure, financing models, and challenges facing the German mental healthcare system for adults. The German mental healthcare system is divided into distinct sectors, including inpatient, outpatient, rehabilitation, and regional complementary services, each with its own financing mechanisms. Statutory health insurance, covering about 88% of the population, funds the majority of the system. Germany allocates 13% of its GDP to healthcare-one of the highest proportions globally-with over 10% of this directed toward mental health. Key challenges include an overemphasis on inpatient services, poor coordination between inpatient and outpatient sectors, insufficient severity-based treatment allocation, limited adherence to clinical guidelines, and a lack of digitalization and routine outcome evaluations. The COVID-19 pandemic led to a temporary reduction in service use and intensified issues with inter-sector collaboration. In the long-term, a healthcare workforce shortage further complicates care delivery. Proposed solutions include regional budgets for integrated care, outcome-based quality assurance, stepped-care models to optimize treatment allocation, and digital infrastructure improvements for better data sharing and transparency. These reforms aim to enhance patient-centered care, improve outcomes, and make more efficient use of resources.}, }
@article {pmid40708204, year = {2025}, author = {Malerba, M and Purghè, B and Ragnoli, B and Manfredi, M and Baldanzi, G}, title = {Molecular profiling of exhaled breath condensate in respiratory diseases.}, journal = {Annals of medicine}, volume = {57}, number = {1}, pages = {2537910}, pmid = {40708204}, issn = {1365-2060}, mesh = {Humans ; Breath Tests/methods ; *COVID-19/metabolism/diagnosis ; Metabolomics/methods ; Proteomics/methods ; SARS-CoV-2 ; Exhalation ; Pulmonary Disease, Chronic Obstructive/diagnosis/metabolism ; Asthma/diagnosis/metabolism ; Mass Spectrometry/methods ; Biomarkers/analysis ; *Respiratory Tract Diseases/diagnosis/metabolism ; }, abstract = {BACKGROUND: Respiratory disorders, , continue to pose a major global health burden. Their complexity and heterogeneity challenge accurate diagnosis, effective monitoring, and therapeutic decision-making. Exhaled breath condensate (EBC) provides a reliable, non-invasive means of sampling the molecular environment of the airways.<br><br>AIM: This review presents the state-of-the-art in EBC-based omics approaches-particularly metabolomics and proteomics-to characterize molecular signatures associated with chronic respiratory (e.g. asthma, chronic obstructive pulmonary disease, and rhinitis) and infectious diseases (e.g. COVID-19).<br><br>RESULTS: We critically examine findings from studies applying nuclear magnetic resonance (NMR), mass spectrometry (MS), and sensor-based technologies to analyze EBC across various respiratory conditions. NMR, valued for its reproducibility and minimal sample preparation, consistently discriminates among disease phenotypes, identifies distinct metabotypes, and monitors treatment response over time. MS-based approaches afford enhanced sensitivity and specificity, enabling detailed profiling of inflammatory mediators, such as lipid-derived eicosanoids and amino acid derivatives. Proteomic studies reveal protein-level alterations associated with inflammation and tissue remodeling. In COVID-19 and long COVID, metabolomic and volatile compound profiling distinguishes affected individuals from healthy controls suggesting clinical potential. However, inconsistent sample processing and lack of analytical standardization remain limiting factors.<br><br>CONCLUSIONS: EBC profiling shows clear promise for improving diagnosis, monitoring, and stratification in respiratory medicine. Yet, translation into clinical practice is hindered by limited standardization and validation. Broader, longitudinal studies will be essential to establish robust molecular signatures across disease states. This review underscores the timely need to implement breathomics investigations to gain mechanistic insight into the underlying biology of respiratory diseases.}, }
@article {pmid40707095, year = {2025}, author = {Sarkar, M}, title = {Tuberculosis infection prevention and control.}, journal = {The Indian journal of tuberculosis}, volume = {72}, number = {3}, pages = {394-400}, doi = {10.1016/j.ijtb.2024.08.011}, pmid = {40707095}, issn = {0019-5707}, mesh = {Humans ; *Tuberculosis/prevention &amp; control/transmission ; *Infection Control/methods ; *Cross Infection/prevention &amp; control ; }, abstract = {Tuberculosis (TB) is the second leading infectious cause of death worldwide, only surpassed by corona virus infection (COVID-19). It is mainly transmitted by the airborne route via droplet nuclei of 1-5 μm in diameter. The four key pillars of TB elimination are "Detect-Treat-Prevent-Build." There are enough evidences of healthcare-associated transmission of TB. Prevention of TB transmission in the healthcare settings is thus an important strategy. The goal of TB infection prevention and control (IPC) is to reduce the likelihood that populations may contract M.tuberculosis by using variety of strategies. The strategies include three levels hierarchy of controls. These include administrative controls, environmental controls, and respiratory protection. This review will discuss the various strategies for TB infection prevention and controls.}, }
@article {pmid40707035, year = {2025}, author = {Meagher, T}, title = {Long Covid in Year 5: Some Progress, Still Many Questions.}, journal = {Journal of insurance medicine (New York, N.Y.)}, volume = {52}, number = {2}, pages = {61-65}, doi = {10.17849/insm-52-2-1-5.2}, pmid = {40707035}, issn = {0743-6661}, mesh = {Humans ; *COVID-19/complications/epidemiology/physiopathology ; Fatigue Syndrome, Chronic ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; }, abstract = {Long Covid was first described in 2020. Five years later, progress in disease characterization has been considerable, and definitions continue to evolve. Several disease mechanisms are under study, and evidence for multiple endotypes is accumulating. No clinical biomarker has been identified, nor has an effective therapy been developed. Overlap with other post-infectious syndromes, particularly myalgic encephalomyelitis/chronic fatigue syndrome, is now more evident. For most individuals, symptoms of long Covid progressively disappear over time. Recurrent Covid-19 infections are now an important contributor to the pool of affected individuals. While symptoms limit activity in as many as 20%, inability to work is less common. The anticipated surge of disability claims from insured individuals has not materialized.}, }
@article {pmid40706277, year = {2025}, author = {Jabs, M and Pennesi, JL and Baillie, S and Hay, P and Mitchison, D and Norton, L and Prnjak, K and Wade, TD and Hart, L}, title = {Validated eating disorder screening tools for paediatric populations: A systematic review.}, journal = {Psychiatry research}, volume = {351}, number = {}, pages = {116631}, doi = {10.1016/j.psychres.2025.116631}, pmid = {40706277}, issn = {1872-7123}, mesh = {Humans ; Child ; *Psychometrics ; *Feeding and Eating Disorders/diagnosis ; *Mass Screening ; Child, Preschool ; Reproducibility of Results ; *Psychiatric Status Rating Scales/standards ; }, abstract = {IMPORTANCE: The COVID-19 pandemic has led to a rise in paediatric eating disorder (ED) cases, highlighting the need for validated screening tools, particularly for pre-adolescent children, to enable early detection.<br><br>OBJECTIVE: This review aims to systematically evaluate the validation and psychometric properties of screening tools for assessing EDs in the paediatric population, with a focus on pre-adolescents (under 12 years).<br><br>EVIDENCE REVIEW: A systematic search of Medline (OVID) and PsycInfo (OVID) databases was conducted following Cochrane Rapid Review Guidelines, registered with PROSPERO (CRD42023465366). Studies were selected based on seven criteria, including ED diagnoses (anorexia nervosa, avoidant/restrictive food intake disorder, bulimia nervosa, binge eating disorder) in children under 12. A random 20% sample was cross-checked for errors. Data extraction followed a pre-defined template with additional independent checks. The primary outcome was the predictive validity of the screening tools.<br><br>RESULTS: Of 3,911 citations screened, 28 studies (N=25,444) were included, with six focusing on children under 12 (N=1,430). The methods varied, with 18 studies using clinical interviews and 10 using validated questionnaires. Most tools achieved a Level 3 rating on The Rational Clinical Examination Levels of Evidence, indicating methodological limitations. The child version of the Eating Attitudes Test (ChEAT) had the most evidence, though it has not been validated for DSM-5 criteria.<br><br>CONCLUSIONS AND RELEVANCE: There is a significant gap in validated ED screening tools for children under 12. Future research should focus on developing tools for this population to improve early detection and treatment outcomes.}, }
@article {pmid40705014, year = {2025}, author = {Legrand, NM and Bull, RA and Hajarizadeh, B and Lloyd, AR and Johnston, K and Issa, K and Harvey, C and Arnott, A and Dwyer, DE and Sintchenko, V and Grant, L and Dore, GJ and Kaldor, J and Martinello, M}, title = {Surveillance of Viral Respiratory Infections within Maximum-Security Prison, Australia.}, journal = {Emerging infectious diseases}, volume = {31}, number = {8}, pages = {1527-1536}, pmid = {40705014}, issn = {1080-6059}, mesh = {Humans ; *Prisons ; *COVID-19/epidemiology/transmission/virology/diagnosis ; Male ; *SARS-CoV-2/genetics/isolation &amp; purification ; Adult ; Female ; Middle Aged ; New South Wales/epidemiology ; Incidence ; Young Adult ; Prisoners ; Australia/epidemiology ; Aged ; *Respiratory Tract Infections/epidemiology/virology ; Disease Outbreaks ; Adolescent ; }, abstract = {Limited surveillance data have hindered understanding of SARS-CoV-2 transmission within prisons. We integrated routine surveillance data with viral sequencing to investigate transmission dynamics and associated factors during a Delta variant outbreak in a maximum-security prison in Sydney, New South Wales, Australia. Infection incidence and associated factors were determined by using person-time and Cox regression. We generated transmission chains by integrating epidemiologic and viral sequencing data. Of 1,562 patients, SARS-CoV-2 infection was diagnosed in 169 (11%), predominantly acquired in prison and asymptomatic. Prisonwide testing identified substantial unrecognized transmission, and 4 subvariants indicated multiple viral introductions. Infection was associated with housing location, having a cellmate (regardless of infection status), and vaccination status. Our findings underscore the inadequacy of symptom-based testing and the efficacy of entry-quarantine, strategic housing, extensive testing, and vaccination in reducing transmission. This integrated approach to surveillance and genomic sequencing offers a valuable model for enhancing infectious disease surveillance in correctional settings.}, }
@article {pmid40704759, year = {2025}, author = {Janas, PP and Rozario, C and Lucas, CD and Hiemstra, PS and Schwarze, J and Chauché, C}, title = {The long reach of influenza and other respiratory viruses: from acute epithelial injury to post-viral lung disease.}, journal = {Clinical microbiology reviews}, volume = {38}, number = {3}, pages = {e0024324}, pmid = {40704759}, issn = {1098-6618}, support = {//British Lung Foundation/ ; VET/2020 -1 EPDF 7//Horserace Betting Levy Board/ ; //British Lung Foundation/ ; }, mesh = {Humans ; *Influenza, Human/virology ; *Respiratory Tract Infections/virology ; *Virus Diseases/virology ; Epithelial Cells/virology ; COVID-19/virology ; Animals ; SARS-CoV-2 ; Respiratory Mucosa/virology/pathology ; Orthomyxoviridae ; *Lung Diseases/virology ; }, abstract = {SUMMARYRespiratory viral infections cause extensive cell death in the lung epithelium, resulting from both direct viral action and exuberant immune responses. Recovery following viral infection requires rapid and coordinated repair programs, ensuring the replacement of the damaged tissue through proliferation, migration, and differentiation of respiratory epithelial progenitor cells. Viral infection and the resulting inflammatory milieu alter host gene expression. Notably, growing evidence indicates that these infections can induce long-term changes in epithelial progenitor cells, which persist even after the infection has resolved. These alterations may play a key role in the development of post-viral lung disease (PVLD). In this review, we discuss current knowledge regarding respiratory viral infections and how these may alter the gene expression and function of epithelial progeny cells arising from the surviving progenitors. We do so by exploring the influenza virus as an example and comparing it with what is known about other important respiratory viruses, such as respiratory syncytial virus (RSV), rhinovirus (HRV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). We highlight the impact of respiratory viral infection and ensuing inflammation on lung epithelial memory, considering the importance of viral strains, and discuss potential new therapeutic strategies that could maximize long-term lung health.}, }
@article {pmid40704480, year = {2025}, author = {Ye, PC and Ren, Y and Su, WL and Kong, H}, title = {Progress in the Application of Stellate Ganglion Block in Non-Analgesic Fields.}, journal = {Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae}, volume = {47}, number = {3}, pages = {462-469}, doi = {10.3881/j.issn.1000-503X.16247}, pmid = {40704480}, issn = {1000-503X}, mesh = {*Stellate Ganglion ; Humans ; *Autonomic Nerve Block/methods ; Anesthetics, Local/administration &amp; dosage ; COVID-19 ; }, abstract = {Stellate ganglion block (SGB) is a specific type of peripheral nerve block in which local anesthetics and/or steroids are injected around the stellate ganglia.In the past,SGB was mainly used to alleviate pain-related syndromes.With the development of ultrasound technology,SGB has been widely used in non-analgesic fields,demonstrating significant therapeutic effects on arrhythmias,hot flashes,psychiatric disorders,cerebrovascular diseases,insomnia,and post coronavirus disease-2019 conditions in recent years.This study reviews the progress in the application of SGB in the non-analgesic fields.}, }
@article {pmid40703998, year = {2024}, author = {Kim, CJ}, title = {Update on sexually transmitted infections in Korea: a narrative review.}, journal = {Ewha medical journal}, volume = {47}, number = {4}, pages = {e52}, pmid = {40703998}, issn = {2234-2591}, abstract = {Sexually transmitted infections (STIs) continue to pose significant public health challenges in Korea, with syphilis, gonorrhea, chlamydia, Mycoplasma genitalium, and herpes simplex virus (HSV) being the most prevalent. This review provides an updated overview of the epidemiology, diagnosis, and treatment of these significant STIs in Korea, highlighting recent trends and concerns. Syphilis incidence rates have fluctuated due to changes in surveillance systems. Starting in 2024, syphilis will be reclassified as a nationally notifiable infectious disease (category 2). Gonorrhea remains a concern due to increasing antibiotic resistance, including the emergence of extensively drug-resistant Neisseria gonorrhoeae strains, underscoring the need for vigilant antimicrobial stewardship. Chlamydia continues to be the most commonly reported STI, although its incidence has declined during the COVID-19 pandemic. M. genitalium has gained attention as a significant STI with rising antibiotic resistance issues, necessitating updated treatment guidelines and consideration of resistance testing. HSV-2 remains a common cause of genital herpes, with steady incidence rates reported. Updated diagnostic methods, including nucleic acid amplification tests, and revised treatment guidelines are presented to effectively address these infections. The impact of the COVID-19 pandemic on other STIs within Korea remains unclear, necessitating further research. Changes in treatment guidelines, such as the recommendation of doxycycline as first-line therapy for chlamydia, reflect evolving evidence and resistance patterns. The importance of updated diagnostic tools, including resistance testing for M. genitalium, is emphasized to improve treatment outcomes. Continued efforts in education, prevention, and research are essential to manage and mitigate the impact of STIs on public health in Korea.}, }
@article {pmid40703719, year = {2025}, author = {Deng, Z and Yang, Z}, title = {Exploring the impact of online education on student engagement in higher education in post-COVID-19: what students want to get?.}, journal = {Frontiers in psychology}, volume = {16}, number = {}, pages = {1574886}, pmid = {40703719}, issn = {1664-1078}, abstract = {The sudden outbreak of COVID-19 has led to an unprecedented impact on traditional higher education classrooms. To ensure that students can continue receiving quality education, online learning has become a mainstream mode of instruction. Therefore, increasing student engagement become a key priority for teachers in online teaching contexts. Few reviews examine student engagement in education in the post-COVID-19 era. To address this gap, the present study aims to explore the key factors that influence student engagement in classroom settings in this context. We identified 30 papers related to our research focus from 498 articles retrieved from the Web of Science and Scopus databases, following the 2020 PRISMA framework. After reviewing related studies, this study examined the characteristics of student engagement about cognitive, affective, and behavioral dimensions. We also analyzed the impact of online education on student engagement. Our findings suggest that emotional, cognitive, and behavioral engagement are interconnected and influence one another. In addition, teachers' support for students' cognitive and emotional needs plays a vital role in fostering their behavioral engagement. This article can help educators better understand the definition of engagement and the factors that influence student engagement in the classroom.}, }
@article {pmid40702967, year = {2025}, author = {He, Q and Zhang, Y and Fu, Z and Ma, X and Liang, Z}, title = {Broad-spectrum coronavirus vaccines: integrated strategies to combat viral diversity.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {1-12}, doi = {10.1080/14760584.2025.2538561}, pmid = {40702967}, issn = {1744-8395}, mesh = {Humans ; *COVID-19 Vaccines/immunology ; *COVID-19/prevention &amp; control/immunology/epidemiology ; *SARS-CoV-2/immunology ; Vaccine Development ; *Viral Vaccines/immunology ; }, abstract = {INTRODUCTION: The early 21st century witnessed three consecutive public health emergencies caused by Betacoronavirus infections, drawing considerable global attention to the hazards posed by Betacoronaviruses. Vaccines have proved instrumental in mitigating the coronavirus disease 2019 (COVID-19) pandemic, yet the persistent emergence of novel variants underscores the necessity for continuous development of updated vaccines tailored to circulating strains. In addition, new coronavirus outbreaks or the reemerging of previously prevalent coronaviruses may occur in the future.<br><br>AREAS COVERED: Broad-spectrum coronavirus vaccines, especially pan-coronavirus vaccines, can serve as powerful weapons against known and unknown coronavirus risks. This article presents a comprehensive review of recent advancements in broad-spectrum coronavirus vaccine development, identifies persistent challenges, and outlines strategic directions for vaccine development. It aims to provide essential references and strategic considerations for broad-spectrum or universal coronavirus vaccines.<br><br>EXPERT OPINION: Prioritizing Betacoronavirus-focused vaccines may provide practical near-term solutions, while long-term success hinges on integrating AI and structural biology for precision engineering. Future efforts must emphasize durable immunity, mucosal strategies, and adaptability to viral diversity. Collaboration across computational, immunological, and virological fields will be essential to achieve universal coronavirus protection.}, }
@article {pmid40702494, year = {2025}, author = {Dubrovskyi, E and Drevytska, T and Portnychenko, A and Dosenko, V and Halabitska, I and Petakh, P and Kainov, DE and Kamyshnyi, O}, title = {Extracellular DNA, hyaluronic acid, HIF pathways, and LncRNAs as predictive biomarkers of severe COVID-19.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {252}, pmid = {40702494}, issn = {1743-422X}, mesh = {Humans ; *COVID-19/diagnosis/blood/metabolism ; *Hyaluronic Acid/blood ; Biomarkers/blood ; *RNA, Long Noncoding/blood ; *Cell-Free Nucleic Acids/blood ; SARS-CoV-2 ; Extracellular Traps/metabolism ; Severity of Illness Index ; *Hypoxia-Inducible Factor 1/metabolism ; }, abstract = {The clinical course of COVID-19 ranges from mild symptoms to severe complications, and common laboratory markers such as D-dimer, ferritin, interleukin-6 (IL-6), and C-reactive protein (CRP) often do not accurately predict which patients will develop severe disease. In this study, we reviewed current literature and analyzed additional data to assess emerging biomarkers that may help identify high-risk cases earlier. These include circulating cell-free DNA (cfDNA) produced during neutrophil extracellular trap formation (NETosis), hyaluronic acid (HA), hypoxia-inducible factor (HIF) isoforms, and related long non-coding RNAs such as HAS2-AS1 and HIF1-AS1. Increased levels of cfDNA/NETs, HA, and elevated expression of HIF isoforms and their lncRNAs are closely associated with key features of severe COVID-19, including immune-related blood clotting, low oxygen levels, vascular damage, and chronic inflammation. These biomarkers show promise for use in risk assessment tools that could support earlier clinical decisions and improve outcomes in patients with COVID-19.}, }
@article {pmid40701750, year = {2025}, author = {Klassen, L and Prévost, J and Safronetz, D}, title = {The significance of studying high-consequence pathogens in their natural reservoirs.}, journal = {Advances in virus research}, volume = {122}, number = {}, pages = {99-112}, doi = {10.1016/bs.aivir.2025.03.001}, pmid = {40701750}, issn = {1557-8399}, mesh = {Animals ; *Disease Reservoirs/virology ; *COVID-19/transmission/virology/epidemiology ; *Peromyscus/virology ; SARS-CoV-2/pathogenicity ; Humans ; *Lassa virus/pathogenicity ; Lassa Fever/transmission/virology ; }, abstract = {Concern over spillover events caused by high-consequence pathogens has grown in recent years due to the increased occurrence of such events, and because the COVID-19 pandemic demonstrated how severe the consequences of spillover events can be. As such, there is escalading interest in uncovering the factors that make spillover events more likely, specifically for high-consequence pathogens. An important aspect of this work involves researching how high-consequence pathogens interact with their reservoir hosts. Thus, this chapter discusses the importance of studying high-consequence pathogens in their reservoir hosts, specifically in experimental laboratory settings, with a special emphasis on Sin Nombre virus and Lassa virus, and their respective rodent reservoir hosts, Peromyscus maniculatus and Mastomys natalensis. Value gained from this research, as well as the current limitations faced when conducting this work are also discussed. Overall, this work helps to shed light on various aspects of these pathogens such as their transmission patterns, pathogenesis (and lack thereof), and mechanisms of persistence in their reservoir hosts. Limitations include a need for highly developed laboratory infrastructure, demanding funding requirements, and a lack of compatible reagents for the exotic species that are often the subject of these studies. Continued interest and research is needed to expand this work to include host reservoirs of other high consequence pathogens so that the risks of future spillover events can be mitigated as best as possible.}, }
@article {pmid40701476, year = {2025}, author = {Choudhary, K and Tanweer, S and Choudhary, MZ and Grover, S}, title = {Mycobacterium tuberculosis methyltransferases as alternative strategies to combat drug resistant tuberculosis.}, journal = {International journal of biological macromolecules}, volume = {321}, number = {Pt 1}, pages = {146198}, doi = {10.1016/j.ijbiomac.2025.146198}, pmid = {40701476}, issn = {1879-0003}, mesh = {*Mycobacterium tuberculosis/enzymology/drug effects/genetics ; Humans ; *Methyltransferases/metabolism/antagonists &amp; inhibitors/genetics ; *Antitubercular Agents/pharmacology/therapeutic use ; *Tuberculosis, Multidrug-Resistant/drug therapy/microbiology ; *Bacterial Proteins/metabolism/antagonists &amp; inhibitors ; }, abstract = {Tuberculosis (TB) is a health concern resulting in 10.8 million cases every year. In 2024, TB had the highest fatalities second only to COVID-19. Global TB management has become difficult due to rise of multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB. Therefore, novel approaches must be developed to fight with M.tb infection. Studies on many strategies like pathogen-centric, host-directed therapeutics, antimicrobial peptides, nano-based drug delivery, and more are still being explored to develop novel therapeutics. One such important target i.e., pathogen associated Methyltransferases (Mtases) used along above-mentioned strategies can be advantageous as targeting Mtases are involved in various cellular processes like mycolic acid synthesis, lipid metabolism, immune evasion, and DNA repair. Mtases are a class of enzymes that transfer the methyl group to their substrate. There are 121 Mtases that are encoded by the genome of M.tb are essential for both the occurrence of drug-resistant tuberculosis and bacterial survival. This review has covered various approaches in treating drug-resistant tuberculosis, with a particular emphasis on Mtases for the creation of innovative treatments for drug development. Thus, Targeting Mtases could give more effective treatments against MDR and XDR-TB.}, }
@article {pmid40701471, year = {2025}, author = {Cai, W and Cai, M and Wu, M and Gao, X}, title = {mRNA vaccines: Emerging opportunities for herpesvirus prevention and therapeutic intervention.}, journal = {International journal of biological macromolecules}, volume = {321}, number = {Pt 1}, pages = {146204}, doi = {10.1016/j.ijbiomac.2025.146204}, pmid = {40701471}, issn = {1879-0003}, mesh = {Humans ; *Herpesviridae/immunology/genetics ; *Herpesviridae Infections/prevention &amp; control/immunology/virology ; *Herpesvirus Vaccines/immunology/genetics/therapeutic use ; COVID-19/prevention &amp; control/immunology/virology ; Animals ; Vaccine Development ; *Vaccines, Synthetic/immunology ; *mRNA Vaccines/immunology ; *RNA, Messenger/immunology/genetics ; }, abstract = {Herpesviruses infect over 90 % of the global population, imposing a significant disease burden worldwide. The complex lifecycle of herpesviruses, characterized by both lytic infection and latency, poses substantial challenges to vaccine development. To date, among the nine known human herpesviruses, only varicella-zoster virus (VZV) has a licensed commercial vaccine, leaving an urgent need for novel and broadly protective vaccine strategies against the remaining members of this viral family. mRNA vaccine platforms, which allow in situ expression of high levels of antigenic proteins without the risk of genomic integration, offer promising advantages in safety and immunogenicity. Their success during the COVID-19 pandemic has highlighted their potential for rapid and effective vaccine development. In this review, we first summarize the infection and latency mechanisms of the nine human herpesviruses. We then comprehensively examine recent advances in mRNA vaccine research targeting these viruses, including antigen design, structural optimization, immune protection profiles, and safety assessments. Finally, we discuss current limitations and bottlenecks in herpesvirus vaccine development, with the goal of informing future efforts toward the design of broad-spectrum, safe, and effective herpesvirus vaccines.}, }
@article {pmid40701086, year = {2025}, author = {Kumar, Y and Xu, B}, title = {Bioactive compounds, health benefits, and practical applications of edible mushroom Schizophyllum commune Fr.: A decade-long critical review.}, journal = {Food chemistry}, volume = {492}, number = {Pt 3}, pages = {145583}, doi = {10.1016/j.foodchem.2025.145583}, pmid = {40701086}, issn = {1873-7072}, mesh = {*Schizophyllum/chemistry ; Humans ; Animals ; Antioxidants/chemistry/pharmacology ; Functional Food/analysis ; }, abstract = {Schizophyllum commune, also known as split-gill mushroom, is an edible fungus with significant medicinal and culinary value. This review explores the bioactive compounds, health benefits, and applications based on research from the last decade. Mushrooms like S. commune are rich in polysaccharides, flavonoids, saponins, and ergosterol, contributing to their antioxidant, antibacterial, antiviral, anti-inflammatory, and immunomodulatory properties. These compounds suggest potential in preventing and managing chronic diseases such as cancer, cardiovascular issues, diabetes, and neurodegenerative conditions. S. commune shows strong antioxidant activity, protecting cells from oxidative stress and DNA damage. It also demonstrates genoprotective and organoprotective effects, particularly against environmental toxins like Bisphenol A. Apart from medicinal use, S. commune acts have applications in pharmaceuticals, functional foods, and nutraceuticals, with notable antibacterial and anticancer effects. It is safe for consumption with no toxicity at high doses and it also offers potential in liver protection, metabolic disorders, and immune health.}, }
@article {pmid40700883, year = {2025}, author = {Te Marvelde, MR and van Dijk, L and Power, MA and Rissmann, M and de Vries, RD and Haagmans, BL}, title = {Human organoid models to study coronavirus infections of the respiratory tract.}, journal = {Current opinion in virology}, volume = {72}, number = {}, pages = {101476}, doi = {10.1016/j.coviro.2025.101476}, pmid = {40700883}, issn = {1879-6265}, mesh = {Humans ; *Organoids/virology/immunology ; SARS-CoV-2/physiology ; Animals ; COVID-19/virology/immunology ; *Coronavirus Infections/virology/immunology ; Viral Tropism ; *Respiratory System/virology/immunology ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic emphasized the need to study coronaviruses more thoroughly. Next to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), humans can be infected by SARS-CoV, Middle East respiratory syndrome coronavirus (MERS-CoV), and various seasonal coronaviruses. It is likely that all human coronaviruses have a zoonotic origin and circulated in animal reservoirs before crossing the species barrier into humans. Historically, these viruses have been investigated in vitro and in vivo, mainly utilizing immortalized cell lines and animal models, respectively. Recently, more advanced physiological model systems have been developed to study coronavirus host interactions, with human organoids serving as innovative in vitro tissue culture system that closely mimics human physiology. Organoids provide a promising platform for investigating coronavirus infections, exploring viral tropism, studying host immune responses, and evaluating potential therapeutic interventions. This review explores the origins and use of airway organoids in studying coronaviruses. Additionally, it outlines prospects for leveraging airway organoids for examination of both innate and adaptive immune responses, evaluation of antiviral drugs, and creating intricate co-culture models for enhanced insight into coronavirus infections of the respiratory tract.}, }
@article {pmid40700874, year = {2025}, author = {VanDerWal, JA and Wilson, DJ and Keener, K and Jaraczewski, T and Prom, JL and Seadler, M and Turner, H and Murphy, P and Dodgion, C and Iverson, KR}, title = {Essential surgery in crisis: A global scoping review of surgical prioritization during the COVID-19 pandemic.}, journal = {Surgery}, volume = {186}, number = {}, pages = {109578}, doi = {10.1016/j.surg.2025.109578}, pmid = {40700874}, issn = {1532-7361}, mesh = {*COVID-19/epidemiology ; Humans ; *Surgical Procedures, Operative/statistics &amp; numerical data/standards ; Developing Countries ; Global Health ; Pandemics ; *Health Priorities ; SARS-CoV-2 ; Developed Countries ; *Specialties, Surgical ; }, abstract = {BACKGROUND: A systematic analysis of how essential surgery developed worldwide throughout the COVID-19 pandemic remains absent. This scoping review aims to define essential surgery by comparing definitions between high-income countries and low- and middle-income countries during COVID-19.<br><br>METHODS: We conducted a scoping review of Ovid, PubMed, Scopus, and Web of Science databases for articles published January 2020 to December 2022 that defined essential surgery during COVID-19. Articles referencing pediatric populations or exclusively elective surgery were excluded. This review was registered with PROSPERO (CRD42024495318). Articles were categorized by country income status, surgical specialty, and methodology. Procedures were classified into 8 surgical systems (neurosurgery, breast/gynecology, etc) and deemed to have strong (&#x2265;75%), moderate (50-74%), or limited (<50%) consensus as essential on the basis of how many articles mentioned the procedure.<br><br>RESULTS: We analyzed 85 articles (61 high-income countries, 24 low- and middle-income countries) from 4,247 screened. Essential surgery comprises procedures needed within 30 days that prevent mortality, are time-sensitive, preserve function, prevent altered prognosis, or have no medical alternatives. Neurosurgery was most represented, with strong consensus for immediate life-threatening conditions needing intervention within 24 hours. Although high-income countries and low- and middle-income countries agreed on procedures addressing immediate threats to life, significant disparities existed in urology, gynecology, and colorectal surgery.<br><br>CONCLUSION: Our findings highlight the need for resource-stratified, specialty-specific guidelines that can be adapted to different health care contexts, while maintaining the core principles of surgical prioritization. Future frameworks should incorporate timeframes for safe surgical delay, risk of disease progression, resource requirements, and expected outcomes to guide ethical surgical triage.}, }
@article {pmid40700530, year = {2025}, author = {Bilagi, A and Kumari, S and Purushotham, A}, title = {Health Disparities Induced by COVID-19 among Adolescents and Potential Mitigation through Yoga in the Post-Pandemic Era: A Narrative Review.}, journal = {Advances in mind-body medicine}, volume = {39}, number = {4}, pages = {20-25}, pmid = {40700530}, issn = {1470-3556}, mesh = {Humans ; *Yoga ; *COVID-19 ; Adolescent ; *Health Status Disparities ; *Adolescent Health ; Holistic Health ; }, abstract = {ABSTRACT: Adolescence is a crucial period that can have lifelong effects on health. The COVID-19 pandemic's adverse effects on adolescent health, particularly the physical and mental well-being, have been emphasized in several World Health Organization (WHO) reports. Factors contributing to health disparities, including socioeconomic determinants, limited healthcare access, and psychosocial challenges, are identified. This article delves into the potential of yoga as a holistic wellness approach, presenting existing evidence on its benefits for adolescents. The mechanisms through which yoga addresses health inequalities are described by emphasizing its impact on physical well-being, mental health, and social connectivity. The implementation strategies for yoga programs, within school curricula and community-based initiatives, are outlined, focusing on cultural sensitivity, accessibility, and inclusivity. It also promotes the role of evidence-based interventions, including yoga, in cultivating resilient adolescent populations in society. Since yoga programs are also offered through telehealth platforms, there is an urgent need to explore the role of these online platforms in extending the reach of yoga, especially in promoting accessibility and inclusivity. The importance of accessibility and inclusivity, including physical and financial aspects, in yoga programs should be considered. Besides, cultural sensitivity is also crucial for effective healthcare promotion, emphasizing the need for tailored yoga interventions that respect diverse cultures. This article also identifies research gaps, offers future directions in studying yoga interventions for adolescents, and highlights the need for longitudinal studies and diverse intervention approaches. In essence, this article promotes a holistic approach to adolescent health, leveraging the benefits of yoga to foster equity and well-being for adolescents in present and future pandemics.<br><br>KEYWORDS: Adolescents Health Disparities, Yoga, Pandemic, COVID-19.}, }
@article {pmid40700327, year = {2025}, author = {Mutua, F and Su, RC and Ball, TB and Kiazyk, S}, title = {The Role of Type I Interferons in Tuberculosis and in Tuberculosis-Risk-Associated Comorbidities.}, journal = {Infectious disease reports}, volume = {17}, number = {4}, pages = {}, pmid = {40700327}, issn = {2036-7430}, abstract = {The identification of a type I interferon-induced transcriptomic signature in active tuberculosis suggests a potential role for these interferons in the pathogenesis of tuberculosis. Comorbidities such as human immunodeficiency virus, diabetes, systemic lupus erythematosus, end-stage renal disease, and coronavirus disease are epidemiologically linked to an increased risk for reactivation of latent tuberculosis infection. Notably, type I interferons are also implicated in the pathogenesis of these conditions, with a recognizable type I interferon transcriptomic signature. The mechanisms by which type I interferons in tuberculosis-risk-associated comorbidities may drive the progression of tuberculosis or maintenance of latent infection however remain largely unknown. This review summarizes the existing literature on the increased association between type I interferons, focusing on interferon-α and -β, and the heightened risk of tuberculosis reactivation. It also underscores the similarities in the immunopathogenesis of these comorbidities. A better understanding of these mechanisms is essential to guide the development of host-directed interferon therapies and improving diagnostic biomarkers in M. tuberculosis infection.}, }
@article {pmid40700054, year = {2025}, author = {Estela-Zape, JL and Sanclemente-Cardoza, V and Espinosa-Cifuentes, MA and Ordoñez-Mora, LT}, title = {Impact of Invasive Mechanical Ventilation on the Lung Microbiome.}, journal = {Advances in respiratory medicine}, volume = {93}, number = {4}, pages = {}, pmid = {40700054}, issn = {2543-6031}, support = {01-2025//Universidad Santiago de Cali/ ; }, mesh = {Humans ; *Respiration, Artificial/adverse effects/methods ; *Microbiota ; *Lung/microbiology ; COVID-19/therapy ; SARS-CoV-2 ; }, abstract = {The lung microbiota is integral to maintaining microenvironmental homeostasis, influencing immune regulation, host defense against pathogens, and overall respiratory health. The dynamic interplay among the lung microbiota emphasizes their significance in shaping the respiratory milieu and potential impact on diverse pulmonary affections. This investigation aimed to identify the effects of invasive mechanical ventilation on the lung microbiome. Materials and Methods: A systematic review was conducted with registration number CRD42023461618, based on a search of PubMed, SCOPUS, and Web of Science databases, in line with the PRISMA guidelines. To achieve this, "(mechanical ventilation) AND (microbiota)" was used as the search term, replicable across all databases. The closing date of the search was 12 March 2025, and the evidence was scored using the MINORS scale. Results: A total of 16 studies were included, with patients aged 13.6 months to 76 years, predominantly male (64.2%). Common ICU admission diagnoses requiring invasive mechanical ventilation (IMV) included pneumonia, acute respiratory failure, and COVID-19. IMV was associated with reduced lung microbiota diversity and an increased prevalence of pathogenic bacteria, including Prevotella, Streptococcus, Staphylococcus, Pseudomonas, and Acinetobacter. The most frequently used antibiotics were cephalosporins, aminoglycosides, and penicillins. IMV-induced pulmonary dysbiosis correlated with higher infection risk and mortality, particularly in pneumonia and COVID-19 cases. Factors such as antimicrobial therapy, enteral nutrition, and systemic inflammation contributed to these alterations. Conclusions: Invasive mechanical ventilation has been associated with the development of alterations in the respiratory microbiome, resulting in reduced diversity of lung microorganisms.}, }
@article {pmid40699702, year = {2025}, author = {Ashraf, MA and Shen, B and Raza, MA and Yang, Z and Amjad, MN and Din, GU and Yue, L and Kousar, A and Kanwal, Q and Hu, Y}, title = {Albumin: A Review of Market Trends, Purification Methods, and Biomedical Innovations.}, journal = {Current issues in molecular biology}, volume = {47}, number = {5}, pages = {}, pmid = {40699702}, issn = {1467-3045}, support = {NVRC-PY-01//This research was funded by the Technical Support Talent Project from Chinese Academy of Sciences and Open foundation of National Virus Resource Center, grant number NVRC-PY-01./ ; }, abstract = {Albumin is the most abundant plasma protein, accounting for approximately 50% of total serum protein in healthy individuals. In recent years, albumin has attracted significant attention due to its biocompatibility, non-toxicity (metabolizing in vivo into harmless degradation products), non-immunogenic properties, ease of purification, and water solubility. These characteristics render it an ideal candidate for a wide range of biomedical applications. Its uses include drug delivery systems, wound healing, antioxidant therapies, infusion treatments, COVID-19 therapeutics, tissue engineering, and other critical care domains. Consequently, the global demand for albumin has been steadily increasing. The international albumin market was valued at USD 5394.9 million in 2021 and is projected to reach USD 9192 million by 2030, with a compound annual growth rate (CAGR) of 6.1%. Given its diverse applications and rising demand, substantial efforts have been made to ensure a sustainable supply of albumin. This review provides an overview of albumin, along with its novel applications, purification methods, and market trends.}, }
@article {pmid40699034, year = {2025}, author = {Santos, GA and Luna, EJA}, title = {The influence of the COVID-19 pandemic on measles vaccination coverage.}, journal = {Cadernos de saude publica}, volume = {41}, number = {6}, pages = {e00183924}, pmid = {40699034}, issn = {1678-4464}, mesh = {Humans ; *COVID-19/epidemiology ; *Vaccination Coverage/statistics &amp; numerical data ; *Measles Vaccine/administration &amp; dosage ; *Measles/prevention &amp; control ; *Pandemics ; SARS-CoV-2 ; *Vaccination/statistics &amp; numerical data ; }, abstract = {We conducted a systematic review to assess the impact of the COVID-19 pandemic on measles vaccination coverage. We searched for articles published between January 2021 and December 2023 in Portuguese, English, and Spanish in the Web of Science, ScienceDirect, PubMed, and LILACS databases. The final sample consisted of 32 studies, which demonstrated that most countries had a 1% to 10% decrease on measles vaccination coverage during the pandemic. However, the influence of the pandemic varied worldwide, ranging from 1% to 60% based on the region. The COVID-19 pandemic has had a relatively modest impact on measles immunization, with a complex intersection of several factors associated with the decrease in measles vaccination coverage.}, }
@article {pmid40698473, year = {2025}, author = {Zahid, M and Hussain, U and Noreen, S and Kabir, S and Rehman, K}, title = {Interventions to mitigate the impact of COVID-19 pandemic on mental health status of healthcare workers: a systematic review.}, journal = {JPMA. The Journal of the Pakistan Medical Association}, volume = {75}, number = {6}, pages = {943-959}, doi = {10.47391/JPMA.21037}, pmid = {40698473}, issn = {0030-9982}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Health Personnel/psychology ; *Mental Health ; SARS-CoV-2 ; Pandemics ; }, abstract = {OBJECTIVE: To evaluate the effectiveness of interventions in addressing the impact of coronavirus disease-2019 on the mental health status of healthcare workers.<br><br>METHODS: The systematic review was conducted from January to August 2023 in line with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses guidelines, and comprised search on Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Allied and Complementary Medicine Database Cumulative Index to Nursing and Allied Health Literature and Cochrane Central Register of Controlled Trials databases for relevant randomised clinical trials published till January 25, 2022, focussing on assessing the effectiveness of interventions addressing the impact of coronavirus disease-2019 on healthcare workers. The risk of bias of the studies was assessed using the revised Cochrane risk of bias tool for randomised clinical trials RoB 2.0.<br><br>RESULTS: There were 17 randomised clinical trials with 4,511 participants. Overall findings showed that mindfulness-based interventions, yoga/music, music therapy/meditation, psychological interventions, creative arts therapy, and acupuncture could be effective in improving mental health outcomes for healthcare workers dealing with coronavirus disease-2019 patients. Pharmacological interventions and transcendental meditation may not be as effective.<br><br>CONCLUSIONS: Implementing non-pharmacological interventions to support the mental health of healthcare workers during times of crisis could be a positive approach.}, }
@article {pmid40697832, year = {2025}, author = {Obeng Nkrumah, S and Adu, MK and Agyapong, B and da Luz Dias, R and Agyapong, VIO}, title = {Prevalence and correlates of depression, anxiety, and burnout among physicians and postgraduate medical trainees: a scoping review of recent literature.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1537108}, pmid = {40697832}, issn = {2296-2565}, mesh = {Humans ; *Burnout, Professional/epidemiology ; Prevalence ; *Depression/epidemiology ; *Physicians/psychology/statistics &amp; numerical data ; *Anxiety/epidemiology ; *Internship and Residency/statistics &amp; numerical data ; Female ; Male ; }, abstract = {BACKGROUND: The mental well-being of physicians is increasingly recognized as vital, both for their personal health and the quality of care they provide to patients. Physicians face a variety of mental health challenges, including depression, anxiety, and burnout, which have become prevalent issues globally. These mental health concerns are like those found in the general population but are particularly significant in the demanding healthcare setting.<br><br>OBJECTIVE: This review aims to explore the prevalence and correlates of depression, anxiety, and burnout among physicians and residents in training.<br><br>METHODS: A comprehensive literature review was conducted, searching databases such as Medline, PubMed, Scopus, CINAHL, and PsycINFO. The review focused on studies published from 2021 to 2024 that addressed the prevalence of these mental health conditions in physicians and residents. The findings, in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, were summarized in detailed tables.<br><br>RESULTS: Following titles and abstracts screening, 196 publications were selected for full-text review, with 92 articles ultimately included in the analysis. The results revealed significant variability in the prevalence of burnout, depression, and anxiety. Burnout rates among physicians ranged from 4.7 to 90.1% and from 18.3 to 94% among residents. Depression prevalence ranged from 4.8 to 66.5% in physicians and from 7.7 to 93% in residents. Anxiety rates were between 8 and 78.9% in physicians and 10 to 63.9% in residents. Notably, women reported higher rates of all three conditions compared to men. Key factors influencing these mental health conditions included demographics (age, gender, education, financial status, family situation, occupation), psychological conditions, social factors (stigma, family life), work organization (workload, work conditions), and COVID-19-related issues (caring for COVID-19 patients, fear of infection, working in high-risk areas, concerns about personal protective equipment (PPE), and testing positive).<br><br>CONCLUSION: This review indicates a high prevalence of burnout, depression, and anxiety among physicians and residents, with female participants consistently showing higher rates than males. These findings can guide policymakers and healthcare administrators in designing targeted programs and interventions to help reduce these mental health issues in these groups.}, }
@article {pmid40696830, year = {2025}, author = {Paulose, M and Adams, NN and Martin, KR and Grant, A}, title = {Lived Experiences of New-Onset Long Covid Pain and Its Impact on Health-Related Quality of Life. A Scoping Review of Current Evidence.}, journal = {Health expectations : an international journal of public participation in health care and health policy}, volume = {28}, number = {4}, pages = {e70352}, pmid = {40696830}, issn = {1369-7625}, support = {//The authors received no specific funding for this work./ ; }, mesh = {Humans ; *Quality of Life/psychology ; *COVID-19/complications/psychology ; *Chronic Pain/psychology/etiology ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long Covid (LC) is a multisystem condition that can cause persistent symptoms such as breathlessness, fatigue, cognitive problems and pain, with major effects on individuals and healthcare systems. Globally, nearly 400 million people have been affected. New-onset pain is among the most commonly reported symptoms and may develop into chronic pain, contributing to reduced health-related quality of life (HRQoL) and highlighting the need for appropriate care. Given its global prevalence, exploring how people experience new-onset LC pain and how it impacts their lives can help improve pain management and support services.<br><br>METHODS: A mixed-methods scoping review was conducted following the Joanna Briggs Institute (JBI) guidance and the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR). The review mapped and synthesised evidence from eligible primary research articles (quantitative, qualitative and mixed-methods) published in English between December 2019 and June 2024. Seven studies using cross-sectional, case-control and observational designs (n&#x2009;=&#x2009;30 to 2507 participants) were included, with data collected from Europe and Asia.<br><br>RESULTS: While qualitative data on lived experience were limited, 69.5% of LC patients reported new-onset pain, most commonly musculoskeletal (MSK) pain (73.2%). Psychological symptoms such as post-traumatic stress disorder (PTSD) were also reported (38%). Pain medications were widely used. Findings suggest that new-onset LC pain affects physical, psychological and social well-being. No studies involving children or adolescents were identified, indicating a gap in the evidence on paediatric experiences of new-onset LC pain.<br><br>CONCLUSION: This review highlights major gaps in the literature, especially the lack of qualitative research on how people experience new-onset LC pain. Future research should explore these experiences in depth, with involvement from patients and the public, to inform the development of appropriate treatment and support strategies.<br><br>During the review process, opportunities to involve PPI were not fully explored due to limited awareness of how to support meaningful involvement in a scoping review, alongside time and resource constraints. Such involvement could have helped shape the review question, refine the search terms and interpret the findings in ways that better reflect lived experience. This is acknowledged as both a limitation and a learning point. PPI will be actively embedded in the next phases of the research.}, }
@article {pmid40696729, year = {2025}, author = {Rahimi, S and Sayevand, Z and Rezaie Kahkhaie, L and Ahmadi, T and Alifarsangi, A}, title = {Exercise and Immune System: A Comprehensive Review in the Era of Coronavirus.}, journal = {Iranian journal of allergy, asthma, and immunology}, volume = {24}, number = {4}, pages = {428-440}, pmid = {40696729}, issn = {1735-5249}, mesh = {Humans ; *COVID-19/immunology ; *Exercise/physiology ; *SARS-CoV-2/immunology ; *Immune System/physiology/immunology ; Pandemics ; }, abstract = {The COVID-19 pandemic has highlighted the essential role of a strong immune system in fighting infectious diseases. Understanding the relationship between exercise, physical activity, and immune function is crucial for recognizing how lifestyle factors can improve immune resilience. This review article aims to provide a comprehensive overview of the effects of exercise on the immune system during the COVID-19 pandemic. Additionally, it presents recommendations, guidelines, and considerations for engaging in physical activity during this period. Based on the literature review, there is some controversy regarding the effects of high-intensity exercise on individuals' immune systems, whereas moderate exercise is generally beneficial in almost all cases. Also, individuals experiencing severe COVID-19 symptoms or other acute illnesses should abstain from physical activity until recovery.}, }
@article {pmid40696687, year = {2025}, author = {He, Y and Xie, J and Weng, Z and Yang, F and Wei, Y and Liang, J and Lei, J}, title = {Exploring the emerging trends and hot topics of 5G technology application in wireless medicine: A bibliometric and visualization analysis.}, journal = {Medicine}, volume = {104}, number = {29}, pages = {e43310}, pmid = {40696687}, issn = {1536-5964}, support = {81871455//the National Natural Science Foundation of China/ ; LY22H180001//Zhejiang Provincial Natural Science Foundation of China/ ; }, mesh = {*Bibliometrics ; Humans ; *Wireless Technology/trends ; *Telemedicine/trends ; COVID-19 ; China ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The online diagnosis and treatment model based on 5th generation mobile communication (5G) technology is one of the important ways to solve the imbalance between supply and demand of medical services.<br><br>OBJECTIVE: We systematically summarized Chinese and English literature on the application of 5G technology in the field of wireless medical and conducted a literature feature analysis.<br><br>METHODS: We used bibliometrics to quantitatively analyze the research trends and hot topics and comparatively analyzed the differences between research in China and other countries.<br><br>RESULTS: This study analyzed 1344 articles and found that China provided the most funding (531 [75.32%]) and far outnumbered other countries in this field (1014 vs 330), but the quality of articles and effective collaboration between authors need to be improved. The hot topics in this field have gradually shifted from the construction of 5G internet hospitals during the COVID-19 to the construction of smart hospitals based on the Internet of Medical Things, and the research focus has gradually shifted from the data transmission layer such as wearable devices to the application layer of smart medical services.<br><br>CONCLUSION: Researchers can further refine the specific application of 5G technology in the field of wireless medical from the 3 major areas of the smart hospital system.}, }
@article {pmid40695486, year = {2025}, author = {Li, X and Xu, X and Zhang, X and Wang, S and Han, W and Shen, C and Lin, J}, title = {COVID-19-Related Collapsing Glomerulopathy and Thrombotic Microangiopathy in Kidney Transplant Recipients: A Case Report and Literature Review.}, journal = {Nephrology (Carlton, Vic.)}, volume = {30}, number = {7}, pages = {e70096}, doi = {10.1111/nep.70096}, pmid = {40695486}, issn = {1440-1797}, mesh = {Humans ; *COVID-19/complications/diagnosis ; *Kidney Transplantation/adverse effects ; *Thrombotic Microangiopathies/etiology/diagnosis/therapy/virology ; Male ; *Glomerulosclerosis, Focal Segmental/therapy/etiology/diagnosis/virology/pathology ; SARS-CoV-2 ; Fatal Outcome ; Middle Aged ; Nephritis, Interstitial ; Antibodies, Monoclonal, Humanized ; }, abstract = {We present a case of collapsing glomerulopathy (CG) and thrombotic microangiopathy (TMA) associated with COVID-19 in an Asian kidney transplant recipient who does not have the APOL1 gene variant, and we conduct a literature review. The patient presented with progressive renal function decline following a negative COVID-19 nucleic acid test, accompanied by TMA manifestations such as thrombocytopenia and peripheral blood schistocytes. The renal biopsy conducted after plasma exchange revealed collapsing focal segmental glomerulosclerosis, along with acute tubulointerstitial nephritis and minor microangiopathic changes. The patient underwent cyclic eculizumab therapy and ultimately died of acute pulmonary embolism. Our findings indicate that kidney transplant recipients still may experience severe renal impairment even after testing negative for COVID-19 nucleic acid. COVID-19 can not only directly damage transplanted kidneys, but also indirectly harm transplanted kidneys by causing the release of cytokines and inflammation. COVID-19-related TMA and CG may be a continuous pathological process, and prolonged TMA may lead to the development of CG with a worse prognosis. It is also possible that CG and TMA coexist when patients present with acute kidney injury (AKI). Therefore, even a mild COVID-19 infection can have serious consequences for kidney transplant recipients. Vigilance for TMA and CG should be maintained in the presence of AKI of unknown cause.}, }
@article {pmid40695455, year = {2025}, author = {Jung, E and Kavanagh, M and King, E and Samuel, A}, title = {The Use of Technology in Clerkship Education: A Rapid Review.}, journal = {The clinical teacher}, volume = {22}, number = {5}, pages = {e70152}, doi = {10.1111/tct.70152}, pmid = {40695455}, issn = {1743-498X}, mesh = {*Clinical Clerkship/methods/organization &amp; administration ; Humans ; COVID-19/epidemiology ; *Educational Technology ; Virtual Reality ; SARS-CoV-2 ; }, abstract = {BACKGROUND: There is growing interest in integrating technology into clinical clerkship education, particularly in response to disruptions during the COVID-19 pandemic. However, limited synthesis exists on how educational technologies are being used in clerkship settings, what instructional purposes they serve and what outcomes they produce.<br><br>METHODS: A rapid review was conducted to identify empirical studies published between January 2020 and January 2023 that examined educational technology use in undergraduate medical clerkships. We searched Medline, Embase and Web of Science for English-language studies focused on technology use with medical students in clinical learning environments. Data were extracted and synthesized narratively, with studies categorized by technology type, instructional purpose, reported benefits and challenges.<br><br>FINDINGS: From 1717 screened citations, 35 studies met inclusion criteria. The main technologies used included virtual reality, learning platforms, video conferencing tools and simulation-based systems. These technologies were primarily used for content delivery, interactive instruction and assessment. Reported advantages included enhanced learner engagement, realism, timely feedback and increased accessibility. Common challenges involved limited access to hardware, lack of robust outcome evaluation and concerns about transferability to real-world clinical performance. Most studies reported short-term outcomes, such as satisfaction and knowledge gain, rather than long-term skill development.<br><br>CONCLUSION: Technology integration in clerkship education has accelerated, but implementation remains uneven, and evaluations are often limited in scope. Educators should align technology use with instructional goals and assess its impact beyond immediate learner reactions. Future research should examine long-term outcomes, particularly in under-resourced or distributed clinical training environments.}, }
@article {pmid40695158, year = {2025}, author = {Arena, AF and Gregory, M and Collins, DAJ and Vilus, B and Bryant, R and Harvey, SB and Deady, M}, title = {Global PTSD prevalence among active first responders and trends over recent years: A systematic review and meta-analysis.}, journal = {Clinical psychology review}, volume = {120}, number = {}, pages = {102622}, doi = {10.1016/j.cpr.2025.102622}, pmid = {40695158}, issn = {1873-7811}, mesh = {Humans ; *Stress Disorders, Post-Traumatic/epidemiology ; *Emergency Responders/psychology/statistics &amp; numerical data ; Prevalence ; Global Health/statistics &amp; numerical data ; }, abstract = {First responders in emergency services are inherently exposed to potentially psychologically traumatic events, increasing their risk for PTSD, burnout, and work incapacity. The current meta-analysis aimed to comprehensively compare PTSD prevalence within varied first responders in the context of both routine exposures and large-scale disasters, assess trends over recent years and differences between economic contexts. In January 2025, five databases were searched for peer-reviewed observational studies on employed or volunteering samples. Publication date was limited to post-2008, given meta-analyses addressing similar questions captured literature until this point. Random effects meta-analyses and meta-regressions explored trends over time and the impacts of exposure category, occupation, economic context, volunteer status, sex, and PTSD measurement. Analyses included 138 studies (173 independent samples). General samples with routine exposures possessed greater prevalence (14.3 %) than samples exposed to large-scale disasters (8.3 %). For the first time, there was some evidence of increasing prevalence over time within routine exposure samples. Low/middle-income countries and non-volunteers exhibited greater PTSD prevalence than high-income countries and volunteers. Prevalence varied based on PTSD outcome measurement, although no differences emerged between occupational and sex subgroups. Increasing PTSD prevalence over time appears to have been largely driven by increases observed since the COVID-19 pandemic, yet important questions remain regarding why prevalence has not decreased in relation to increasing efforts to support this population's mental health. All first responder occupations appear equally prone to PTSD, and thus equally in need of intervention. Workers in low/middle-income countries are particularly vulnerable to PTSD, potentially due to more limited resourcing.}, }
@article {pmid40693930, year = {2025}, author = {Yoon, SH and Kanne, JP and Ashizawa, K and Biederer, J and Castañer, E and Fan, L and Frauenfelder, T and Ghaye, B and Henry, TS and Huang, YS and Jeong, YJ and Kay, FU and Kligerman, S and Ko, JP and Parkar, AP and Piyavisetpat, N and Prosch, H and Raptis, CA and Simpson, S and Tanaka, N and Brown, KK and Inoue, Y and Sandbo, N and Richeldi, L and Larici, AR}, title = {Best Practice: International Multisociety Consensus Statement for Post-COVID-19 Residual Abnormalities on Chest CT Scans.}, journal = {Radiology}, volume = {316}, number = {1}, pages = {e243374}, doi = {10.1148/radiol.243374}, pmid = {40693930}, issn = {1527-1315}, mesh = {Humans ; Consensus ; *COVID-19/diagnostic imaging/complications ; *Lung/diagnostic imaging ; *Radiography, Thoracic/methods ; SARS-CoV-2 ; Societies, Medical ; *Tomography, X-Ray Computed/methods/standards ; }, abstract = {Residual lung abnormalities on CT scans after COVID-19 respiratory infection may be associated with persistent or progressive respiratory symptoms and frequently correlate with abnormal pulmonary function testing results. These abnormalities have been described using varying terms in numerous publications. Chest CT lung abnormalities after COVID-19 infection tend to stabilize or regress over time, indicating that they are nonprogressive and postinfectious in nature. This multisociety consensus statement, developed by 21 thoracic radiologists from the European Society of Thoracic Imaging, the Society of Thoracic Radiology, and the Asian Society of Thoracic Radiology with a two-round survey process, aims to standardize the indication, acquisition, and reporting of post-COVID-19 residual lung abnormalities on CT scans. Key recommendations include performing chest CT in patients with persistent or progressive respiratory symptoms 3 months after infection, using low-dose CT protocols (range, 1-3 mSv) for follow-up chest CT examinations, using Fleischner Society glossary of terms for radiologic descriptors, and avoiding the term interstitial lung abnormality to describe post-COVID-19 abnormalities. Instead, to prevent misinterpreting post-COVID-19 abnormalities as an early manifestation of interstitial lung disease, use the term post-COVID-19 residual lung abnormality. This consensus statement will help harmonize radiology practice and research for the substantial number of affected patients.}, }
@article {pmid40693746, year = {2025}, author = {Bidlan, M and Kumar, M and Bhargava, A and Goel, V and Kumar, V}, title = {Endocan, a Potential Biomarker of Endothelial Dysfunction: A Brief Overview.}, journal = {Angiology}, volume = {}, number = {}, pages = {33197251356576}, doi = {10.1177/00033197251356576}, pmid = {40693746}, issn = {1940-1574}, abstract = {Endocan (endothelial cell-specific molecule 1, ESM-1), is a proteoglycan produced by the vascular endothelium that modulates cellular functions such as adhesion, migration, and proliferation. Elevated serum endocan levels are associated with autoimmune and inflammatory disorders, acting as a marker of endothelial activation and dysfunction. This brief overview considers endocan's role in HTN, cirrhosis, diabetes, peripheral arterial disease (PAD), coronavirus Disease 2019 (COVID-19), erectile dysfunction (ED), and psoriasis vulgaris. Data were gathered from research reporting endocan levels, illness markers, and clinical outcomes. Elevated endocan levels are associated with endothelial dysfunction, which contributes to diabetes complications and associated with vascular endothelial growth factor A (VEGF-A) activation. In HTN, endocan promotes inflammatory signaling and lymphocyte infiltration. In liver disease, particularly cirrhosis, elevated levels correlate with hepatic fibrosis and poor prognosis. PAD patients show raised endocan correlating with disease severity. COVID-19 studies suggest coronavirus induces endotheliitis. In ED, higher endocan levels are linked with endothelial dysfunction and impaired vascular reactivity, serving as a potential biomarker for vascular-related ED. In psoriasis vulgaris, endocan levels correlate with disease severity and cardiovascular risk. The present brief overview supports that monitoring endocan levels may improve treatment and prognosis. Further research is required to define its clinical potential.}, }
@article {pmid40693247, year = {2025}, author = {Costanza, A and Alexander, J and Amerio, A and Aguglia, A and Magnani, L and Parise, A and Saverino, D and Serafini, G and Amore, M and Nguyen, KD}, title = {Microbial Dysbiosis as an Emerging Pathology of Suicidal Behaviour? A Critical Review, Passing Through Depression to Chronic Pain.}, journal = {Annals of neurosciences}, volume = {}, number = {}, pages = {09727531251349024}, pmid = {40693247}, issn = {0972-7531}, abstract = {BACKGROUND: Suicidal behaviour (SB) is one of the most complex neuropsychiatric conditions, with an etiopathogenesis that remains elusive despite a myriad of studies revealing its multifaceted nature, influenced by various biological, psychological, socioeconomic and cultural factors, usually with complex reciprocal and synergistic interactions. Emerging evidence has recently suggested a potential involvement of pathogens and host-tissue derived microbial species in contributing to SB. This review aims to provide a concise synthesis of clinical evidence focusing on the presence of microbial alterations in subjects with SB and in those exhibiting risk factors for SB, thereby exploring a possible new perspective in suicidology.<br><br>SUMMARY: We conducted a surveillance of the literature in the PUBMED database, from its inception to 10 May 2025, to identify associations between infection/microbial alterations with SB and some of its risk factors (by focusing on two pathologic examples of psychiatric and somatic origins, respectively: depression and chronic pain, two often closely related conditions). Major clinical findings were selected and synthesised into a hypothetical framework to support the presence of a microbe-related origin of SB. We found that SB was associated with selected infections, such as Toxoplasma gondii and Cytomegalovirus. Dysbiosis, including changes in diversity and/or abundance of selected microbial species, in the oral cavity, gastrointestinal tract, and other mucosal tissues, was observed in subjects with SB and individuals with psychiatric (depression) and somatic (chronic pain) risk factors of SB.<br><br>KEY MESSAGE: Microbial dysbiosis might contribute to SB etiopathogenesis. Further studies in this emerging field of research are expected to provide additional mechanistic insights for an improved understanding, prevention, and therapeutic management of this neuropsychiatric condition.}, }
@article {pmid40692648, year = {2025}, author = {Yin, YY and Wan, ZZ and Wang, B}, title = {Patient-centered group psychotherapy for depression and negative emotions: a systematic review and meta-analysis.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1530615}, pmid = {40692648}, issn = {1664-0640}, abstract = {OBJECTIVE: Depressive disorders and negative emotions are a major global health challenge, affecting over 280 million people and worsened by the COVID-19 pandemic. Traditional treatments have limitations such as high relapse rates and accessibility issues. This study aimed to assess the efficacy of patient-centered group psychotherapy (PCGP) on depressive symptoms and functional outcomes, identify moderators, and provide recommendations.<br><br>METHODS: Following PRISMA guidelines, we searched PubMed, CNKI, and other databases through October 2024, including 7 randomized controlled trials (RCTs) and one Clinical study (total N = 1,989). Study quality was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses via RevMan 5.4 calculated risk ratios (RRs) and standardized mean differences (SMDs), with heterogeneity evaluated via I&#xb2; statistics.<br><br>RESULTS: Eligible participants comprised adults (&#x2265;18 years) with a principal diagnosis of major depressive disorder (DSM-5/ICD-10 criteria) or clinically significant negative emotional symptoms (e.g., PHQ-9&#x2265;15), excluding those with primary non-depressive psychiatric comorbidities. Studies involving mixed populations were included only if subgroup data for depressed participants were extractable. PCGP showed significant positive effects on overall effectiveness (RR = 1.10, 95% CI: 1.01-1.19, p = 0.03), symptom reduction (Positive and Negative Syndrome Scale (PANSS) scores, SMD = -1.96, 95% CI: -2.31 to -1.61, p < 0.001), and functional outcomes (Personal and Social Performance (PSP) scores, SMD = 1.96, 95% CI: 1.41-2.51, p < 0.001). It also improved negative mood (SMD = -4.28, 95% CI: -8.03 to -0.52, p = 0.03) but with high heterogeneity (I&#xb2; = 99.0%). A positive trend was noted for medication adherence (RR = 1.11, 95% CI: 0.89-1.38, p = 0.35).<br><br>CONCLUSION: PCGP is an effective first-line adjunct therapy for depression, particularly in resource-limited settings. It addresses both symptom reduction and functional recovery by combining personalized goal-setting with group dynamics.}, }
@article {pmid40690975, year = {2025}, author = {Satoh, S and Itakura, A and Ikeda, T and Kurasawa, K and Nakai, A}, title = {The Perinatal Committee report: Review of the progress of obstetric healthcare in Japan.}, journal = {The journal of obstetrics and gynaecology research}, volume = {51}, number = {7}, pages = {e16354}, pmid = {40690975}, issn = {1447-0756}, mesh = {Humans ; Japan ; Female ; Pregnancy ; *Obstetrics/history/trends ; History, 20th Century ; Infant, Newborn ; *Perinatal Care/history/trends ; Maternal Mortality/trends ; History, 21st Century ; Societies, Medical/history ; Perinatal Mortality/trends ; }, abstract = {BACKGROUND: Japan's maternal mortality rate and perinatal mortality rate have shown one of the world's most significant declines, positioning Japan at the global forefront of the lowest levels. The nearly logarithmic annual decline in maternal and perinatal mortality rates suggests that, in addition to advances in medicine and healthcare, various types of care for mothers and newborns have played a crucial role in this achievement.<br><br>METHOD: From the period of World War II to the postwar era, up to around 1980, and then every decade thereafter, the events and movements surrounding perinatal healthcare in each era were examined from the perspectives of epidemiology, medical/healthcare advancements, and institutional/policy trends.<br><br>RESULTS: The major events in each era are outlined as follows: Until around 1980: After World War II, in 1948, several laws were enacted to protect mothers and fetuses, including the Maternal and Child Health Handbook, in 1966. The number of births experienced a baby boom for about 10&#x2009;years following 1945, peaking in 1973. Birthplaces shifted from home deliveries to medical facilities, with doctors becoming the primary birth attendants. Academically, the Japan Association of Obstetricians and Gynecologists (JAOG) for Maternal Protection and the Japan Society of Obstetrics and Gynecology (JSOG) were established in 1949. In the medical field, neonatal intensive care units (NICUs) were introduced and neonatal transport systems became well-established by the 1970s. In 1976, the limit of viability was revised from under 28&#x2009;weeks of gestation to under 24&#x2009;weeks. The late 1970s saw the fetal heart rate monitoring, the heartbeat detection using Doppler ultrasound and the ultrasound imaging techniques. 1980s: The perinatal medicine became well established, leading to hold The Japan Society of Perinatal Medicine. For fetal management, the fields of fetal diagnosis and fetal treatment entered their early stages with the widespread use of fetal heart rate monitoring and ultrasound imaging. In neonatal care, neonatal transport systems to NICU facilities were enhanced. A major breakthrough in this field was the discovery and widespread use of pulmonary surfactant. Two key concepts that emerged and advanced during this period were maternal transport systems and the Perinatal Maternal and Child Center initiative. In 1987, cases of hepatitis caused by non-heat-treated coagulation products became a major issue. As a result, informed consent affecting mothers and fetuses became a significant point of discussion. The Obstetrics and Gynecology Specialist system was introduced, along with the regular publication of Training Notes for Obstetricians and Gynecologists and Glossary of Obstetrics and Gynecology Terms. As a result of these efforts, both the perinatal mortality rate and the maternal mortality rate were reduced by approximately half over the course of 10&#x2009;years. 1990s: In 1991, the limit of viability was revised to 22&#x2009;weeks of gestation. In terms of maternal care, nutritional management guidelines for general pregnant women were introduced. In fetal medicine, major topics included the administration of steroids to the mother to promote fetal lung maturation, as well as direct fetal treatments such as shunt procedures and needle aspirations. In neonatal care, inhaled nitric oxide therapy and extracorporeal membrane oxygenation treatment became more widely adopted. Following the Great Hanshin-Awaji Earthquake, in 1995, led to the development of the Disaster Medical Assistance Team and the establishment of Perinatal Maternal and Child Medical Center. In 1996, the Maternal Protection Law was enacted, and the Japan Council for Quality Health Care (JCQHC) was founded to standardize medical care. Asia &amp; Oceania Federation of Obstetrics &amp; Gynecology Journal and Journal of Obstetrics and Gynecology Research were launched as English-language academic journals. 2000s: Japan's perinatal mortality rate became the lowest in the world, but the maternal mortality rate was still struggling. Obstetric care changed significantly after an obstetrician was arrested for causing a maternal death during a cesarean section. The JSOG and the JAOG developed practice guidelines describing standard obstetric diagnosis and treatments, and the JCQHC established the Japan Obstetric Compensation System for Cerebral Palsy. In addition, a project to report on maternal deaths by JAOG was also launched, and the combination of these measures led to form a framework of professional autonomy for obstetricians. During this period, brain hypothermic therapy for brain injury was developed. 2010s: The Great East Japan Earthquake in 2011 led to major changes in disaster medical planning. This included the introduction of training programs for disaster medical coordinators and the development of disaster-time pediatric and perinatal liaisons. To enhance medical safety, JAOG launched an incidental case reporting system in 2004. Additionally, in 2010, a maternal mortality reporting system was introduced, followed by the maternal severe complications reporting system in 2021. The Japan Council for Implementation of Maternal Emergency Life-Saving System was established, along with the Japan Association for Labor Analgesia, a collaborative council for academic societies and organizations related to painless delivery. Suicide as a significant cause of maternal death led to the establishment of the "Mother and Child Mental Forum" academic conference, which later evolved into the Mental Health Care for Mother &amp; Child training program. In the field of prenatal testing, non-invasive prenatal testing was introduced as a clinical research initiative. From 2020 onward: The year 2020 began with the global outbreak of COVID-19. Until 2023, numerous issues arose due to repeated pandemics, including delivery methods and locations for COVID-positive pregnant women, standard precautions during labor, mother-infant separation after birth, vaccination, so on. JSOG and JAOG worked together to address these challenges. The most pressing issue in the perinatal field is the declining birth rate. Alongside an aging workforce of physicians and a shortage of successors, the decrease in new obstetric clinic openings has become a major concern. By 2024, the decrease in the number of full-time obstetricians and the overtime work limits in Medical Care Act are making it necessary to reconsider the structure of obstetric medical services. Japan's perinatal care system, which has maintained the highest global standards, now stands at a major crossroads.<br><br>CONCLUSION: Researchers (clinicians), academic societies, and professional organizations, centered on the mother and child, have collaborated with support from the government, making progress and building the current safe pregnancy and childbirth management system. However, significant issues remain that need urgent attention, including regulations on overtime work, securing obstetrician numbers, the rapid decline in childbirth facilities, and the functional collapse of perinatal maternal-child healthcare centers. These are critical challenges that must be addressed promptly.}, }
@article {pmid40690731, year = {2025}, author = {Kuroda, D and Moriyama, S and Sasaki, H and Takahashi, Y}, title = {Optimizing the breadth of SARS-CoV-2-neutralizing antibodies in vivo and in silico.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2526873}, pmid = {40690731}, issn = {2164-554X}, mesh = {Humans ; *SARS-CoV-2/immunology ; *Antibodies, Viral/immunology ; *COVID-19/immunology/prevention &amp; control ; *Antibodies, Neutralizing/immunology ; Epitopes/immunology ; Computer Simulation ; *Broadly Neutralizing Antibodies/immunology ; Animals ; Spike Glycoprotein, Coronavirus/immunology ; COVID-19 Vaccines/immunology ; }, abstract = {Since the emergence of SARS-CoV-2, the ongoing arms race between mutating viruses and human antibodies has revealed several novel strategies by which antibodies adapt to viral escape. While SARS-CoV-2 viruses exhibit high variability in epitopes targeted by neutralizing antibodies, certain epitopes remain conserved owing to their essential roles on viral fitness. Antibodies can acquire broadly neutralizing activity by targeting these vulnerable sites through affinity-based somatic evolution of immunoglobulin genes. Notably, the specificity encoded in antibody germline genes also plays a fundamental role in acquiring the breadth. In-depth genetic and structural analyses of the antibody repertoires have uncovered multiple strategies for adapting to evolving targets. The integration of large-scale antibody datasets with computational approaches increases the feasibility and efficiency of designing broadly neutralizing antibody therapeutics from ancestral antibody clones with limited initial efficacy. In this review, we discuss strategies to optimize antibody breadth for the development of broadly neutralizing antibody therapeutics and vaccine antigens.}, }
@article {pmid40690407, year = {2025}, author = {Abordo, J and Casabona, A and Resonable, G and Narvaez, RA}, title = {A review of telehospice use during the COVID-19 pandemic.}, journal = {International journal of palliative nursing}, volume = {31}, number = {7}, pages = {337-347}, doi = {10.12968/ijpn.2025.0022}, pmid = {40690407}, issn = {2052-286X}, mesh = {Humans ; *COVID-19/epidemiology ; *Hospice Care ; Pandemics ; *Telemedicine ; *Terminal Care ; }, abstract = {BACKGROUND: The COVID-19 pandemic disrupted traditional hospice care, prompting the use of telehospice to deliver end-of-life services remotely while maintaining quality and continuity of care.<br><br>AIM: This integrative review examines the feasibility, effectiveness and challenges of telehospice during the COVID-19 pandemic, with a focus on patient outcomes and caregiver experiences.<br><br>METHOD: An integrative review approach was used to analyse 12 peer-reviewed studies published between January 2020 and June 2023.<br><br>FINDINGS: Telehospice enhanced access to care in rural and underserved areas, enabled timely symptom management and strengthened interdisciplinary collaboration. Families reported improved communication, emotional support and involvement in decision-making. However, challenges to telehospice care such as limited internet access, digital literacy gaps and difficulties replicating the intimacy of in-person care were frequently noted.<br><br>CONCLUSION: Telehospice is a feasible and acceptable model for end-of-life care. Ongoing investment in infrastructure, training and equitable access is essential for long-term integration.}, }
@article {pmid40690308, year = {2025}, author = {Ruggiero-Ruff, RE and Coss, D}, title = {Neuroendocrinology and the Genetics of Obesity.}, journal = {Endocrinology}, volume = {166}, number = {9}, pages = {}, pmid = {40690308}, issn = {1945-7170}, support = {HD091167//National Institute of Child Health and Human Development/ ; AI180561//National Institute of Allergy and Infectious Diseases/ ; }, mesh = {Humans ; *Obesity/genetics/metabolism/epidemiology ; Genetic Predisposition to Disease ; Animals ; COVID-19 ; Genome-Wide Association Study ; Energy Metabolism/genetics ; }, abstract = {The increase in the incidence of obesity has coincided with changes in lifestyle, diet, and environment. Comorbidities associated with obesity include cardiovascular disease, diabetes, musculoskeletal disorders, stroke, and thromboembolism, affecting public health. The effect of increased weight has recently become even more obvious, since obesity has been significantly associated with increased severity and higher mortality among COVID-19 patients. The need to decrease rates of obesity prompted a surge in the use of glucagon-like peptide-1 agonist medications. Twin studies, however, determined that increased weight has a large genetic component, estimating the heritability of obesity to be 45% to 70%. Surprisingly, obesity due to known single gene mutation comprises only 5% to 10% of individuals, who mostly exhibit early-onset severe obesity. Genome-wide linkage studies and association studies identified more than 250 genes associated with obesity, but each of these has a relatively small effect size. Further, several genetic syndromes, associated with neurodevelopmental disabilities and congenital malformations, encompass obesity in their constellation of symptoms. This review will summarize several known genetic causes of obesity, focusing specifically on how they relate to the brain circuitry that regulates food intake and energy homeostasis. The review will indicate a need for further studies to integrate the role of diet and environmental contribution with genetic components of this multifactorial condition. Given that genetics of obesity is unlikely to explain the recent dramatic temporal increase in the prevalence of obesity, our review will point to the need to understand interactions between genes and other contributing environmental or sex-dependent factors.}, }
@article {pmid40689082, year = {2025}, author = {Li, J and Shan, R and Miller, H and Filatov, A and Byazrova, MG and Yang, L and Liu, C}, title = {The roles of macrophages and monocytes in COVID-19 Severe Respiratory Syndrome.}, journal = {Cell insight}, volume = {4}, number = {4}, pages = {100250}, pmid = {40689082}, issn = {2772-8927}, abstract = {The global COVID-19 pandemic has highlighted the pivotal role of the immune system in the development of severe respiratory symptoms, termed COVID-19 Severe Respiratory Syndrome (COVID-19-SR). This review aims to dissect the involvement of lung macrophages and monocytes in orchestrating immune responses to SARS-CoV-2, influencing disease severity and outcomes. Initially, we provide an overview of SARS-CoV-2's invasion process and the body's primary immune defense mechanisms, including the antibody complement system and cytokine production. We then delve into the roles of the monocyte-macrophage system in mediating hyperinflammation and cytokine storms, discussing how abnormal cytokine and chemokine levels contribute to disease progression. Subsequent sections examine the perturbations and overactivation of the monocyte-macrophage compartment during infection, linking these changes to the observed immune dysregulation in COVID-19 patients. In light of these insights, we explore therapeutic strategies targeting macrophages, such as dexamethasone, antisense lipid nanoparticles(ALN), and inhaled recombinant human granulocyte-macrophage colony-stimulating factor (rh-GM-CSF), which aim to modulate inflammation, suppress viral replication, and enhance viral clearance. Additional potential treatments include GSDMD inhibitors and GPR183 antagonists, which warrant further investigation. This review synthesizes current understanding of the immunopathology underlying COVID-19-SR, proposing macrophage- and monocyte-centered therapeutic avenues and outlining future research priorities essential for advancing clinical management and improving patient outcomes.}, }
@article {pmid40688748, year = {2025}, author = {Haque, R and Islam, MS and Hanson, M and Rahaman, MZ and Afrin, S and Shome, S and Rahman, M and Rahman, SM and Saif-Ur-Rahman, KM and Raqib, R}, title = {A systematic review of the pivotal role of environmental toxicant exposure on infectious diseases in low- and middle-income countries.}, journal = {Public health in practice (Oxford, England)}, volume = {10}, number = {}, pages = {100631}, pmid = {40688748}, issn = {2666-5352}, abstract = {OBJECTIVE: The objective of this review is to identify which environmental toxicants are linked to infectious diseases in low- and middle-income countries (LMICs) by synthesizing available evidence. It aims to summarize key findings, identify research gaps and provide policy recommendations based on the associations between specific toxicants and disease outcomes.<br><br>STUDY DESIGN: Systematic review.<br><br>METHODS: We conducted a comprehensive search in PubMed, Scopus, Web of Science (core collection), and CENTRAL (the Cochrane Library) to identify studies on bacterial, viral, and parasitic pathogenic activity.<br><br>RESULT: This search yielded 11,468 studies, of which 55 met inclusion criteria after screening following the standard methods. A consistent association is found between particulate matter (PM2.5 and PM10) exposure and increased respiratory infection risk, with PM2.5 particularly linked to increased incidence and mortality in diseases like COVID-19 and tuberculosis. Heavy metals, including lead, cadmium, and mercury worsen chronic infections such as HIV/AIDS and hepatitis by increasing body burden and inflammation. The review highlights air pollutants' substantial impact on infectious disease spread and severity while noting a research gap on other pollutants including persistent organic pollutants (POPs) and polycyclic aromatic hydrocarbons (PAHs). Bias assessment indicates around half the studies show low risk of bias; however, potential biases were noted in confounding variables and blinding of outcome assessment.<br><br>CONCLUSION: The systematic review emphasizes the need for research on biological mechanisms underlying these associations and the impacts of other pollutants. Findings advocate for reducing environmental pollution exposure in LMICs to mitigate infectious disease risk.}, }
@article {pmid40688746, year = {2025}, author = {White, JM and Goodfellow, CL and Adeleke, AO and Awde, FP and Chua, YW and Jovic, A and Scott, E}, title = {Missed opportunities: The unknown impact of the COVID-19 pandemic on early childhood development in the WHO European region.}, journal = {Public health in practice (Oxford, England)}, volume = {10}, number = {}, pages = {100636}, pmid = {40688746}, issn = {2666-5352}, abstract = {BACKGROUND: Early childhood experiences can promote or adversely affect children's development and wellbeing with lifelong impact. The COVID-19 pandemic disrupted children's and families' lives worldwide. It is important to understand the effect on early childhood development. We aimed to examine what is known about the impact of the COVID-19 pandemic, and the related public health measures, on young children's development.<br><br>STUDY DESIGN: We carried out a mixed-method study which included a scoping review of review-level evidence about early childhood development over the course of the pandemic compared to beforehand and a web-based survey of early childhood development data published in the WHO European Region.<br><br>METHODS: A systematic search of three databases was used to identify studies, published in English, up to November 2024. Findings were synthesised narratively by developmental domain. A web-based search was used to identify, routinely collected, national surveillance child development data in the WHO European Region. To illustrate the potential role of routine surveillance in the timely identification of developmental concerns, trend data from Scotland was examined.<br><br>RESULTS: Seven reviews met the inclusion criteria. Most studies examined young children's mental health, while others assessed language development, mother-child bonding, and broader developmental outcomes. Findings were inconsistent, with some studies reporting adverse effects, with others finding no significant changes. There were significant gaps in the availability of national surveillance child development data in WHO European Region countries. Scottish surveillance data identified increases in developmental concerns, which affected disadvantaged groups more.<br><br>CONCLUSIONS: The available evidence about the effect of the COVID-19 pandemic, and related public health measures, on early childhood development is limited and inconclusive. Strengthening data collection and reporting across the WHO European Region is essential for timely and accurate assessment of developmental outcomes and to guide policy development.}, }
@article {pmid40687982, year = {2025}, author = {Kraemer, K and Steg, J}, title = {When normality collapses from one moment to the next. A sociological theory of singular crisis.}, journal = {Frontiers in sociology}, volume = {10}, number = {}, pages = {1596427}, pmid = {40687982}, issn = {2297-7775}, abstract = {Since the emergence of sociology, it has been part of the discipline's self-image to diagnose crises in modern societies. Sociology, however, has no theory that differentiates between normal and extranormal or singular crises. In this article, we want to develop a crisis typology that distinguishes between these two types. While a normal crisis is characterised by cyclical and structural patterns, which usually build up gradually and lead to incremental change, a singular crisis is characterised by eruptive ruptures in relation to the pre-crisis state. Such ruptures can challenge the traditional social order, both institutionally and narratively. Unlike normal crises, a singular crisis is marked by exogenous shocks like wars, natural disasters, or pandemics. This shock marks the beginning of a process of crisis intervention, which we examine to reconstruct the sociological peculiarities of a singular crisis. By using the Covid-19-crisis as an empirical slide, we analyse a singular crisis and list various dimensions and criteria-namely involvement and impact, temporality, principle of order, social change, isomorphism, path dependency, collective morality, mode of legitimation and spatial order-that can be used to differentiate between singular and normal crises.}, }
@article {pmid40686626, year = {2025}, author = {Kanani, A and Krasowska, J and Fornalski, KW and Bevelacqua, JJ and Welsh, J and Mortazavi, S}, title = {Adaptive Response: A Scoping Review of Its Implications in Medicine, Space Exploration, and Beyond.}, journal = {Dose-response : a publication of International Hormesis Society}, volume = {23}, number = {3}, pages = {15593258251360051}, pmid = {40686626}, issn = {1559-3258}, abstract = {OBJECTIVES: Radiation Adaptive Response (AR) is a biological phenomenon in which exposure to low-dose radiation (LDR) enhances an organism's ability to withstand subsequent higher doses. This scoping review explores AR across multiple disciplines, summarizing evidence, identifying research gaps, and evaluating potential applications in cancer therapy, neurodegenerative disease management, space medicine, and pandemic response.<br><br>METHODS: A comprehensive review of experimental/clinical studies on AR was conducted, focusing on molecular mechanisms, biological implications, biophysical modeling, and translational applications.<br><br>RESULTS: In oncology, AR has shown promise in selectively protecting normal tissues during radiotherapy while sensitizing tumor cells, yet its effects remain cell-type dependent. LDR may manage neurodegenerative diseases by modulating oxidative stress and inflammation. In space medicine, AR-based astronaut selection has been proposed as a novel strategy to mitigate radiation risks during long-term space missions, although empirical validation is lacking. LDR therapy for managing COVID-19 pneumonia has been explored, but ethical concerns and long-term safety risks require further investigation.<br><br>CONCLUSION: Despite AR's potential, its clinical and spaceflight implementation requires mechanistic elucidation, standardized protocols, and rigorous studies. The risks of tumorigenesis, individual variability in AR, and potential immunomodulatory effects must be evaluated before widespread application. Moreover, inconsistent AR appearance complicates its study and clinical use.}, }
@article {pmid40686451, year = {2025}, author = {Alderman, L and Beck, E}, title = {Distinguishing Collaboration From Other Group Work to Help Public Health and Other Sectors Solve Wicked Problems to Improve Health and Well-Being for All.}, journal = {Public health reports (Washington, D.C. : 1974)}, volume = {140}, number = {5-6}, pages = {485-495}, pmid = {40686451}, issn = {1468-2877}, mesh = {Humans ; *Public Health ; *Cooperative Behavior ; COVID-19/epidemiology ; }, abstract = {Public health devotes significant resources to address "wicked" challenges, a term coined nearly 50 years ago to distinguish complex problems from tame problems. Tame problems (eg, building a hospital) may be difficult, but known experts and agreed-upon processes exist to address them. Wicked problems (eg, the obesity epidemic) seem intractable, with no agreed-upon solution or cause. Broad agreement exists that wicked problems require collaboration, especially in periods of hyperuncertainty, marked by the rapid onset of multiple wicked problems and uncertainty. One example of a recent hyperuncertain period occurred in 2020, beginning with major political shifts, followed rapidly by COVID-19, widespread social unrest, and multiple crises from extreme weather events (eg, hurricanes). With collaboration increasing, collaboration scholars lament the lack of broad consensus on what distinguishes collaboration from other group work (eg, coordination). Without a common understanding of and roadmap to build collaboration, public health is limited to address wicked problems. To support effective collaboration, we synthesized 4 decades of scholarship to identify where scholars across 3 related areas of collaboration literature are coalescing on the unique elements required for collaboration. From our synthesis, we created a new definition to distinguish collaboration from other group work, including its requisite key elements that public health can use as guideposts to collaborate effectively. We found no explicit focus on these key elements in the public health collaboration articles reviewed, a gap this article seeks to fill. Longer term, public health agencies and schools can use this work to bolster transdisciplinary collaborative problem-solving capacity.}, }
@article {pmid40685806, year = {2025}, author = {Borland, ML and Loveys, K and Babl, FE and Cotterell, E and Haskell, L and O'Brien, S and Oakley, E and Wilson, CL and Alsweiler, J and Armstrong, D and Craig, SS and Crawford, NW and Crellin, D and Crone, S and Duke, T and George, S and Jeffries-Stokes, C and Krishnan, N and Lithgow, A and Peacock, K and Ratoni, T and Richmond, P and Smith, A and Starkie, R and Thomas, D and Wallace, A and Zhang, M and Tavender, E and Dalziel, SR and , }, title = {Australasian Bronchiolitis Guideline: 2025 Update.}, journal = {Journal of paediatrics and child health}, volume = {61}, number = {8}, pages = {1197-1215}, pmid = {40685806}, issn = {1440-1754}, support = {//National Health and Medical Research Council/ ; //State Government of Victoria/ ; //Cure Kids/ ; //Royal Children's Hospital Foundation/ ; }, mesh = {Humans ; *Bronchiolitis/therapy/diagnosis ; Infant ; Australia ; New Zealand ; Emergency Service, Hospital ; COVID-19 ; Australasia ; *Practice Guidelines as Topic ; Infant, Newborn ; }, abstract = {AIM: To provide updated evidence-based clinical guidance in the management of infants with bronchiolitis presenting to emergency departments (EDs), general paediatric, or intensive care units (ICUs) in Australia and Aotearoa New Zealand (AoNZ) following the first publication in 2016.<br><br>METHOD: The Paediatric Research in Emergency Departments International Collaborative (PREDICT) network guideline working group appraised, summarised, and updated evidence from 1 January 2000 to 24 January 2024 addressing 41 questions (30 from the 2016 guideline and 11 new questions for 2025). Recommendations were developed using GRADE methodology and revised after a period of external consultation.<br><br>RESULTS: The literature search identified 26&#x2009;467 citations with 431 included in 41 recommendations providing 11 new and 7 key updates. The key changes included: (i) refinement of the clinical features of bronchiolitis, (ii) addition of new risk factors for severity of illness, (iii) advice on the role of biomarkers for unexpected deterioration or admission to ICU, (iv) guidance on glucocorticoids in SARS-CoV-2 co-infection, (v) guidance on combined glucocorticoids/inhaled epinephrine in severe bronchiolitis requiring ICU level care, (vi) refinement of oxygen saturation targets, (vii) guidance on humidified high flow therapy and continuous positive airway pressure, (viii) recommendation on use of RSV prevention therapies/immunisations for babies and mothers.<br><br>CONCLUSION: The updated Australasian Bronchiolitis Guideline provides clinicians across Australasian settings with the latest evidence-based guidance on the management of the commonest condition in infancy requiring hospital admission.}, }
@article {pmid40685703, year = {2025}, author = {Tully, J and McLean, S and Rowse, J}, title = {Technology-Facilitated Sexual Abuse and Exploitation of Children Is Everyone's Problem; How Can Healthcare Practitioners Respond to the Second Global Pandemic of the 21st Century? A Narrative Review.}, journal = {Journal of paediatrics and child health}, volume = {61}, number = {9}, pages = {1378-1384}, pmid = {40685703}, issn = {1440-1754}, mesh = {Humans ; *Child Abuse, Sexual/prevention &amp; control/statistics &amp; numerical data ; Child ; Australia ; *COVID-19/epidemiology ; *Social Media ; *Health Personnel ; Pandemics ; Adolescent ; }, abstract = {Sexual harm of children online is commonplace. The proposed ban on social media for children under 16 in Australia has been met with mixed responses about its likely effectiveness in preventing harm, as well as the possible negative effect on caregiver vigilance and children's willingness to report. Consideration of the possibility of online sexual harm may now be even more important, and healthcare practitioners are well placed in their interactions with children and caregivers to provide advice and recognise and respond to concerns. This article explores the spectrum of Technology-Facilitated Child Sexual Abuse and Exploitation (TFCSAE) and provides guidance for practitioners, including around recognising alerting signs, useful tips for caregivers, a suggested framework for conversations with children, as well as including helpful resources for children and families. The need for the development of specific training for healthcare practitioners in Australia in relation to the recognition and response to TFCSAE is discussed.}, }
@article {pmid40685482, year = {2025}, author = {Rivera-Orellana, S and Bautista, J and Palacios-Zavala, D and Ojeda-Mosquera, S and Altamirano-Colina, A and Alcocer-Veintimilla, M and Parrales-Rosales, G and Izquierdo-Condoy, JS and Vásconez-González, J and Ortiz-Prado, E and Muslin, C and López-Cortés, A}, title = {Oncolytic virotherapy and tumor microenvironment modulation.}, journal = {Clinical and experimental medicine}, volume = {25}, number = {1}, pages = {256}, pmid = {40685482}, issn = {1591-9528}, mesh = {*Oncolytic Virotherapy/methods ; Humans ; *Tumor Microenvironment/immunology ; *Oncolytic Viruses/genetics ; *Neoplasms/therapy/immunology ; Animals ; }, abstract = {Oncolytic viruses (OVs) have emerged as a transformative approach in cancer therapy, offering tumor-specific lysis while sparing normal tissues. In addition to their direct cytolytic effects, OVs actively reshape the tumor microenvironment (TME) by enhancing immune infiltration, disrupting immunosuppressive signals, and promoting tumor antigen presentation. However, the complexity of the TME poses challenges, often necessitating combination therapies to improve OV efficacy and overcome tumor resistance. This review explores the evolution of oncolytic virotherapy, from the early use of naturally occurring viruses to the development of genetically engineered OVs. Among the most significant advancements, T-VEC, an FDA-approved herpesvirus, has been modified to express GM-CSF, enhancing immune activation in metastatic melanoma. Similarly, JX-594, a vaccinia virus, has been engineered for selective replication in tumor cells, demonstrating the potential of OVs to combine direct oncolysis with immune modulation. Other HSV-based OVs, such as HF10 and HSV1716, further highlight the ability of OVs to enhance immune cell infiltration and increase antigen presentation within the TME. Recent advances in tumor microenvironment remodeling have expanded OV therapeutic strategies. By converting immunologically "cold" tumors into "hot" tumors, OVs can overcome immune evasion through mechanisms such as enhanced antigen release, immune checkpoint inhibition, and metabolic reprogramming. To maximize therapeutic potential, researchers are developing genetically engineered OVs carrying immune-stimulatory transgenes, exploring synergistic combination therapies with immune checkpoint inhibitors, and utilizing nanoparticle-based delivery systems for improved precision. Additionally, novel OVs-including measles virus, Newcastle virus, Zika virus, and SARS-CoV-2-are being investigated for their unique ability to disrupt the TME and enhance anti-tumor immunity. Looking ahead, OV therapy will depend on optimizing TME-targeted strategies, improving viral delivery mechanisms, and identifying predictive biomarkers to personalize patient responses. Advances in viral engineering and immunomodulation hold the potential to revolutionize cancer treatment, offering more precise and effective therapeutic options. This review provides a comprehensive analysis of current progress in oncolytic virotherapy, emphasizing its potential to remodel the TME and improve clinical outcomes.}, }
@article {pmid40685330, year = {2025}, author = {Far, BF and Akbari, M and Habibi, MA and Katavand, M and Nasseri, S}, title = {CRISPR Technology in Disease Management: An Updated Review of Clinical Translation and Therapeutic Potential.}, journal = {Cell proliferation}, volume = {58}, number = {11}, pages = {e70099}, pmid = {40685330}, issn = {1365-2184}, mesh = {Humans ; *CRISPR-Cas Systems/genetics ; *Gene Editing/methods ; *Genetic Therapy/methods ; Neoplasms/therapy/genetics ; Disease Management ; COVID-19/therapy ; SARS-CoV-2 ; *Translational Research, Biomedical ; Nervous System Diseases/therapy/genetics ; Animals ; Immunotherapy/methods ; }, abstract = {CRISPR-Cas9 technology has rapidly advanced as a transformative genome-editing platform, facilitating precise genetic modifications and expanding therapeutic opportunities across various diseases. This review explores recent developments and clinical translations of CRISPR applications in oncology, genetic and neurological disorders, infectious diseases, immunotherapy, diagnostics, and epigenome editing. CRISPR has notably progressed in oncology, where it enables the identification of novel cancer drivers, elucidation of resistance mechanisms, and improvement of immunotherapies through engineered T cells, including PD-1 knockout CAR-T cells. Clinical trials employing CRISPR-edited cells are demonstrating promising results in hematologic malignancies and solid tumours. In genetic disorders, such as hemoglobinopathies and muscular dystrophies, CRISPR-Cas9 alongside advanced editors like base and prime editors show significant potential for correcting pathogenic mutations. This potential was affirmed with the FDA's first approval of a CRISPR-based therapy, Casgevy, for sickle cell disease in 2023. Neurological disorders, including Alzheimer's, ALS, and Huntington's disease, are increasingly targeted by CRISPR approaches for disease modelling and potential therapeutic intervention. In infectious diseases, CRISPR-based diagnostics such as SHERLOCK and DETECTR provide rapid, sensitive nucleic acid detection, particularly valuable in pathogen outbreaks like SARS-CoV-2. Therapeutically, CRISPR systems target viral and bacterial genomes, offering novel treatment modalities. Additionally, CRISPR-mediated epigenome editing enables precise regulation of gene expression, expanding therapeutic possibilities. Despite these advances, significant challenges remain, including off-target effects, delivery methodologies, immune responses, and long-term genomic safety concerns. Future improvements in editor precision, innovative delivery platforms, and enhanced safety assessments will be essential to fully integrate CRISPR-based interventions into standard clinical practice, significantly advancing personalised medicine.}, }
@article {pmid40684905, year = {2025}, author = {Gershon, AS and Fung, D and Lam, GY}, title = {Diagnosing Respiratory Long COVID: A Practical Approach.}, journal = {Chest}, volume = {168}, number = {4}, pages = {874-879}, pmid = {40684905}, issn = {1931-3543}, mesh = {Humans ; *COVID-19/complications/diagnosis/physiopathology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Dyspnea/etiology ; Cough/etiology ; Male ; Fatigue/etiology ; Middle Aged ; Female ; }, abstract = {Long COVID or a post-COVID condition, defined as the persistence of symptoms at least 3 months after acute COVID-19 infection, is a novel condition in which a definitive diagnostic marker and treatment have yet to be found. This condition, which has been estimated to impact > 65 million individuals worldwide, manifests with multisystem involvement, most commonly presenting with fatigue, brain fog, dyspnea, cough, or a combination thereof. The burden of these symptoms can range from mild to severe, with many patients reporting an inability to return to usual activities. Herein, we present several hypothetical but clinically representative case reports to allow discussion around how we approach the diagnosis of respiratory symptoms of long COVID in those with and without chronic lung disease.}, }
@article {pmid40684673, year = {2025}, author = {Bachmann, MF and Mohsen, MO and Speiser, DE}, title = {The impact of viral evolution on vaccine development for SARS-CoV-2.}, journal = {Current opinion in immunology}, volume = {96}, number = {}, pages = {102612}, doi = {10.1016/j.coi.2025.102612}, pmid = {40684673}, issn = {1879-0372}, mesh = {Humans ; *SARS-CoV-2/immunology/genetics ; *COVID-19 Vaccines/immunology ; *COVID-19/immunology/prevention &amp; control ; Spike Glycoprotein, Coronavirus/immunology/genetics ; *Vaccine Development ; Antibodies, Neutralizing/immunology ; Antibodies, Viral/immunology ; Animals ; Angiotensin-Converting Enzyme 2/immunology ; B-Lymphocytes/immunology ; Evolution, Molecular ; }, abstract = {In order to stay circulating in the human population over many years, viruses need to adapt to the environment, mainly to the host's immune response, allowing for reinfection despite preexisting immunity. These different viral strategies are clearly important for guiding vaccine design. SARS-CoV-2 is no exception, using three main strategies to avoid protective and long-lived antibody responses: one very common and two rather unique tactics, consisting of 1) random mutation to partially escape existing antibody responses, 2) increasing affinity of the receptor-binding domain (RBD) of the spike protein to it's receptor Angiotensin-converting enzyme 2 (ACE 2), and 3) diluting out neutralizing epitopes on the viral surface to avoid strong and enduring antibody responses. As the correlate of protection from SARS-CoV-2 is neutralizing antibody response, this review focuses on B cells, the major player in protecting against COVID-19.}, }
@article {pmid40684072, year = {2025}, author = {Shehab, A and Al Dhanhani, H and Alhammadi, O and Hassan, MB and Farghaly, M and Hassoun, A and Mahboub, B and Tahlak, M and Abutayeh, RF and Haridy, H and Hassanien, A and Joury, J and Al-Shamsi, HO}, title = {Strategies for the Prevention and Management of Respiratory Infections in Patients at High Risk in the UAE: A Cross-Disciplinary Position Paper.}, journal = {Pulmonary therapy}, volume = {11}, number = {3}, pages = {405-421}, pmid = {40684072}, issn = {2364-1746}, abstract = {Respiratory infections are a major cause of mortality among young children and adults, particularly the elderly or those with underlying medical conditions. Many respiratory infections, including influenza, COVID-19, pneumococcal disease, and respiratory syncytial virus (RSV), have available vaccines and antiviral agents. However, vaccine coverage rates remain low. Experts representing a broad spectrum of medical specialties from the United Arab Emirates (UAE) made evidence-based recommendations on treating patients considered high risk for respiratory infections, highlighting gaps in current practices and suggesting strategies for improved communication between healthcare professionals and patients. To effectively manage respiratory infections, the experts emphasized the importance of adhering to guidelines, considering all vaccines and antiviral treatments, and strictly following vaccination schedules. Early testing upon recognition of symptoms was also encouraged. Improving vaccine uptake was considered crucial and could be achieved by educating patients about disease prevention through vaccines and the role of antiviral treatments for COVID-19. Addressing knowledge gaps and combating vaccine hesitancy among both patients and healthcare professionals were also essential steps. Recommendations for future initiatives include healthcare professionals educating the public on precautionary measures to reduce the spread of respiratory infections. Additionally, the experts agreed that clinical management guidelines for chronic diseases should be updated to include preventative strategies such as vaccines, prophylaxis, and counselling. Monitoring the performance of healthcare facilities using key performance indicators is also recommended to ensure effective management and continuous improvement of vaccination programs. Patient populations in the UAE who are considered at high risk of serious disease from respiratory infections have diverse medical needs and may access healthcare across a wide range of settings and specialisms. Therefore, it is vital that all healthcare professionals across specialisms who may engage with these individuals are able to provide appropriate advice on managing the risk through vaccination, prompt testing, and treatments as needed.}, }
@article {pmid40683613, year = {2025}, author = {Chen, K and Wang, Z and Li, J and Xu, Y and Gu, S and Li, H and Li, J and Zhang, Y and Mao, N}, title = {Chronic inflammation in Long COVID relationship to autoimmune diseases.}, journal = {Autoimmunity reviews}, volume = {24}, number = {10}, pages = {103882}, doi = {10.1016/j.autrev.2025.103882}, pmid = {40683613}, issn = {1873-0183}, mesh = {Humans ; *COVID-19/immunology/complications ; *Autoimmune Diseases/immunology/therapy/complications ; *SARS-CoV-2/immunology ; *Inflammation/immunology ; Chronic Disease ; Gastrointestinal Microbiome/immunology ; Post-Acute COVID-19 Syndrome ; }, abstract = {The new coronavirus pandemic has been ongoing for nearly five years. In addition to the severe symptoms in the acute phase, it is accompanied by long-term complications and sequelae involving the respiratory, neurological, immune, circulatory, and gastrointestinal systems for several months or even years, which is called the Long COVID. Many studies have suggested that systemic chronic inflammation caused by residual viral components may be one of the pathophysiologic mechanisms of Long COVID. In this paper, we will review the autoimmune diseases caused by chronic inflammation. In particular, cytokine storminess, pro-inflammatory responses of inflammatory vesicles, mast cell activation syndrome, changes in the gut microbiota, molecular mimicry, reactivation of latent viruses, and coagulation abnormalities are among the pathways that contribute to autoimmune diseases, including Systemic Lupus Erythematosus, Guillain-Barré syndrome, rheumatoid arthritis. We intervene in the treatment of the disease with probiotics, immunoglobulins, the RECOVER clinical trial model, and immunomodulatory drugs. The aim is to enhance understanding of the pathophysiological mechanism of Long COVID and to provide a reference for the immunotherapy of patients.}, }
@article {pmid40683420, year = {2025}, author = {Damkjær, MW and Laursen, DRT and Elkjær, M and Gerke, O and Lundh, A and Hróbjartsson, A and Schroll, JB}, title = {Preapproval and postapproval diagnostic test accuracy of food and drug administration-authorized rapid antigen SARS-CoV-2 tests used according to instruction: a systematic review and meta-analysis.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {31}, number = {10}, pages = {1630-1638}, doi = {10.1016/j.cmi.2025.07.009}, pmid = {40683420}, issn = {1469-0691}, mesh = {Humans ; *Antigens, Viral/analysis ; *COVID-19/diagnosis ; *COVID-19 Serological Testing/methods/standards ; *COVID-19 Testing ; *Diagnostic Test Approval ; *SARS-CoV-2/immunology/isolation &amp; purification ; Sensitivity and Specificity ; United States ; United States Food and Drug Administration ; }, abstract = {BACKGROUND: Manufacturers claim high sensitivity for rapid antigen SARS-CoV-2 tests on product labels, yet systematic reviews report considerably lower sensitivity.<br><br>OBJECTIVES: This study aimed to describe study characteristics and compare the sensitivity and specificity of United States Food and Drug Administration (FDA)-approved rapid antigen SARS-CoV-2 tests in preapproval vs. postapproval studies.<br><br>METHODS: Methods include systematic review and meta-analysis.<br><br>DATA SOURCES: Data sources include FDA website, Medline, Embase, and Google Scholar.<br><br>STUDY ELIGIBILITY CRITERIA: Study eligibility criteria include diagnostic test accuracy studies according to the instruction for use.<br><br>PARTICIPANTS: Participants include patients with symptoms of COVID-19.<br><br>TESTS: Test includes rapid antigen SARS-CoV-2 tests.<br><br>REFERENCE STANDARD: Reference standard includes RT-PCR.<br><br>ASSESSMENT OF RISK OF BIAS: Assessment of risk of bias was conducted using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.<br><br>METHODS OF DATA SYNTHESIS: Methods of data synthesis include bivariate binomial-normal restricted maximum likelihood random-effect meta-analysis and meta-regressions applying the delta method and likelihood-ratio tests.<br><br>RESULTS: We identified postapproval studies for 13 of 61 (21%) rapid antigen tests, of which nine tests had eligible studies. The analysis incorporated 13 preapproval studies (591 patients with COVID-19, 3155 participants) and 26 postapproval studies (2765 patients with COVID-19, 12 444 participants). The pooled sensitivity for preapproval and postapproval studies was 86.5% (95% CI: 83.3-89.1%) and 84.5% (95% CI: 81.2-87.3%), respectively. The absolute difference was 2.0% (95% CI: -1.9% to 6.2%) and (0%, 95% CI: -0.6% to 0.6%) for sensitivity and specificity, respectively. Two of the nine tests had lower sensitivity in postapproval studies.<br><br>DISCUSSION: Our study found that sensitivity estimates from postapproval studies on FDA-approved rapid antigen tests are largely consistent with manufacturers' estimates. However, for two of the nine tests, postapproval sensitivity was lower than the manufacturers' high estimates. Differences in sensitivity observed in prior systematic reviews likely result from variations in study populations, not bias in study conduct. Given that 79% of FDA-approved rapid antigen tests lacked postapproval studies, ongoing evaluations are needed to ensure alignment with clinical expectations.}, }
@article {pmid40683416, year = {2025}, author = {Zuch de Zafra, CL and Carosino, CM}, title = {Platform-based opportunities to streamline animal use in support of the 3Rs - recommendations from an antibody-drug conjugate analysis.}, journal = {Regulatory toxicology and pharmacology : RTP}, volume = {162}, number = {}, pages = {105912}, doi = {10.1016/j.yrtph.2025.105912}, pmid = {40683416}, issn = {1096-0295}, mesh = {Animals ; *Immunoconjugates/toxicity ; Humans ; COVID-19 ; Drug Evaluation, Preclinical/methods ; *Animal Testing Alternatives/methods ; }, abstract = {The field of antibody drug conjugates (ADCs) continues to be an active area of development which has greatly evolved over the past 25 years since the first approved ADC in 2000 (Mylotarg). Simultaneously, increasing attention is being given to the use of animals, particularly large animal species, in biopharmaceutical drug development in the wake of the global COVID-19 pandemic and legislation implemented/pending in the US Congress (the FDA Modernization Act). A recent publication summarizing data from an analysis of 14 antibody-drug conjugates (ADCs) provides a springboard for the recommendation of best practices to streamline nonclinical toxicology evaluation for these molecules. Additionally, key principles from the ADC molecule class may be applied to other biologic platforms, such as CD3 bispecific antibodies and possibly cell and gene therapy. Widespread adoption of modernized program strategies should lead both to a reduction in the use of animals in nonclinical toxicology evaluation and to more rapid delivery of new medicines to patients with unmet medical needs. The primary goal of nonclinical toxicology evaluation in the pharmaceutical industry is the identification of hazards and characterization of their monitorability, manageability, and reversibility in support of clinical trials and the eventual marketing of new drugs. An additional key deliverable of a toxicology program is the determination of appropriate dose levels to be evaluated in clinical trials. To accomplish these goals, nonclinical toxicology studies have traditionally utilized animal models in keeping with recommendations of global health authorities (e.g., ICH M3 for small molecule drugs and ICH S6 for biologic drugs). Although the 3Rs of ethical animal use (reduce, refine, replace) have been recognized since the late 1950s (Russell and Burch, 1959), increasing attention is being given to the use of animals in pharmaceutical research. The COVID-19 pandemic and accompanying ban on the export of non-human primates (NHPs) from China highlighted the dependence of nonclinical safety evaluation on NHPs, particularly for biologics and other modalities that have limited cross-reactivity. This realization contributed to the passage of the FDA Modernization Act 2.0 and the drafting of additional legislation (FDA Modernization Act 3.0) and the recent 'Roadmap to Reducing Animal Testing in Preclinical Safety Studies' which codify support in the US for the refinement of nonclinical toxicology programs and signal an opportunity for decreased reliance on animal models for safety evaluation. Similarly, the European Federation of Pharmaceutical Industries and Associations (EFPIA) recently released 'EFPIA Recommendations on Phasing Out Animal Testing for Chemical Safety Assessments' with comparable assessments and recommendations aimed at the evolution of pharmaceutical toxicity testing away from animal studies.}, }
@article {pmid40683410, year = {2025}, author = {Mohammed, A and Muustafa, MI}, title = {Nanobodies: A new frontier in antiviral therapies.}, journal = {SLAS discovery : advancing life sciences R &amp; D}, volume = {35}, number = {}, pages = {100251}, doi = {10.1016/j.slasd.2025.100251}, pmid = {40683410}, issn = {2472-5560}, mesh = {*Single-Domain Antibodies/therapeutic use/immunology/pharmacology ; Humans ; *Antiviral Agents/therapeutic use/pharmacology ; SARS-CoV-2/immunology/drug effects ; Animals ; COVID-19 Drug Treatment ; COVID-19/immunology ; Virus Internalization/drug effects ; Antibodies, Viral/immunology/therapeutic use ; Influenza, Human/immunology/drug therapy ; Antibodies, Neutralizing/immunology/therapeutic use ; }, abstract = {Nanobodies, derived from the immune systems of camelids such as alpacas and llamas, represent a novel class of therapeutics with significant potential in fighting respiratory viral infections, such as SARS-CoV-2 and influenza. Nanobodies are small biomolecules that are highly stable and have unique binding features that allow for the effective neutralization of viral particles and inhibition of viral replication. This review highlights the advantages of nanobodies over traditional antibodies, including cost-effective production and enhanced specificity for target antigens. We discuss the mechanisms through which nanobodies block viral entry, their applications in diagnostics, and the methodologies for their development, such as phage display technology. Furthermore, we explore the efficacy of nanobodies in preclinical studies and their potential in clinical settings. As research progresses, structural optimization and the exploration of combination therapies may enhance their therapeutic efficacy, providing a promising approach for addressing global health challenges caused by emerging viral pathogens.}, }
@article {pmid40683291, year = {2025}, author = {Winkler, AS and Brux, CM and Carabin, H and das Neves, CG and Häsler, B and Zinsstag, J and Fèvre, EM and Okello, A and Laing, G and Harrison, WE and Pöntinen, AK and Huber, A and Ruckert, A and Natterson-Horowitz, B and Abela, B and Aenishaenslin, C and Heymann, DL and Rødland, EK and Berthe, FCJ and Capua, I and Sejvar, J and Lubroth, J and Corander, J and May, J and Roth, LF and Thomas, LF and Blumberg, L and Lapinski, MK and Stone, M and Agbogbatey, MK and Xiao, N and Hassan, OA and Dar, O and Daszak, P and Guinto, RR and Senturk, S and Sahay, S and Samuels, TA and Wasteson, Y and Amuasi, JH}, title = {The Lancet One Health Commission: harnessing our interconnectedness for equitable, sustainable, and healthy socioecological systems.}, journal = {Lancet (London, England)}, volume = {406}, number = {10502}, pages = {501-570}, doi = {10.1016/S0140-6736(25)00627-0}, pmid = {40683291}, issn = {1474-547X}, support = {001/WHO_/World Health Organization/International ; }, }
@article {pmid40683284, year = {2025}, author = {Carlson, CJ and Trisos, CH and Oppenheim, B and Bansal, S and Davies, SE and Diongue-Niang, A and Fan, VY and Kraemer, JD and Golden Kroner, R and Gostin, LO and Hayman, DTS and Koopmans, M and Lavelle, TE and das Neves, CG and O'Donoghue, Z and Pereira, LM and Roche, B and Sirleaf, M and Zamanian, K and Zambrana-Torrelio, C and Phelan, AL}, title = {Pathways to an Intergovernmental Panel on Pandemics: lessons from the IPCC and IPBES.}, journal = {The Lancet. Microbe}, volume = {6}, number = {10}, pages = {101178}, doi = {10.1016/j.lanmic.2025.101178}, pmid = {40683284}, issn = {2666-5247}, mesh = {Humans ; *Pandemics/prevention &amp; control ; *Climate Change ; Biodiversity ; Global Health ; Ecosystem ; International Cooperation ; COVID-19 ; }, abstract = {Pandemics pose a global threat to human wellbeing, justice, economies, and ecosystems and are comparable with other planetary crises such as climate change and biodiversity loss in terms of urgency and impact. The global community would benefit from a dedicated scientific synthesis body to assess pandemic risks and solutions. In this Personal View, we explore proposals for an Intergovernmental Panel on Pandemics and assess potential pathways to its creation. Learning lessons from the Intergovernmental Panel on Climate Change (IPCC) and the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) might help national governments and international organisations to chart a course through important decisions about format, governance, operations, scientific scope and process, and ability to recommend policies that make the world safer.}, }
@article {pmid40683139, year = {2025}, author = {Munoz, FM and Kampmann, B and Stergachis, A and Chaudhary, M and Cutland, CL and Khalil, A and Gentile, A and Jones, CE and Marshall, H and Sevene, E and Darko, DM and Swamy, G and Hyde, TB and Voss, G and Muelen, AS}, title = {A template tool for the evaluation of vaccines for emerging pathogens to be used for pregnant and breast-feeding women.}, journal = {Vaccine}, volume = {62}, number = {}, pages = {127513}, doi = {10.1016/j.vaccine.2025.127513}, pmid = {40683139}, issn = {1873-2518}, mesh = {Humans ; Female ; Pregnancy ; *COVID-19 Vaccines/administration &amp; dosage/immunology ; *Breast Feeding ; *COVID-19/prevention &amp; control ; SARS-CoV-2/immunology ; *Communicable Diseases, Emerging/prevention &amp; control ; *Pregnancy Complications, Infectious/prevention &amp; control ; Vaccination ; *Vaccines ; }, abstract = {Vaccination during pregnancy provides effective protection against pathogens that increase the risk of maternal and infant morbidity and mortality for mothers and their infants. The SARS-CoV-2 pandemic demonstrated the need for the inclusion of pregnant and breast-feeding women in research and development of vaccines for emerging pathogens, such as Ebola, Zika, Lassa fever, Chikungunya, and influenza virus of pandemic potential. The COVID-19 Vaccines Global Access (COVAX) Maternal Immunization Working Group (MIWG), in collaboration with the Coalition for Epidemic Preparedness Innovation and the Safety Platform for Emergency Vaccines (CEPI-SPEAC) developed a standardized template with key considerations to guide the assessment of vaccines against emerging pathogens in pregnant and breast-feeding women. The aim of this tool is to enable key stakeholders to perform an early structured assessment of the overall potential benefit and risk for maternal immunization against an emerging pathogen. It can also be used to support risk management and pharmacovigilance planning, communication strategies, policy development, and acceptance of vaccination during pregnancy in future pandemics.}, }
@article {pmid40683021, year = {2025}, author = {Gabelmann, A and Biesel, A and Loretz, B and Lehr, CM}, title = {Exploring the future of mRNA delivery: Beyond lipid nanoparticles.}, journal = {Biochemical and biophysical research communications}, volume = {778}, number = {}, pages = {152347}, doi = {10.1016/j.bbrc.2025.152347}, pmid = {40683021}, issn = {1090-2104}, mesh = {Humans ; *Nanoparticles/chemistry ; *RNA, Messenger/administration &amp; dosage/genetics/chemistry ; COVID-19/prevention &amp; control ; *Lipids/chemistry ; SARS-CoV-2/genetics ; *Gene Transfer Techniques/trends ; COVID-19 Vaccines/administration &amp; dosage ; *Drug Delivery Systems/methods ; Animals ; Liposomes ; }, abstract = {Over six decades of fundamental research and technological innovation have culminated in the emergence of lipid nanoparticles (LNPs) as the gold standard for mRNA delivery. In the COVID-19 pandemic, they have been pivotal for the rapid development of mRNA-based vaccines. Despite their clinical success, LNPs possess several intrinsic limitations. In this work, we aim to showcase these weak spots but going beyond, we intend to point out solutions and current trends. We discuss strategies to improve mRNA stability and translational efficiency, including formulation stabilization through lyophilization. Furthermore, we analyze novel materials such as poly (beta-amino esters) (PBAEs) and alternative lipid components to replace PEG-lipids, as well as hybrid (e.g. lipid-polymer) nanoparticle systems designed to enhance delivery efficiency, reduce toxicity, and enable tissue-specific targeting. Different targeting strategies, including passive and active nanoparticle-mediated delivery are compared to approaches based on novel medical devices as inhalers or microneedles. Finally, we address advancements in manufacturing technologies tailored for personalized medicine, alongside analytical, regulatory, and intellectual property considerations critical for the development and commercialization of next-generation mRNA formulations.}, }
@article {pmid40682371, year = {2025}, author = {Pittman, CA and Liu, H and Kowkuntla, S and Choe, E and Copeland, MJ and Hoa, M and Briggs, S and Kim, HJ}, title = {Contemporary Clinical Management of Otosyphilis for Practicing Otolaryngologists-A Scoping Review.}, journal = {The Laryngoscope}, volume = {}, number = {}, pages = {}, doi = {10.1002/lary.32421}, pmid = {40682371}, issn = {1531-4995}, abstract = {OBJECTIVE: The COVID-19 pandemic marked the resurgence of an old disease, syphilis. The CDC reported increased syphilis cases in the United States from 2016 to 2022, necessitating early recognition of syphilis to properly diagnose complications. We revisit otosyphilis management with the intent of developing an updated diagnostic testing algorithm and treatment plan for otolaryngologists to prevent worsening hearing loss.<br><br>DATA SOURCES: MEDLINE, PubMed, Embase, Web of Science, and Cochrane databases.<br><br>METHODS: A scoping review of diagnostic and treatment methods for otosyphilis was completed and reported in compliance with the guidelines outlined in the PRISMA-ScR extension for scoping reviews statement. A retrospective case series was also conducted by reviewing patient charts from a tertiary care hospital network. Patients with otosyphilis or neurosyphilis with otic symptoms, as diagnosed by an otolaryngology or infectious disease specialist, were included.<br><br>RESULTS: In 57 studies (222 patients), the mean reported symptom duration was 6.6 &#xb1; 5.0&#x2009;weeks (n&#x2009;=&#x2009;30) with nine outliers presenting after 6&#x2009;months (65%) had hearing loss, 95 (43%) tinnitus, and 53 (24%) vertigo. Most (97%) received penicillin. Of 84 with outcomes, 48 (57%) improved. In 18 additional patients from the tertiary hospital system cohort (17 males, 1 female; 25-87&#x2009;years, 9 HIV-positive), penicillin or doxycycline was used. Six patients fully recovered, four required further therapy, two partially recovered, and one did not improve.<br><br>CONCLUSION: Otosyphilis has an insidious presentation and can mimic other audiovestibular demanding early testing. Complex serologic interpretation may require referral to infectious disease specialists. Clear diagnostic protocols ensure timely treatment and improved outcomes.}, }
@article {pmid40682315, year = {2025}, author = {Porat-Dahlerbruch, J and Boyd, J and Fighel, H}, title = {Investing in the Advanced Practice Nursing Workforce to Improve Health System Responses to Armed Conflict.}, journal = {International nursing review}, volume = {72}, number = {3}, pages = {e70074}, pmid = {40682315}, issn = {1466-7657}, mesh = {Humans ; *Advanced Practice Nursing/organization &amp; administration ; *Armed Conflicts ; *Delivery of Health Care/organization &amp; administration ; Nurse's Role ; COVID-19/nursing ; Israel ; }, abstract = {AIM: To pose an argument for health systems to improve responses to armed conflict by investing in developing the advanced practice nursing workforce.<br><br>BACKGROUND: Armed conflict catalyzes infectious disease, noncommunicable disease, and physical and psychological trauma. Health systems in countries at war face challenges in meeting the health service needs for affected populations while providing sufficient care for the rest of the public. Integrating advanced practice nurses into the workforce is one solution to address the demand for health services during war. Importantly, policies facilitating a quick, efficacious advanced practice nurse response during war must be in place before armed conflict arises.<br><br>SOURCES OF EVIDENCE: A critical narrative review of peer-reviewed articles was conducted. The review focused on the benefits of advanced practice nurses during crises and systemic policy setbacks preventing advanced practice nurse workforce development. A case study from the Israel-Hamas War is presented.<br><br>DISCUSSION: Holistic, patient-centered care positions advanced practice nurses to care for the physical and psychological needs of the population arising from war. Evidence from other public health crises, such as the COVID-19 and H1N1 pandemics, reinforces this notion. However, common policy setbacks, such as an ill-defined scope of practice and a lack of interprofessional awareness of the role, prevent advanced practice nurses from providing care when conflict arises. Israel's policy efforts before and during the Israel-Hamas War exemplify advanced practice nursing workforce policy development that facilitated an effective response to crisis.<br><br>CONCLUSION: Addressing expanded advanced practice nurse authorities before conflict starts will facilitate an improved health system response.<br><br>Research examining the effectiveness of advanced practice nursing care quality during armed conflict will facilitate national-level investment in advanced practice nursing workforce development.}, }
@article {pmid40682141, year = {2025}, author = {Ciapponi, A and Bardach, A and Berrueta, M and Ballivian, J and Brizuela, M and Caravario, J and Castellana, N and Comande, D and Couto, E and Mazzoni, A and Ortega, V and Parker, EPK and Sambade, JM and Florencia, S and Smutny, JP and Stegelmann, K and Xiong, X and Stergachis, A and Munoz, FM and Buekens, P}, title = {A global living systematic review and meta-analysis hub of emerging vaccines in pregnancy and childhood.}, journal = {Reproductive health}, volume = {22}, number = {1}, pages = {129}, pmid = {40682141}, issn = {1742-4755}, mesh = {Humans ; Pregnancy ; Female ; *COVID-19 Vaccines ; *COVID-19/prevention &amp; control ; Child ; SARS-CoV-2 ; Meta-Analysis as Topic ; Vaccine Development ; }, abstract = {The COVID-19 pandemic accelerated vaccine development and generated a rapidly evolving body of evidence before and after the vaccine rollout. We developed a robust online platform to efficiently synthesize this emerging information for current and future challenges. Expanding upon our interactive living systematic review-initially focused on COVID-19- we now include chikungunya and Lassa fever (with protocols presented in this issue), Mpox, and Disease X (https://www.safeinpregnancy.org). We aim to continuously monitor and periodically update and disseminate high-quality data on vaccine safety, efficacy, effectiveness, and immunogenicity in pregnancy and childhood. This platform computes real-time meta-analyses and features a visualization tool to present findings in a clear and accessible manner, supporting decision-making, vaccine development pipelines, and implementation strategies worldwide. It is also designed to integrate data on a hub of emerging vaccines in pregnancy and childhood and reflects a collaborative effort among multiple organizations.}, }
@article {pmid40681210, year = {2025}, author = {Yang, C and Lapp, L and Amstutz, A and Briel, M and Shannon, CP and Zhao, H and Espin, E and Assadian, S and Toma, M and Tebbutt, SJ}, title = {Cardiac adverse events associated with remdesivir in COVID-19 patients: a systematic review and meta-analysis of randomised controlled trials.}, journal = {BMJ open}, volume = {15}, number = {7}, pages = {e089977}, pmid = {40681210}, issn = {2044-6055}, mesh = {Humans ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; *Adenosine Monophosphate/analogs &amp; derivatives/adverse effects ; *Antiviral Agents/adverse effects/therapeutic use ; *Alanine/analogs &amp; derivatives/adverse effects ; SARS-CoV-2 ; COVID-19 ; *Heart Diseases/chemically induced/epidemiology ; }, abstract = {OBJECTIVES: To evaluate whether remdesivir is associated with cardiac adverse events (CAEs), addressing concerns raised by basic experiments, clinical case reports and observational studies.<br><br>DESIGN: Systematic review and meta-analysis.<br><br>DATA SOURCES: MEDLINE and Embase, searched from January 2020 to December 2023.<br><br>STUDY SELECTION: Randomised controlled trials (RCTs) comparing remdesivir with placebo or standard care in patients with COVID-19, with a primary focus on cardiac safety.<br><br>We included RCTs that evaluated the safety of remdesivir in patients with COVID-19 . Eligible studies were those that compared remdesivir with placebo or standard care in adult patientsCOVID-19 . Inclusion criteria emphasised safety outcomes, particularly CAEs, as primary endpoints.<br><br>DATA EXTRACTION AND SYNTHESIS: Two reviewers independently extracted data. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Harms guidelines. Risk of bias (RoB) was assessed using the Cochrane Collaboration tool. A random-effects model was used for data synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to assess the certainty of evidence. The primary outcome was the incidence of any CAEs, defined as a composite of all reported cardiac-related harms. Secondary outcomes included specific CAEs such as arrhythmias, heart failure and myocardial disorders.<br><br>RESULTS: We identified 1698 studies, of which seven RCTs met the inclusion criteria, comprising a total of 4566 participants. The RoB was assessed across multiple domains, with four RCTs showing low risk and three showing moderate risk in specific areas. Pooled analysis revealed no significant association between remdesivir use and CAEs (RR=0.84, 95%&#x2009;CI: 0.68 to 1.04, p=0.118). Subgroup analyses showed consistent findings across different patient demographics and comorbidities. GRADE assessment indicated moderate certainty for overall CAEs, low certainty for arrhythmias and heart failure (due to imprecision and study-level bias), and very low certainty for myocardial disorders (due to small sample size and indirectness).<br><br>CONCLUSIONS: Contrary to preliminary concerns and case reports, our meta-analysis found no evidence of a statistically significant association between remdesivir and CAEs among patients with COVID-19 . These findings provide reassurance to clinicians regarding the safety profile of remdesivir in this patient population, supporting its use as an antiviral therapy in the treatment of COVID-19. Further research is warranted to validate these findings and to clarify whether remdesivir may have a neutral or potentially protective effect on cardiac outcomes.<br><br>PROSPERO REGISTRATION NUMBER: CRD42022383647.}, }
@article {pmid40680937, year = {2025}, author = {Meschino, D and Lindsay, D and Tang, GH and James, P and Fralick, M and Sholzberg, M}, title = {Evaluating the combined effect of antifibrinolytics and estrogen on the risk of thromboembolism: a scoping review.}, journal = {Journal of thrombosis and haemostasis : JTH}, volume = {23}, number = {11}, pages = {3540-3560}, doi = {10.1016/j.jtha.2025.06.033}, pmid = {40680937}, issn = {1538-7836}, mesh = {Humans ; Female ; *Estrogens/adverse effects ; *Antifibrinolytic Agents/adverse effects/therapeutic use ; *Thromboembolism/chemically induced ; Risk Factors ; Risk Assessment ; *Menorrhagia/drug therapy/blood ; Adult ; Postpartum Hemorrhage/drug therapy ; }, abstract = {BACKGROUND: Up to 30% of reproductive-aged women seek medical attention for heavy menstrual bleeding (HMB). Estrogen-containing contraceptives and antifibrinolytics are first-line treatments. Despite evidence for these agents for HMB and for antifibrinolytics in other high-estrogen states (eg, postpartum), many antifibrinolytic monographs warn against use with concurrent estrogen-containing contraception given theoretical thromboembolic risk.<br><br>OBJECTIVES: This study aimed to systematically evaluate the literature that explores the combined effect of pharmacologic or high physiologic estrogen and antifibrinolytic agents on thromboembolic risk in women of reproductive age when used for heavy menstrual or postpartum bleeding.<br><br>METHODS: A systematic literature search was performed of records until April 2023. Publications written in English describing risk or reported cases of thromboembolism in reproductive-age women prescribed antifibrinolytics with estrogen-containing contraceptives or with a physiologic estrogenic state were included.<br><br>RESULTS: We identified 4302 publications; 55 publications with 199 228 participants were included. Two case reports and one case series described thromboembolism with concomitant estrogen-containing contraceptives and antifibrinolytic use. Four of 5 patients in the case series had other thrombotic risk factors. Fifty-two publications investigated antifibrinolytic use postpartum. Four RCTs of postpartum antifibrinolytic use assessed thromboembolism as a secondary outcome, none of which reported increased risk with antifibrinolytics. One case report suggested possible thrombotic risk wherein the patient had other provoking risk factors.<br><br>CONCLUSION: We found no strong evidence that intermittent antifibrinolytic use in physiologic estrogenic states is associated with increased reported cases or risk of thromboembolic events. Prospective studies are warranted to assess the thrombotic risk of combined estrogen-containing contraceptives and antifibrinolytics.}, }
@article {pmid40680383, year = {2025}, author = {Chen, TH and Jeng, TH and Lee, MY and Wang, HC and Tsai, KF and Chou, CK}, title = {Viral mitochondriopathy in COVID-19.}, journal = {Redox biology}, volume = {85}, number = {}, pages = {103766}, pmid = {40680383}, issn = {2213-2317}, mesh = {Humans ; *COVID-19/virology/metabolism/pathology/immunology/complications ; *SARS-CoV-2/pathogenicity ; *Mitochondria/metabolism/virology/pathology ; Mitochondrial Dynamics ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), disrupts cellular mitochondria, leading to widespread chronic inflammation and multi-organ dysfunction. Viral proteins cause mitochondrial bioenergetic collapse, disrupt mitochondrial dynamics, and impair ionic homeostasis, while avoiding antiviral defenses, including mitochondrial antiviral signaling. These changes drive both acute COVID-19 and its longer-term effects, known as "long COVID". This review examines new findings on the mechanisms by which SARS-CoV-2 affects mitochondria and for the impact on chronic immunity, long-term health risks, and potential treatments.}, }
@article {pmid40680300, year = {2025}, author = {Hu, M and Song, T and Gong, Z and Che, Q and Guo, J and Chen, L and Zhang, H and Li, H and Liang, N and Zhao, G and Wang, Y and Shi, N and Liu, B}, title = {Symptom Trajectories and Clinical Subtypes in Post-COVID-19 Condition: Systematic Review and Clustering Analysis.}, journal = {JMIR public health and surveillance}, volume = {11}, number = {}, pages = {e72221}, pmid = {40680300}, issn = {2369-2960}, mesh = {Humans ; *COVID-19/complications/epidemiology ; Cluster Analysis ; Post-Acute COVID-19 Syndrome ; Fatigue/epidemiology ; Prevalence ; }, abstract = {BACKGROUND: Post-COVID-19 condition presents complex symptomatology involving multifaceted interactions, which has resulted in a current lack of comprehensive understanding of its disease trajectory. This knowledge gap significantly compromises the efficiency of symptom management and adversely affects patients' quality of life.<br><br>OBJECTIVE: This study aims to comprehensively characterize the temporal evolution of post-COVID-19 condition by identifying core symptom clusters and clinical phenotypes, thereby enhancing understanding of the disease trajectory.<br><br>METHODS: The PubMed, Web of Science, and Embase databases were searched from December 1, 2019, to March 1, 2024. Observational studies related to the prevalence of symptoms in post-COVID-19 condition had been included. We conducted a meta-analysis to synthesize symptom prevalence across different follow-up intervals following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used a network to explore interrelationships and co-occurrence patterns among symptoms, enabling the identification of core symptoms and changes over time. Clustering analysis was used to classify included studies into distinct clinical subtypes.<br><br>RESULTS: This study analyzed 155 sets of macrolevel data from 108 clinical studies, encompassing 63,771 patients. Fatigue was the most prevalent symptom across all 4 follow-up points (52%, 48%, 46%, and 54%). Dyspnea peaked at the third and sixth follow-ups (36% and 31%) and then declined steadily (28% and 22%). Subgroup analysis revealed that Africa reported the fewest symptoms overall, yet showed high early incidences of fatigue (68%, 95% CI 50%-85%) and dyspnea (56%, 95% CI 15%-98%). The Americas placed greater emphasis on symptom evolution within the first postinfection year, with notably higher prevalence of anxiety (60%, 95% CI 54%-66%) and depression (36%, 95% CI 16%-55%). Asia and Europe documented the most comprehensive symptom profiles, with Asia reporting lower early dyspnea rates (29%, 95% CI 18%-40%) and Europe exhibiting more complex multisystem involvement during long-term follow-up. Network analysis showed that core post-COVID-19 symptoms evolved from early respiratory-neurological manifestations to chronic multisystem symptoms dominated by dizziness. Clustering analysis further indicated a progressive convergence of 2 initially distinct post-COVID-19 subtypes, with the acute inflammatory type becoming less prominent and gradually transitioning into a more chronic, persistent pattern.<br><br>CONCLUSIONS: This study provides a comprehensive characterization of the dynamic evolution of post-COVID-19 condition symptoms and clinical subtypes, highlighting their multisystem involvement. The results reveal a progressive decline in respiratory symptoms over time, while neurological manifestations emerge as the most persistent and systemically impactful core symptoms. Our findings emphasize the need for region-specific surveillance and early warning systems informed by symptom progression patterns. By continuously monitoring the trajectories of symptom clusters, this approach offers valuable insights for identifying early warning signals and targeted intervention points in the management of postinfectious sequelae arising from future large-scale epidemics.}, }
@article {pmid40679664, year = {2025}, author = {El Houdi, M and Skhoun, H and Guennoun, A and Dakka, N and Ameziane El Hassani, R and Ouzzif, Z and El Baghdadi, J}, title = {Deciphering TLR and JAK/STAT pathways: genetic variants and targeted therapies in COVID-19.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {733}, pmid = {40679664}, issn = {1573-4978}, mesh = {Humans ; *COVID-19/genetics/immunology/virology ; *STAT Transcription Factors/metabolism/genetics ; *Janus Kinases/metabolism/genetics ; Signal Transduction/genetics ; SARS-CoV-2 ; *Toll-Like Receptors/genetics/metabolism ; COVID-19 Drug Treatment ; Immunity, Innate ; Molecular Targeted Therapy ; Toll-Like Receptor 7/genetics ; Mutation ; Antiviral Agents/therapeutic use ; }, abstract = {Genetic alterations affecting the immune-related pathways can significantly disrupt the innate immune system among patients with COVID-19, contributing to disease severity. Research investigations have shown that common or rare mutations in TLR genes, mainly TLR3 and TLR7, can impair the recognition of viral RNA, leading to an altered interferon response. Moreover, the NF-κB pathway, which represents a vital regulator of inflammatory cytokine production, may also be genetically disturbed, resulting in either insufficient inflammatory signaling or, adversely, excessive cytokine release in the most severe cases. Alterations in the JAK/STAT signaling pathway that mediates the downstream effects of type I interferons and other cytokines, can further compromise the antiviral defenses. The purpose of this review is to outline recent literature describing the current understanding of immunogenetic mechanisms in response to SARS-CoV-2 infection, with an emphasis on TLR and JAK/STAT signaling pathways. We aimed to investigate important variants within the genes related to these cascades and their involvement in COVID-19 severity. We also discussed emerging therapeutic strategies, especially the JAK/STAT modulators and TLR antagonists in severe COVID-19.Despite significant advances in targeting JAK/STAT pathways for the treatment of COVID-19, these approaches can show partial efficacy in monitoring critical inflammatory responses, due to the rapid viral evolution. Moreover, JAK inhibitors, being beneficial in decreasing hyperinflammation, may present potential side effects, particularly linked to immunosuppression. Hence, by integrating genetic profiling and modulation of immunity pathways, novel precision medicine approaches may greatly optimize treatment strategies and COVID-19 patient outcomes.}, }
@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.<br><br>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.<br><br>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.<br><br>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.}, }
@article {pmid40679324, year = {2025}, author = {Mohanty, B and Mohan, M and Nanjappa, DP and Shenoy, RD and Hosmane, GB and Chakraborty, G and Chakraborty, A}, title = {Biomedical Models: Use of Zebrafish as a Multi-Utility In Vivo Tool Box.}, journal = {WIREs mechanisms of disease}, volume = {17}, number = {4}, pages = {e70002}, doi = {10.1002/wsbm.70002}, pmid = {40679324}, issn = {2692-9368}, support = {VIR/COVID-19/23/2021/ECD-I//ICMR, Government of India/ ; }, mesh = {Animals ; *Zebrafish/genetics ; *Disease Models, Animal ; Humans ; *Biomedical Research/methods ; Genomics/methods ; Proteomics/methods ; Metabolomics ; }, abstract = {Molecular research has gradually revealed the biological significance of genetically encoded information and how this information is transmitted and utilized in a cell. The scientific advances of the last few decades have brought about paradigm shifts in the strategies traditionally used to decipher biological information. From unidirectional approaches, we now have multidirectional model-system-based integrated OMICs that aim to describe the pathophysiology of diseases through a combination of genetic, transcriptomic, proteomic, and metabolomic data. Compared to other vertebrate models, zebrafish have a wealth of advantages that make them a powerful tool with a wide range of applications in biomedical research. The high degree of genetic conservation with humans, coupled with the availability of various gene manipulation techniques, has made zebrafish an immensely popular multi-utility genetic toolbox. This review describes the advances in the field of zebrafish-based biomedical research with a focus on its applications in disease modeling, functional omics, toxicology, and pharmacology. This article is categorized under: Cancer > Genetics/Genomics/Epigenetics Infectious Diseases > Molecular and Cellular Physiology Congenital Diseases > Molecular and Cellular Physiology.}, }
@article {pmid40678731, year = {2025}, author = {Singh, A and Kashyap, A and Varshney, S and Bhattacharya, S}, title = {Decades of discovery: unveiling emerging trends, pivotal research areas, and landmark publications in national tobacco research in India.}, journal = {Frontiers in research metrics and analytics}, volume = {10}, number = {}, pages = {1496571}, pmid = {40678731}, issn = {2504-0537}, abstract = {INTRODUCTION: Tobacco use remains a major public health concern in India, contributing significantly to the burden of non-communicable diseases and premature mortality. Over the past two decades, national tobacco research has evolved in response to shifting regulatory frameworks, scientific developments, and increasing awareness of tobacco's health, social, and environmental implications. The World Health Organization Framework Convention on Tobacco Control (WHO FCTC), adopted in 2003, has played a catalytic role in aligning research efforts with global priorities. However, there is a need to map the growth and direction of this research to identify strengths, gaps, and emerging trends within the Indian context.<br><br>METHODS: A bibliometric analysis was conducted to evaluate tobacco-related research output affiliated with Indian institutions between 2003 and 2024. Data were retrieved from the SCOPUS database, limited to peer-reviewed journal articles and reviews published in English. Analytical tools included SCOPUS Analytics, Microsoft Excel, the Biblioshiny package in R, and VOS viewer software. These tools were used to extract and visualize trends in publication volume, subject categories, key authors, institutional collaborations, citation metrics, and thematic hotspots. Inclusion criteria were confined to Indian-affiliated institutions contributing to national and global discourse on tobacco research.<br><br>RESULTS: Tobacco research in India showed a consistent upward trend post-2003, with notable surges corresponding to key public health developments. The majority of publications were concentrated in the domain of medicine, particularly focusing on cancer prevention and tobacco control interventions. Leading contributors included institutions such as the All India Institute of Medical Sciences (AIIMS), with significant collaborations observed with United States-based researchers. Despite increased output, research on the social and environmental consequences of tobacco use remained limited. Additionally, international collaboration was relatively low, and funding was primarily from Indian agencies, with minimal support from global or low-income country partnerships. Notably, recent studies employed advanced methodologies, such as machine learning and nanotechnology, and examined newer themes like the intersection of tobacco use and COVID-19-related respiratory risks.<br><br>DISCUSSION: The findings indicate a maturing research ecosystem around tobacco in India, strongly anchored in biomedical science and policy interventions. However, the underrepresentation of interdisciplinary studies exploring socio-cultural and ecological dimensions suggests a critical gap. Moreover, the low levels of international collaboration and inadequate funding for low-income contexts highlight systemic limitations that could hinder progress. To advance tobacco research nationally and globally, enhanced collaboration across disciplines and geographies is essential. Incorporating emerging technologies and focusing on equity-driven research agendas will be pivotal in addressing the multifaceted impact of tobacco use.}, }
@article {pmid40678729, year = {2025}, author = {Li, Z and Liu, Y and Ding, W and Liu, Y and Li, W and Guan, S and Liu, X and Wang, G and Liu, Q and Jiang, C and Peng, X and Li, H and Li, Z and Li, J}, title = {Food and medicine homology: a potential nutritional intervention strategy for post-acute COVID-19 syndrome.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1588037}, pmid = {40678729}, issn = {1663-9812}, abstract = {After recovering from severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) acute infection, some patients with corona virus disease 2019 (COVID-19) still are affected by post-acute COVID-19 syndrome (PACS). Traditional Chinese medicine (TCM) has played an important role in the recovery period of COVID-19. As a unique type of Chinese botanical drugs, foods with property of food and medicine homology (FMH) has the dual characteristics of drug and food, which has advantages over usual drugs in safety and daily application. This review analyzed a total of 290 peer-reviewed publications on the progress of dozens of formulas and single botanical drugs, which were systematically collected from the electronic scientific databases, including PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI), as well as other literature sources, such as classic Chinese medicine books. The symptoms of PACS and the advancements in the application of FMH foods in PACS intervention are summarized, and the challenges in the regulatory characteristics and food safety are further discussed. It is expected that the application of FMH foods would bring new opportunity for the treatment and daily intervention of PACS, and this review provides a foundation for the development of PACS intervention foods.}, }
@article {pmid40678698, year = {2025}, author = {Crealock-Ashurst, B and Levanita, S and Frischer, SR and Adhikari, S and Mwebia, W and Kadri-Alabi, Z and Davidson, L and Jeena, L and Evans, M and Morley, G and Harriss, E and Carson, G and Norton, A and Sigfrid, L}, title = {PEARLES challenges and solutions to the implementation of clinical research responses to epidemics and pandemics: a scoping review.}, journal = {EClinicalMedicine}, volume = {85}, number = {}, pages = {103294}, pmid = {40678698}, issn = {2589-5370}, abstract = {Conducting clinical research in response to infectious disease outbreaks presents unique challenges. In a previous review, we identified a range of political, economic, administrative, regulatory, logistical, ethical and social (PEARLES) challenges and proposed solutions to effective implementation of outbreak research responses. Following the COVID-19 pandemic, we conducted an update to explore if solutions recommended had been implemented, or new challenges identified. We searched seven databases (Ovid MEDLINE, Global Health, Embase, and PsycINFO, Scopus, Epistemonikos, Google Scholar) and grey literature from 01/06/2018 to 28/09/2023 for studies presenting PEARLES challenges/solutions to epi/pandemic research responses. Of 12,652 records, 191 were included. Our review identified many persisting challenges, particularly the lack of international research co-ordination, pre-planned research strategies, and limited research infrastructure in resource deprived settings. While some solutions were implemented, many remain recommendations e.g. pre-prepared regulatory guidelines and protocols, research infrastructure investment and international research coordination. Our data shows an urgent need to address challenges identified, implement and evaluate recommended solutions, to strengthen global health security to new and (re-) emerging epidemics and pandemics.}, }
@article {pmid40678258, year = {2025}, author = {Zhang, J and Li, J and Zhou, J and Zhong, J and Xu, Y and Mao, X and Xu, M and Luo, S and Yang, Y and Hu, R and Liu, DA and Chen, S and Qiu, Y and Chen, K and Yuan, J and Zhang, X and Li, X}, title = {A Critical Review of the CRISPR-Cas Technology in the Detection of SARS-CoV-2 Variants.}, journal = {The Canadian journal of infectious diseases &amp; medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2025}, number = {}, pages = {9107724}, pmid = {40678258}, issn = {1712-9532}, abstract = {Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still going on, and as the epidemic situation continues, the genome of SARS-CoV-2 is also mutating and evolving, resulting in more and more SARS-CoV-2 mutant strains, which have brought serious pressure on the prevention and control of COVID-19. Given that the COVID-19 is still spreading, it is extremely important to rapidly identify SARS-CoV-2 variants by nucleic acid assays. Thus, developing highly sensitive and specific assays that are suitable for field testing, high-throughput, and automation, as well as other diagnostic applications for SARS-CoV-2 variants, is urgently needed. This paper reviews the research progress of novel CRISPR-based diagnostic methods for SARS-CoV-2 variants.}, }
@article {pmid40677981, year = {2025}, author = {Yau, MTK and Tsien, C}, title = {Telemedicine Approaches for Patients with Cirrhosis, Including Vulnerable Populations: A Narrative Review.}, journal = {Canadian liver journal}, volume = {8}, number = {2}, pages = {329-343}, pmid = {40677981}, issn = {2561-4444}, abstract = {BACKGROUND: The COVID-19 pandemic accelerated the adoption of telemedicine in health care. However, telemedicine in cirrhosis care remains underexplored. In particular, patients with alcohol use disorder (AUD) and hepatitis C virus (HCV) may be overrepresented among vulnerable populations, but have limited access to telemedicine.<br><br>METHOD: We performed a literature review on telemedicine approaches for patients with cirrhosis as well as patients with AUD and HCV with or without cirrhosis. Peer-reviewed studies involving direct patient-physician interactions were searched on PubMed and Google Scholar. Keywords used included cirrhosis, AUD, HCV, and telemedicine. Abstracts were screened. Full texts were reviewed.<br><br>RESULTS: Among patients with cirrhosis, videoconferencing at satellite sites shortened the time from liver transplant referral to evaluation and listing. Telephone calls were less effective, especially for those with decompensated cirrhosis. Among patients with AUD, videoconferencing at satellite sites was effective, with patients being five times more likely to be prescribed medications. Treatment programs involving videoconferencing and telephone calls demonstrated retention rates above 50%. Among patients with HCV, videoconferencing was effective, with high (>90%) sustained virological response rates. Across all approaches, concerns raised included audiovisual quality, patient privacy, and licensing restrictions.<br><br>CONCLUSION: Videoconferencing at satellite sites is most promising if audiovisual quality and other barriers are optimized. Telemedicine may not be appropriate for management of decompensated cirrhosis.}, }
@article {pmid40677668, year = {2025}, author = {Balacescu, S and Geavlete, B and Ungureanu, C and Ene, C and Ene, CD and Bulai, C and Mares, C and Punga, A and Militaru, A and Geavlete, P}, title = {The Experience of SARS-CoV-2 in Patients with Benign Prostatic Hyperplasia: Is There Any Correlation between Them?.}, journal = {Maedica}, volume = {20}, number = {1}, pages = {112-116}, pmid = {40677668}, issn = {1841-9038}, abstract = {Introduction: Recent studies suggest that the international prostate symptom score (IPSS), especially in older men, may result from COVID-19, and that LUTS may be high in the early stages of the illness. The primary goal of the present review is to ascertain the true impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the development of patients with benign prostatic hyperplasia (BPH) by analyzing the body of available literature. Materials and methods: By May 2023, a comprehensive and categorized search of the literature was conducted utilizing the following global databases: the Cochrane Library, Web of Science, PubMed, Embase and Scopus. To assess their eligibility, all English-language records were included, including peer-reviewed online publications and published works. Additional sources were identified using the retrieved material's citations. There were no limitations on the sample size. Results: SARS-CoV-2 penetrates cells by attaching itself to the angiotensin-converting enzyme 2 (ACE2) receptor of the prostate. This combination may cause direct harm to the prostate and accelerate the development of BPH. The pathophysiology of BPH involves androgen receptors, and the infection caused by SARS-CoV-2 may be androgen-mediated. This may cause the symptoms of BPH to worsen and progress. Pro-inflammatory pathways can be triggered and cytokine release increased by SARS-CoV-2 infection. This inflammation can exacerbate lower urinary tract symptoms (LUTS) and cause the prostate gland to become inflamed. Benign prostatic hyperplasia may occur because of metabolic disturbances brought on by the coronavirus disease caused by SARS-CoV-2 (COVID-19), such as newly diagnosed diabetes and cardiovascular issues. Conclusion: To illustrate the impact of COVID-19 on the onset of these symptoms and quantify the changes in them, it is desirable to identify the factors that contribute to the worsening of BPH-related LUTS after COVID-19 recovery.}, }
@article {pmid40677535, year = {2024}, author = {Mundra, P and Kailani, Z and Yaghoobi, M and Matthews, P and Tobis, M and Sadeghian, S and Albashir, S}, title = {Liver injury in post-acute COVID-19 syndrome: A systematic review and meta-analysis of early observational studies.}, journal = {Canadian liver journal}, volume = {7}, number = {4}, pages = {470-489}, pmid = {40677535}, issn = {2561-4444}, abstract = {BACKGROUND: Post-acute COVID-19 syndrome (PACS; long COVID) is characterized by persistent or delayed symptoms at least 4 weeks from acute COVID-19 infection. Given the well-documented incidence of liver injury in acute COVID-19, this systematic review aims to assess the odds of liver injury in earlier experiencers of PACS.<br><br>METHODS: Observational studies published prior to March 2022 were screened for data describing liver injury (defined per primary study) in patients with PACS.<br><br>RESULTS: A total of 2,117 abstracts and 35 full texts were screened, of which 26 met the inclusion criteria. The mean time since acute COVID infection across all studies was 195.5 days. Seven studies included COVID-negative control groups. Twenty-three studies measured lab findings, and nine studies measured imaging or elastography. Five studies were eligible for meta-analysis of odds ratios, which did not demonstrate a statistically significant difference in odds for liver injury in patients with PACS compared with COVID-negative patients (OR 2.22 [95% CI 0.51-9.61; p = 0.28]). Newcastle-Ottawa Scale assessments for all studies found 24 of 26 studies with high to very high risk of bias. ROBINS-E assessments for studies included in the meta-analysis found five of five studies with high to very high risk of bias.<br><br>CONCLUSIONS: Overall, our findings demonstrate no statistical difference in odds ratios of liver injury in patients with PACS compared with COVID-negative controls. As such, routine assessment and monitoring of liver injury in patients with PACS may not be required; however, higher quality data with lower risk of bias are required to make recommendations of higher certainty.}, }
@article {pmid40676931, year = {2025}, author = {Abdul-Azees, PA and Marinkovic, M and Singh, BB and Dean, DD and Chen, XD and Goldberg, MP and Restrepo, MI and Loomer, PM and Yeh, CK}, title = {The Impact of Aging Oral Health on Long COVID-19.}, journal = {Journal of dental research}, volume = {104}, number = {12}, pages = {1294-1303}, doi = {10.1177/00220345251349805}, pmid = {40676931}, issn = {1544-0591}, mesh = {Humans ; *COVID-19/complications/immunology ; *Oral Health ; *Aging/physiology/immunology ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Mouth Diseases/virology ; }, abstract = {At least 10% of individuals infected with SARS-CoV-2 develop a variety of multisystem symptoms lasting more than 12 wk known as postacute sequelae of COVID-19 (PASC) or "long COVID." While the precise pathogenesis of PASC remains unclear, immune dysregulation is widely recognized as a key factor. Moreover, PASC disproportionately affects older individuals who are prone to age-related immune system decline, which further exacerbates the risk and severity of PASC. The oral cavity, a primary site for initial SARS-CoV-2 infection, may contribute to the development and persistence of PASC. Emerging evidence suggests that changes in age-related oral health, such as periodontitis, salivary gland (SG) dysfunction, and gustatory and olfactory impairments, may create an environment conducive to forming an oral reservoir of intact virus or viral antigens, which may contribute to the chronicity of PASC. Alternatively, the pathogenesis of PASC may increase the risk of a wide range of oral health issues, such as dental diseases, dry mouth, and sensory dysfunction (e.g., taste and smell) that are frequently reported by patients with PASC. This review highlights how aging facilitates oral SARS-CoV-2 infection, co-infection with other viruses may drive PASC in aging patients, aging and PASC dysregulate the oral microbiome, SARS-CoV-2 infection promotes molecular mechanisms involved in oral tissue aging, aging oral health affects susceptibility to developing PASC, and inflammation associated with PASC exacerbates dysregulation of metabolic/enzymatic pathways of aging oral mucosa and diseases of the periodontal apparatus, SGs, and taste. It underscores the urgent need to comprehensively address the interplay between aging oral health and PASC, which will help mitigate long-term complications and improve overall health outcomes for affected individuals.}, }
@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 &amp; control/epidemiology/transmission ; Humans ; *COVID-19/epidemiology ; Animals ; Neglected Diseases/prevention &amp; 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.}, }
@article {pmid40675172, year = {2025}, author = {Nepogodiev, D and Picciochi, M and Ademuyiwa, A and Adisa, A and Agbeko, AE and Aguilera, ML and Agyei, F and Alexander, P and Henry, J and Anyomih, TTK and Aregawi, AB and Atun, R and Biccard, B and Chalwe, M and Chu, K and Coomarasamy, A and Crawford, R and Darzi, A and Davies, J and Gathuya, Z and George, C and Ghaffar, A and Ghosh, D and Glasbey, JC and Haque, PD and Harrison, EM and Hesse, A and Allen Ingabire, JC and Kamarajah, SK and Karekezi, C and Kruger, D and Lapitan, MC and Latif, A and Lawani, I and Ledda, V and Li, E and Linder, C and Makasa, E and Martin, J and Maswime, S and Mathai, S and Meara, JG and Mudede-Moffat, F and Ntirenganya, F and Park, KB and Phelan, LN and Pramesh, CS and Ramos-De la Medina, A and Raykar, N and Rivello, R and Roslani, AC and Roy, N and Samad, L and Shrime, M and Sobhy, S and Sullivan, R and Tabiri, S and Tangi, V and Tissingh, E and Weiser, TG and Williams, O and Bhangu, A}, title = {Surgical health policy 2025-35: strengthening essential services for tomorrow's needs.}, journal = {Lancet (London, England)}, volume = {406}, number = {10505}, pages = {860-880}, doi = {10.1016/S0140-6736(25)00985-7}, pmid = {40675172}, issn = {1474-547X}, mesh = {Humans ; Developing Countries ; *General Surgery/trends ; Global Health ; *Health Policy/trends ; *Health Services Needs and Demand ; *Surgical Procedures, Operative ; }, abstract = {Progress towards The Lancet Commission on Global Surgery's 2030 targets has been too slow and too patchy, particularly in low-income and middle-income countries. The unmet need for surgery has continued to grow, reaching at least 160 million operations per year. Ensuring high-quality surgical care remains a crucial global challenge, with 3·5 million adults dying after surgery each year. The COVID-19 pandemic exposed the fragility of surgical services long undermined by chronic underfunding, workforce shortages, and under-resourced infrastructure. However, The Lancet Commission on Global Surgery inspired a new generation of surgeons to engage with policy, and several countries have developed national surgical plans, although most remain unfunded. Advancements in surgical data science have allowed health systems to identify priorities for improvement. Preserving this infrastructure is important, especially during periods of uncertain global health funding. The next decade requires urgent change to prevent economic instability and armed conflict from forcing surgery down the global health agenda. Reframing surgery as an essential service that saves lives, strengthens health systems, and fosters economic productivity could unlock much needed investment. Sustained progress requires integration of funding both within hospital infrastructure and across care pathways. Such holistic approaches would reinforce entire hospital systems, which are essential to national security and wellbeing.}, }
@article {pmid40674998, year = {2025}, author = {Yaseen, M and Alsayed Hassan, D and O'Hara, L}, title = {Sleep patterns in autistic children and adolescents and their caregivers during the COVID-19 pandemic lockdown: A systematic review.}, journal = {Acta psychologica}, volume = {258}, number = {}, pages = {105258}, doi = {10.1016/j.actpsy.2025.105258}, pmid = {40674998}, issn = {1873-6297}, mesh = {Adolescent ; Child ; Female ; Humans ; Male ; *Autistic Disorder/psychology ; *Caregivers/psychology ; *COVID-19/prevention &amp; control/psychology ; *Quarantine/psychology ; *Sleep ; *Sleep Quality ; *Sleep Wake Disorders/epidemiology ; }, abstract = {BACKGROUND: Sleep patterns significantly influence health and wellbeing, with disturbances to sleep quality and duration, and increased sleep disorders commonly affecting autistic people. The COVID-19 pandemic lockdown altered daily routines for almost all people, impacting their sleep patterns.<br><br>AIM: This study aimed to systematically review studies on sleep patterns among autistic children, adolescents, and their caregivers during the COVID-19 lockdown.<br><br>METHODS: In April 2023, six databases (PubMed, Embase, Web of Science, Scopus, ProQuest Central, and CINAHL) were searched for quantitative and qualitative studies. Data from eligible studies were extracted and analyzed through narrative synthesis.<br><br>RESULTS: Thirty-four studies were included, with thirty-one focusing on autistic children and adolescents and three on caregivers. Autistic males and mothers were the predominant demographic groups in the studies. The findings regarding sleep quality, duration, and disorders were inconsistent; some studies reported improvements, while others noted worsening sleep or no changes. The most common negative impacts in autistic children and adolescents were decreased sleep quality and an increase in sleep disorders. All caregiver studies indicated significant declines in sleep quality and duration.<br><br>CONCLUSION: The COVID-19 lockdown adversely affected sleep patterns in many autistic children, adolescents, and their caregivers. To address these challenges during extreme circumstances such as lockdowns, strategies are needed to maintain or improve sleep quality and reduce the risk of negative sleep patterns in these populations.}, }
@article {pmid40674860, year = {2025}, author = {Bikmen, N}, title = {Collective memory of pandemics.}, journal = {Current opinion in psychology}, volume = {65}, number = {}, pages = {102097}, doi = {10.1016/j.copsyc.2025.102097}, pmid = {40674860}, issn = {2352-2518}, mesh = {Humans ; *COVID-19/psychology ; *Pandemics ; *Memory ; *Social Identification ; }, abstract = {Pandemics have rarely been studied by psychologists as an object of collective memory. Because they do not bear on national identities, pandemics are not nationally commemorated and quickly decay from public memory after they end. Yet interest in pandemic memories increased during the recent COVID-19 pandemic. A review of these recent studies suggests that there may be other social identities that are served by remembering pandemics, fulfilling the identity function of collective memories. Further, memories of past pandemics are often transmitted intergenerationally and used to direct action in current health crises. I suggest continued study of past pandemics with a focus on which identities are supported by remembering pandemics and what lessons these memories provide for responding to new challenges.}, }
@article {pmid40673226, year = {2025}, author = {Inoue, Y and Ichise, N and Ukai, W and Shinozaki, J and Ogawa, T and Karaushi, T and Tanaka, M and Akiyama, Y and Furuhashi, M and Kuno, A and Sato, T}, title = {Mapping research trends in obsessive-compulsive disorder before and after the COVID-19 pandemic: a bibliometric analysis focusing on its molecular mechanisms.}, journal = {Frontiers in psychiatry}, volume = {16}, number = {}, pages = {1615497}, pmid = {40673226}, issn = {1664-0640}, abstract = {Obsessive-compulsive disorder (OCD) is a psychiatric disorder that primarily develops during adolescence, and is characterized by obsessive thoughts and compulsive behaviors. Although multiple factors including heredity, environment, and abnormalities in neural networks and synapses are involved in the onset and exacerbation of OCD, their underlying molecular mechanisms have not been fully elucidated. In addition, recent studies have demonstrated that the novel coronavirus disease (COVID-19) pandemic worsened OCD phenotypes. Hence, this global crisis may have changed the field of molecular-focused OCD research. We conducted a brief bibliometric analysis to investigate changes in prevalent topics in molecular-focused OCD research before (2015-2019) and after (2020-2025) the COVID-19 pandemic using Web of Science and VOSviewer. "Schizophrenia" and "metaanalysis" remained highly ranked terms in molecular-focused OCD research. In terms of neurotransmitters, the term "serotonin" became more prevalent than "dopamine" after the COVID-19 pandemic. In addition, research interest shifted toward younger populations, and there was a noticeable increase in terms related to neural networks such as "connectivity". However, only a few specific molecular mechanisms or cellular physiological pathways by which COVID-19 exacerbates OCD have been identified. To address this gap, an additional post hoc analysis focusing on inflammation-related terms was conducted, revealing the emergence of "oxidative stress" and "c-reactive protein" in studies published after the COVID-19 pandemic. The findings of this study highlight several potential clues for elucidating the pathophysiology of OCD and identifying aggravating factors such as COVID-19, while also emphasizing the importance of continued molecular-focused research to establish novel therapeutic targets.}, }
@article {pmid40671971, year = {2025}, author = {Gandhi, AP and Yadav, P and Kapoor, A and Ramasamy, N and Kaviprawin, M and Saravanan, K and Yadav, A and Choudhary, A and Joseph, FK}, title = {Safety of COVID-19 Vaccines Among Pregnant Women in India: A Systematic Review and Meta-Analysis.}, journal = {Cureus}, volume = {17}, number = {6}, pages = {e86115}, pmid = {40671971}, issn = {2168-8184}, abstract = {Coronavirus disease 2019 (COVID-19) documented an estimated decrease in life expectancy of 1.6 years globally. Pregnant women exhibited higher infection rates and experienced prolonged illness durations, often exceeding four months. COVID-19 was also related to adverse maternal morbidity and near-miss incidents. In India, although there are studies on the effectiveness of COVID-19 vaccines among the overall population, the effectiveness in preventing infections among pregnant women is not well documented. The present meta-analysis pooled the safety of the COVID-19 vaccine among pregnant women in India. The search was conducted among the major electronic databases: PubMed, Scopus, Web of Science, and Cochrane (date of search: November 30, 2024). Screening, risk of bias (ROB), and data extraction of the studies were undertaken by two independent reviewers, with adjudication of conflicts by a third reviewer. We described the pooled effectiveness of vaccination on adverse events following immunization (AEFI) and fetomaternal outcomes using RStudio (Posit Software, Boston, MA). The I[2] statistic assessed the heterogeneity among studies. We conducted a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment to ascertain the certainty of the results. Database search yielded 215 unique articles. We included nine eligible studies for the analysis, including 5,630 pregnant women. Covishield and Covaxin were the vaccines taken by them. The pooled odds ratio (OR) for preterm labor in mothers with COVID-19 vaccination was 0.62 (95% confidence interval (CI): 0.49-0.79), with low certainty. The OR for low birth weight was 0.88 (95% CI: 0.06-13.71). AEFI rates were similar between the vaccinated pregnant and non-pregnant women (OR: 0.88, 95% CI: 0.00-268.11). No studies on efficacy and effectiveness could be found. Our pooled analysis concluded that COVID-19 vaccination among pregnant women in India is not associated with the increased risk of AEFIs or maternal or fetal outcomes.}, }
@article {pmid40671275, year = {2025}, author = {Du, X and Jia, J and Duan, T and Tao, X and Li, J and Yalikun, S and Wu, H and Zhou, Z and Ren, Z}, title = {Trend of Chinese adolescent anxiety symptoms before and after COVID-19: A cross-temporal meta-analysis with segmented regression.}, journal = {Journal of research on adolescence : the official journal of the Society for Research on Adolescence}, volume = {35}, number = {3}, pages = {e70046}, doi = {10.1111/jora.70046}, pmid = {40671275}, issn = {1532-7795}, support = {22&amp;ZD187//the Major Program of the National Social Science Foundation of China/ ; }, mesh = {Adolescent ; Female ; Humans ; Male ; *Anxiety/epidemiology/psychology ; China/epidemiology ; *COVID-19/psychology/epidemiology ; East Asian People ; }, abstract = {Adolescent anxiety symptoms are a global concern, and studying their trends and influencing factors in China is essential due to unique cultural and social dynamics impacting mental health. This study presents a cross-temporal meta-analysis of research employing the GAD-7 to assess anxiety symptoms among Chinese adolescents. Systematic searches were conducted across databases including CNKI, Wanfang, VIP, Web of Science, PubMed, Scopus, ProQuest, and Wiley, resulting in the inclusion of 66 articles (67 studies) spanning data collection from 2016 to 2023. The findings revealed that: (1) Anxiety symptoms among Chinese adolescents showed a slight decrease from 2016 to 2020, which was not statistically significant, but then experienced a significant increase from 2021 to 2023. (2) Throughout the period, female adolescents had significantly higher increases in anxiety symptoms compared to males. Clinically anxious adolescents had a slightly more pronounced decline in anxiety symptoms from 2016 to 2020 compared to those with subclinical anxiety, but this difference was not significant from 2021 to 2023. (3) Social change factors including social connectedness, socioeconomic conditions, and social threats did not significantly impact adolescent anxiety symptoms in China from 2016 to 2020, and this pattern continued from 2021 to 2023. This research advances the understanding of the mechanisms driving adolescent anxiety symptoms in China and offers a foundation for targeted prevention and intervention strategies, emphasizing the importance of addressing emerging stressors in mental health policies.}, }
@article {pmid40671020, year = {2025}, author = {Wang, Y and Li, X and Hui, H and Yang, D}, title = {Efficacy and safety of traditional Chinese medicine for post-COVID-19 syndrome: a systematic review and meta-analysis.}, journal = {Journal of translational medicine}, volume = {23}, number = {1}, pages = {801}, pmid = {40671020}, issn = {1479-5876}, mesh = {Humans ; *Medicine, Chinese Traditional/methods/adverse effects ; *COVID-19/complications ; *Drugs, Chinese Herbal/therapeutic use/adverse effects ; Randomized Controlled Trials as Topic ; Treatment Outcome ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; Fatigue/drug therapy ; Cough/drug therapy ; *COVID-19 Drug Treatment ; }, abstract = {BACKGROUND: Post-COVID-19 syndrome, characterized by persistent symptoms such as fatigue, dyspnea, cough, insomnia, and exercise intolerance, poses a significant challenge to global healthcare systems. Traditional Chinese Medicine (TCM) has been used to manage post-viral syndromes, but high-quality evidence for its effectiveness in post-COVID-19 recovery is limited. This study aimed to evaluate the clinical efficacy and safety of Chinese herbal medicine (CHM) in treating post-COVID-19 syndrome through a systematic review and meta-analysis of randomized controlled trials (RCTs).<br><br>METHODS: Five electronic databases (PubMed, Embase, Web of Science, Cochrane Library and CNKI) were systematically searched up to March 15, 2025. RCTs comparing CHM with placebo or usual care in patients with confirmed post-COVID-19 syndrome were included. Primary outcomes were symptom severity measured by the Visual Analogue Scale (VAS); secondary outcomes included relief rates of cough, fatigue, chest tightness, dyspnea, insomnia, and exercise intolerance. Data were pooled using a random-effects model, and heterogeneity was assessed using I[2] statistics.<br><br>RESULTS: Ten RCTs involving 2401 patients were included. CHM showed a greater reduction in VAS scores compared to controls (MD&#x2009;=&#x2009;-1.03; 95% CI -2.10 to 0.03; P&#x2009;=&#x2009;0.0577), with higher heterogeneity (I[2]&#x2009;=&#x2009;92%). Although this result did not reach conventional statistical significance, it suggests a potentially meaningful clinical trend favoring CHM. Subgroup analysis indicated both short-term and long-term CHM treatments improved VAS scores, with a stronger effect in long-term treatment. CHM significantly improved chest tightness (RR&#x2009;=&#x2009;1.40; 95% CI 1.21-1.61; P&#x2009;<&#x2009;0.0001; I[2]&#x2009;=&#x2009;0%) and insomnia (RR&#x2009;=&#x2009;1.23; 95% CI 1.03-1.47; P&#x2009;=&#x2009;0.0216; I[2]&#x2009;=&#x2009;0%). A trend toward improvement was observed in fatigue (RR&#x2009;=&#x2009;1.58, 95% CI 0.95-2.64; P&#x2009;=&#x2009;0.0781) and dyspnea (RR&#x2009;=&#x2009;1.39, 95% CI 0.99-1.95; P&#x2009;=&#x2009;0.0554), although these results did not reach statistical significance. No significant difference was observed in terms of 6-min walking distance (MD&#x2009;=&#x2009;13.95&#xa0;m, 95% CI -11.64 to 39.55; P&#x2009;=&#x2009;0.2853). Adverse event rates were comparable between the herbal and control groups (RR&#x2009;=&#x2009;0.72, 95% CI 0.49-1.07; P&#x2009;=&#x2009;0.1052).<br><br>CONCLUSIONS: This meta-analysis indicates that Traditional Chinese Medicine (TCM) may help relieve certain post-COVID-19 symptoms, especially chest tightness and insomnia. Trends toward benefit were also noted for fatigue and dyspnea, though without statistical significance. Given the non-significant VAS results and high heterogeneity, these findings should be interpreted cautiously. Further large-scale, high-quality trials are needed to validate these outcomes and optimize treatment strategies.<br><br>https://www.crd.york.ac.uk/PROSPERO/home , CRD420251016442.}, }
@article {pmid40670321, year = {2025}, author = {Li, Q and Jiao, W and Li, X and Liang, L}, title = {An Overview of Ophthalmic Complications Associated With Emerging/Re-Emerging Viruses: Focus on ZIKV, DENV, SARS-CoV-2, and MPXV.}, journal = {Reviews in medical virology}, volume = {35}, number = {4}, pages = {e70056}, doi = {10.1002/rmv.70056}, pmid = {40670321}, issn = {1099-1654}, support = {YDZJ202501ZYTS057//Natural Science Foundation of Jilin Province/ ; }, mesh = {Humans ; *COVID-19/complications/virology/epidemiology ; SARS-CoV-2/pathogenicity ; *Zika Virus Infection/complications/virology ; Zika Virus/pathogenicity ; Dengue Virus/pathogenicity ; *Communicable Diseases, Emerging/virology/complications ; *Dengue/virology/complications ; *Eye Diseases/virology ; *Eye Infections, Viral/virology ; Eye/virology/pathology ; }, abstract = {Infections caused by emerging and re-emerging viral pathogens are currently known as a significant global public health issue, affecting various human organ systems such as the ocular system. Several emerging and re-emerging viral infections, such as those caused by Zika virus (ZIKV), dengue virus (DENV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and monkeypox virus (MPXV), have been involved in the development of various ophthalmic disorders including uveitis, conjunctivitis, retinitis, optic neuritis, and more severe vision-threatening complications. The present review comprehensively describes the ophthalmic manifestations linked to these viruses, with a primary focus on their underlying pathogenesis, diverse clinical presentations, and the intricate potential mechanisms of viral invasion into ocular tissues. Describing the ocular involvement of emerging and re-emerging viral pathogens, particularly how they target and affect the ocular system, is critical for early diagnosis, appropriate management, and reducing long-term visual manifestations in affected patients. This review aims to address existing gaps in clinical knowledge and support timely ophthalmological management during emerging viral outbreaks.}, }
@article {pmid40670058, year = {2025}, author = {Aretouli, E and Malik, M and Widmann, C and Parker, AM and Oh, ES and Vannorsdall, TD}, title = {Cognitive and mental health outcomes in long covid.}, journal = {BMJ (Clinical research ed.)}, volume = {390}, number = {}, pages = {e081349}, doi = {10.1136/bmj-2024-081349}, pmid = {40670058}, issn = {1756-1833}, mesh = {Humans ; *COVID-19/psychology/complications ; SARS-CoV-2 ; Mental Health ; *Cognitive Dysfunction/etiology ; Post-Acute COVID-19 Syndrome ; *Anxiety/etiology ; Risk Factors ; *Depression/etiology ; }, abstract = {Roughly one in five adults who meet criteria for long covid present with objective or subjective cognitive dysfunction or elevated symptoms of depression or anxiety lasting ≥12 weeks from an acute covid illness. These neuropsychiatric sequelae have considerable functional consequences at the level of the individual, society, and the broader economy. Neuropsychiatric long covid symptoms are thought to be causally diverse, and a range of risk factors as well as biological, psychological, and environmental mechanisms have been hypothesized to contribute to symptom development and persistence. When present, objective cognitive deficits tend to be modest for most individuals, with some evidence suggesting increased risk of dysfunction and decline specifically for older adults with a history of severe acute illness. Longitudinal data suggest a delayed emergence of psychiatric symptoms may occur in the weeks and months after an acute covid illness. Emerging research points to the early recovery period as a potential window of opportunity for intervention to alter patient trajectories, though evidence based treatment remains lacking.}, }
@article {pmid40669792, year = {2025}, author = {Liang, Z and Shan, G and Shan, S and Ding, Z and Zhang, J and Chu, B}, title = {Comprehensive review on emerging nanotechnologies for combating COVID-19 and future pandemic preparedness.}, journal = {International journal of pharmaceutics}, volume = {682}, number = {}, pages = {125970}, doi = {10.1016/j.ijpharm.2025.125970}, pmid = {40669792}, issn = {1873-3476}, mesh = {Humans ; COVID-19 ; *Nanotechnology/methods/trends ; SARS-CoV-2 ; *Pandemics/prevention &amp; control ; Antiviral Agents/administration &amp; dosage ; *Pneumonia, Viral/diagnosis/prevention &amp; control/drug therapy/therapy ; *Coronavirus Infections/diagnosis/prevention &amp; control/drug therapy/therapy ; Drug Delivery Systems ; Nanoparticles ; *Betacoronavirus/drug effects ; COVID-19 Drug Treatment ; Animals ; Pandemic Preparedness ; }, abstract = {Since its emergence in China in December 2019, the outbreak of COVID-19 caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has escalated into a global pandemic emergency, demanding immediate and coordinated international action. This comprehensive review offers a broad, interdisciplinary perspective, exploring how advancements in nanotechnologies can aid in the battle against COVID-19 and other infectious diseases, with an emphasis on future pandemic preparedness. By analyzing the virus's life cycle, we identify key points where nanotechnology can be effective. Nanoparticles (NPs) can inactivate viruses through photothermal or photocatalysis-induced reactive oxygen species generation, offering potential healthcare applications. Nanotechnology can also revolutionize diagnostics by creating simple, rapid, and cost-effective assays for SARS-CoV-2 detection. Additionally, it can facilitate targeted drug delivery to the lungs, disrupting the interaction between ACE2 receptors and the viral S protein. Furthermore, the exemplary innovative strategies pertinent to nanomaterials in antiviral research on SARS-CoV-2 are also concisely recapped with a primary focus on interrupting the virus's life cycle to effectively combat it. In conclusion, emerging nanotechnologies stands as a vital tool in the fight against COVID-19 and will be indispensable in preparing for and mitigating the impact of future pandemics.}, }
@article {pmid40669421, year = {2025}, author = {Wu, Q and Li, W and Liu, H and Xue, Y and Huang, K and Pourghadamyari, H and Liu, Z}, title = {Respiratory emerging viruses and drug resistance in lung cancer: challenges and new perspectives in treatment.}, journal = {Molecular aspects of medicine}, volume = {104}, number = {}, pages = {101383}, doi = {10.1016/j.mam.2025.101383}, pmid = {40669421}, issn = {1872-9452}, mesh = {Humans ; *Lung Neoplasms/virology/therapy/drug therapy/immunology/pathology ; Tumor Microenvironment/immunology ; SARS-CoV-2 ; *COVID-19/complications/virology ; *Drug Resistance, Neoplasm ; Influenza, Human/complications/virology ; Oncolytic Virotherapy/methods ; Orthomyxoviridae ; Immunotherapy ; Animals ; }, abstract = {Emerging viral pathogens, particularly those targeting the respiratory system such as SARS-CoV-2 and influenza virus, pose significant challenges for patients with lung cancer. These patients show increased susceptibility to serious infections caused by these viruses as a result of immunosuppression from various therapies such as immunotherapy, chemotherapy, and targeted agents. Respiratory viral infections can induce tumor progression and drug resistance through affecting the tumor microenvironment (TME), modulating immune checkpoints, or interfering with therapeutic efficacy. The present review discusses the reciprocal interactions between these viral pathogens and lung cancer, underscoring mechanisms by which SARS-CoV-2 and influenza viruses affect the lung cancer TME promoting tumor progression, immune evasion, and ultimately, resistance to anti-cancer therapies such as tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs). Sections discussed in this study include: (i) increased susceptibility to viral infections, (ii) virus-induced modulation of the tumor microenvironment, and (iii) mechanisms of therapy resistance. This review also addresses emerging strategies, such as oncolytic virotherapy, as potential candidates for lung cancer treatment. It aims to provide new perspectives on therapeutic optimization for patients with lung cancer in the context of SARS-CoV-2 and influenza viruses, by reviewing evidence from virology, oncology, and immunology.}, }
@article {pmid40668847, year = {2025}, author = {Shaeri, S and Considine, J and Dainty, KN and Olasveengen, TM and Morrison, LJ}, title = {The role of contributing factors, triggers, and prodromal symptoms in the etiological classification of out-of-hospital cardiac arrest; A scoping review.}, journal = {PloS one}, volume = {20}, number = {7}, pages = {e0327651}, pmid = {40668847}, issn = {1932-6203}, mesh = {Humans ; *Out-of-Hospital Cardiac Arrest/etiology/classification ; *Prodromal Symptoms ; Emergency Medical Services ; Risk Factors ; }, abstract = {BACKGROUND: Current Utstein etiological classifications for out-of-hospital cardiac arrest (OHCA) are heterogenous and inaccurate when compared with robust sources. This heterogeneity may influence reporting incidence and outcomes and patient enrollment in observational studies and clinical trials. Circumstance-related factors may contribute to cardiac arrest; however, the role of these factors in improving the etiological classification of OHCA is unknown.<br><br>OBJECTIVE: This scoping review was proposed to explore current evidence to identify the role of contributing factors, triggers, and prodromal symptoms of out-of-hospital cardiac arrest in the reported etiology of cardiac arrest based on emergency medical services data, medical records, or autopsy reports.<br><br>METHOD: We searched Medline, Embase, and EMB review-Cochrane databases from 1946 to 2024. Studies were selected if the included population was adults with OHCA for whom the initial etiology was assigned, and any contributing factors, triggers, or prodromal symptoms of OHCA were reported. A descriptive review of the included studies was conducted.<br><br>RESULT: The search yielded 24,833 citations. Seventy studies met the inclusion criteria. These studies were published predominantly in Europe and Asia between 2010 and 2024 and classified as contributing factors (n&#x2009;=&#x2009;24), exercise (n&#x2009;=&#x2009;13), environmental triggers (n&#x2009;=&#x2009;24), and prodromal symptoms (n&#x2009;=&#x2009;9). The etiology of cardiac arrest initially assigned to cardiac or obvious non-cardiac classification may be precipitated by seizures (n&#x2009;=&#x2009;8), trauma (n&#x2009;=&#x2009;7), alcohol or drug intoxication (n&#x2009;=&#x2009;6), Covid-19 infection (n&#x2009;=&#x2009;5), myocardial infarction (n&#x2009;=&#x2009;4), suicide (n&#x2009;=&#x2009;4), antipsychotic medications (n&#x2009;=&#x2009;4), and illicit drug use (n&#x2009;=&#x2009;3). Exercise and environmental factors (e.g., particulate matter (PM) 2.5&#xb5; and ambient temperature) may trigger cardiac arrest predominantly due to cardiac etiologies. Based on EMS data, approximately 50% of patients with OHCA experienced symptoms prior to cardiac arrest which suggested cardiac and non-cardiac etiologies.<br><br>CONCLUSION: Many circumstance-related factors may directly or indirectly contribute to cardiac arrest etiology classification. Listing these factors in the reporting template may help prehospital personnel and data abstractors gather enough information to identify more accurately the etiology of OHCA.}, }
@article {pmid40668418, year = {2025}, author = {Panja, A and Manna, S and Chatterjee, M and Ghosh, T and Bid, S and Choudhury, SM}, title = {Diabetes Mellitus, a Leading Comorbidity in COVID-19: an Insight on Pathophysiology, Molecular Interactions, and Comprehensive Management.}, journal = {Current microbiology}, volume = {82}, number = {9}, pages = {388}, pmid = {40668418}, issn = {1432-0991}, mesh = {Humans ; *COVID-19/epidemiology/complications/physiopathology ; *Diabetes Mellitus/physiopathology/epidemiology ; SARS-CoV-2/physiology ; Angiotensin-Converting Enzyme 2/metabolism ; Risk Factors ; Comorbidity ; *Diabetes Complications ; Hyperglycemia ; }, abstract = {Coronavirus disease 2019 (COVID-19) has triggered a global pandemic with widespread disruption. Its mortality rate is notably higher in individuals with coexisting non-communicable diseases, particularly diabetes mellitus (DM). Despite extensive efforts, there remains no definitive treatment for COVID-19, making it imperative to protect populations with pre-existing risk factors that predispose them to severe or fatal outcomes. In this systematic literature review, we delineate the key biological and clinical risk factors-specifically, chronic hyperglycemia, endothelial dysfunction, and dysregulated angiotensin-converting enzyme 2 (ACE2) expression-that may exacerbate COVID-19 severity in diabetic patients. We explore how immune and inflammatory pathways intersect with COVID-19 pathogenesis and contribute to differential clinical manifestations in diabetic versus non-diabetic individuals. Particular emphasis is placed on the pathophysiological mechanisms facilitating viral entry and propagation in diabetic patients. Currently, insulin is the primary therapeutic modality for managing acute hyperglycemia in COVID-19, while sodium-glucose cotransporter 2 (SGLT2) inhibitors are generally discouraged due to potential adverse outcomes. As existing evidence is largely preliminary, further research is essential to establish optimized treatment strategies for this vulnerable patient population.}, }
@article {pmid40668265, year = {2025}, author = {Lee, OJ and Keating, A}, title = {Mesenchymal stromal cells: an update.}, journal = {Current opinion in hematology}, volume = {32}, number = {5}, pages = {270-278}, doi = {10.1097/MOH.0000000000000887}, pmid = {40668265}, issn = {1531-7048}, mesh = {Humans ; *Mesenchymal Stem Cells/metabolism/immunology/cytology ; *COVID-19/therapy/immunology ; *Mesenchymal Stem Cell Transplantation/methods ; *SARS-CoV-2 ; MicroRNAs/genetics ; Animals ; }, abstract = {PURPOSE OF REVIEW: Mesenchymal stromal cells (MSCs) are widely utilized in preclinical and clinical studies, with over 1500 clinical trials, including applications in Covid-19 treatment. This review consolidates recent advances in understanding MSC biology, mechanisms of action, and clinical utility.<br><br>RECENT FINDINGS: This review discusses recent progress made in understanding MSC biology, including immunomodulatory mechanisms mediated by microRNAs and long noncoding RNAs. Clinically, MSC therapies have shown promise in treating conditions like Covid-19-associated ARDS and several MSC therapeutic products have been approved. Single-cell analyses have shed light on MSC heterogeneity, revealing tissue-specific and conserved subpopulations influenced by the extracellular matrix. The FDA's updated recommendations on potency assays emphasize a holistic approach to quality control, reinforcing the need for a universal reference standard to improve reproducibility and clinical outcomes. In addition, to better understand their limited success in randomized clinical trials, we highlight the importance of a universal reference standard for MSC potency.<br><br>SUMMARY: MSCs offer significant therapeutic potential, but addressing challenges in heterogeneity and potency standardization is essential. Advances in understanding their immune properties and clinical applications provide opportunities to refine and expand their use in regenerative medicine.}, }
@article {pmid40667972, year = {2025}, author = {Vimieiro, VL and Vimieiro, CBS and Oliveira, AC}, title = {Reuse of N95 respirators: a systematic review on effectiveness and occupational safety for healthcare professionals.}, journal = {Revista gaucha de enfermagem}, volume = {46}, number = {}, pages = {e20240312}, doi = {10.1590/1983-1447.2025.20240312.en}, pmid = {40667972}, issn = {1983-1447}, mesh = {Humans ; *Equipment Reuse ; *N95 Respirators/standards ; *Health Personnel ; *Occupational Health ; COVID-19/prevention &amp; control ; }, abstract = {OBJECTIVE: To analyze the evidence on the effectiveness of extended use and reuse protocols of N95 respirators, with a focus on the occupational safety of healthcare professionals.<br><br>METHOD: Systematic review of articles published between 2003 and 2024 in the Medline/PubMed, Web of Science, SCOPUS, Embase, and CENTRAL databases. Experimental, quasi-experimental and observational studies were included. Methodological quality was assessed using the Joanna Briggs Institute tool. Narrative synthesis was used to present the results.<br><br>RESULTS: The review encompassed 21 articles. The most investigated aspect was sealing (71.4%), followed by structural integrity (33.3%), filtration efficiency (19.0%), and, finally, tensile testing of the fastening straps (4.8%). Damage such as dirt accumulation, broken nose clips, and strap breakage, as well as degradation of elastic resistance, were observed, leading to inadequate fit and reduced filtration capacity. Four studies were classified as high quality, while 17 were of moderate quality.<br><br>CONCLUSION: Extended use and reuse of N95 respirators are not recommended, as they increase occupational risk. Although they maintain adequate filtration efficiency in different contexts, this is not sufficient to ensure user protection. When unavoidable, strict evidence-based protocols must be followed.}, }
@article {pmid40667951, year = {2025}, author = {Sawada, NO and Reis, TMD and Freitas, PS and Moraes, CM and Peloso-Carvalho, BM and Assunção, MRS and Horvath, CMSP and Silva, RS and Mendes, KDS}, title = {Prevalence of systemic complications of COVID-19 in critically ill patients: systematic review with meta-analysis.}, journal = {Revista latino-americana de enfermagem}, volume = {33}, number = {}, pages = {e4608}, pmid = {40667951}, issn = {1518-8345}, mesh = {Humans ; *COVID-19/complications ; *Critical Illness ; Prevalence ; Nervous System Diseases/epidemiology/etiology ; }, abstract = {to identify the prevalence of systemic complications of COVID-19 in critically ill patients, to estimate the clinical conditions that may have a worse prognosis when associated with COVID-19. systematic review with meta-analysis of observational studies, based on the recommendations of the JBI Manual for Evidence Synthesis for systematic reviews of prevalence and incidence, in six databases and grey literature, period 2020 to 2024, languages Portuguese, English and Spanish. We identified 2393 publications. The selection, data extraction and methodological evaluation of the studies were carried out by two independent researchers. The meta-analysis was performed using the Freeman Tukey transformational random-effects statistical method. ten papers were included. The meta-analysis of seven papers dealing with respiratory complications due to COVID-19 demonstrated a mean prevalence of 42%, (95% CI 0.2-0.66) with heterogeneity I2=97.4; the meta-analysis of 4 papers involving the prevalence of neurological complications due to COVID-19 showed an average prevalence of 62%, (95% CI 0.49- 0.74) with heterogeneity I2=87.4 and the meta-analysis of 8 studies showed a prevalence of mortality due to COVID-19 of 33%, (95% CI 0.23- 0.44) with heterogeneity I2=93.6. respiratory and neurological complications were the most prevalent in the reviewed studies. PROSPERO Registration: CRD42020214617.}, }
@article {pmid40667838, year = {2025}, author = {de Paula, MML and Oliveira, RTR and Hottz, ED}, title = {Platelets and platelet-leukocyte interactions in infectious diseases.}, journal = {Current opinion in hematology}, volume = {32}, number = {5}, pages = {261-269}, doi = {10.1097/MOH.0000000000000878}, pmid = {40667838}, issn = {1531-7048}, mesh = {Humans ; *Blood Platelets/immunology/pathology/metabolism ; *Leukocytes/immunology/pathology/metabolism ; *Communicable Diseases/immunology ; COVID-19/immunology ; Animals ; Platelet Activation ; SARS-CoV-2/immunology ; Immunity, Innate ; *Cell Communication ; }, abstract = {PURPOSE OF REVIEW: Platelets are essential effector cells in the immune continuum. Understanding platelet roles during infectious diseases is paramount to understanding pathological and protective immune responses. In this review, we compiled recent data about platelets in immune response to infectious diseases.<br><br>RECENT FINDINGS: Platelets recognize and respond to pathogens, including viruses, bacteria and parasites, contributing to the assembly of the immune response. Platelet activation and platelet-leukocyte aggregates formation have been observed in naturally infected humans and in experimental models of diseases. In this review we discuss recent findings on the mechanisms and outcomes of platelet activation and platelet-leukocyte interaction in infectious diseases and response to vaccine. Pathogens may modulate platelet response to escape immune surveillance, but platelets still contribute to host defense. We compiled evidence of platelet mediated-pathological responses, but also their contributions to pathogen clearance. We focused on the participation of platelets in pathophysiological and protective responses in infectious diseases of global impact such as COVID-19, HIV-1, viral hemorrhagic fevers, bacterial sepsis and parasite infections.<br><br>SUMMARY: Platelets contribute to protective and pathological responses by regulating innate and adaptive immunity through activation, hyperaggregability and directly interacting with pathogens. Even though many mechanisms underlying platelet roles in infectious disease have been revealed, much remains to be investigated.}, }
@article {pmid40667491, year = {2025}, author = {Liu, J and Chen, M and Wu, H and Cai, H and Tu, S and Lee, E and Zhang, X}, title = {An effective short form of the 20-item University of California Los Angeles Loneliness Scale version 3: item response theory and network psychometrics.}, journal = {General psychiatry}, volume = {38}, number = {4}, pages = {e102055}, pmid = {40667491}, issn = {2517-729X}, abstract = {Loneliness is a complex and usually unpleasant emotional response to isolation, which has been considered the latest global health epidemic exacerbated by the coronavirus disease 2019 pandemic, affecting nearly two-thirds of older adults. Some profound health implications carried by loneliness include depression, cognitive impairment, hypertension and frailty. Across the world, there is no consensus definition of loneliness, and its measure is based on the phenomenological perspective of the individual. The 20-item University of California Los Angeles Loneliness Scale version 3 (UCLA-20) is the most common measure. This scale demonstrates acceptable psychometric properties but is too long and complex for a phone interview. This paper addresses the increasing need to shorten this scale by adopting classical item response theory and network psychometrics to advance scale development. Through an item reduction analysis, we trimmed the original scale into an effective short form, which is as valid as the original one. With respondents' time at a premium in most research nowadays, this short-form scale is an efficient and practical alternative to the original UCLA-20.}, }
@article {pmid40666612, year = {2025}, author = {Zabłocka-Żytka, L and Lahad, M}, title = {The BASIC Ph model in communication and building individual and group resilience in crises. An example of use during the refugee crisis in Poland.}, journal = {Postepy psychiatrii neurologii}, volume = {34}, number = {2}, pages = {93-98}, pmid = {40666612}, issn = {2720-5371}, abstract = {PURPOSE: Everyday difficulties, but also new threats experienced by individuals and whole societies, are sources of stress that, due to their intensity, occurrence over time and in the absence of adequate support, can trigger crises and traumatic experiences. Examples of the latter are COVID-19 or military action in Europe, among other things, and the related wave of refugees who have sought refuge in many Western European countries since February 2022 in particular. This is why it is so important to cultivate resilience and the ability to cope effectively cope with stress not only at the individual level but also in entire social groups, and to nurture the resources not only of those already experiencing crises and mental health disorders, but also of entire populations.<br><br>VIEWS: The BASIC Ph model devised by Prof. Mooli Lahad (2013) is a tool for effective crisis communication and thus building individual and social resilience. It has been successfully implemented for several decades in the process of educating individuals and social groups about stress and forming new, effective ways of coping with it, thereby building mental resilience in situations such as natural disasters, epidemics, wars, migration, and refugee crises.<br><br>CONCLUSIONS: The article presents the application of the BASIC Ph model in the example of the refugee crisis and its use for people experiencing the trauma of war and forced migration, as well as citizens of host and migrant-supporting countries.}, }
@article {pmid40666529, year = {2025}, author = {Nakarin, F and Sprenger, KG}, title = {A paradigm shift in simulating affinity maturation to elicit broadly neutralizing antibodies.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1627674}, pmid = {40666529}, issn = {1664-3224}, mesh = {Humans ; *Antibody Affinity/immunology ; *B-Lymphocytes/immunology ; *Broadly Neutralizing Antibodies/immunology ; *SARS-CoV-2/immunology ; Receptors, Antigen, B-Cell/immunology ; Germinal Center/immunology ; *COVID-19/immunology ; *Antibodies, Viral/immunology ; Animals ; Models, Immunological ; *Antibodies, Neutralizing/immunology ; }, abstract = {Broadly neutralizing antibodies (bnAbs) offer a promising route to protect against rapidly evolving pathogens such as HIV, influenza, and SARS-CoV-2, yet eliciting them through vaccination remains a significant challenge. A key to this problem lies in understanding antibody affinity maturation (AM), the evolutionary process within germinal centers (GCs) that shapes the B cell and thus antibody response. Traditionally, AM has been viewed as favoring the selection of B cells with the highest-affinity B cell receptors (BCRs) through competitive interplays. However, emerging evidence suggests that GCs are more permissive, allowing B cells with a broad range of affinities to persist, thereby promoting clonal diversity and enabling the rare emergence of bnAbs. This review reassesses affinity-based selection models and proposes a new paradigm that integrates multifactorial processes, including stochastic B cell decisions within GC dynamics, antigen extraction efficiency influenced by probabilistic bond rupture, and avidity-driven BCR binding alterations and representations on multivalent antigens. We highlight how advanced AM simulations that move beyond affinity as the sole determinant provide a more realistic and predictive representation of AM, marking a major step forward in developing strategies to promote effective immune responses against highly mutable, complex antigens.}, }
@article {pmid40665593, year = {2025}, author = {Cao, BK and Hanifa, RS and Nguyen, TP and Postma, MJ and van der Schans, J}, title = {Economic evaluations of vaccines against respiratory infections in adults in Southeast Asia: A systematic review.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2528409}, pmid = {40665593}, issn = {2164-554X}, mesh = {Adult ; Humans ; Asia, Southeastern/epidemiology ; Cost-Benefit Analysis ; *COVID-19/prevention &amp; control/economics ; *COVID-19 Vaccines/economics/administration &amp; dosage ; *Influenza Vaccines/economics/administration &amp; dosage ; *Pneumococcal Vaccines/economics/administration &amp; dosage ; *Respiratory Tract Infections/prevention &amp; control/economics ; SARS-CoV-2 ; Vaccination/economics ; Vaccine Efficacy ; }, abstract = {Respiratory infections significantly impact adult health in Southeast Asia, yet vaccine coverage remains low. This systematic review evaluated the economic evaluations of vaccines targeting respiratory infections in the region. A comprehensive search was conducted across several databases, including MEDLINE/PubMed, EMBASE, NHSEED, CINAHL, EconLit, Web of Science, Scopus, and Cochrane Library, up to April 24, 2024. Nineteen eligible studies were identified, focusing primarily on influenza (8 studies) and COVID-19 vaccines (7 studies), with fewer studies on pneumococcal (2 studies), varicella (1 study), and pertussis (1 study) vaccines. Overall, influenza, COVID-19 (boosters), and pneumococcal vaccines were found to be cost-effective or highly cost-effective compared to no-vaccine or no-booster scenarios. The only study on maternal pertussis vaccination found it not to be cost-effective. The most common parameters considered in sensitivity analyses were vaccine efficacy and discount rates. This review highlights the economic evaluations of influenza, COVID-19, and pneumococcal vaccines in Southeast Asia, providing essential evidence to guide vaccine policy. Future studies should address limitations in model selection, incorporate herd immunity, ensure the model validation (i.e. validity of cost and benefit measurements), and explore the cost-effectiveness of other vaccines across the region.}, }
@article {pmid40664036, year = {2025}, author = {Al-Khrasani, M and Essmat, N and Boldizsár, I and Varga, BT and Chalabiani, Y and Abbood, SK and Ernyey, AJ and Király, K and Máté, A and Riba, P and Timár, J and Gyertyán, I and Miklya, I and Parenti, C and Pasquinucci, L and Ágg, B and Fürst, S and Ferdinandy, P and Vizi, ES and Harsing, LG}, title = {Do vitamins halt the COVID-19-evoked pro-inflammatory cytokines involved in the development of neuropathic pain?.}, journal = {Biomedicine &amp; pharmacotherapy = Biomedecine &amp; pharmacotherapie}, volume = {189}, number = {}, pages = {118346}, doi = {10.1016/j.biopha.2025.118346}, pmid = {40664036}, issn = {1950-6007}, mesh = {*COVID-19/complications/metabolism ; *Neuralgia/etiology/metabolism/prevention &amp; control ; SARS-CoV-2 ; *Vitamins/pharmacology/therapeutic use ; *Cytokines/metabolism ; Humans ; Dietary Supplements ; Animals ; Inflammation Mediators/antagonists &amp; inhibitors/metabolism ; }, abstract = {Neuropathic pain (NP), a disease affecting the somatosensory nervous system, causes a high socioeconomic burden on healthcare systems and society; yet, its management has not been fully solved. Post COVID-19, with sequelae of the somatosensory system, further increases the number of individuals with chronic pain, thus further exacerbating the social burden related to NP. The pro-inflammatory mediators, such as TNF-α, IL-1β, and IL-6, are massively released in patients with COVID-19 and are known to be involved in the pathomechanisms of NP, particularly in relation to neuronal sensitization. Specifically, the release of large amounts of these pro-inflammatory cytokines from immune and non-immune effector cells during the acute and post COVID-19 phases prone to have substantial involvement in the development of post COVID-19 NP. Several preclinical and clinical studies have shown that vitamins' supplementation, namely vitamins A, B1, B2, B3, B5, B6, B7, B9, B12, C, D, E, and K can attenuate the enhanced release of TNF-α, IL-1β, and IL-6. The early supplementation of these vitamins may mitigate the neuronal sensitization evoked by cytokine storm due to COVID-19 or other viruses. This strategy may provide a novel approach to prevent the development of post COVID-19 NP. This review highlights the mechanisms by which COVID-19 can induce NP and how vitamins may help to alleviate these post COVID-19 sequelae.}, }
@article {pmid40663485, year = {2025}, author = {Liu, L and Chen, S and Hu, D and Zhu, Y and Wu, C and Liu, A and Hao, T and Chen, L and Jin, C and Wu, J and Fu, H and Liu, S and Zheng, H and Qiu, H and Yang, Y and Liu, S}, title = {VON WILLEBRAND FACTOR IN ECMO: A DYNAMIC MODULATOR OF HEMORRHAGE AND THROMBOSIS.}, journal = {Shock (Augusta, Ga.)}, volume = {64}, number = {3}, pages = {291-302}, doi = {10.1097/SHK.0000000000002632}, pmid = {40663485}, issn = {1540-0514}, mesh = {Humans ; *von Willebrand Factor/metabolism ; *Extracorporeal Membrane Oxygenation/adverse effects ; *Thrombosis/etiology/metabolism ; *Hemorrhage/etiology/metabolism ; ADAMTS13 Protein/metabolism ; Animals ; }, abstract = {Von Willebrand factor (vWF) orchestrates hemostasis through platelet activation, factor VIII stabilization, and inflammatory modulation, with emerging evidence highlighting its shear-dependent conformational dynamics as a critical regulator of thrombus formation. The protease ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13) cleaves ultralarge vWF multimers under physiological conditions, although its efficiency declines sharply at supraphysiological shear forces characteristic of extracorporeal membrane oxygenation (ECMO) circuits. Beyond proteolytic regulation, cumulative evidence confirms that vWF self-association, autoregulatory domains, and inflammatory mediators collectively modulate vWF's thrombogenic potential during ECMO support. Contrary to early assumptions that ECMO-associated vWF dysfunction solely reflects quantitative depletion, contemporary multimodal analyses reveal a biphasic trajectory: an initial prothrombotic phase mediated by shear-induced unfolding of high-molecular-weight multimers, which triggers platelet hyperreactivity in ECMO initiation, followed by a hemorrhagic phase due to progressive vWF multimer degradation and ADAMTS13 exhaustion, with acquired von Willebrand syndrome cases showing simultaneous platelet dysfunction. Post-ECMO removal, endothelial vWF surge then reignites thrombosis risk-a paradoxical rebound observed in survivors despite anticoagulation. Major bleeding and thrombotic events remain despite anticoagulation, underscoring the inadequacy of current anticoagulation and monitoring strategies. Although pulsatile flow modulation and vWF multimer monitoring show promise in preserving hemostatic balance, cohort data are conflicting on post-ECMO anticoagulation efficacy. This review synthesizes mechanistic insights from shear-stress models, clinical outcome studies, and emerging monitoring technologies, providing insights and references for establishing a temporal management framework aimed at maintaining vWF-ADAMTS13 homeostasis across ECMO phases.}, }
@article {pmid40663038, year = {2025}, author = {Avais, LS and Pacheco, EC and Gomes, LPOZ and Baldani, MH and Martins, CM and Waldman, EA and Gonzalez, JPJ and Steen, TY and Borges, PKO}, title = {Oral Manifestations in the Post COVID-19 Condition: A Systematic Review With Meta-Analysis.}, journal = {Reviews in medical virology}, volume = {35}, number = {4}, pages = {e70057}, pmid = {40663038}, issn = {1099-1654}, support = {//Coordena&#xe7;&#xe3;o de Aperfei&#xe7;oamento de Pessoal de N&#xed;vel Superior/ ; //Conselho Nacional de Desenvolvimento Cient&#xed;fico e Tecnol&#xf3;gico/ ; }, mesh = {Humans ; *COVID-19/complications/virology ; *Mouth Diseases/epidemiology/etiology/virology ; SARS-CoV-2/pathogenicity ; *Taste Disorders/epidemiology/virology ; Prevalence ; Xerostomia ; }, abstract = {Post-COVID-19 condition, or Long COVID, is characterised by symptoms persisting or emerging beyond 12 weeks after acute infection. Among over 200 reported symptoms, oral manifestations such as taste loss and dry mouth have been identified. This systematic review reports the frequency and characteristics of these symptoms. Registered in PROSPERO and following PRISMA guidelines, the review included observational studies on COVID-19-positive adults presenting oral symptoms in the post-COVID-19 condition. A search in six databases (Medline/PubMed, Embase, Web of Science, Cochrane, SCOPUS, and LILACS) was conducted in January 2024. Risk of bias was assessed using Joanna Briggs Institute's critical appraisal tools, and certainty of evidence via GRADE. A meta-analysis using the inverse variance method estimated oral symptom prevalence. Of 4552 articles, 107 were included. Taste dysfunction persisted in 8% (95% CI 6%-10%) of patients beyond 12 weeks. Combined taste and smell alterations had a prevalence of 17% (95% CI 13%-21%). Less frequent symptoms included hyposalivation, periodontitis, mouth ulcers, tongue mucosal changes, facial tingling, sensitivity in the trigeminal nerve, difficulty swallowing, and lesions in the hard palate. Taste alterations were the most commonly reported symptom, underscoring the need for clinical recognition and appropriate management by oral health professionals. Additionally, the wide range of other oral manifestations highlights the necessity for further research to better understand their prevalence, underlying mechanisms, and clinical implications in post-COVID-19 patients.}, }
@article {pmid40662947, year = {2025}, author = {Margerison, CE and Joachim, GE and Michling, TR and Johnson, CY}, title = {Platform-Mediated Gig Work and Health: A Scoping Review.}, journal = {American journal of industrial medicine}, volume = {68}, number = {9}, pages = {729-739}, pmid = {40662947}, issn = {1097-0274}, support = {//The authors received no specific funding for this work./ ; }, mesh = {Humans ; COVID-19/epidemiology ; Mental Health ; *Occupational Health ; *Teleworking ; Occupational Injuries/epidemiology ; SARS-CoV-2 ; Health Status ; }, abstract = {BACKGROUND: We sought to assess the size, depth, and rigor of empirical literature on platform-mediated gig work and health.<br><br>METHODS: We conducted a scoping review of peer-reviewed studies from January 1, 2000, through May 29, 2024, that examined platform-mediated gig work and any measure of physical or mental health. We abstracted country, study design, population, sample size, exposure measure, and health outcome. We assessed whether the study addressed any of three potential mechanisms connecting gig work and health: occupational hazards, social determinants, or the specific nature of digital platforms.<br><br>RESULTS: We identified 45 total studies examining transportation safety (n&#x2009;=&#x2009;12), work-related injuries (n&#x2009;=&#x2009;4), other physical health outcomes (n&#x2009;=&#x2009;5), COVID-19 vulnerabilities (n&#x2009;=&#x2009;10), mental health (n&#x2009;=&#x2009;10), mental well-being (n&#x2009;=&#x2009;18), and safety (n&#x2009;=&#x2009;12). These categories were not mutually exclusive. Cross-sectional and qualitative studies identified physical and mental health problems among gig workers, but the literature lacks study population-representative designs, prospective data, comparisons of gig workers to other similar non-gig workers (i.e., external comparison groups), and validated measures of physical health.<br><br>CONCLUSIONS: Platform-mediated gig work may have unique impacts on health, but causal evidence is lacking. Future research should examine how the nature of digital platforms-specifically, algorithmic control, ratings, and surveillance-impacts health of workers.}, }
@article {pmid40661998, year = {2025}, author = {Omar, AS and Alchalabi, H and Gordon, A}, title = {Impact of the COVID-19 Pandemic on Medical Career Aspirations Among Children of Physicians and Other Healthcare Workers: A Scoping Review.}, journal = {Cureus}, volume = {17}, number = {6}, pages = {e85994}, pmid = {40661998}, issn = {2168-8184}, abstract = {Existing reviews examine medical students' specialty choices and physician‑parent burnout separately; none link parental pandemic experiences to children's career aspirations. To map and synthesise all empirical evidence on how the COVID‑19 pandemic, particularly parental occupational stress/burnout, has influenced the intentions of children (five to 25 years) of physicians and other healthcare workers (HCWs) to pursue medical careers. We followed the JBI scoping review methodology and PRISMA-ScR guidelines. Databases searched included MEDLINE, Embase, PubMed, ProQuest, and Google Scholar. Screening and data extraction processes involved two reviewers, and quality appraisal was performed using the AXIS checklist. Only one study was eligible, involving 53 adolescents from India. Results indicated nearly equal proportions of participants shifted towards and away from medical careers (15% and 13%, respectively), with the majority (72%) showing no change. There is a substantial gap in the literature regarding this specific impact of the pandemic. Further research, including multi-country and longitudinal studies, is needed.}, }
@article {pmid40660830, year = {2025}, author = {Pagliano, P and Salzano, F and D'Amore, C and Spera, A and Conti, V and Folliero, V and Franci, G and Ascione, T}, title = {How do drug discovery scientists address the unmet need of long COVID syndrome therapeutics and what more can be done?.}, journal = {Expert opinion on drug discovery}, volume = {20}, number = {10}, pages = {1251-1265}, doi = {10.1080/17460441.2025.2534056}, pmid = {40660830}, issn = {1746-045X}, mesh = {Humans ; *COVID-19/complications/physiopathology ; Post-Acute COVID-19 Syndrome ; *Drug Discovery/methods ; *COVID-19 Drug Treatment ; *Antiviral Agents/pharmacology/therapeutic use/administration &amp; dosage ; COVID-19 Vaccines/administration &amp; dosage ; SARS-CoV-2 ; }, abstract = {INTRODUCTION: Long COVID (LC), also known as post-acute COVID-19 syndrome (PASC), has emerged as a significant public health concern characterized by persistent symptoms following SARS-CoV-2 infection. This condition affects regardless of initial illness severity and can significantly impair daily functioning. Understanding the implications of LC is crucial, given that approximately 6.9 % of adults reported related symptoms in 2022, with increased prevalence among women and individuals of Hispanic descent. The pathogenesis of LC is multifactorial, involving mechanisms such as endothelial dysfunction, chronic inflammation, immune dysregulation, and potential viral persistence. The clinical manifestations include fatigue, cognitive impairment, musculoskeletal pain, and sleep disturbances. Current research emphasizes the importance of early antiviral interventions and vaccines to mitigate the risk of developing LC. Despite promising therapies like anti-inflammatory agents and metabolic enhancers, the lack of established biomarkers complicates diagnosis and treatment.<br><br>AREAS COVERED: The authors provide an overview of the pathogenesis of LC and briefly review the currently available therapy. The authors then give their perspectives on how best future drug discovery efforts can be utilized to address the current demand for novel LC therapeutics to reduce the burden of this public health problem.<br><br>EXPERT OPINION: Progress has been made in understanding the pathophysiology and potential treatment options, as well as in establishing reliable biomarkers for potential tailored strategies. Future research should prioritize both pharmacological and non-pharmacological interventions to enhance patient outcomes and quality of life. Addressing these challenges is essential for developing comprehensive care protocols for individuals affected by LC.}, }
@article {pmid40660410, year = {2025}, author = {Oktaria, V and Wiratama, BS and Riyanto, S and Purbaningrum, RP and Kusuma, CW and Saraswati, LD and Widyaningsih, V and Febrinasari, RP and Probandari, A and Ahmad, RA}, title = {A scoping review: the impact of nutritional status on the efficacy, effectiveness, and immunogenicity of COVID-19 vaccines.}, journal = {Tropical diseases, travel medicine and vaccines}, volume = {11}, number = {1}, pages = {21}, pmid = {40660410}, issn = {2055-0936}, support = {1570/UNI/DITLIT/Dit-Lit/PT.01.03/2022//Universitas Gadjah Mada/ ; 1570/UNI/DITLIT/Dit-Lit/PT.01.03/2022//Universitas Gadjah Mada/ ; 1570/UNI/DITLIT/Dit-Lit/PT.01.03/2022//Universitas Gadjah Mada/ ; 1570/UNI/DITLIT/Dit-Lit/PT.01.03/2022//Universitas Gadjah Mada/ ; 1570/UNI/DITLIT/Dit-Lit/PT.01.03/2022//Universitas Gadjah Mada/ ; 1570/UNI/DITLIT/Dit-Lit/PT.01.03/2022//Universitas Gadjah Mada/ ; }, abstract = {BACKGROUND: Vaccination is one of the most effective strategies in mitigating the severity of SARS-CoV-2 infection. While a connection between poor nutritional status and diminished immune responses to vaccination has been noted, comprehensive reviews elucidating this association have been scarce. To address this gap, we conducted a scoping review to characterise the relationship between nutritional status (specifically, body mass index (BMI) or micronutrient deficiencies) and the responses to COVID-19 vaccination, encompassing efficacy, effectiveness, and immunogenicity.<br><br>METHOD: We searched PubMed, OVID-Medline, Scopus, Cochrane Covid Register, LitCovid, and WHO COVID-19 research databases for studies that reported the association between nutritional status and responses to the COVID-19 vaccines (published between December 20, 2019, and December 30, 2023). Two reviewers independently screened the articles, and disagreements were resolved through consensus or by a third reviewer.<br><br>RESULTS: Seventy-three out of 1,853 identified articles were included in this review, predominantly featuring cohort designs (72%). Among these studies, 63% reported BMI, 30% focused on micronutrients (specifically vitamin D, selenium, iron, zinc), and 6% examined both. Most studies (84%) focused on vaccine immunogenicity. The most frequently studied vaccines were BNT162b2 (Pfizer, 74%), ChAdOx (AstraZeneca, 23%), and mRNA-1273 (Moderna, 14%). High BMI significantly reduced COVID-19 vaccine immunogenicity in 23 studies, while adequate vitamin D was associated with increased vaccine response in seven studies.<br><br>CONCLUSION: Overnutrition and micronutrient deficiencies (vitamin D, iron, selenium and zinc) have been observed to attenuate the potency of COVID-19 vaccines. Future strategies aimed at prioritizing vaccination in obese and overweight individuals, or enhancing their vaccine response, may involve identifying measures such as the provision of booster doses. Additionally, efforts should ensure micronutrient adequacy, including improving vitamin D status through strategies like increased sun exposure or supplementation, particularly for deficient individuals.}, }
@article {pmid40660066, year = {2025}, author = {Shaibie, NA and Mohammad Faizal, NDF and Buang, F and Srichana, T and Mohd Amin, MCI}, title = {Inhaled biologics for respiratory diseases: clinical potential and emerging technologies.}, journal = {Drug delivery and translational research}, volume = {15}, number = {11}, pages = {4098-4114}, pmid = {40660066}, issn = {2190-3948}, mesh = {Humans ; Administration, Inhalation ; *Biological Products/administration &amp; dosage/therapeutic use ; *Drug Delivery Systems/methods ; Dry Powder Inhalers ; Nebulizers and Vaporizers ; COVID-19 Drug Treatment ; COVID-19 ; Metered Dose Inhalers ; *Respiratory Tract Diseases/drug therapy ; }, abstract = {The pulmonary route has gained significant attention as a drug delivery method, particularly for managing respiratory diseases. This approach provides several benefits, such as rapid therapeutic action, minimized systemic exposure, improved patient adherence, and the ability to deliver high drug concentrations directly to the lungs. Advances in inhalation devices, including pressurized metered-dose inhalers (pMDIs), dry powder inhalers (DPIs), and nebulizers, have established the pulmonary route as effective for administering both small-molecule drugs and complex biologics. Recent research has showcased the successful use of inhaled biologics such as monoclonal antibodies, nanobodies, and protein-based treatments in conditions like asthma, chronic obstructive pulmonary disease (COPD), pulmonary fibrosis, COVID-19, and respiratory syncytial virus (RSV). These treatments employ innovative mechanisms, such as muco-trapping and immune modulation, to optimize site-specific drug delivery and minimize systemic side effects. As technologies for pulmonary administration continue to evolve, they provide a non-invasive and highly promising platform for enhancing respiratory therapies and broadening the applications of biologics.}, }
@article {pmid40659853, year = {2025}, author = {Maes, M and Almulla, AF and You, Z and Zhang, Y}, title = {Neuroimmune, metabolic and oxidative stress pathways in major depressive disorder.}, journal = {Nature reviews. Neurology}, volume = {21}, number = {9}, pages = {473-489}, pmid = {40659853}, issn = {1759-4766}, mesh = {Humans ; *Oxidative Stress/physiology/immunology ; *Depressive Disorder, Major/immunology/metabolism ; *Neuroimmunomodulation/physiology ; COVID-19/immunology ; Stress, Psychological/immunology/metabolism ; }, abstract = {This Review examines the role of neuroimmune imbalances and their relationship with metabolism and oxidative stress in the development and progression of major depressive disorder (MDD) and suicidal behaviours. We provide a concise overview of the neuroinflammatory environment and indicators of neuronal injury in the central nervous system of individuals with MDD. Furthermore, we explore the evidence for perturbations in both the peripheral and central immune system, T cell activation versus T regulatory cell depletion, intracellular signalling networks including nuclear factor-κB, lipid metabolism and neuroprotection. Last, we examine the mechanisms by which psychological stressors, translocation of Gram-negative bacteria, viral infections such as SARS-CoV-2 and metabolic syndrome can contribute to neuroimmune imbalances and, consequently, the acute phase of MDD.}, }
@article {pmid40659439, year = {2025}, author = {Giltenane, M and Dowling, M}, title = {Nursing and midwifery faculty experience of emergency remote teaching during Covid-19 pandemic: Qualitative evidence synthesis.}, journal = {Journal of professional nursing : official journal of the American Association of Colleges of Nursing}, volume = {59}, number = {}, pages = {88-99}, doi = {10.1016/j.profnurs.2025.04.013}, pmid = {40659439}, issn = {1532-8481}, mesh = {*COVID-19/epidemiology ; Humans ; *Faculty, Nursing/psychology ; *Education, Distance ; *Midwifery/education ; Qualitative Research ; Pandemics ; SARS-CoV-2 ; Education, Nursing, Baccalaureate ; }, abstract = {BACKGROUND: Many universities switched their pedagogical approach to teach remotely during Covid-19 pandemic for the first time, posing many challenges for faculty including technology infrastructure, lack of technical support, a changed teaching environment and more responsibility for supporting students to meet intended learning.<br><br>AIM: To Synthesise nursing and midwifery faculty experiences of online teaching during the Covid-19 pandemic.<br><br>METHOD: A systematic review of qualitative evidence was completed to systematically synthesise nursing and midwifery faculty experiences of online teaching during Covid-19 pandemic.<br><br>RESULTS: Nine qualitative and three mixed-methods studies reporting on the experiences of 248 faculty were included in this 'best fit' framework using Chickering and Gamson's Seven Principles for Good Practice in Undergraduate Education. The importance of face-to-face interaction between faculty and students was highlighted for effective communication and interpersonal relationships. Clinical placement exposure was deemed imperative. Professional development and managerial support are paramount to effectively incorporate the use of online technologies to support nursing and midwifery education.<br><br>CONCLUSIONS: Clinical placement and practical skills training are essential to be delivered in-person. Face-to-face programmes could be enhanced using online components. Professional development and managerial support, together with collaboration among Higher Educational Institutions, Clinical Practice Partners and Regulatory Bodies is imperative for effective blended programmes.}, }
@article {pmid40656803, year = {2024}, author = {Ghimire, R and Kharel, S and Giri, S and Hamilton, AJ}, title = {The Growing Need for Web-Based Simulation in Low- and Middle-Income Countries.}, journal = {JNMA; journal of the Nepal Medical Association}, volume = {62}, number = {279}, pages = {789-795}, pmid = {40656803}, issn = {1815-672X}, mesh = {Humans ; *Simulation Training/methods ; *Developing Countries ; *COVID-19/epidemiology ; *Education, Distance/methods ; *Internet ; *Education, Medical/methods ; SARS-CoV-2 ; Pandemics ; }, abstract = {Simulation education is the bridge between learning clinical medicine in the classroom and delivering it at the bedside. As healthcare simulation has matured over the last two decades, it has begun to evolve many of the same methodologies. Rapid technological advancements across the fields of computer science, bioengineering, and curriculum design have helped to provide healthcare that is delivered more efficiently, effectively, and ethically. Web-based simulation programs (Web-SP) are poised to provide an efficient way to deliver asynchronous training in healthcare professionals' education. Web-SPs could also sponsor specialty-specific, web-based fellowships for clinicians of LMICs. The COVID-19 pandemic provided unique insight into the robustness of web-based learning tools that permitted remote learning opportunities. Under similar circumstances, should they arise again, Web-SPs would be a valuable tool for sustaining medical training under conditions where only remote learning may be feasible. Studies indicate that cost-effective simulation training can be delivered to learners in remote, low-resource areas worldwide, including South Asia, where access to such education is limited. We aimed to explore the effectiveness, challenges, and strategies for implementing web-based simulation education in low- and middle-income countries, based on a thorough PubMed search focused on web-based simulation programs in medical education.}, }
@article {pmid40654120, year = {2025}, author = {Chouksey, G and Choure, R and Singhal, K}, title = {Health-related quality of life after prosthodontic rehabilitation in patients with COVID-19-associated mucormycosis: A systematic review.}, journal = {Journal of Indian Prosthodontic Society}, volume = {25}, number = {1}, pages = {30-39}, pmid = {40654120}, issn = {1998-4057}, mesh = {Humans ; *COVID-19/complications ; *Quality of Life ; *Mucormycosis/rehabilitation ; SARS-CoV-2 ; Patient Satisfaction ; }, abstract = {Health-related quality of life (HRQOL) measures an individual's ability to function optimally in various aspects of life and their subjective sense of well-being across the physical, mental, and social dimensions of health. COVID-19-associated mucormycosis often necessitates aggressive surgical removal of infected tissues and restoration of the defect. Evaluating patient satisfaction and HRQOL following prosthodontic rehabilitation is essential for assessing the effectiveness of interventions on individuals dealing with their condition. This systematic review aimed to evaluate the impact of prosthodontic rehabilitation on the HRQOL of individuals affected by COVID-19-associated mucormycosis. The research strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO 2023CRD42023495778). Comprehensive searches across databases such as PubMed, Cochrane Library, Google Scholar, and Semantic Scholar were done to include studies after the year 2020, written in English language, regardless of geographic location, which presented data on prosthodontic interventions for individuals affected by COVID-19-associated mucormycosis. Independently, the three authors conducted a comprehensive quality assessment of the selected studies using the National Heart Lung and Blood Institute (NHLBI) study quality assessment tool to gauge the risk of bias specifically for before-after (pre-post) studies lacking a control group. A total of 116 records were screened, out of which 109 records were excluded. Eight studies were included in the study. HRQOL assessment after prosthodontic intervention included functional, physical, social, and psychological limitations. Questionnaires that were included in the studies were the Obturator Functioning Scale, Appearance Anxiety Inventory, Patient Health Questionnaire, auditory perception analysis, Oral Health Impact Profile, and the Liverpool Oral Rehabilitation Questionnaire. The HRQOL was reported compositely in 2 out of 8 studies. There was an improvement after prosthodontic rehabilitation in all the studies. HRQOL in patients with COVID-19-associated mucormycosis shows improvement after prosthodontic rehabilitation. Obturators and zygomatic implant-supported prostheses are preferred options for rehabilitation in patients who have undergone maxillectomy due to COVID-19-associated mucormycosis. Prosthodontic rehabilitation has a positive impact on the HRQOL of individuals affected by COVID-19-associated mucormycosis improving their functional, physical, social, and psychological well-being.}, }
@article {pmid40653738, year = {2025}, author = {Li, M and Wan, S and Yao, X and Meng, R and Ji, X}, title = {Study on Cerebral Venous Thrombosis From 2014 to 2023: A Bibliometric Analysis via CiteSpace.}, journal = {Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis}, volume = {31}, number = {}, pages = {10760296251359289}, pmid = {40653738}, issn = {1938-2723}, mesh = {*Bibliometrics ; Humans ; *Venous Thrombosis/epidemiology/therapy/diagnosis ; *COVID-19/epidemiology ; *Intracranial Thrombosis/epidemiology/therapy/diagnosis ; SARS-CoV-2 ; }, abstract = {ObjectiveWe aimed to explore the development status, turning and key points, and emerging trends of the cerebral venous thrombosis (CVT).MethodsLiterature pertaining to CVT published from 2014 to 2023 in the Web of Science Core Collection database was searched. The 6.3.R1 version of CiteSpace software was used to conduct a bibliometric analysis.ResultsA total of 2421 articles were ultimately retained. The annual publication volume exhibited a general trend of gradual growth, culminating in 2022. In terms of both publication volume and citation frequency, the journal "Stroke" emerges as the preeminent publication with high quantity and quality. The United States, China and India have become the foremost contributors while Pakistan and England exhibit a strong international collaboration. Ferro JM from Universidade de Lisboa, Coutinho JM from University of Amsterdam and Ji XM from Capital Medical University from are identified as the leading scholars. Burst analyses of keyword and co-cited references reveal that prior to 2021, the predominant research topics in the field of CVT were epidemiology, diagnosis and management, with increased attention to endovascular therapies and novel imaging modalities. From 2021 to 2023, the focus has shifted primarily to COVID-19 and vaccine-induced immune thrombotic thrombocytopenia (VITT).ConclusionOver the past decade, research on CVT has demonstrated continuous growth. The most influential institutions and scholars were from Europe and China. Our analysis showed that core research priorities in CVT centered on epidemiology, diagnosis and management while the COVID-19 pandemic temporarily shifted focus toward COVID-19 and VITT associated CVT.}, }
@article {pmid40653578, year = {2025}, author = {Dilmen, S and Dilmen, &#x130; and Özbek, H}, title = {A Contemporary Perspective on Spirituality During Pregnancy: A Bibliometric Analysis.}, journal = {Journal of religion and health}, volume = {64}, number = {4}, pages = {2832-2857}, pmid = {40653578}, issn = {1573-6571}, mesh = {Humans ; *Spirituality ; Pregnancy ; Female ; *Bibliometrics ; }, abstract = {Spirituality during pregnancy has increasingly been recognized as a critical factor influencing maternal well-being; however, comprehensive investigations into global research trends in this domain remain limited. This study presents a bibliometric analysis of global literature on spirituality in pregnancy from 2004 to 2024, evaluating scholarly productivity, patterns of collaboration, thematic developments, and impact citation. A systematic bibliometric review was conducted on 528 English-language articles indexed in Scopus, focusing specifically on nursing-related literature concerning "pregnancy and spirituality" and excluding non-academic sources. The analysis encompassed annual publication growth, authorship trends, international collaboration networks, keyword clusters, and citation metrics. Results indicate an average annual growth rate of 11.36% in publications, peaking in 2023 with 67 articles. The United States led both in publication output (387 articles) and citation count (2045), followed by Iran with 277 articles. The United Kingdom emerged as a key center for international collaboration, notably with Ghana and Ethiopia. Thematic clustering revealed four principal research areas: (1) spirituality as a coping mechanism (e.g., religiosity, anxiety), (2) birth and midwifery (e.g., prayer, childbirth), (3) psychological well-being (e.g., resilience, quality of life), and (4) grief and cultural practices (e.g., stillbirth, embodiment). Foundational studies emphasized cultural and religious influences on maternal experiences, whereas recent trends (2021-2024) have highlighted the impact of COVID-19 and the rise of digital spirituality. While the field demonstrates notable growth, disparities persist in geographical representation and citation visibility. Future research should prioritize underrepresented regions, adopt interdisciplinary methodologies, and explore clinical strategies for integrating spiritual care into maternal health services.}, }
@article {pmid40652462, year = {2025}, author = {Landsteiner, I and Pinheiro, JA and Leles Vieira de Souza, B and Setti Frizon, DM and Federighi Baisi Chagas, E and Marques Payão, SL}, title = {Effect of COVID-19 Related Social Isolation on Cognitive Decline in Neurocognitive Disorder Patients: A Systematic Review and Meta-Analysis.}, journal = {Neurology India}, volume = {73}, number = {1}, pages = {10-16}, doi = {10.4103/neurol-india.Neurol-India-D-24-00337}, pmid = {40652462}, issn = {1998-4022}, mesh = {Humans ; *COVID-19/psychology ; *Social Isolation/psychology ; *Cognitive Dysfunction/psychology ; *Dementia/psychology ; Quarantine/psychology ; }, abstract = {The COVID-19 lockdown placed individuals at significant risk of social isolation. Particularly, older people were more vulnerable to the deleterious effects on mental and physical health caused by the COVID-19 pandemic quarantine, in which social confinement was associated with aggravated cognitive function among older adults. Correspondingly, it concerns the repercussions of the lockdown on the cognitive function of patients with dementia or Mild Cognitive Impairment (MCI) during the pandemic. This study aimed to assess the hypothesis that COVID-19 might cause cognitive decline in dementia patients due to social isolation by assessing changes in Mini-Mental State Examination (MMSE) scores between the pre and post-pandemic era. We systematically searched PubMed, Embase, and Cochrane Library for eligible studies from inception to April 2023. We included studies reporting the MMSE in patients with dementia or MCI one year prior to the beginning of the COVID-19 pandemic and one year after the lockdown. Standardized mean differences (SMD) with 95% confidence intervals (CI) were pooled with a random-effects model. Among 4,160 studies, twelve were included, comprising 4,096 patients with dementia or MCI. Patients with dementia exhibited significant MMSE decline compared to pre-pandemic levels (SMD = 0.341, P < 0.001). Similarly, MCI patients demonstrated an MMSE decline during lockdown (SMD = 0.315, P = 0.015). Sub-analyses of dementia types also indicated cognitive decline during lockdown, and a 12-month follow-up revealed an MMSE decline among dementia patients. During the COVID-19 lockdown, there was an overall decline in MMSE scores amongst those with dementia or MCI when compared to pre-pandemic parameters.}, }
@article {pmid40651571, year = {2025}, author = {Tanaka, T and Kakiuchi, S and Fujita, A and Tashiro, M and Izumikawa, K}, title = {Vaccination strategies for transplantation in Japan (solid organ transplantation and hematopoietic stem cell transplantation).}, journal = {Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy}, volume = {31}, number = {9}, pages = {102772}, doi = {10.1016/j.jiac.2025.102772}, pmid = {40651571}, issn = {1437-7780}, mesh = {Humans ; *Hematopoietic Stem Cell Transplantation/adverse effects ; Japan ; *Vaccination/methods ; *Immunocompromised Host/immunology ; *Organ Transplantation/adverse effects ; COVID-19/prevention &amp; control ; SARS-CoV-2/immunology ; *Vaccine-Preventable Diseases/prevention &amp; control ; COVID-19 Vaccines/administration &amp; dosage ; }, abstract = {The management of infectious diseases in immunocompromised patients represents a critical component of managing severe and refractory conditions, with early diagnosis and prompt therapeutic intervention serving as fundamental principles. Vaccine-preventable disease (VPD) management is equally essential. From a health economics perspective, this approach is pivotal in preventing potentially intractable scenarios. This article reviews immunization strategies in adult patients undergoing solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) in Japan, two distinct categories of immunocompromised individuals. Although many recommended vaccines overlap between these groups, the timing and significance of vaccination prophylaxis differ. Patients who undergo SOT remain immunocompromised long-term, whereas those who have received HSCT experience a period of immune reconstitution following the cessation of immunosuppressive therapy. Additionally, numerous recommended vaccinations must be completed within a defined timeframe, and their management is more complex than that for immunocompetent individuals. Recently, several new vaccines, such as those for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), recombinant zoster, pneumococcal (Pneumococcal conjugate vaccine (PCV)15, 20, 21), and Respiratory syncytial virus (RSV), have been introduced. Recommended vaccination guidance varies across countries, combining established and new information, although some updates may not yet be incorporated. This article provides an overview of current vaccination guidance for SOT and HSCT recipients, highlighting country-specific issues in Japan as well as common challenges faced globally, and proposes optimal strategies for future vaccination policies in Japan.}, }
@article {pmid40651487, year = {2025}, author = {Flamant, A and Demirjian, A and Lamagni, T and Toubiana, J and Smeesters, PR and Cohen, JF}, title = {Invasive group A streptococcal infections: lessons learned from the 2022-23 upsurge.}, journal = {The Lancet. Infectious diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/S1473-3099(25)00343-3}, pmid = {40651487}, issn = {1474-4457}, abstract = {During the late phase of the COVID-19 pandemic, several high-income countries reported a surge in invasive group A streptococcal (iGAS) infections, with notable paediatric morbidity and mortality. This Review explores three potential drivers of this increase: the role of the COVID-19 pandemic and associated non-pharmaceutical interventions on group A streptococcus (GAS) circulation; the potential burden associated with other respiratory viruses such as influenza and respiratory syncytial virus; and the potential role of hypervirulent GAS clones and lineages. The resurgence of iGAS disease highlights the need for enhanced surveillance of both invasive and non-invasive GAS infections, as well as further research to clarify the role of immunity, viral interactions, and bacterial molecular epidemiology and its evolution. A comprehensive understanding of these dynamics is essential to inform future public health strategies aimed at mitigating the burden of iGAS disease.}, }
@article {pmid40651127, year = {2025}, author = {Okuhara, T and Okada, H and Yokota, R and Kiuchi, T}, title = {Effectiveness and determinants of narrative-based corrections for health misinformation: A systematic review.}, journal = {Patient education and counseling}, volume = {139}, number = {}, pages = {109253}, doi = {10.1016/j.pec.2025.109253}, pmid = {40651127}, issn = {1873-5134}, mesh = {Humans ; *Communication ; COVID-19 ; *Health Communication/methods ; *Narration ; Social Media ; }, abstract = {OBJECTIVE: This systematic review aimed to evaluate the effectiveness of narrative-based interventions in correcting health-related misinformation and to identify key message-related, sender-related, and recipient-related factors influencing their success.<br><br>METHODS: A comprehensive literature search was conducted in databases including PubMed, CINAHL, PsycINFO, Academic Search Complete, Communication Abstracts, and Web of Science. Eligible studies included quantitative intervention studies examining the impact of narrative-based corrections on health-related misinformation.<br><br>RESULTS: Twenty studies covering topics such as COVID-19, vaccination, tobacco use, and e-cigarette use were included. Among the 16 studies comparing narrative and nonnarrative corrections, only four showed that narratives were significantly more effective in reducing misinformation-related beliefs than other message types. Several factors influenced narrative effectiveness. Message-related factors include emotional language, social framing, and message sidedness. Sender-related factors, such as the credibility of the source and relational closeness with recipients, also affected outcomes. Recipient-related factors, including cognitive style, political ideology, and social media use motivation, moderated the intervention effects. Some studies have reported unintended backfire effects in which narratives reinforce misinformation.<br><br>CONCLUSION: Narrative-based corrections show the potential for addressing health-related misinformation; however, their effectiveness remains inconsistent. The variability in narrative design, media platforms, and insufficient theoretical grounding may explain these mixed results. Future research should focus on theoretically informed narratives and systematically examine the influencing factors to optimize misinformation correction strategies.<br><br>PRACTICAL IMPLICATIONS: The effectiveness of narrative-based corrections on health misinformation depends on thoughtful design grounded in theoretical principles such as transportation, identification, and exemplification. Health communicators should consider narrative length, depth, and emotional content and adapt messages to different platforms (e.g., social media). Tailoring interventions to audience characteristics, such as cognitive styles and prior beliefs, can further enhance efforts to correct misinformation.}, }
@article {pmid40650616, year = {2025}, author = {Lee, H and Mahmoudi, H and Chang, D and Jalali, MS}, title = {Review of human behavior integration in COVID-19 modeling studies.}, journal = {Journal of public health (Oxford, England)}, volume = {47}, number = {4}, pages = {e568-e576}, doi = {10.1093/pubmed/fdaf082}, pmid = {40650616}, issn = {1741-3850}, support = {//U.S. National Science Foundation/ ; 2229819//Division of Mathematical Sciences and Division of Social and Economic Sciences/ ; }, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; SARS-CoV-2 ; Pandemics ; *Epidemiological Models ; }, abstract = {BACKGROUND: Human behavior influences the spread of infectious diseases, making it essential to integrate behavioral processes into epidemiological models. This became particularly evident during the COVID-19 pandemic, as many models did not incorporate behavior in response to policies.<br><br>METHODS: We reviewed modeling analyses of population dynamics in response to interventions intended to mitigate the spread of COVID-19 from February 2020 to February 2023. Key characteristics of each study were extracted, including the behavioral aspects integrated within the models and utilized databases.<br><br>RESULTS: We analyzed 276 COVID-19 modeling studies. Among them, only 38% attempted to incorporate human behavior. Even within this subset, behavioral integration was typically narrow, often limited to a single factor like compliance or mobility. We synthesized the identified behavioral factors into six categories. The majority (92%) of these studies employed a mechanistic modeling approach. Furthermore, only 34% of these studies used a database to model behavior.<br><br>CONCLUSIONS: Our review highlights a substantial gap in the incorporation of behavioral components into COVID-19 modeling studies. Limited models rely on databases, potentially compromising accuracy in reflecting the dynamic nature of human behavior. Our findings emphasize the necessity for future models to engage more deeply with behavioral sciences to enhance epidemiological modeling.}, }
@article {pmid40650276, year = {2025}, author = {Alvarado-Hernández, DL and Noyola, MV and Martínez-Rider, R and Bernal-Silva, S and Comas-Garcia, A}, title = {NK Cells: A Powerful Squad Versus SARS-CoV-2.}, journal = {International journal of molecular sciences}, volume = {26}, number = {13}, pages = {}, pmid = {40650276}, issn = {1422-0067}, mesh = {Humans ; *Killer Cells, Natural/immunology ; *COVID-19/immunology/virology/pathology ; *SARS-CoV-2/immunology ; Immunity, Innate ; Animals ; }, abstract = {The function of NK cells in cancer and viral infections is well documented and understood. NK cell activity, including cytokine secretion, cytotoxic activity, and the coordination of inhibitory and activating receptors, linking innate and adaptive immunity, among others, has been examined for numerous pathogens, including parasites, bacteria, and viruses. The emergence of the SARS-CoV-2 health crisis has exposed a deficiency in understanding the previously elucidated mechanisms; the rationale for the reported variability in symptomatology among COVID-19 patients is extensive and intricate. It is evident that NK cells exert a significant influence on symptom severity, and their absence, with the presence or absence of their surface receptors, elicits a tailored response to the virus. This overview examines the impact of NK cells on the progression of several viral diseases, emphasizing their involvement in the pathogenesis of SARS-CoV-2 via the activation of surface receptors.}, }
@article {pmid40650158, year = {2025}, author = {Capotă, R and Ciaușu-Sliwa, D and Bostănaru-Iliescu, AC and Năstasă, V and Mareș, M}, title = {Latest Findings in Immunoglobulin Y Technologies and Applications.}, journal = {International journal of molecular sciences}, volume = {26}, number = {13}, pages = {}, pmid = {40650158}, issn = {1422-0067}, mesh = {*Immunoglobulins/therapeutic use/immunology/isolation &amp; purification ; Animals ; Humans ; COVID-19/immunology/prevention &amp; control/therapy ; SARS-CoV-2/immunology ; }, abstract = {Immunoglobulin Y (IgY), the major antibody class in birds, has gained increasing attention in recent years as a versatile and ethically sustainable alternative to mammalian immunoglobulins. IgY has demonstrated strong potential in diagnostics, prophylaxis, and therapy across a wide range of fields, including infectious diseases, allergy management, oral health, and food safety. Its applications in animal health-particularly in poultry, livestock, and companion animals-further underscore its relevance within the One Health framework. This review provides a comprehensive synthesis of IgY technology, starting with its physiological role in maternal immunity and the structural characteristics that distinguish it from mammalian immunoglobulin G (IgG). This review outlines current strategies for IgY production and purification. It also provides an overview of its biomedical and veterinary applications, including its use in diagnostics, prevention, and treatment-such as for SARS-CoV-2-primarily based on studies published in the past five years. The final section addresses the current limitations of IgY technology, such as variability in protocols, stability challenges, and the need for safety assessment, while highlighting the importance of harmonized guidelines to support broader implementation. With growing scientific interest, expanding clinical research, and increasing availability of commercial products, IgY is well positioned to become a valuable immunobiological tool for both human and veterinary applications.}, }
@article {pmid40649991, year = {2025}, author = {Hein, ZM and Thazin,  and Kumar, S and Che Ramli, MD and Che Mohd Nassir, CMN}, title = {Immunomodulatory Mechanisms Underlying Neurological Manifestations in Long COVID: Implications for Immune-Mediated Neurodegeneration.}, journal = {International journal of molecular sciences}, volume = {26}, number = {13}, pages = {}, pmid = {40649991}, issn = {1422-0067}, mesh = {Humans ; *COVID-19/immunology/complications ; SARS-CoV-2/immunology ; *Neurodegenerative Diseases/immunology/etiology ; Blood-Brain Barrier/immunology ; Biomarkers ; Post-Acute COVID-19 Syndrome ; *Immunomodulation ; }, abstract = {The COVID-19 pandemic has revealed the profound and lasting impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the nervous system. Beyond acute infection, SARS-CoV-2 acts as a potent immunomodulatory agent, disrupting immune homeostasis and contributing to persistent inflammation, autoimmunity, and neurodegeneration. Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is characterized by a spectrum of neurological symptoms, including cognitive dysfunction, fatigue, neuropathy, and mood disturbances. These are linked to immune dysregulation involving cytokine imbalance, blood-brain barrier (BBB) disruption, glial activation, and T-cell exhaustion. Key biomarkers such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NFL) correlate with disease severity and chronicity. This narrative review examines the immunopathological mechanisms underpinning the neurological sequelae of long COVID, focusing on neuroinflammation, endothelial dysfunction, and molecular mimicry. We also assess the role of viral variants in shaping neuroimmune outcomes and explore emerging diagnostic and therapeutic strategies, including biomarker-guided and immune-targeted interventions. By delineating how SARS-CoV-2 reshapes neuroimmune interactions, this review aims to support the development of precision-based diagnostics and targeted therapies for long COVID-related neurological dysfunction. Emerging approaches include immune-modulatory agents (e.g., anti-IL-6), neuroprotective drugs, and strategies for repurposing antiviral or anti-inflammatory compounds in neuro-COVID. Given the high prevalence of comorbidities, personalized therapies guided by biomarkers and patient-specific immune profiles may be essential. Advancements in vaccine technologies and targeted biologics may also hold promise for prevention and disease modification. Finally, continued interdisciplinary research is needed to clarify the complex virus-immune-brain axis in long COVID and inform effective clinical management.}, }
@article {pmid40649892, year = {2025}, author = {Aklilu, A and Lai, MS and Jiang, Z and Yip, SP and Huang, CL}, title = {Immunothrombosis in Sepsis: Cellular Crosstalk, Molecular Triggers, and Therapeutic Opportunities-A Review.}, journal = {International journal of molecular sciences}, volume = {26}, number = {13}, pages = {}, pmid = {40649892}, issn = {1422-0067}, support = {COVID1903007 - Theme B//Health and Medical Research Fund Commissioned Research on COVID-19/ ; }, mesh = {Humans ; *Sepsis/immunology/complications/pathology/therapy ; Animals ; Blood Platelets/immunology/metabolism ; Signal Transduction ; Immunity, Innate ; *Thromboinflammation/immunology ; Blood Coagulation ; Neutrophils/immunology/metabolism ; Disseminated Intravascular Coagulation/immunology ; *Thrombosis/immunology ; }, abstract = {Sepsis remains a critical global health challenge characterized by life-threatening organ dysfunction arising from a dysregulated host response to infection. Immunothrombosis refers to the intersection of immune activation and coagulation pathways, particularly relevant in the context of sepsis. A growing body of evidence identifies immunothrombosis, a tightly interwoven process between innate immunity and coagulation. While immunothrombosis serves as a host defense mechanism under physiological conditions, its aberrant activation in sepsis precipitates microvascular thrombosis, organ ischemia, and progression toward disseminated intravascular coagulation (DIC). This review provides a comprehensive overview of the cellular contributors to immunothrombosis, including neutrophils, monocytes, platelets, and endothelial cells, and elucidates the signaling cascades, such as nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), and inflammasome activation, that govern their interplay. We further highlight emerging molecular mediators, including extracellular traps, tissue factor expression, and cytokine amplification loops, that collectively promote pathological thromboinflammation. A deeper understanding of these interconnected pathways offers critical insights into the pathogenesis of sepsis and unveils potential targets for timely intervention. Ultimately, this review aims to bridge immunological and hematological perspectives to inform the development of novel therapeutic strategies against sepsis-induced coagulopathy.}, }
@article {pmid40649397, year = {2025}, author = {Brahmi, F and Mackrill, JJ and Ghzaiel, I and Rezig, L and Benkhalifa, R and Zarrouk, A and Jouanny, P and Vejux, A and Lizard, G}, title = {Oxysterol-Induced Inflammation in Human Diseases: Strategies for Treatment with Natural Compounds and Synthetic Molecules.}, journal = {Molecules (Basel, Switzerland)}, volume = {30}, number = {13}, pages = {}, pmid = {40649397}, issn = {1420-3049}, mesh = {Humans ; *Oxysterols/metabolism/adverse effects ; *Inflammation/drug therapy/metabolism/chemically induced ; *Biological Products/therapeutic use/pharmacology ; Anti-Inflammatory Agents/therapeutic use/pharmacology ; Animals ; Hydroxycholesterols ; }, abstract = {Oxysterols can be derived from the diet, physiologically produced via specific enzymes, or are generated by autoxidation. These molecules have physiological properties and can also adversely affect vital organs. Indeed, some of them have pro-oxidant and pro-inflammatory activities and can lead to major pathologies. The present review focuses on oxysterols (7-ketocholesterol, 7β-hydroxycholesterol, 25-hydroxycholesterol, 27-hydroxycholesterol, 5,6α-epoxycholesterol, 5,6β-epoxycholesterol, and cholestane-3β, 5α, 6β-triol) involved either in cholesterol metabolism, age-related diseases (such as cardiovascular, neurodegenerative, and eye diseases, e.g., sarcopenia), and inflammatory diseases (especially Behcet's disease and bowel and lung diseases (e.g., sarcoidosis, COVID-19)). Metabolic pathways associated with oxysterol-induced inflammation are discussed considering the cytokinic TLR4 pathway, non-cytokinic pathways, and the contribution of Ca[2+] and K[+] channels. Therapeutic approaches targeting oxysterol-induced inflammation either by natural or synthetic molecules are also presented.}, }
@article {pmid40648935, year = {2025}, author = {Abumayyaleh, M and Schupp, T and Behnes, M and El-Battrawy, I and Hamdani, N and Akin, I}, title = {COVID-19 and Myocarditis: Trends, Clinical Characteristics, and Future Directions.}, journal = {Journal of clinical medicine}, volume = {14}, number = {13}, pages = {}, pmid = {40648935}, issn = {2077-0383}, abstract = {COVID-19, caused by SARS-CoV-2, has been associated with a range of cardiovascular complications, including myocarditis. This review aims to systematically present the clinical manifestations, underlying pathophysiological mechanisms, diagnostic approaches, and management strategies for both COVID-19-associated myocarditis and myocarditis related to SARS-CoV-2 vaccination. We conducted a literature search using the PubMed database, covering studies published up to early 2024. Search terms included combinations of "COVID-19", "Coronavirus", "SARS-CoV-2", and/or "vaccination" with "cardiac injury", "cardiac inflammation", "myocarditis". The reported prevalence of COVID-19-associated myocarditis varies between 2.3% and 5.0%, though myocardial injury is more frequently observed than confirmed myocarditis. Pathophysiological mechanisms include direct viral damage, immune-mediated injury, and molecular mimicry. Clinically, patients may present with chest pain, dyspnea, and fever. Diagnostic workup includes electrocardiography (ECG), troponin measurement, echocardiography, cardiac magnetic resonance imaging (cMRI), and in selected cases, endomyocardial biopsy (EMB). The management and disposition of COVID-19-associated myocarditis varies according to severity, especially to allow targeted treatment of complications. Glucocorticoids are a mainstay of treatment in severe cases. Myocarditis following SARS-CoV-2 vaccination is rare, more frequently reported in males under 30 years, and is generally associated with a favorable prognosis. Despite this, the benefits of vaccination continue to outweigh the risks. COVID-19 is associated with an increased risk of heart failure and other cardiovascular complications, underlining the importance of long-term follow-up and preventive strategies. Further research is needed to better understand the pathogenesis and optimal management of myocarditis in the context of COVID-19, with the goal of developing evidence-based therapeutic algorithms.}, }
@article {pmid40648597, year = {2025}, author = {Sakaretsanou, AK and Bakola, M and Chatzeli, T and Charalambous, G and Jelastopulu, E}, title = {Mental Health Impacts of the COVID-19 Pandemic on College Students: A Literature Review with Emphasis on Vulnerable and Minority Populations.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {13}, pages = {}, pmid = {40648597}, issn = {2227-9032}, abstract = {The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic's impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises.}, }
@article {pmid40648560, year = {2025}, author = {Kalok, A and Kamisan Atan, I and Sharip, S and Safian, N and Shah, SA}, title = {Psychosocial Determinants of Childbirth Fear Among Asian Women: A Scoping Review.}, journal = {Healthcare (Basel, Switzerland)}, volume = {13}, number = {13}, pages = {}, pmid = {40648560}, issn = {2227-9032}, support = {FF-2023-316//Faculty of Medicine, Universiti Kebangsaan Malaysia/ ; }, abstract = {Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth.}, }
@article {pmid40647079, year = {2025}, author = {Wimalawansa, SJ}, title = {Reforming Food, Drug, and Nutraceutical Regulations to Improve Public Health and Reduce Healthcare Costs.}, journal = {Foods (Basel, Switzerland)}, volume = {14}, number = {13}, pages = {}, pmid = {40647079}, issn = {2304-8158}, abstract = {Neglecting preventive healthcare policies has contributed to the global surge in chronic diseases, increased hospitalizations, declining quality of care, and escalating costs. Non-communicable diseases (NCDs)-notably cardiovascular conditions, diabetes, and cancer-consume over 80% of healthcare expenditure and account for more than 60% of global deaths, which are projected to exceed 75% by 2030. Poor diets, sedentary lifestyles, regulatory loopholes, and underfunded public health initiatives are driving this crisis. Compounding the issue are flawed policies, congressional lobbying, and conflicts of interest that prioritize costly, hospital-based, symptom-driven care over identifying and treating to eliminate root causes and disease prevention. Regulatory agencies are failing to deliver their intended functions. For instance, the U.S. Food and Drug Administration's (FDA) broad oversight across drugs, devices, food, and supplements has resulted in inefficiencies, reduced transparency, and public safety risks. This broad mandate has allowed the release of unsafe drugs, food additives, and supplements, contributing to the rising childhood diseases, the burden of chronic illness, and over-medicalization. The author proposes separating oversight responsibilities: transferring authority over food, supplements, and OTC products to a new Food and Nutraceutical Agency (FNA), allowing the FDA to be restructured as the Drug and Device Agency (DDA), to refocus on pharmaceuticals and medical devices. While complete reform requires Congressional action, interim policy shifts are urgently needed to improve public health. Broader structural changes-including overhauling the Affordable Care Act, eliminating waste and fraud, redesigning regulatory and insurance systems, and eliminating intermediaries are essential to reducing costs, improving care, and transforming national and global health outcomes. The information provided herein can serve as a White Paper to help reform health agencies and healthcare systems for greater efficiency and lower costs in the USA and globally.}, }
@article {pmid40646438, year = {2025}, author = {Valkanas, H and McFadden, K and Mignacca, I and Qi, X and Jordan, M and Bayoumi, I and Li, P}, title = {Impact of the COVID-19 era on preventative primary care for children 0-5 years old: a scoping review.}, journal = {BMC primary care}, volume = {26}, number = {1}, pages = {221}, pmid = {40646438}, issn = {2731-4553}, support = {#6035080/CAPMC/CIHR/Canada ; #6035080/CAPMC/CIHR/Canada ; #6035080/CAPMC/CIHR/Canada ; #6035080/CAPMC/CIHR/Canada ; #6035080/CAPMC/CIHR/Canada ; }, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; Infant ; Child, Preschool ; *Primary Health Care/statistics &amp; numerical data ; Infant, Newborn ; SARS-CoV-2 ; Developmental Disabilities ; }, abstract = {BACKGROUND: Restrictions to routine preventative primary care well child visits (WCV) during COVID-19 may have affected a variety of outcomes for young children including growth, development, and the identification and management of developmental delays. To better understand the effect of the pandemic on these outcomes, we conducted a scoping review of studies published between March 2020 and April 2024. The objectives of this scoping review were to determine the impact of the COVID-19 era on WCV attendance and developmental outcomes in children 0-5 years old.<br><br>RESULTS: 23 articles met inclusion criteria. Most studies were conducted in the U.S. The overall COVID-19 era WCV rate was lower compared to pre-COVID visit rates. Higher rates of missed WCVs and reduced access were reported for racialized children and those from families with lower socioeconomic status. Studies measuring developmental outcomes found associations between children born during the pandemic and increased rates of expressive language delays, decreased personal-social skills, increased delays in achieving verbal, motor, and overall cognitive performance milestones, increased externalizing behaviours, and decreased prosocial behaviour. No study examined the impact of WCV attendance rates on developmental outcomes.<br><br>CONCLUSIONS: During the COVID-19 pandemic, infants, toddlers, and young children attended fewer preventative primary care visits and pandemic-born children were more likely to show signs of developmental delay. This review highlights the need for further research to better understand the longitudinal impact of reduced access to preventative primary care and child health outcomes, including the early detection of, and referral for, developmental delays.}, }
@article {pmid40645979, year = {2025}, author = {Ryu, JO and Seong, YJ and Lee, E and Lee, SY and Lee, DW}, title = {Applications and research trends in organoid based infectious disease models.}, journal = {Scientific reports}, volume = {15}, number = {1}, pages = {25185}, pmid = {40645979}, issn = {2045-2322}, support = {RS-2024-00453887//Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Education/ ; RS-2023-00212410//the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT)/ ; RS-2024-00332142//ministry of food and drug safety/ ; RS-2023-00222910//the Bio &amp; Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT)/ ; }, mesh = {*Organoids/virology/pathology/cytology ; Humans ; *COVID-19/virology/pathology ; SARS-CoV-2 ; *Models, Biological ; Animals ; *Communicable Diseases ; Induced Pluripotent Stem Cells/cytology ; }, abstract = {Recently, three-dimensional (3D) cell culture technology has been developing rapidly, and disease-specific organoid models that can simulate human diseases are being developed. These models are being studied as a valuable tool that can be applied to pathogen biology research and drug screening analysis platforms to obtain fast, reliable, and reproducible results. Organoids are 3D cell aggregates formed from embryonic stem cells (ESCs), adult stem cells (ASCs), or induced pluripotent stem cells (iPSCs) through self-renewal and self-organization. They are also called mini-organs and have a structure and function similar to those of real organs, providing a more physiologically relevant model compared to traditional 2D cultures. In particular, due to the recent epidemics of infectious diseases such as coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many studies are using organoids for infectious disease research, enabling more accurate pathogen-host interaction modeling. In this review, we briefly introduce organoids and discuss research trends in developing organoid-based models of infectious diseases, focusing on organoids derived from the brain, liver, intestines, lung, kidney, skin, and blood vessels. These models hold significant potential for advancing our understanding of disease mechanisms and therapeutic development.}, }
@article {pmid40645921, year = {2025}, author = {Gurley, ES and Plowright, RK}, title = {A Roadmap of Primary Pandemic Prevention Through Spillover Investigation.}, journal = {Emerging infectious diseases}, volume = {31}, number = {8}, pages = {1501-1506}, pmid = {40645921}, issn = {1080-6059}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; *Pandemics/prevention &amp; control ; SARS-CoV-2 ; Animals ; *Henipavirus Infections/prevention &amp; control/epidemiology/transmission ; *Primary Prevention/methods ; Nipah Virus ; }, abstract = {Since the COVID-19 pandemic, attention and investment in pandemic preparedness have increased. Although there are many valiant plans around pandemic preparedness, they typically involve slowing the spread or mitigating the effects of a pathogen after it has already entered the human population. The task of stopping the pathogen from entering the human population in the first place, spillover prevention, remains a neglected area in discussions and planning for pandemic risk mitigation. Every spillover offers an opportunity to learn about an emerging public health threat and the conditions that aligned to enable spillover occurrence. In this article, we outline One Health approaches for use in spillover investigations, drawing from our experience investigating Hendra and Nipah virus spillovers. We present a roadmap for how findings from those investigations can lead to the development of interventions for spillover and ultimately pandemic prevention.}, }
@article {pmid40644863, year = {2025}, author = {Chen, X and Shao, M and Liu, Y and Zhou, J and Cao, F and Liu, Y and Qiu, G and Jiang, T and Huang, M and Zhang, L}, title = {Role of the renin-angiotensin-aldosterone system in sepsis and its therapeutic targets.}, journal = {International immunopharmacology}, volume = {162}, number = {}, pages = {115192}, doi = {10.1016/j.intimp.2025.115192}, pmid = {40644863}, issn = {1878-1705}, mesh = {Humans ; *Renin-Angiotensin System/drug effects ; *Sepsis/drug therapy/metabolism/immunology ; Animals ; }, abstract = {An imbalance in the host's response to infection causes sepsis, a potentially fatal condition. Sepsis may advance to septic shock, organ dysfunction (including the brain, liver, lung, kidney, and heart), skeletal muscle atrophy, and an array of severe complications. The renin-angiotensin-aldosterone system (RAAS) undergoes significant alterations during sepsis, and the expression of its principal bioactive components is closely associated with the prognosis of patients with sepsis. Targeting RAAS may offer an effective approach to managing sepsis and its complications. Consequently, this review primarily summarizes the impact of sepsis on the activity and expression of key RAAS components in the circulation and tissues. We also discuss the effects and mechanisms of selectively modulating the RAAS in the context of sepsis and its associated complications. Furthermore, we introduce innovative perspectives on the precise regulation of the RAAS with the aim of optimizing treatment strategies tailored to different stages of sepsis and diverse complications.}, }
@article {pmid40643565, year = {2025}, author = {Jeeves, SP and Kotwa, JD and Pearl, DL and Pickering, BS and Bowman, J and Mubareka, S and Jardine, CM}, title = {Coronaviruses in wild rodent and eulipotyphlan small mammals: a review of diversity, ecological implications and surveillance considerations.}, journal = {The Journal of general virology}, volume = {106}, number = {7}, pages = {}, pmid = {40643565}, issn = {1465-2099}, mesh = {Animals ; *Coronavirus/genetics/classification/isolation &amp; purification ; *Coronavirus Infections/virology/veterinary/epidemiology/transmission ; *Rodentia/virology ; Humans ; Host Specificity ; Phylogeny ; Animals, Wild/virology ; Chiroptera/virology ; *Mammals/virology ; }, abstract = {Coronaviruses are abundant and diverse RNA viruses with broad vertebrate host ranges. These viruses include agents of human seasonal respiratory illness, such as human coronaviruses OC43 and HKU1; important pathogens of livestock and domestic animals such as swine acute diarrhoea syndrome coronavirus and feline coronavirus; and human pathogens of epidemic potential such as SARS-CoV, MERS-CoV and SARS-CoV-2. Most coronavirus surveillance has been conducted in bat species. However, small terrestrial mammals such as rodents and eulipotyphlans are important hosts of coronaviruses as well. Although fewer studies of rodent and eulipotyphlan coronaviruses exist compared to those of bats, notable diversity of coronaviruses has been reported in the former. No literature synthesis for this area of research has been completed despite (a) growing evidence for a small mammal origin of certain human coronaviruses and (b) global abundance of small mammal species. In this review, we present an overview of the current state of coronavirus research in wild terrestrial small mammals. We conducted a literature search for studies that investigated coronaviruses infecting rodent and eulipotyphlan hosts, which returned 63 studies published up to and including 2024. We describe trends in coronavirus diversity and surveillance for these studies. To further the examination of the interrelatedness of these viruses, we conducted a phylogenetic analysis of coronavirus whole genomes recovered from rodent and eulipotyphlan hosts. We discuss important facets of terrestrial small mammal coronaviruses, including evolutionary aspects and zoonotic spillover risk. Lastly, we present important recommendations and considerations for further surveillance and viral characterization efforts in this field.}, }
@article {pmid40643301, year = {2025}, author = {Beka, SG and Griffiths, RF and Myers, JA and Skirrow, PM}, title = {Appropriate Screening Tests to Assess Post-COVID-19 Cognitive Dysfunction in Aeromedical Settings.}, journal = {Aerospace medicine and human performance}, volume = {96}, number = {5}, pages = {414-424}, doi = {10.3357/AMHP.6500.2025}, pmid = {40643301}, issn = {2375-6322}, mesh = {Humans ; *COVID-19/complications/psychology ; *Cognitive Dysfunction/diagnosis/etiology ; *Pilots/psychology ; *Aerospace Medicine ; *Neuropsychological Tests ; SARS-CoV-2 ; Mass Screening ; }, abstract = {INTRODUCTION: Post-COVID-19, 10-20% of individuals may experience long-term symptoms (some having cognitive deficits), even after mild or nonsymptomatic infection. A sufficiently sensitive screening test of cognitive function, based on the typical cognitive effects of COVID-19 and skills considered most relevant to pilot performance, would be highly beneficial to be used alongside other performance checks. This study aimed to identify appropriate screening tests for post-COVID-19 cognitive dysfunction.<br><br>METHODS: Initially, a systematic search and narrative review identified 13 screening tools that are likely to be effective in screening pilots for post-COVID-19 neurocognitive impairment. Following a more in-depth evaluation of the identified tools, five tests including the Trail Making Test, Symbol Digit Modalities Test, Stroop Color Word Test, Psychomotor Vigilance Test, and Paced Auditory Serial Addition Test were chosen for a Delphi evaluation exercise. A two-round modified Delphi process was undertaken with international aviation medicine and psychology experts to obtain a consensus on which of the identified tests would be appropriate to screen for cognitive dysfunction in pilots.<br><br>RESULTS: Based on evaluation of literature review findings and Delphi consultation with subject matter experts, the Trail Making Test and Symbol Digit Modalities Test were identified as quick and suitable screening tests likely to detect post-COVID-19 cognitive dysfunction.<br><br>DISCUSSION: These tools are objective, have good utility, are available in multiple versions, and assess cognitive abilities relevant to pilot performance. Their use for screening in aeromedical examinations would be further supported by confirming their ability to reliably detect neurocognitive impacts associated with COVID-19. Beka SG, Griffiths RF, Myers JA, Skirrow PM. Appropriate screening tests to assess post-COVID-19 cognitive dysfunction in aeromedical settings. Aerosp Med Hum Perform. 2025; 96(5):414-424.}, }
@article {pmid40642339, year = {2025}, author = {Rahimian, A and Askari, H and Nabati, A and Aminian, M}, title = {A Roadmap for the Application of Convalescent Plasma and Hyperimmune Globulins in Emerging Viral Outbreaks.}, journal = {TheScientificWorldJournal}, volume = {2025}, number = {}, pages = {9976167}, pmid = {40642339}, issn = {1537-744X}, mesh = {Humans ; *COVID-19/therapy/epidemiology ; COVID-19 Serotherapy ; *Immunization, Passive/methods ; SARS-CoV-2 ; *Disease Outbreaks/prevention &amp; control ; }, abstract = {The outbreak of COVID-19 took the world by surprise and dealt a serious blow to the global economy. Even today, few drugs against SARS-CoV-2 infection have been proven useful, and repurposing existing antiviral therapies remains a major research area in the treatment of the disease. During previous viral outbreaks, therapies using convalescent plasma and related products have repeatedly been used as empirical approaches. Rapid preparation of convalescent plasma and hyperimmune globulins (hIVIGs) makes these two treatment options useful in dealing with outbreaks of emerging diseases. The current study presents a systematic roadmap concerning the guidelines, criteria, and regulations involved in plasma transfusion and the preparation of hIVIGs applicable to possible future viral outbreaks.}, }
@article {pmid40642279, year = {2025}, author = {Momeni Moghaddam, A and Rastkar, M and Soltanzadi, A and Vaheb, S and Ghajarzadeh, M}, title = {Incidence of multiple sclerosis (MS) relapse after COVID-19 infection: A systematic review and meta-analysis.}, journal = {Caspian journal of internal medicine}, volume = {16}, number = {2}, pages = {192-197}, pmid = {40642279}, issn = {2008-6164}, abstract = {BACKGROUND: COVID-19 could exacerbate the symptoms of autoimmune diseases such as multiple sclerosis (MS). Literature shows an increase in the incidence of relapse in patients with MS after COVID-19. We designed this systematic review and meta-analysis to estimate the pooled incidence of MS-relapse after COVID-19.<br><br>METHODS: We performed a systematic search in PubMed, Scopus, EMBASE, Web of Science, and Google scholar. Gray literature including references of the references and conference abstracts were also searched to find relevant articles. We extracted data regarding the total number of participants, the name of the first author, publication year, country of origin, mean age, mean disease duration, mean Expanded Disability Status Scale&#xa0;(EDSS), and the number of patients with relapse after COVID.<br><br>RESULTS: A literature search revealed 5160 articles, after deleting duplicates, 2270 remained. After careful evaluation of the full texts, twelve studies were included for meta-analysis. Totally, 1595 patients with MS who had a history of COVID-19 were evaluated. Most studies were done in Iran. The mean age of included patients ranged between 35 and 49 years, and mean durations of the disease were between 7and 15.4 years. The incidence of relapse ranged between 2% and 20% in included studies.The pooled incidence of relapse after COVID-19 was 7% (95%CI:5-10%) (I2=64%, p<0.001).<br><br>CONCLUSIONS: The results of this systematic review and meta-analysis show that the pooled incidence of MS-related relapse after COVID-19 is 7%.}, }
@article {pmid40642209, year = {2025}, author = {Zhang, M and Hu, X and Wu, H and Fan, H}, title = {Narcolepsy: a machine learning bibliometric analysis (1996-2024).}, journal = {Frontiers in neurology}, volume = {16}, number = {}, pages = {1505574}, pmid = {40642209}, issn = {1664-2295}, abstract = {BACKGROUND: Narcolepsy is a rare neurological cause of chronic sleepiness. This study aimed to better understand global narcolepsy through bibliometric analysis.<br><br>METHODS: Articles and reviews on narcolepsy were sourced from the Web of Science Core Collection. A bibliometric analysis was performed using Microsoft Excel, Python, CiteSpace, VOSviewer, R (bibliometrix), and the Online Analysis Platform of Literature Metrology to assess publication outputs, countries, institutions, authors, journals, co-cited references, and keywords.<br><br>RESULTS: The analysis included 5,215 publications, with citations significantly increasing from 1996 to 2024. The USA led in publications, while the top institutions were Stanford University, INSERM, and Universit&#xe9; de Montpellier. Key authors like Professors Plazzi G, Mignot E, and Dauvilliers Y greatly contributed to the field through numerous publications and high citation rates. Sleep published the most articles, followed by Sleep Medicine. Keyword analysis indicated a shift toward molecular mechanisms, comorbidities, and diagnosis. Recent interest has surged in medications for excessive daytime sleepiness, such as "Pitolisant", "Modafinil" and "Sodium Oxybate" along with the relationship between narcolepsy and COVID-19.<br><br>CONCLUSION: "Pitolisant," "Modafinil," and "Sodium Oxybate" have gained prominence in narcolepsy treatment. This study also highlights common comorbidities linked to narcolepsy, including "obstructive sleep apnea", "epilepsy" and "atrial fibrillation" driving researchers to explore these conditions to improve the quality of life for affected individuals. However, the interactions between key neurotransmitters in narcolepsy are still unclear, and challenges remain regarding factors that complicate drug therapy efficacy, necessitating further investigation.}, }
@article {pmid40642004, year = {2025}, author = {Wang, F and Ge, R and Cai, Y and Zhao, M and Fang, Z and Li, J and Xie, C and Wang, M and Li, W and Wang, X}, title = {Oxidative stress in ARDS: mechanisms and therapeutic potential.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1603287}, pmid = {40642004}, issn = {1663-9812}, abstract = {Acute respiratory distress syndrome (ARDS) is a life-threatening condition characterized by acute lung inflammation, increased vascular permeability, and hypoxemic respiratory failure. Oxidative stress, driven by excessive reactive oxygen species (ROS), is a key contributor to ARDS pathogenesis, causing cellular damage, inflammation, and alveolar-capillary barrier disruption. This review elucidates the mechanisms of oxidative stress in ARDS, focusing on ROS production via NADPH oxidase (NOX) and mitochondria, which activate pathways like NF-κB and MAPK, promoting pro-inflammatory cytokine release. ROS-induced lipid and protein peroxidation, endothelial dysfunction, and programmed cell death (PCD), including apoptosis, pyroptosis, and ferroptosis, exacerbate lung injury. In COVID-19-related ARDS, SARS-CoV-2 spike protein amplifies mitochondrial ROS, worsening outcomes. Antioxidant therapies falter due to non-specific ROS suppression, patient heterogeneity (e.g., GSTP1 polymorphisms), and poor bioavailability. We propose a model where oxidative stress drives ARDS stages-early alveolar injury and late systemic dysfunction-suggesting targeted therapies like endothelial-specific nanoparticles or ferroptosis inhibitors. Precision medicine using biomarkers (e.g., mtDNA) and gender-specific approaches (e.g., estrogen-Nrf2 regulation) could enhance outcomes. This review bridges mechanistic gaps, critiques therapeutic failures, and advocates novel strategies like mitochondrial-targeted therapies to improve ARDS management.}, }
@article {pmid40641675, year = {2025}, author = {Schmeyers, L and Thomschke, S and Mende, LV and Stichel, G and Schiller, D and Fleßa, S}, title = {Economic methods and spatial scales in One Health: Results from a scoping review.}, journal = {One health (Amsterdam, Netherlands)}, volume = {21}, number = {}, pages = {101115}, pmid = {40641675}, issn = {2352-7714}, abstract = {INTRODUCTION: COVID-19 and other zoonoses indicate the close connection between human, animal, and environmental health. This interdependency underscores the need for a comprehensive One Health approach. However, the One Health concept is sometimes reduced to combating zoonoses and antimicrobial resistance, neglecting the spatial and environmental dimensions. This narrow focus overlooks the potential of One Health in geographic contexts, where it can optimize health within regional ecosystems. Therefore, this paper aims to provide an overview of geographic contexts and economic approaches to measuring One Health and the importance of these factors for effective health outcomes.<br><br>MATERIAL AND METHODS: A comprehensive search for economic evidence and the geographical scope of One Health was conducted. The search terms 'One Health', combined with 'region, landscape, area, geography, cost, economics, utility,' were used in Web of Science, Scopus, and PubMed. Articles were screened by two blinded reviewers. Year, author, economic method, intervention, outcome, study aim, topic, and geographical area of the articles were recorded.<br><br>RESULTS: 1214 articles were retrieved and 108 were included in this analysis. The topics focused on: zoonoses (56&#xa0;%), antimicrobial resistance (14&#xa0;%), food safety/security (7&#xa0;%), animal welfare (6&#xa0;%), and governance (6&#xa0;%). Most studies were conducted in African countries, the majority of studies (57&#xa0;%) adopted a regional perspective, while 19&#xa0;% employed a national and 13&#xa0;% adopted a multi-country perspective. The most common economic approaches were mixed methods and CEA, regression analysis, as well as index methods.<br><br>DISCUSSION: The analyzed articles largely focus on zoonoses and current measurement instruments that do not yet align with the requirements of the One Health Joint Plan of Action 2022-26. Integrating geographical considerations promises a more comprehensive and effective approach to One Health challenges. The diversity of identified measurement instruments provides a valuable foundation for developing future, context-sensitive One Health strategies.}, }
@article {pmid40641674, year = {2025}, author = {Peng, Y and Ke, Y and Cai, R and Lv, B and Liu, S and Liu, Y and Li, X and Song, H and Chen, Q}, title = {Post-pandemic one health: Unpacking the role of greenspaces and human-dog interactions in long-term health and well-being.}, journal = {One health (Amsterdam, Netherlands)}, volume = {21}, number = {}, pages = {101116}, pmid = {40641674}, issn = {2352-7714}, abstract = {The social isolation measures implemented during the outbreak of COVID-19 in 2020 have had lasting effects on public health and well-being. In response, a growing body of discourse has emerged to examine the long-term impacts of the pandemic on human health and welfare. Addressing these complex challenges requires innovative, interdisciplinary approaches grounded in a conceptual framework that integrates perspectives from both the social and natural sciences. At the intersection of human-animal-green space interactions, the One Health framework has become a prominent driver of holistic health research. However, there is still a lack of comprehensive reviews on how this framework has been applied to investigate the interconnected health and well-being outcomes associated with these dynamics. To fill this gap, the present study conducted a systematic scoping review to identify patterns, gaps, and key themes in the literature, while outlining priorities and considerations for future research. Following standardized PRISMA guidelines, the review employed clearly defined inclusion and exclusion criteria, along with dual-reviewer screening and data extraction procedures. A total of 29 studies were included, all of which directly or indirectly utilized the One Health framework. These studies were categorized into two primary thematic areas: (1) the role of green spaces in promoting human health in the post-pandemic context, and (2) emotional interactions between humans and animals during the pandemic. A notable trend in the literature is the incorporation of the Sense of Coherence as a key dimension of health and well-being within the One Health framework, highlighting the potential of human-dog-green space interactions to contribute meaningfully to salutogenic health processes. The limited number of studies identified also reflects the current underrepresentation of well-being as a core pillar within established One Health research. Based on existing evidence, this review provides a foundational reference for researchers seeking to explore health and well-being through a One Health perspective. It offers guidance for future investigations into the synergistic effects of human-dog-green space interactions on well-being, and proposes data-driven interventions and policy recommendations to address both general health outcomes and the prolonged effects of COVID-19.}, }
@article {pmid40640180, year = {2025}, author = {Guo, Y and Pan, N and Zou, Y and Long, Y and Zhang, X and Li, Q and Suo, X and Singh, MK and Wang, S and Gong, Q}, title = {Neuroimaging insights into the psychosocial impact of the COVID-19 pandemic: a systematic review.}, journal = {Translational psychiatry}, volume = {15}, number = {1}, pages = {236}, pmid = {40640180}, issn = {2158-3188}, support = {82027808//National Natural Science Foundation of China (National Science Foundation of China)/ ; }, mesh = {Humans ; *Brain/diagnostic imaging/physiopathology ; *COVID-19/psychology ; *Mental Disorders/diagnostic imaging/etiology ; *Neuroimaging ; Pandemics ; }, abstract = {The COVID-19 pandemic has posed an unprecedented threat to global health. However, neural substrates underlying mental health vulnerabilities brought by the pandemic remain elusive. We conducted a systematic review relating structural and functional brain abnormalities to mental health issues associated with COVID-19 at brain regional and network levels. A literature search on neuroimaging studies of mental health problems derived by COVID-19 was conducted in the PubMed, Web of Science and MEDLINE databases. We identified 46 studies across various imaging techniques and found that COVID-19-related mental health problems were principally associated with brain structural and functional alterations in the prefrontal cortex, insula, cingulate, hippocampus, and amygdala, as well as the affective cortical network. This review may facilitate the targeted development of therapies tailored to the pandemic context and provide insights for proactive prevention against future collective stressors and traumas.}, }
@article {pmid40640033, year = {2025}, author = {Giunta, S and Giuliani, A and Sabbatinelli, J and Olivieri, F}, title = {A multidimensional immunological perspective on long COVID.}, journal = {Cytokine &amp; growth factor reviews}, volume = {84}, number = {}, pages = {1-11}, doi = {10.1016/j.cytogfr.2025.07.001}, pmid = {40640033}, issn = {1879-0305}, mesh = {Humans ; *COVID-19/immunology/complications ; *SARS-CoV-2/immunology ; Inflammation/immunology ; Cytokines/immunology ; Post-Acute COVID-19 Syndrome ; Autoantibodies/immunology/blood ; }, abstract = {Long COVID is a chronic condition that arises after SARS-CoV-2 infection and is characterized by persistent and often debilitating symptoms, such as fatigue, cognitive dysfunction ("brain fog"), dyspnea, and autonomic disturbances. Increasing evidence suggests that Long COVID shares key immunopathological mechanisms with autoimmune diseases, primarily sustained immune dysregulation. In individuals with genetic or immunological susceptibility, SARS-CoV-2 infection can trigger the production of autoantibodies targeting cytokines, membrane receptors, and components of the autonomic nervous system (ANS), thereby disrupting neuroimmune homeostasis. This immune imbalance may impair anti-inflammatory regulatory pathways, such as the cholinergic anti-inflammatory pathway (CAP), and may contribute to a chronic state of inflammation and autoimmunity. One proposed contributor to this process is inflammaging - a chronic, low-grade inflammation associated with aging - which may not only predispose individuals to Long COVID but may also be amplified by the persistent immune activation seen in this condition. In this perspective, we propose a conceptual framework in which inflammaging, immune-tolerance breakdown, and autonomic dysfunctions interact to sustain the pathophysiology of Long COVID. We discuss emerging biomarkers across these axes, including inflammatory cytokines, circulating autoantibodies, immune cell phenotypes, epigenetic modifications, and heart rate variability. Advances in inflammaging-related biomarkers and biological clocks may support early identification of individuals at higher risk for persistent immune and autonomic dysregulation, ultimately informing more precise diagnostic and therapeutic strategies for Long COVID.}, }
@article {pmid40639876, year = {2025}, author = {Chalmers, JD and Mall, MA and Nielsen, KG and Chang, AB and Aliberti, S and Blasi, F and Korkmaz, B and Lorent, N and Taggart, CC and Loebinger, MR}, title = {Neutrophil-derived biomarkers in bronchiectasis: identifying a common therapeutic target.}, journal = {The European respiratory journal}, volume = {66}, number = {3}, pages = {}, pmid = {40639876}, issn = {1399-3003}, mesh = {Humans ; *Bronchiectasis/metabolism/therapy/diagnosis/drug therapy ; *Biomarkers/metabolism ; *Neutrophils/metabolism ; Inflammation ; Lung ; }, abstract = {Bronchiectasis is a chronic respiratory disease that can lead to a substantial decline in lung function, ultimately leading to a significantly increased risk of morbidity and mortality. Despite the increasing global impact of bronchiectasis, no specific (or licensed) treatment for the disease currently exists, with most available therapies, though beneficial, focusing on symptom management and infection control. In part, the lack of specific treatments for bronchiectasis may be due to a lack of established biomarkers for the disease. Because bronchiectasis varies so widely in its clinical presentation and can be caused by various aetiologies, the establishment of validated biomarkers has proven challenging. However, identifying key biomarkers in bronchiectasis is crucial to developing appropriate diagnosis and management plans, as well as to measuring effective responses to treatment. While there is a multitude of potential biomarkers in bronchiectasis, almost all instances of bronchiectasis are underpinned by chronic neutrophilic inflammation. The imbalance in neutrophil serine proteases (NSPs) and their endogenous inhibitors has been strongly linked to the lung destruction, mucosal-related defects, infection and worsening of clinical outcomes that are frequently observed in bronchiectasis. In this review, we discuss the various biomarkers linked to bronchiectasis, with a specific focus on NSPs as the most validated biomarkers in bronchiectasis, given their marked role in the pathogenesis of the disease. Lastly, we touch on potential therapeutic approaches aimed at reducing NSP activity in bronchiectasis, showing that, to date, indirect NSP inhibition appears to be the strategy that most effectively addresses chronic neutrophilic inflammation in bronchiectasis.}, }
@article {pmid40639793, year = {2025}, author = {Siefken, K and Pratt, M and Mejía-Grueso, J and Bauman, A and Salvo, D and Woods, CB and Wendel-Vos, W and Richards, J and Miranda, JJ and Hallal, PC and Ramírez Varela, A}, title = {Chance or Strategy? Assessing the Unanticipated Policy Window for Active Transportation During the COVID-19 Pandemic: A Systematic Review.}, journal = {Journal of physical activity &amp; health}, volume = {22}, number = {8}, pages = {989-999}, doi = {10.1123/jpah.2024-0489}, pmid = {40639793}, issn = {1543-5474}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Transportation/methods ; *Exercise ; SARS-CoV-2 ; *Health Policy ; Pandemics ; Bicycling ; Built Environment ; }, abstract = {UNLABELLED: Physical activity (PA) policy is essential for promoting population-level PA by coordinating efforts across various sectors. Global crises like the COVID-19 pandemic can open policy windows, enabling rapid implementation of innovative policies. This study examined how policy windows shaped active transportation (AT) policies during the pandemic, resulting in infrastructural changes.<br><br>METHODS: A systematic review using PubMed, Scopus, ProQuest-Coronavirus Research Database, Web of Science, WHO COVID-19 Research Database, PsycInfo, and SPORTDiscus conducted to characterize AT policy during the pandemic (2020-2023). Descriptive analyses were conducted in Stata. PROSPERO registration number: CRD42025644930.<br><br>RESULTS: The search retrieved 3879 articles; 1162 were duplicates, leaving 2716 eligible. After applying inclusion and exclusion criteria, 14 were selected for data extraction. Findings demonstrate the pandemic's influence on AT policy implementation and its impact on the built environment, such as the creation of bicycle lanes and pedestrian-friendly spaces. While these policies indirectly impacted PA, many were transient and unintended. Regional disparities in case-study cities highlighted mobility alternatives to mitigate SARS-CoV-2 transmission. Enablers and challenges for effective policy implementation were identified.<br><br>CONCLUSION: The pandemic catalyzed global AT policies, demonstrating that urgency and political willpower can expedite policy enactment. Rapid urban infrastructure changes highlighted the potential for swift policy implementation during health emergencies, facilitating utilitarian PA. AT emerged as a practical solution, allowing essential movement. Addressing the immediate crisis proved more effective in implementing AT policies than prepandemic efforts focused on the physical inactivity's health burden. Understanding local sustainability determinants can inform future urban planning for integrating AT initiatives sustainably.}, }
@article {pmid40639355, year = {2025}, author = {Rengarajan, A and Bazarbashi, AN and Gyawali, CP}, title = {Pathophysiology of Achalasia.}, journal = {Digestion}, volume = {}, number = {}, pages = {1-9}, doi = {10.1159/000547354}, pmid = {40639355}, issn = {1421-9867}, abstract = {BACKGROUND: Achalasia is a rare primary esophageal motility disorder of the esophageal smooth muscle, characterized by abnormal relaxation of the lower esophageal sphincter and associated with abnormal, spastic, or absent esophageal body peristalsis.<br><br>SUMMARY: The primary pathophysiological defect is abnormal esophageal inhibitory nerve function from neuronal death in the esophageal neuronal plexuses and ganglia that control esophageal smooth muscle peristalsis. This is a consequence of an autoimmune cytotoxic insult from molecular mimicry following an intercurrent viral infection, typically herpes simplex virus, varicella zoster virus, human papillomavirus, measles virus, and even the COVID-19 virus. Neuronal inflammation rather than death can lead to an imbalance between excitatory and inhibitory forces, and varying degrees of retained spastic, premature or even normal peristalsis in the smooth muscle esophageal body. Chagas disease caused by Trypanosoma cruzi, eosinophilic inflammation, direct infiltration with neoplastic cells from adjacent cancers, or humoral autoimmune destruction from distant cancers can also result in an achalasia-like syndrome. Mechanical obstruction from tight strictures, anti-reflux or bariatric surgery, and extrinsic compression can mimic the manometric features of achalasia. Chronic opioid medication usage can result in a clinical and pathophysiological syndrome identical to spastic achalasia.<br><br>KEY MESSAGES: Careful clinical evaluation and judicious interpretation of esophageal function tests following pathophysiological principles can lead to an accurate diagnosis of achalasia, opening the door to durable permanent disruption of the malfunctioning esophageal smooth muscle and resulting in symptom relief.}, }
@article {pmid40638063, year = {2025}, author = {Hinzpeter, EL and Kairies-Schwarz, N and Beaudart, C and Douxfils, J and Nayak, D and Hiligsmann, M}, title = {A Systematic Review of Discrete Choice Experiments on Preferences for COVID-19 Vaccinations.}, journal = {The patient}, volume = {18}, number = {5}, pages = {461-480}, pmid = {40638063}, issn = {1178-1661}, mesh = {Humans ; *COVID-19/prevention &amp; control ; *COVID-19 Vaccines/administration &amp; dosage ; *Choice Behavior ; *Vaccination/psychology ; SARS-CoV-2 ; *Patient Preference ; }, abstract = {BACKGROUND AND OBJECTIVE: The COVID-19 pandemic has significantly influenced vaccination strategies and public health policies. Discrete choice experiments have emerged as a valuable tool for understanding preferences regarding vaccination. This study systematically reviews discrete choice experiments conducted on COVID-19 public vaccination preferences to identify key determinants influencing vaccine uptake and to assess methodological approaches used in these studies.<br><br>METHODS: A systematic literature search was conducted across major databases, including PubMed, Scopus, and Web of Science, to identify discrete choice experiments focusing on COVID-19 vaccination preferences up to 31 December, 2024. Attribute categorization into five dimensions Outcome, Process, Cost, Trust, and Framing was performed and quality appraised according to the DIRECT checklist. Conditional relative importance as well as geographical differences were assessed.<br><br>RESULTS: The review identified 58 studies employing discrete choice experiments that assessed public COVID-19 vaccine preferences. Among attribute categories, outcome-related factors were the most frequently used and had the highest relative importance. Other commonly evaluated attributes included cost, origin/brand, and required doses. A notable geographic disparity was observed, with studies being unevenly distributed across different regions. Methodological heterogeneity was observed in attribute selection and experimental design.<br><br>CONCLUSIONS: This review emphasizes the importance of considering individual preferences into vaccination strategies to enhance uptake, particularly in preparation for future pandemics. The findings reveal that vaccine effectiveness and safety are key concerns for individuals. Future research could focus on increasing representation of underexamined regions in preference studies to better inform local policymakers in developing effective vaccination programs for future health crises.<br><br>CLINICAL TRIAL REGISTRATION: This review was prospectively registered in PROSPERO (International Prospective Register of Systematic Reviews) with the ID CRD42025543234.}, }
@article {pmid40636277, year = {2025}, author = {Tralongo, P and Ballato, M and Fiorentino, V and Giordano, WG and Zuccalà, V and Pizzimenti, C and Bakacs, A and Ieni, A and Tuccari, G and Fadda, G and Larocca, LM and Martini, M}, title = {Cuproptosis: A Review on Mechanisms, Role in Solid and Hematological Tumors, and Association with Viral Infections.}, journal = {Mediterranean journal of hematology and infectious diseases}, volume = {17}, number = {1}, pages = {e2025052}, pmid = {40636277}, issn = {2035-3006}, abstract = {Cuproptosis is a distinct modality of regulated cell death precipitated by an overload of intracellular copper, critically dependent on mitochondrial respiration. The underlying mechanism involves the direct interaction of copper ions with lipoylated components integral to the mitochondrial tricarboxylic acid (TCA) cycle. This binding event triggers the aggregation of these proteins, induces significant proteotoxic stress, and leads to the depletion of essential iron-sulfur cluster proteins, culminating in cell demise. Given that copper homeostasis is frequently dysregulated within cancer cells, rendering them potentially more susceptible to copper-induced toxicity, cuproptosis has rapidly become a focal point of oncological research. This systematic review meticulously analyzes and synthesizes findings from a curated collection of 45 research articles. It aims to provide a comprehensive description of the molecular intricacies of cuproptosis, explore its documented associations with a spectrum of solid tumors (including gastric, lung, liver, neuroblastoma, and ovarian cancers) and lymphoma, and examine its emerging connections with viral infections like COVID-19 and pseudorabies virus. The review elaborates on the reported prognostic significance of cuproptosis-related genes and associated pathways across various malignancies. Furthermore, it details the burgeoning therapeutic strategies designed to harness cuproptosis, encompassing the application of copper ionophores, the development of sophisticated nanomedicine platforms, and synergistic approaches that combine cuproptosis induction with immunotherapy, chemotherapy, or sonodynamic therapy. The potential clinical utility of cuproptosis-associated biomarkers for predicting patient prognosis and therapeutic response is discussed based on the evidence presented in the reviewed literature.}, }
@article {pmid40636108, year = {2025}, author = {Hu, C and Niu, C and Li, X and He, K and Li, M and Gao, X and Wei, Q and Sun, W and Zhao, Y and Li, Y and Xia, X and Ren, Z and Li, X and Wang, T}, title = {Progress in combination vaccines and the co-administration of influenza virus and SARS-CoV-2 vaccines.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1578733}, pmid = {40636108}, issn = {1664-3224}, mesh = {Humans ; *Influenza Vaccines/immunology/administration &amp; dosage ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; *Influenza, Human/prevention &amp; control/immunology ; *COVID-19/prevention &amp; control/immunology ; *SARS-CoV-2/immunology ; Animals ; Vaccines, Combined/immunology/administration &amp; dosage ; *Coinfection/prevention &amp; control/immunology ; Clinical Trials as Topic ; }, abstract = {COVID-19 and seasonal influenza have taken a huge toll on the global economy and global health. Given the potential of COVID-19 to transform into a chronic epidemic akin to seasonal influenza, the influenza virus and SARS-CoV-2 will continue to be a significant threat to healthcare for some time to come. Coinfection involving the two viruses has been proven to worsen the severity of the illness, as evidenced by clinical observational data. Vaccination remains the most effective measure in the prevention and treatment of infectious diseases. In addition, the coadministration of influenza virus and SARS-CoV-2 vaccines offered greater benefits than either vaccine alone. Combination vaccines are also a major hotspot in novel vaccine development. This review highlights the advancements in the development of combined vaccines for COVID-19 and seasonal influenza, as demonstrated in animal studies and clinical trials, and emphasizes the importance of a combined vaccine.}, }
@article {pmid40635758, year = {2025}, author = {Pan, J and Lin, S and Qian, Q and Fu, S and Liu, X}, title = {Gut-brain axis in post-traumatic stress disorder: microbial - mediated mechanisms and new therapeutic approaches - A narrative review.}, journal = {Frontiers in pharmacology}, volume = {16}, number = {}, pages = {1621678}, pmid = {40635758}, issn = {1663-9812}, abstract = {Post-traumatic stress disorder (PTSD) is a severe mental disorder that occurs after experiencing or witnessing a traumatic event. Not only does this disorder severely impair the quality of life and emotional wellbeing of patients, but in recent years the global rate of PTSD diagnoses has increased to 1.5-2 times, and the prevalence of PTSD associated with COVID-19 events in particular has surged to 10%-25%, underscoring the urgency of developing effective treatments. The lifetime prevalence of PTSD in the general population is estimated to be approximately 3.9%, while in high-risk populations, such as war veterans, it can be as high as 30%. As a key pathway connecting the central nervous system to peripheral organs, the gut-brain axis has received increasing attention for its role in PTSD. Although the gut-brain axis has been shown to be associated with several psychiatric disorders, especially depression, its specific role in PTSD remains undercharacterized. Existing studies suggest that specific strains of Lactobacillus (e.g., Lactobacillus reuteri) may alleviate inflammatory responses and improve PTSD-like behaviors by down-regulating the expression of pro-inflammatory factors (IL-6 and TNF-α). In this study, we used a narrative review approach to sort out the research progress of gut microbiota alteration in PTSD, and compared the characteristics of changes in specific microbial taxa (e.g., Bacteroides, Lactobacillus, etc.), the index of microbiota diversity (α/β diversity), and the levels of inflammatory markers (e.g., IL-6, TNF-α) between the animal model and the human patients, respectively, in order to We further explored the potential pathogenic mechanisms mediated by microorganisms, such as influencing the vagal pathway, hypothalamic-pituitary-adrenal (HPA) axis function, immune system and other processes involved in the pathology of PTSD, and summarized the intervention strategies targeting gut microecology, such as probiotic supplementation, dietary interventions and fecal bacteria transplantation.}, }
@article {pmid40634987, year = {2025}, author = {Ayo-Farai, O and Gopep, N and Alarape-Raji, A and Adnan, H and Ahmed, M and Arif, R and Kashif, E and Oduoye, MO and Haider, MU}, title = {Exploring co-infection dynamics and immune response interactions between COVID-19 and Monkeypox: implications for disease severity, viral transmission, and vaccine efficacy.}, journal = {Virology journal}, volume = {22}, number = {1}, pages = {230}, pmid = {40634987}, issn = {1743-422X}, mesh = {Humans ; *COVID-19/immunology/transmission/prevention &amp; control/epidemiology/virology ; *Coinfection/immunology/virology ; SARS-CoV-2/immunology ; *Mpox, Monkeypox/immunology/transmission/prevention &amp; control/epidemiology/virology ; Vaccine Efficacy ; Severity of Illness Index ; Male ; Middle Aged ; }, abstract = {BACKGROUND: Coronavirus disease (COVID-19) and Monkeypox (Mpox) are viral infections that have similar modes of presentation, diagnosis and treatment strategies. Understanding their co-infection dynamics and immune response is important for public health policies.<br><br>AIM: This article aims to determine the relationship between dynamicity and immune response interactions between Mpox and COVID-19, focusing more on the implications for disease severity, viral transmission, and vaccine efficacy.<br><br>METHODOLOGY: An extensive literature review was conducted through electronic databases including PubMed, Google Scholar and Web of Science from the last decade (2014-2024) using keywords: COVID-19, Co-infections, Immune response, Monkeypox, and Vaccination.<br><br>RESULTS: Several co-infections between COVID-19 and Mpox have been reported, especially a case from Florida, in the United States of America (USA), in Barcelona, Spain (a 56-year-old man who suffered both Mpox and COVID-19 and syphilis simultaneously, and from Italy (a 36-year-old male). Both COVID-19 and Mpox have been shown to have some effects on the immunity of a person, especially the innate system, which can occasionally produce inadvertent effects. A common factor that links the two diseases is the endoglycosidase named Heparanase (HPSE). Both COVID-19 and Mpox clinical features have bizarre severity and complications. The rising co-infection of COVID-19 and increased Mpox infection rate has led to the development of only approved vaccines JYNNEOS and COH04S1.<br><br>CONCLUSION: Global efforts such as adequate awareness campaigns through webinars, social media platforms, and research, including experimental studies, cohort studies, case series, etc., should be put in place to give more insights into both diseases. Such efforts should be backed up with good political will, adequate funding, the establishment of research facilities and interprofessional measures among the concerned countries and policymakers in the world.}, }
@article {pmid40633919, year = {2025}, author = {Ivanova, J and Ong, T and Wilczewski, H and Cummins, M and Soni, H and Barrera, J and Welch, B and Bunnell, B}, title = {Mental Health Care Guidelines for Telemedicine During the COVID-19 Pandemic: Scoping Review.}, journal = {JMIR mental health}, volume = {12}, number = {}, pages = {e56534}, pmid = {40633919}, issn = {2368-7959}, mesh = {Humans ; *COVID-19 ; *Mental Health Services/standards ; Pandemics ; *Practice Guidelines as Topic ; SARS-CoV-2 ; *Telemedicine/standards ; }, abstract = {BACKGROUND: Mental health care providers have widely adopted telemedicine since the onset of the COVID-19 pandemic. Some providers have reported difficulties in implementing telemedicine and are still assessing its sustainability for their practices. Recommendations, best practices, and guidelines for telemedicine-based mental health care (ie, telemental health care [TMH]) have been published, but the nature and extent of this guidance have not been assessed.<br><br>OBJECTIVE: We aimed to determine (1) the form of TMH guidelines and recommendations presented to providers, (2) the most commonly presented recommendations and guidelines, and (3) the perceived benefits and challenges of these TMH guidelines and recommendations.<br><br>METHODS: Through our scoping review of practice guidelines, we aimed to identify themes in TMH guidelines and clinical recommendations published between 2020 and 2024 in peer-reviewed journals. This review focused on the first 2 years of the COVID-19 pandemic to identify and characterize the available TMH guidance. We searched PubMed/MEDLINE and ScienceDirect for articles in peer-reviewed journals published between January 1, 2020, and July 16, 2024. We included articles that were available in English and presented recommendations, best practices, or guidelines for TMH. We excluded duplicates, articles unrelated to telehealth, brief editorial introductions, and those not publicly available. We applied the Healthcare Provider Taxonomy of the National Uniform Claim Committee to article titles and abstracts to identify records relevant to mental health. We used content and thematic analyses to identify key themes.<br><br>RESULTS: Of the 1348 articles retrieved, we identified 76 that matched our criteria. Through content and thematic analyses, we identified 3 main themes-along with subthemes and topics-related to Facilitators, Concerns, and Changes Advised. The majority of articles called for further research (59/76) and for telemental health education and innovation in some form (43/76) regarding advised changes. Twenty-four articles included specific guidelines, recommendations, or checklists for providers.<br><br>CONCLUSIONS: The results highlight the need for further large-scale research to support the development of effective guidelines and protocols for therapy plans. Although TMH care is widespread, scholarly work emphasizes the need for a stronger evidence base that includes testing protocols in diverse settings and populations. The results also underscore the importance of increasing health professionals' knowledge of regulatory compliance and providing them with adequate TMH practice education.}, }
@article {pmid40633841, year = {2025}, author = {Zhang, Y and Ji, X and Huang, D and Lu, G and Chen, X}, title = {The coronavirus 3CL protease: Unveiling its complex host interactions and central role in viral pathogenesis.}, journal = {Virologica Sinica}, volume = {40}, number = {4}, pages = {509-519}, pmid = {40633841}, issn = {1995-820X}, mesh = {Humans ; *Host-Pathogen Interactions ; Virus Replication ; *Coronavirus 3C Proteases/metabolism/genetics ; *SARS-CoV-2/pathogenicity/enzymology ; Autophagy ; Immunity, Innate ; Animals ; *Coronavirus/pathogenicity/enzymology ; Signal Transduction ; }, abstract = {The 3CL protease, a highly conserved enzyme in the coronavirus, plays a crucial role in the viral life cycle by facilitating viral replication through precise cleavage of polyproteins. Beyond its proteolytic function, the 3CL protease also engages in intricate interactions with host cell proteins involved in critical cellular processes such as transcription, translation, and nuclear-cytoplasmic transport, effectively hijacking cellular machinery to promote viral replication. Additionally, it disrupts innate immune signaling pathways, suppresses interferon activity and cleaves antiviral proteins. Furthermore, it modulates host cell death pathways including pyroptosis and apoptosis, interferes with autophagy and inhibits stress granule formation to maintain viral infection and exacerbate viral pathogenesis. This review highlights the molecular mechanisms by which the 3CL protease orchestrates virus-host interactions, emphasizing its central role in coronavirus pathogenesis and highlighting potential therapeutic targets for future interventions.}, }
@article {pmid40633818, year = {2025}, author = {Bustin, SA and Wittwer, CT}, title = {Fragile methods, fractured trust: rethinking scientific responsibility.}, journal = {Methods (San Diego, Calif.)}, volume = {242}, number = {}, pages = {54-61}, doi = {10.1016/j.ymeth.2025.07.003}, pmid = {40633818}, issn = {1095-9130}, mesh = {Humans ; *Trust ; SARS-CoV-2 ; COVID-19/diagnosis ; Pandemics/prevention &amp; control ; *Coronavirus Infections/diagnosis/virology/prevention &amp; control ; Betacoronavirus/genetics ; Public Health ; }, abstract = {Science has a credibility problem, and it is not just the fault of politicians, journalists, or conspiracy theorists. It begins within science itself. This review examines how flawed methods and selective reporting, combined with overly polished communications that prioritise image over clarity, have normalised bad practice in molecular biology, diagnostics, and related applied sciences. The quantitative real-time polymerase chain reaction (qPCR) offers a clear example: a conceptually simple, technically mature technology that is nonetheless routinely misused, despite published standards and repeated calls for methodological rigour over the past two decades. If qPCR is so often misapplied, what does that suggest about confidence in more complex, less transparent technologies? An additional problem lies in the way scientific findings are misreported or exaggerated. Such distortions have far-reaching consequences beyond individual studies. From the MMR-autism scare to COVID-19 testing and vaccine hesitancy, they have fuelled confusion, eroded public trust, and endangered public health. Consequently, when flawed or overstated findings shape public policy or clinical decisions, the damage undermines science's role as a reliable source of knowledge and informed choice. Credibility must rest on transparent practice, ethical responsibility, and attention to both how results are produced and how they are communicated. Until scientists recognise that communication is not value-neutral, and that our public voice carries consequences far beyond the lab, public scepticism will be justified.}, }
@article {pmid40633204, year = {2025}, author = {Shi, T and Ye, Y and Fan, Z and Yang, Q and Ma, Y and Zhu, J}, title = {Respiratory mucosal vaccines: Applications, delivery strategies and design considerations.}, journal = {Biomedicine &amp; pharmacotherapy = Biomedecine &amp; pharmacotherapie}, volume = {189}, number = {}, pages = {118326}, doi = {10.1016/j.biopha.2025.118326}, pmid = {40633204}, issn = {1950-6007}, mesh = {Humans ; Animals ; *Drug Delivery Systems/methods ; *Vaccines/administration &amp; dosage/immunology ; *Immunity, Mucosal ; *Respiratory Mucosa/immunology ; Nanoparticles ; Drug Design ; }, abstract = {Respiratory mucosal vaccines represent a groundbreaking and promising route to trigger both local and systemic immune responses by mimicking the natural cause of infection, offering great potential for fighting against pathogens and limiting their transmission at entry sites, particularly effective for infectious diseases like Influenza virus and Coronavirus. In this article, we provide a comprehensive overview of recent advance and current landscape of vaccines by mucosal routes, with an emphasis on their design, engineering, and delivery mechanisms across various vaccine platforms. Particular attention is given to the emerging advanced technologies, exosome and lipid nanoparticle vaccine delivery systems. The critical design considerations of mucosal vaccines are highlighted for engineering safe and efficacious mucosal vaccines, proving meaningful insights on the engineering of safe and effective mucosal vaccines. We foresee a promising future for respiratory mucosal vaccines in their translation into clinical applications, ultimately bringing benefits to human individuals.}, }
@article {pmid40632470, year = {2025}, author = {Nairz, M and Weiss, G}, title = {How to identify respiratory pathogens in primary health care - a review on the benefits, prospects and pitfalls in using point of care tests.}, journal = {Infection}, volume = {53}, number = {6}, pages = {2321-2340}, pmid = {40632470}, issn = {1439-0973}, mesh = {Humans ; *Primary Health Care ; *Respiratory Tract Infections/diagnosis/microbiology/virology ; *Point-of-Care Testing ; SARS-CoV-2/isolation &amp; purification ; Bordetella pertussis/isolation &amp; purification ; Sensitivity and Specificity ; }, abstract = {PURPOSE: Respiratory tract infections are among the most common reasons for consultations in primary health care (PHC) settings. In this review, we aim to provide an overview of diagnostic tests for selected respiratory pathogens useful in PHC.<br><br>METHODS: We performed a PubMed search on diagnostic tests for influenza virus, respiratory syncytial virus (RSV), Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), Streptococcus pneumoniae, Legionella pneumophila, Mycoplasma pneumoniae and Bordetella pertussis. We then selected and summarized clinical trials, meta-analyses and systematic reviews published between May 1994 and April 2025 relevant to PHC.<br><br>RESULTS: Diagnostic tests are useful if the test result will guide subsequent clinical management. Polymerase chain reaction (PCR) tests have high diagnostic accuracy but are not always available in PHC. Accurate rapid antigen detections tests (RADTs) are required to have a sensitivity of at least 80% and a specificity of at least 97% and are available for influenza virus, RSV and SARS-CoV-2 as are urinary antigen tests for Streptococcus pneumoniae and Legionella pneumophila. In contrast, due to the lack of appropriate RADTs, infections with Mycoplasma pneumoniae or Bordetella pertussis typically require PCR tests.<br><br>CONCLUSION: From a clinical perspective, the differentiation between viral and bacterial infections and the accurate identification of the specific causative agent may guide medical interventions including antimicrobial therapy. From a diagnostic perspective, adequate microbiologic sampling and careful interpretation of laboratory test results in a clinical context are central requirements.}, }
@article {pmid40627495, year = {2025}, author = {Onohuean, H and Ogunmola, T and Adesiyan, A and Oluwamayowa Samuel, A and Oni, E and Okechukwu Paul Chima, U}, title = {Updates on cancer vaccines in brain cancer: Advances in neuroblastoma, delivery systems, and emerging technologies.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2526964}, pmid = {40627495}, issn = {2164-554X}, mesh = {Humans ; *Brain Neoplasms/therapy/immunology ; *Neuroblastoma/therapy/immunology ; *Cancer Vaccines/administration &amp; dosage/immunology/therapeutic use ; Blood-Brain Barrier/metabolism ; *Drug Delivery Systems/methods ; Nanoparticles/administration &amp; dosage ; COVID-19 Vaccines ; Child ; Immunotherapy/methods ; SARS-CoV-2/immunology ; COVID-19/prevention &amp; control ; }, abstract = {Neuroblastoma stands as a major concern in pediatric oncology because it develops from neural crest cells as a neuroendocrine cancer. Nanoparticle-based vaccine delivery approaches the therapeutic activity of immune cells only toward tumor cells without inflicting damage to healthy tissues like those sustained by chemotherapy and radiation therapy. Neuroblastoma treatment faces two major barriers: penetrating the blood-brain barrier (BBB) and using nanoparticle technology. The promising developments for neuroblastoma treatment emerge from mRNA COVID-19 vaccine research and brain cancer vaccine clinical trials especially through phase I autologous dendritic cell vaccine studies. Future research needs to develop optimized nanoparticles which can trigger the release of mRNA or peptides based on tumor-specific pH and enzyme signals. The BBB can be opened temporarily through ultrasound and receptor-mediated transport approaches, which enhance vaccine delivery to brain tissues. New immunotherapeutic approaches for pediatric malignancies emerge from these recent findings to yield future success.}, }
@article {pmid40625789, year = {2025}, author = {Bartlett, ML and Palese, P and Davis, MF and Vermund, SH and Bréchot, C and Evans, JD and Sauer, LM and Osterhaus, A and Pekosz, A and Nelson, M and Stachler, E and Krammer, F and Moreno, G and Olinger, G and Koopmans, M}, title = {Enhancing the response to avian influenza in the US and globally.}, journal = {Lancet regional health. Americas}, volume = {46}, number = {}, pages = {101100}, pmid = {40625789}, issn = {2667-193X}, abstract = {The recent emergence of highly pathogenic H5N1 avian influenza virus infections in dairy cows and humans in the U.S. has raised alarms regarding the potential for a pandemic. Over 995 dairy cow herds and at least 70 humans have been affected, including cases of severe disease and the first reported H5N1-related death in the U.S. Sporadic human infections with no known contact with infected animals highlight the possibility of viral adaptation for efficient human-to-human transmission. Concurrently, the virus continues to circulate in wild birds, backyard flocks, and hunted migratory species, further amplifying the risk to humans and domestic animals. This article provides an overview of the current outbreak status, emphasizes the importance of robust surveillance systems to detect emerging strains with pandemic potential, and highlights risks to the U.S. dairy and poultry industries. Recommendations for risk mitigation include enhanced biosecurity measures, improved surveillance, decentralized testing, and targeted public health messaging. The Global Virus Network calls for urgent, proactive measures to prevent widespread outbreaks, leveraging lessons learned from prior pandemics. These measures include targeted vaccination, improved communication strategies to combat vaccine hesitancy, and the incorporation of social sciences to address barriers to public health interventions.}, }
@article {pmid40625421, year = {2025}, author = {Goel, F and Kumar, D and Singh, P and Rai, SN}, title = {The dual threat: exploring the emergence of human metapneumovirus and SARS-CoV-2 coinfections in respiratory infections.}, journal = {3 Biotech}, volume = {15}, number = {8}, pages = {235}, pmid = {40625421}, issn = {2190-572X}, abstract = {SARS-CoV-2-triggered COVID-19 epidemic has thrown unprecedented challenges at the global public health system but has also drawn attention to the co-circulation of other respiratory viruses, among them human metapneumovirus (hMPV). Both viruses are significant contributors to respiratory illnesses. Human metapneumovirus (hMPV) can cause serious respiratory infections, particularly in young children, elderly, and immunocompromised individuals. This review explores the overlap between human metapneumovirus (hMPV) and SARS-CoV-2, focusing on their epidemiological patterns, clinical manifestations, and the impact of co-infection on disease severity and patient outcomes. We consider the molecular mechanisms of hMPV's interaction with the host immune system, which might have an impact or exacerbate SARS-CoV-2 pathogenicity. The challenges of identifying and treating co-infections are also discussed in this study as are the effects of clinical management during the present pandemic. Furthermore, the possibilities of synergistic effects between the two viruses involved in these coinfections, particularly modified immune response and worsened respiratory outcomes, have been brought up. We address the intersection of these two viral pathogens to provide insights into their combined burden on healthcare systems, underscore the need for improved diagnostic tools, and advocate for research on targeted treatment and vaccine strategies. This review highlights the dual threat posed by hMPV and SARS-CoV-2 and calls for greater attention to the implications of viral co-infections in respiratory diseases.}, }
@article {pmid40625176, year = {2025}, author = {Naito, T}, title = {A second-generation, self-amplifying COVID-19 Vaccine: World's first approval and distribution in the Japanese market with vaccine hesitancy.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2530291}, pmid = {40625176}, issn = {2164-554X}, mesh = {Humans ; Clinical Trials as Topic ; *COVID-19/prevention &amp; control/immunology ; *COVID-19 Vaccines/immunology/administration &amp; dosage ; Drug Approval ; Japan ; *Vaccination Hesitancy ; Vaccines, Synthetic/immunology/administration &amp; dosage ; }, abstract = {The mRNA vaccine is a milestone in immunotherapeutics, as symbolized by the 2023 Nobel Prize for Physiology or Medicine awarded to Drs. Karikó and Weissman. Whereas the conventional, "first-generation" mRNA vaccine was globally distributed to hundreds of millions of people to decrease COVID-19 prevalence, further advanced constructs have been pursued by researchers and pharmaceutical manufacturers. The key feature of the "second-generation" mRNA vaccine is a self-amplifying replicon that may allow a low dose to ensure durable immunogenicity. In clinical trials, ARCT-154 indeed showed effectiveness (magnitude, persistence, and breadth) superior to conventional mRNA vaccines, with similar or less frequent adverse responses, and acquired its world's first approval in November 2023 in Japan (brand name: KOSTAIVE manufactured by Meiji Seika Pharma, Tokyo, Japan) to prevent COVID-19 infection. Real-world distribution of KOSTAIVE was started in October 2024, and researchers are collecting data on its effectiveness and safety despite nonscientific, but persistent, antivaccine skepticism.}, }
@article {pmid40624586, year = {2025}, author = {Alzahrani, RS and Alkhatabi, TF and Bokhari, AF and Ismail, WM and Alyamani, AS and Alsudais, AS and AlRajhi, B and Almutairi, DM}, title = {Efficacy of Omega-3 supplementation in olfactory dysfunction: a systematic review of randomized controlled trials.}, journal = {BMC nutrition}, volume = {11}, number = {1}, pages = {135}, pmid = {40624586}, issn = {2055-0928}, abstract = {BACKGROUND: Olfactory dysfunction (OD) significantly impacts patients' quality of life, yet effective treatments are limited. Omega-3 fatty acids have shown promise in improving olfactory function, but further research is needed to evaluate their efficacy.<br><br>AIMS/OBJECTIVES: This systematic review aimed to assess the effects of omega-3 supplementation on OD.<br><br>METHODS: A comprehensive search identified randomized controlled trials investigating omega-3 supplementation in OD patients. Inclusion criteria involved adult patients receiving omega-3 fatty acids and undergoing olfactory function assessments.<br><br>RESULTS: Three studies with 175 participants were included. Two studies reported omega-3's protective effect against olfactory loss over three months. However, a trial on COVID-19 patients found no significant improvement in olfactory function.<br><br>CONCLUSIONS: Omega-3 supplementation, along with olfactory training or nasal rinses, appears to improve olfactory function in OD patients. However, further research is needed to evaluate its standalone efficacy. Omega-3 fatty acids offer a potential therapy for OD, warranting optimization and long-term effects investigation.}, }
@article {pmid40623772, year = {2025}, author = {Eneh, SC and Anokwuru, CC and Onukansi, FO and Obi, CG and Ikhuoria, OV and Dauda, Z and Obiekwe, SJ and Udoewah, SA}, title = {Implementation of integrated disease surveillance and response systems in West Africa: lessons learned and future directions.}, journal = {BMJ health &amp; care informatics}, volume = {32}, number = {1}, pages = {}, pmid = {40623772}, issn = {2632-1009}, mesh = {Humans ; Africa, Western/epidemiology ; *Population Surveillance/methods ; *Disease Outbreaks/prevention &amp; control ; COVID-19/epidemiology ; Capacity Building ; *Communicable Disease Control/organization &amp; administration ; }, abstract = {The Integrated Disease Surveillance and Response (IDSR) framework, introduced by the WHO in 1998, aimed to unify disease surveillance across West Africa, replacing fragmented systems. However, challenges such as limited real-time reporting, inadequate data collection and workforce shortages continue to impede disease control and outbreak response. The resurgence of infectious diseases like Ebola, cholera, COVID-19 and monkeypox highlights the need to strengthen IDSR systems for effective public health management. This article reviews IDSR implementation in West Africa, identifying persistent gaps, including delayed outbreak detection, limited laboratory capacity and weak surveillance infrastructure. It emphasises the importance of policy development, capacity building and stakeholder engagement to secure political support and resources. Integrating technological innovations-such as mobile health (mHealth), geographic information systems (GIS), electronic health records and big data analytics-can enhance real-time data sharing and response coordination. Strengthening laboratories, workforce training and monitoring frameworks is essential to improve IDSR performance. Strategic investments are crucial to bolster public health capacities, accelerate response times and mitigate future epidemics in West Africa.}, }
@article {pmid40623651, year = {2025}, author = {Bowyer, W and Haslam, A and Prasad, V}, title = {An analysis of studies comparing myocarditis and pericarditis in COVID-19 vaccinated and SARS-CoV-2 infected individuals.}, journal = {The American journal of the medical sciences}, volume = {370}, number = {4}, pages = {392-399}, doi = {10.1016/j.amjms.2025.06.012}, pmid = {40623651}, issn = {1538-2990}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; *COVID-19 Vaccines/adverse effects ; Incidence ; *Myocarditis/epidemiology/etiology ; *Pericarditis/epidemiology/etiology ; Retrospective Studies ; *Vaccination/adverse effects ; }, abstract = {We sought to identify studies that examined myocarditis and pericarditis after both COVID-19 vaccination and SARS-CoV-2 infection. A literature search was conducted, and retrospective cohort studies examining incidence rates for myocarditis and pericarditis after both COVID-19 vaccination and SARS-CoV-2 infection were included. The methodologies and conclusions of each study was assessed, and a risk of bias was determined. We found 6 articles that utilized cohorts of both vaccinated and infected populations. Of the included articles, all of them had risk of bias concerns, with 50 % having a poor-quality rating and 50 % having a fair quality rating. Methodological biases, including reliance on electronic health record data, inadequate observational periods, and failure to account for baseline characteristics between the two cohorts, were observed across studies. Ultimately, these methodological limitations lead to hyperinflated myocarditis rates in the infection cohorts and a lack of meaningful comparisons between the infection and vaccination cohorts.}, }
@article {pmid40622507, year = {2025}, author = {Sadowski, J and Huk, J and Otulak, S and Zawiło, J and Klaudel, T and Roszak, M and Tenczyński, D and Bułdak, RJ}, title = {Association between Guillain-Barré syndrome and SARS-CoV-2 virus infection, including the impact of COVID-19 vaccination in the context of the development and general clinical characteristics of the disease.}, journal = {Journal of neurovirology}, volume = {31}, number = {4}, pages = {333-346}, pmid = {40622507}, issn = {1538-2443}, mesh = {Humans ; *Guillain-Barre Syndrome/immunology/virology/epidemiology/pathology/etiology ; *COVID-19/immunology/prevention &amp; control/virology/complications ; *SARS-CoV-2/immunology/pathogenicity ; *COVID-19 Vaccines/adverse effects/immunology ; Vaccination/adverse effects ; Cytokines/immunology ; Autoantibodies/immunology ; }, abstract = {During the COVID-19 pandemic, a statistically significant increase in the incidence of Guillain-Barré syndrome (GBS) has begun to be observed. This article discusses the impact of immunological processes on structural and functional changes in the peripheral nervous system on the pathogenesis of GBS. The aim of the systematic review is to analyze and discuss available information from the scientific literature regarding a possible clinical relationship between SARS-CoV-2 infection along with vaccination mainly, adenovector and mRNA vaccines and the development of different types of Guillain-Barré syndrome. The review specifically discusses the role of proinflammatory cytokines and "cytokine storm" in patients with COVID-19 and their potential impact on the phenomenon of "molecular mimicry" and the generation of autoantibodies in GBS. This issue has been expanded to include information from studies on the impact of vaccination against SARS-CoV-2 virus and the higher number of observed cases of Guillain-Barré syndrome. Focusing on the characteristics of the methods, materials, results and conclusions, the review finally included 114 publications, like studies, meta-analyses, clinical cases and reviews. The systematic review was conducted using PubMed, Google Scholar, and Elsevier databases. It pointed out the molecular and clinical association between SARS-CoV-2 virus infections and COVID-19 vaccination, in the development of Guillain-Barré syndrome in the context of its clinical course.}, }
@article {pmid40622467, year = {2025}, author = {Chatterjee, D and Maparu, K}, title = {Long COVID syndrome: exploring therapies for managing and overcoming persistent symptoms.}, journal = {Inflammopharmacology}, volume = {33}, number = {7}, pages = {4097-4113}, pmid = {40622467}, issn = {1568-5608}, mesh = {Humans ; *COVID-19/therapy/complications/epidemiology/physiopathology ; Post-Acute COVID-19 Syndrome ; COVID-19 Drug Treatment ; SARS-CoV-2 ; Risk Factors ; }, abstract = {Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), is a growing global health concern, affecting 10-35% of COVID-19 survivors. Characterized by persistent multisystem symptoms lasting beyond 12 weeks, common manifestations include fatigue, dyspnea, chest pain, cognitive impairment, depression, and anxiety. The underlying pathophysiology remains unclear but is likely to involve immune dysregulation, persistent inflammation, endothelial dysfunction, gut dysbiosis, and viral persistence. This review examines the epidemiology, risk factors, and clinical manifestations of long COVID, with a focus on its impact on cardiopulmonary, neurological, and mental health. Therapeutic approaches include pharmacological interventions such as anti-inflammatory agents, antioxidants, neuroprotective drugs, and repurposed medications. Non-pharmacological strategies, such as physical rehabilitation, cognitive therapy, dietary modification, and emerging therapies like stem cell therapy, as well as immunomodulatory approaches, offer promising avenues for recovery. We also highlight ongoing clinical trials evaluating targeted therapies for long-term COVID syndrome. Future research should focus on elucidating the pathophysiological mechanisms, identifying biomarkers, and optimizing personalized treatment strategies for long-term COVID-19 management.}, }
@article {pmid40621974, year = {2025}, author = {Chen, J and Aherfi, S and Steichen, P and Rios, G and Waldmann, R and Barbry, P}, title = {[Molecular epidemiology of viruses sequenced from wastewater].}, journal = {Medecine sciences : M/S}, volume = {41}, number = {6-7}, pages = {585-592}, doi = {10.1051/medsci/2025083}, pmid = {40621974}, issn = {1958-5381}, mesh = {*Wastewater/virology ; Humans ; *SARS-CoV-2/genetics/isolation &amp; purification ; COVID-19/epidemiology/virology ; *Molecular Epidemiology/methods ; *Viruses/genetics/isolation &amp; purification ; Metagenomics/methods ; Pandemics ; Genome, Viral ; }, abstract = {Virus surveillance using metagenomic analysis of sequences from wastewater appears to be a promising epidemiological tool for monitoring the spread of viruses in large populations. Its use during the COVID-19 pandemic enabled the monitoring of SARS-CoV-2 circulation without requiring the collection of multiple individual samples. This approach allows both symptomatic and asymptomatic infections to be monitored in a highly cost-effective way. Initially based on PCR detection, the introduction of nucleic acid sequencing has improved this tool by providing more detailed metagenomic information. Experience with COVID-19 pandemics suggests that this epidemiological tool should now be extended to other viruses detectable in wastewater. This review discusses the different methods used, highlighting the challenges of a rapid deployment on an international scale to better understand the global circulation of viral pathogens.}, }
@article {pmid40621515, year = {2025}, author = {Azhar, S and Ibañez, NC and Zamora, J and Cavanillas, AB}, title = {Coronavirus-two infection among adults: A scoping review of literature published in 2023-24.}, journal = {Pakistan journal of medical sciences}, volume = {41}, number = {6}, pages = {1788-1798}, pmid = {40621515}, issn = {1682-024X}, abstract = {OBJECTIVE: To identify and synthesize evidence on Coronavirus-two infection (SARS-CoV-2) among adults diagnosed by polymerase chain reaction.<br><br>METHODS: The protocol was registered on Open Science Forum (doi: 10.17605/OSF.IO/2837X). Three bibliographic databases (Medline, SCOPUS, and Web of Science) were searched from July 2024 to December 2024. Peer-reviewed, quantitative studies with participants aged 18 and over were eligible to enlist potential risk factors of SARS-CoV-2 infection confirmed by Polymerase Chain Reaction PCR). The evidence was summarized as illustrations and tabulations with risk factors grouped into various categories. EndNote 20 was used for deduplications and organization of the literature.<br><br>RESULTS: Of 28,688 unique entries searched, 299 were shortlisted and 32 full-text manuscripts selected from 17 countries. There were two (6.2%) manuscripts based on real-time surveillance of at-risk populations. A total of 42 individual risk factors were examined in the evidence.<br><br>CONCLUSION: Low socioeconomic status and occupation were consistent risk factors of SARS-CoV-2 infection, with minimal representation from low- and middle-income countries in the evidence body. Future research should prioritize standardized methods and inclusion of underrepresented regions to enhance global applicability and inform targeted public health interventions.}, }
@article {pmid40620334, year = {2025}, author = {Endeshaw, D and Kebede, N and Abadi Tareke, A and Adal, O and Getachew, E and Belayneh, AG and Andargie, GA and Seid, K and Lakew, G and Yirsaw, AN and Tefera, M and Bogale, EK and Anagaw, TF and Fenta, ET}, title = {Prevalence of infection and associated factors after intramedullary nailing in African countries with the Surgical Implant Generation Network program: A systematic review and meta-analysis of available evidence.}, journal = {SAGE open medicine}, volume = {13}, number = {}, pages = {20503121251352653}, pmid = {40620334}, issn = {2050-3121}, abstract = {BACKGROUND: Infections following orthopedic procedures, such as implant insertion, are common and pose significant burdens globally. Comprehensive evidence of its prevalence and the influencing factors is crucial for developing effective infection prevention strategies across regions.<br><br>OBJECTIVE: To assess the prevalence of infection and associated factors after Surgical Implant Generation Network nailing in African countries with the Surgical Implant Generation Network program.<br><br>METHOD: A comprehensive search was performed across multiple databases, including PubMed, Global Index Medicus, Scopus, Embase, Science Direct, Hinari, and African Journals Online, complemented by a search of Google Scholar. After data extraction, the data were exported to STATA 17 statistical software for analysis. The pooled prevalence of infection was estimated using a random effects model. The level of heterogeneity was assessed using the I&#xb2; test, while publication bias was evaluated through a funnel plot and Egger's and Begg's tests.<br><br>RESULTS: This meta-analysis included 23 full-text studies involving a total of 4266 patients treated with Surgical Implant Generation Network intramedullary nailing for long bone fractures. The pooled prevalence of infection was 5.69% (95% CI: 4.55%-6.83%), with a moderate level of heterogeneity (I&#xb2;&#x2009;=&#x2009;57.86%, p&#x2009;<&#x2009;0.001). The review also identified significant predictors of infection, including open fracture type, complex fracture patterns, surgery performed within 15&#x2009;days of injury, the presence of a prophylactic drain, female gender, and procedures conducted by junior surgeons.<br><br>CONCLUSION: This meta-analysis revealed a relatively high infection prevalence in patients who underwent Surgical Implant Generation Network nailing for fractures. Infection risk was significantly higher in cases involving open or complex fractures, early surgical intervention, use of prophylactic drains, female patients, and procedures conducted by less-experienced surgeons. To mitigate this burden, clinical efforts should focus on optimizing the timing of surgery, avoiding unnecessary drain placement, strengthening supervision for junior surgeons, and prioritizing enhanced intraoperative and postoperative care for high-risk fracture types.}, }
@article {pmid40619741, year = {2025}, author = {Brüssow, H}, title = {From Bat to Worse: The Pivotal Role of Bats for Viral Zoonosis.}, journal = {Microbial biotechnology}, volume = {18}, number = {7}, pages = {e70190}, pmid = {40619741}, issn = {1751-7915}, mesh = {*Chiroptera/virology ; Animals ; Humans ; *Viral Zoonoses/transmission/virology/epidemiology ; COVID-19/transmission ; Disease Reservoirs/virology ; SARS-CoV-2 ; *Zoonoses/transmission/virology ; Pandemics ; }, abstract = {Zoonotic infections are increasingly observed and bats (Chiroptera) are playing a pivotal role here. The causal chain of events has been elucidated for Henipavirus (family: paramyxoviruses) infections. Deforestation combined with climate change has reduced the food sources of Pteropus fruit bats and attracted them to fruit trees planted around piggeries in Malaysia, transmitting Nipah virus to pigs as amplifying hosts and then to pig farmers and abattoir workers. Similar scenarios were seen in Australia where Pteropus bats transmitted Hendra virus to horses as intermediate hosts for human infections. Pteropus bats contaminated palm sap collected in Bangladesh with Nipah virus where fatal human-to-human transmissions occurred annually. Less direct evidence links coronaviruses carried by Rhinolophus bats with SARS and COVID-19 pandemics and a piglet epidemic in China. Rousettus bats living in caves transmitted the Marburg virus (family: filovirus) to miners in Africa. Most cases of human rabies in North America were caused by bat lyssaviruses (family: Rhabdoviruses). Bats are viral reservoir species for various virus families (reovirus, Hepacivirus of Flavivirus family, influenza A viruses). Bats are the only flying mammals which opened enormous evolutionary possibilities resulting in a worldwide radiation with 1400 species. Some bat species are represented by huge populations that come together in extremely crowded resting places that are conducive to viral transmission. Bats have evolved mechanisms that tolerate virus replication but suppress the associated pathology, making them healthy carriers for many viruses. It is speculated that with that strategy bats avoid an arms race with viruses for resistance and anti-resistance mechanisms. The excretion of viruses that are highly pathogenic for other mammalian orders could be used as biological weapons to defend their habitat against intrusion by mammalian competitors, including humans. This hypothesis might explain the increasing involvement of bat viruses in emerging infectious diseases observed in recent decades and expected in the future.}, }
@article {pmid40619035, year = {2025}, author = {Ghosh, M and Lahiri, M and Dalal, A and Parida, KK and Kalia, NP}, title = {Advancements in tuberculosis diagnostics: An update.}, journal = {Microbial pathogenesis}, volume = {207}, number = {}, pages = {107843}, doi = {10.1016/j.micpath.2025.107843}, pmid = {40619035}, issn = {1096-1208}, mesh = {Humans ; *Tuberculosis/diagnosis/microbiology ; *Mycobacterium tuberculosis/genetics/isolation &amp; purification ; Molecular Diagnostic Techniques/methods ; COVID-19 ; Point-of-Care Systems ; Tuberculin Test ; }, abstract = {Tuberculosis (TB) is one of the major life-threatening diseases caused by a single pathogen which has become a social menace owing to its high resistance. TB has even surpassed AIDS prior the COVID 19 pandemic. Every year the number of affected persons is increasing exponentially. In 2023 8.2 million new cases of TB were reported. There are various factors responsible for such infectivity rate of Mycobacterium tuberculosis (Mtb) including emergence of rapid resistant strains, treatment failure and lack of proper diagnosis. In order to combat the infection, early and effective treatment of the infection is very crucial. This calls for the existence of effective and point of care (POC) diagnostic tool for successful management of the disease. The conventional diagnostics includes staining, microscopy, tuberculin skin test and chest X ray. However, they have various limitations which increases the public threat. These tools lack the ease of transportation, less sensitive, time consuming and lack accuracy. To eliminate such limitations and bridge the gap associated with the proper diagnosis of disease, various biochemical, molecular, immunological diagnostic tools have come up in rescue of the infection. These modern tools are potent enough in characterizing Mtb, detect mutations correlated with the existing medications and ensure effective management. In this article we are focusing on modern diagnostic tools such as T-SPOT, artificial intelligence, electronic nose, RT PCR, TB LAM, CRISPR, biosensor-based detection techniques including the conventional techniques for detection of Mtb in clinical setup in resource limited healthcare facilities for comprehensive diagnosis of tuberculosis.}, }
@article {pmid40618429, year = {2025}, author = {Hazra, S and Bisht, KS and Makkar, S and Bora, KS}, title = {Knowledge, attitude, perception and satisfaction level of Ayurveda and allopathy in India: A systematic literature review.}, journal = {Explore (New York, N.Y.)}, volume = {21}, number = {5}, pages = {103208}, doi = {10.1016/j.explore.2025.103208}, pmid = {40618429}, issn = {1878-7541}, mesh = {*Medicine, Ayurvedic ; Humans ; India ; COVID-19 ; *Health Knowledge, Attitudes, Practice ; *Integrative Medicine ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: Ayurveda, an ancient Indian medical system, remains integral to India's healthcare despite the dominance of allopathy. The lack of scientific validation, standardized regulations, and clinical trials has hindered its integration into modern healthcare. The Ministry of AYUSH has played a key role in promoting Ayurveda, though regional disparities persist in its implementation. The COVID-19 pandemic revived interest in Ayurveda, highlighting its preventive aspects but also raising concerns about misinformation. A balanced, integrative approach combining Ayurveda and allopathy can enhance healthcare by leveraging the strengths of both systems. This study aimed to decipher the knowledge, attitude, perception, and satisfaction levels of Ayurveda and Allopathic, and/or integrative system of medicine, among the Indian Population.<br><br>METHODS: The search for eligible studies for inclusion was conducted via the following databases: PubMed, Scopus, and Web of Science. Original research, review, early access, open/early access articles, and meeting abstracts were eligible for inclusion.<br><br>RESULTS: This search generated 10,690 articles published between 2004 and 2024, and of these, 24 were assessed for eligibility. This included 20 original research and 4 review article. Only the research articcles were considered for the present review, with a collective total of 7952 participants. The manuscript revealed that the preference for Ayurveda was driven by perceptions of naturalness, safety, cultural familiarity, and affordability, rather than scientific validation. Additionally, while patients viewed it as a low-risk alternative, it was revealed through the included studies that there is limited awareness of proper dosage, risks, and potential interactions with Allopathy, leading to unsafe practices. Moreover, the gap between public interest in Ayurveda and the healthcare system's ability to provide regulated, evidence-based services was highlighted as one of the key issues in the adoption of Ayurvedic system of medicine. Thus, despite increased government support, integration remains weak due to operational barriers, professional hesitancy, and regional disparities in AYUSH services. Additionally, the private sector has not significantly incorporated Ayurveda, limiting urban access to integrative care.<br><br>CONCLUSIONS: The review highlights the preference for Ayurveda in chronic disease management and Allopathy for acute care, driven more by perceptions of safety and affordability than scientific validation. However, a lack of awareness about proper usage and herb-drug interactions leads to unsafe practices like unsupervised dual-use. Despite government efforts, integration remains limited due to operational barriers, professional hesitancy, and uneven AYUSH service distribution. The private sector has not meaningfully adopted Ayurveda, restricting urban access to integrative care. Advancing integrative medicine requires rigorous research, regulatory frameworks, and institutional reforms to ensure the safe, evidence-based coexistence of both systems.}, }
@article {pmid40617907, year = {2025}, author = {Rostami, M and Parsa-Kondelaji, M and Bos, MHA and Mansouritorghabeh, H}, title = {Antiphospholipid antibodies in patients with COVID-19: a systematic review and meta-analysis.}, journal = {Journal of thrombosis and thrombolysis}, volume = {58}, number = {7}, pages = {982-1001}, pmid = {40617907}, issn = {1573-742X}, support = {4022475//Mashhad University of Medical Sciences/ ; }, mesh = {Humans ; *COVID-19/immunology/blood/epidemiology/complications/diagnosis ; *Antibodies, Antiphospholipid/blood/immunology ; *Thrombosis/immunology/blood/epidemiology ; *SARS-CoV-2/immunology ; Prevalence ; Antibodies, Anticardiolipin/blood ; beta 2-Glycoprotein I/immunology ; Venous Thromboembolism/immunology/epidemiology/blood ; }, abstract = {COVID-19 patients are at an increased risk of developing thrombotic events, with venous thromboembolism (VTE) occurring in 16% and arterial thrombosis in 11.1% of cases. This systematic review and meta-analysis aimed to explore the prevalence of anti-phospholipid antibodies (aPLs) in COVID-19 patients and their potential role in thrombotic complications. A comprehensive literature search across PubMed, Scopus, and Web of Science identified 48 studies from an initial pool of 1,819 articles, which met the inclusion criteria and were rigorously evaluated for methodological quality. The analysis of studies revealed varying prevalence rates of aPLs among COVID-19 patients. Anti-β2 glycoprotein I IgM (aβ2GPI-IgM) was found in 5.3% of 5,176 patients, while aβ2GPI-IgG was observed in 3.6% of 5,348 patients. In contrast, aβ2GPI-IgA showed a higher prevalence of 10.8% across 18 studies involving 1,930 patients. Anti-cardiolipin antibodies also demonstrated distinct prevalence rates: aCL-IgG was present in 7.2% of 5,478 patients, aCL-IgM in 6.7% of 5,485 patients, and aCL-IgA in 4.7% of 1,626 patients. Notably, lupus anticoagulant (LA) had the highest pooled prevalence rate of 27.2% across 16 studies involving 1,731 patients. Among the aPL subgroups, LA were the most frequently detected, which may be due to interference of C-reactive protein (CRP). The findings underscore the heterogeneity in aPL distribution and emphasize the need for further research to clarify their role in the thrombotic manifestations of COVID-19. These insights may aid in prevention of thrombotic events by administration of anticoagulants in affected patients. PROSPERO REGISTRATION NUMBER: CRD42024529786.}, }
@article {pmid40617735, year = {2025}, author = {Bauernschmidt, D and Dichter, MN and Horbach, A and Meyer, G and Müller, M and Rahn, AC and Möhler, R}, title = {[Nursing research in the SARS-CoV-2 pandemic in Germany: A scoping review].}, journal = {Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen}, volume = {197}, number = {}, pages = {79-88}, doi = {10.1016/j.zefq.2025.05.006}, pmid = {40617735}, issn = {2212-0289}, mesh = {Humans ; *COVID-19/nursing/epidemiology ; Germany/epidemiology ; *Pandemics ; *Nursing Research/statistics &amp; numerical data ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The SARS-CoV-2 pandemic had a major impact on nursing and healthcare as well as on research. The aim of this study was to analyse the characteristics of nursing- and SARS-CoV-2-related research in Germany.<br><br>METHODS: A scoping review was conducted. We systematically searched (06/2023) Medline, CINAHL, the German Register of Clinical Trials, abstract books of conferences and conducted a manual literature search. We included empirical studies addressing aspects of nursing and the pandemic and involving German researchers. Study selection and data extraction were conducted independently by two reviewers. Results were analysed descriptively.<br><br>RESULTS: We included 131 publications (85 quantitative, 27 qualitative, 6 mixed-/multi-methods studies, 12 systematic reviews, 1 discussion paper); 49&#x202f;% of the studies were published in 2021. First authors were mostly from medicine, psychology and nursing science, last authors from medicine. Most studies were explorative. Most of the quantitative studies used observational designs, only four were experimental. Nurses and other healthcare professionals were the most common target group; people with care needs or relatives were rarely addressed. The most common topics included health, perceived burden, working conditions, and characteristics of care during the pandemic. A quarter of the studies were not externally funded, 32&#x202f;% did not provide information on funding. The Federal Ministry of Education and Research (21&#x202f;%) was the most common funding body.<br><br>CONCLUSION: Pandemic-related nursing research was published to a limited extent by nursing scientists; clinical nursing research was particularly underrepresented. Dependable funding and the development of a research infrastructure for nursing research are necessary to ensure evidence-based nursing in times of crisis and to generate findings that are relevant to clinical practice and health policy decision-makers.}, }
@article {pmid40617558, year = {2025}, author = {Milne, BM and Mallett, EM and Brogly, SB}, title = {The Effect of COVID-19 Vaccination on Menstrual Cycles of Adolescents and Young Adults: A Systematic Review and Meta-analysis.}, journal = {Journal of pediatric and adolescent gynecology}, volume = {38}, number = {6}, pages = {653-660}, doi = {10.1016/j.jpag.2025.06.010}, pmid = {40617558}, issn = {1873-4332}, mesh = {Humans ; Female ; Adolescent ; *Menstrual Cycle/drug effects ; *COVID-19 Vaccines/adverse effects ; Young Adult ; *COVID-19/prevention &amp; control ; *Vaccination/adverse effects ; Child ; Adult ; }, abstract = {The binding of the SARS-CoV-2 spike protein from vaccination can affect the menstrual cycle. Most studies have focused on women of reproductive age, with less attention given to adolescent and young women, despite their increased risk of heightened responses to vaccines. Thus, we consolidated evidence on menstrual changes after COVID-19 vaccination for adolescent and young women.<br><br>METHODS: The OVID MEDLINE, EMBASE, and CINAHL databases were searched (January 2020-December 2024) for peer-reviewed studies on COVID-19 vaccination in menstruating people <25 years old. Of 80 articles identified, 15 met the inclusion criteria after review by 2 independent reviewers. We estimated risk ratios (RRs) and mean differences (MDs) when data permitted. We assessed publication bias with funnel plots and evaluated heterogeneity using Cochran's Q, Galbraith plots, and the I&#xb2; statistic. Outcomes included any measured or perceived changes in menstrual cycles, bleeding length, and cycle length (ie, length between the first day of bleeding of 2 periods).<br><br>RESULTS: Among the 15 studies, 24,647 adolescents and young adults aged 12-25 were included. The summary effect measure showed no effect of vaccination on any menstrual change (RR = 1.09; 95% CI, 0.84-1.42) and significant heterogeneity across studies (I[2] = 69%). There was, however, a greater risk of longer cycle length after vaccination (RR = 1.17; 95% CI, 1.08-1.27) and no heterogeneity between 2 studies (I[2] = 0%); however, when assessed continuously, there was a nonsignificant increase in cycle length (MD = 0.24 days; 95% CI, -0.34 to 0.82). No studies assessed menses bleeding length in adolescent and young women. Funnel plots suggested no publication bias.<br><br>CONCLUSION: Although few studies were included, the available data suggest that there may be an increased risk of a longer menstrual cycle length in adolescents and young women, but no other changes were identified. Further data are needed.}, }
@article {pmid40616979, year = {2025}, author = {Wier, J and Price, N and Brisley, H and Brockmann, P}, title = {Underserved groups access to reproductive services: A literature review of women aged 18-25 years.}, journal = {Sexual &amp; reproductive healthcare : official journal of the Swedish Association of Midwives}, volume = {45}, number = {}, pages = {101126}, doi = {10.1016/j.srhc.2025.101126}, pmid = {40616979}, issn = {1877-5764}, mesh = {Humans ; Female ; *Health Services Accessibility ; *Reproductive Health Services ; COVID-19/epidemiology ; Adolescent ; Young Adult ; Adult ; *Vulnerable Populations ; SARS-CoV-2 ; Contraception ; }, abstract = {The Covid-19 pandemic highlighted the need for several improvements for young women, in terms of accessing, funding, and strategies for the development of sexual and reproductive health care (SRH). Core recommendations were highlighted by the All-Party Parliamentary Group (APPG) Report (Johnson,2020) on sexual and reproductive Health in the UK. Key recommendations included that the choice of method and delivery of reproductive services for women is reducing. This was furthered globally by the World Health Organisation (WHO) (2023) who note a need for equity in access, supportive health monitoring and a focus on underserved groups. This literature review was conducted using the established method of thematic analysis (Braun &amp; Clarke,2006), and in parallel with the APPG report and WHO recommendations, consolidates the findings into three key themed areas: underserved women's reproductive healthcare, cost effective contraception, young people's access to and understanding of fertility and contraception services. Underserved communities such as young women from marginalised groups, people of colour (Messinis et al,2021), women who have sex with women (Burkill &amp; Waterhouse2019) and women with disabilities (McCarthy,2011), experience inadequate and disparity of provision when accessing reproductive services. The review highlights limited high quality, recent, UK-based studies to further inform local governments, that considers the views and needs of young women 18-25 years when accessing reproductive services to implement change.}, }
@article {pmid40616095, year = {2025}, author = {Atnafu, A and Teshale, G and Dellie, E and Park, YS}, title = {Exploring health system challenges and gaps for crisis response in Ethiopia: a scoping review of publications and reports from 2020-2024.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {928}, pmid = {40616095}, issn = {1472-6963}, support = {RF-EGA-2023-H03//Research Investment for Global Health Technology (RIGHT) Foundation/ ; RF-EGA-2023-H03//Research Investment for Global Health Technology (RIGHT) Foundation/ ; RF-EGA-2023-H03//Research Investment for Global Health Technology (RIGHT) Foundation/ ; RF-EGA-2023-H03//Research Investment for Global Health Technology (RIGHT) Foundation/ ; }, mesh = {Ethiopia/epidemiology ; Humans ; *COVID-19/epidemiology ; *Delivery of Health Care/organization &amp; administration ; SARS-CoV-2 ; Disasters ; }, abstract = {BACKGROUND: Ethiopia's health system has faced significant challenges due to COVID-19, natural disasters, and conflicts, disrupting healthcare delivery. This scoping review examined health system gaps and responses during crises, aiming to recommend strategies for resilience.<br><br>METHOD: We followed a systematic scoping review approach using the five-step methodology: defining the research question, identifying relevant literature, selecting studies, charting the data, and summarizing/analyzing results. The review was guided by PRISMA-ScR and used the Population, Concept, and Context (PCC) framework. We included all English-language studies published between January 2000 and December 2024 addressing challenges or responses of the Ethiopian health system during crises, regardless of study design. PubMed, SCOPUS, Google Scholar, and Google were searched using MeSH terms/keywords. After title, abstract, and full-text screening, 44 articles were included for final analysis. Data were synthesized using descriptive analytical methods and narrative synthesis to summarize and interpret findings.<br><br>RESULTS: Findings revealed crises severely impacted health services due to shortages of medical supplies, workforce, and infrastructure. Demand surges, transport restrictions, border closures, and financial constraints exacerbated these gaps. Additional challenges included poor data availability, high staff turnover, lack of emergency communication plans, and insufficient funding.<br><br>The COVID-19 pandemic and the northern Ethiopian conflict notably disrupted routine services, infrastructure, and health information systems. To build resilience, the study recommends: (1) developing scalable emergency plans for essential services, (2) strengthening primary healthcare and community-based systems, (3) maintaining medical stockpiles, and (4) providing crisis-specific training for health workers. These measures aim to enhance preparedness and sustainability in Ethiopia's health system amid future shocks.}, }
@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 &amp; 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.<br><br>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&#x202f;% confidence intervals to quantify adverse effects and therapeutic outcomes.<br><br>RESULTS: The analysis of nine studies encompassing diverse demographic populations (ages &#x2265;2 years, both sexes) established a clear safety profile for tocilizumab. The treatment demonstrated a statistically important association (P&#x202f;<&#x202f;0.05) with mild adverse effects (nausea, diarrhea, headache, fatigue; r&#x202f;=&#x202f;0.62, 95&#x202f;% CI = 0.59-0.71) and moderate adverse effects (tremors, urinary difficulties, mood changes; r&#x202f;=&#x202f;0.54, 95&#x202f;% CI = 0.47-0.60). More concerning were the severe adverse effects, including hepatobiliary dysfunction and hypersensitivity reactions (r&#x202f;=&#x202f;0.36, 95&#x202f;% CI = 0.32-0.41), with rare but critical instances of acute liver failure (r&#x202f;=&#x202f;0.18, 95&#x202f;% CI = 0.15-0.22). Notably, despite this safety profile, tocilizumab exhibited significant therapeutic efficacy (P&#x202f;<&#x202f;0.01) in ameliorating COVID-19 symptoms, particularly in cases complicated by cytokine storm syndrome.<br><br>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.}, }
@article {pmid40614415, year = {2025}, author = {Shahid, S and Hasan, A and Iqbal, M and Khan, M and Ayatullah, O and Qasim, SA and Batool, A}, title = {Discontinuation of disease-modifying therapy in stable multiple sclerosis: A systematic review and meta-analysis.}, journal = {Multiple sclerosis and related disorders}, volume = {101}, number = {}, pages = {106599}, doi = {10.1016/j.msard.2025.106599}, pmid = {40614415}, issn = {2211-0356}, mesh = {Humans ; *Multiple Sclerosis/drug therapy ; *Withholding Treatment ; *Immunologic Factors/therapeutic use ; }, abstract = {BACKGROUND: Disease-modifying therapies (DMTs) are used to manage multiple sclerosis (MS), particularly in individuals with relapse-onset MS, to slow disease progression, reduce inflammation and demyelination and improve quality of life. Discontinuing treatment may pose a greater relapse risk for younger individuals with active disease, whereas the safety of treatment cessation in older, stable patients remains uncertain.<br><br>METHODS: We conducted a systematic review and meta-analysis of studies comparing discontinuation of disease-modifying therapy in stable multiple sclerosis patients. Data were collected from PubMed, Embase, and Cochrane Central databases. Statistical analysis was performed using Review Manager v5.4. A random-effects model was applied to pool risk ratios (RRs) and 95 % confidence intervals, with statistical significance set at p < 0.05.<br><br>RESULTS: A total of eight studies, including 4517 patients (3355 in the continuation group and 1162 in the discontinuation group), were analyzed. The mean age of participants was 53 years, with 72.7 % being female. Discontinuation of disease-modifying therapy (DMT) in patients with stable multiple sclerosis (MS) was associated with a significantly higher risk of mild adverse events (RR 1.29; 95 % CI 1.15-1.46; p < 0.0001). However, the risk of relapse (RR 0.31; 95 % CI 0.03-3.21; p = 0.33), as well as moderate (RR 1.11; 95 % CI 0.97-1.28; p = 0.14) and severe adverse events (RR 0.90; 95 % CI 0.45-1.78; p = 0.75), was comparable between the two groups. Similarly, the risk of common or treatment-related adverse events, including COVID-19 (RR 0.65; 95 % CI 0.28-1.52; p = 0.32), influenza (RR 0.39; 95 % CI 0.14-1.08; p = 0.07), and abnormal white blood cell count (RR 1.03; 95 % CI 0.11-3.21; p = 9.77), did not differ significantly between the continuation and discontinuation groups.<br><br>CONCLUSION: This meta-analysis found no significant increase in relapse risk after DMT discontinuation in stable MS patients. However, outcomes varied based on patient age, prior DMT, and duration of disease stability. Agents like S1P inhibitors and natalizumab may carry higher relapse risk after cessation. Additionally, new MRI lesions were noted in some studies, highlighting the need for continued monitoring. Treatment decisions should be individualized until further long-term data become available.}, }
@article {pmid40614091, year = {2025}, author = {Matula, Z and Bacskai, M and Andrikovics, H and Bors, A and Csabán, D and Őrfi, Z and Gyenesei, A and Uher, F and Vályi-Nagy, I}, title = {[Genetic factors underlying the susceptibility to SARS-CoV-2 infection and severe COVID-19].}, journal = {Orvosi hetilap}, volume = {166}, number = {18}, pages = {679-696}, doi = {10.1556/650.2025.33280}, pmid = {40614091}, issn = {1788-6120}, mesh = {Humans ; *COVID-19/genetics/immunology ; *Genetic Predisposition to Disease ; *SARS-CoV-2 ; Severity of Illness Index ; Risk Factors ; }, abstract = {The clinical manifestations of coronavirus disease (COVID–19) are highly variable, ranging from asymptomatic cases to life-threatening complications and death. Severe disease progression is more common in older individuals and males, as well as in the presence of various comorbidities. Beyond these risk factors, the intrinsic characteristics of the virus and the host genetic factors also contribute to the heterogeneous clinical course of COVID–19. Genetic research is fundamental in understanding the biological mechanisms underlying congenital diseases, identifying the genes and proteins responsible for the susceptibility to various inherited conditions, recognizing therapeutically relevant targets, suggesting drug repurposing, and clarifying causal relationships for modifiable environmental risk factors. Although these studies typically take a long time to conduct, especially to translate their findings into clinical practice, the scientific community has swiftly uncovered genetic signals underlying the diverse COVID–19 phenotypes. In this review, in addition to a concise summary of SARS-CoV-2 recognition and the initial steps of the immune responses, we aim to provide an overview of the literature concerning the genetic factors associated with susceptibility to the disease and its severe progression. We also review the pioneering research in identifying the affected genes and the most significant genome-wide association studies, covering both common and rare genetic variants, which have greatly contributed to understand the etiology of the disease and have guided effective COVID–19 treatment during the most challenging times. Orv Hetil. 2025; 166(18): 679–696.}, }
@article {pmid40613275, year = {2025}, author = {Grewal, T and Buechler, C}, title = {Physiological Activities of Adiponectin Provide Therapeutic Opportunities in Sepsis.}, journal = {Frontiers in bioscience (Landmark edition)}, volume = {30}, number = {6}, pages = {26129}, doi = {10.31083/FBL26129}, pmid = {40613275}, issn = {2768-6698}, mesh = {Humans ; *Adiponectin/blood/physiology/metabolism/therapeutic use ; *Sepsis/metabolism/blood/drug therapy/physiopathology ; Animals ; Inflammation ; }, abstract = {Sepsis represents a life-threatening organ dysfunction due to a compromised host response caused by bacterial and viral infections. Although progress has been made to unravel the underlying pathophysiology, sepsis remains a very serious condition. Adiponectin is an adipokine with multiple beneficial activities relevant to glucose and lipid metabolism whose serum levels are low in obesity and metabolic diseases. In addition, several immunoregulatory activities of adiponectin have been described and circulating adiponectin levels have been positively associated with inflammation in autoimmune diseases such as rheumatoid arthritis and type 1 diabetes. Although an understanding of physiological consequences is still limited, blood adiponectin levels are also elevated in chronic kidney disease and liver cirrhosis, possibly due to impaired biliary and renal excretion. Natriuretic peptides, which increase adiponectin synthesis in adipocytes and are induced in autoimmune diseases and cirrhosis and decreased in obesity, appear to contribute to altered systemic adiponectin levels. In patients with sepsis, data on circulating adiponectin levels are not concordant, probably due to the large diversity in cohorts analyzed, often including patients with a higher risk for severe sepsis due to chronic metabolic disease or other comorbidities. This review article summarizes the main physiological activities of adiponectin and describes its role in inflammation and experimental sepsis. Adiponectin levels obtained in observational studies from serum or plasma of patients with critical illness are discussed. From this analysis, we conclude that circulating adiponectin levels are reduced in sepsis and septic shock, suggesting the potential of adiponectin receptor agonists as an option for sepsis therapy.}, }
@article {pmid40613193, year = {2025}, author = {Wang, ZH and Zhao, JY and Shi, XF}, title = {[Interaction between COVID-19 Infection and Hematological Malignancies --Review].}, journal = {Zhongguo shi yan xue ye xue za zhi}, volume = {33}, number = {3}, pages = {922-926}, doi = {10.19746/j.cnki.issn.1009-2137.2025.03.046}, pmid = {40613193}, issn = {1009-2137}, mesh = {Humans ; *COVID-19/complications ; *Hematologic Neoplasms/complications ; SARS-CoV-2 ; }, abstract = {The pandemic of coronavirus disease 2019 (COVID-19) has impacted our lifestyles. On the one hand, the patients with hematological malignancies (HM) are more vulnerable to COVID-19 infection. Once infected with COVID-19, these patients tend to develop into severe type with a higher mortality rate. Although patients with HM demonstrated a reduced response to COVID-19 vaccines, they still can benefit from vaccine injection with reduced rates of viral infection and incidence of severe cases. The combination of monoclonal antibodies and antiviral drugs is helpful to the COVID-19 treatment of patients with HM. On the other hand, COVID-19 infection can lead to a delay of hematopoietic recovery and low immunity in patients with HM. For HM patients with COVID-19 infection, to reduce the intensity and shorten the course of radiotherapy and chemotherapy is needed. This article will review the interaction between COVID-19 infection and HM.}, }
@article {pmid40612950, year = {2025}, author = {Almskog, LM and Ågren, A}, title = {Thromboinflammation vs. immunothrombosis: strategies for overcoming anticoagulant resistance in COVID-19 and other hyperinflammatory diseases. Is ROTEM helpful or not?.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1599639}, pmid = {40612950}, issn = {1664-3224}, mesh = {Humans ; *COVID-19/immunology/complications/blood ; *Anticoagulants/therapeutic use ; *SARS-CoV-2 ; *Thromboinflammation/drug therapy/immunology ; *Inflammation/immunology/drug therapy ; Thrombelastography ; *COVID-19 Drug Treatment ; Drug Resistance ; Blood Coagulation/drug effects ; Blood Platelets/immunology ; *Thrombosis/drug therapy/immunology ; Cytokine Release Syndrome ; }, abstract = {Thrombosis and inflammation are closely interconnected. Systemic inflammation activates the coagulation system, while components of the coagulation system can, in turn, significantly influence the inflammatory response. This process, where the immune system contributes to thrombus formation, is known as immunothrombosis. Conversely, thromboinflammation describes the effect of thrombus formation on the immune system. Various immune cells, including neutrophils and monocytes, play key roles in these processes, as well as endothelial cells, strategically positioned to rapidly detect and respond to invading pathogens. Platelets are also actively recruited, promoting coagulation and releasing procoagulant factors. When the endothelium becomes dysfunctional and acquires proinflammatory and procoagulant properties, it fosters the formation of microvascular thrombosis. The excessive release of proinflammatory cytokines and chemokines further intensifies this cycle, contributing to cytokine storms, as observed in severe COVID-19 cases. This phenomenon exemplifies immunothrombosis and thromboinflammation. Anticoagulant therapy is standard care for venous thromboembolism prevention in Intensive Care Unit patients, with critically ill COVID-19 patients often receiving higher doses. However, variations in individual responses to heparin were observed in COVID-19 patients, suggesting a degree of resistance to anticoagulant therapy. This resistance may be linked to thromboinflammation, where the intense inflammatory response diminishes the effectiveness of anticoagulation. In this context, combining anticoagulants with immunomodulatory drugs has shown promising potential. This review aims to delve into the concepts of immunothrombosis and thromboinflammation, with a particular focus on the complex interplay between the coagulation and inflammation systems and their mutual reinforcement in the context of COVID-19. We examine why standard anticoagulant therapies often proved insufficient in managing hyperinflammatory diseases and discuss potential alternative treatment strategies. Furthermore, we evaluate the potential role of rotational thrombelastometry (ROTEM) in managing immunothrombotic states.}, }
@article {pmid40612812, year = {2025}, author = {Chittiprol, N and Kandi, V and Pinnelli, VBK and Suvvari, TK and Madamsetti, N and Ca, J and Challa, ST}, title = {The Re-emergence of Human Metapneumovirus: Virus Classification, Characteristics, Mechanisms of Infection, Clinical Features, Diagnosis, Epidemiology, Prevention, and Treatment.}, journal = {Cureus}, volume = {17}, number = {6}, pages = {e85259}, pmid = {40612812}, issn = {2168-8184}, abstract = {The respiratory virus known as the human metapneumovirus (HMPV) was discovered for the first time in 2001 in the Netherlands. It is a ribonucleic acid (RNA) virus that belongs to the Paramyxoviridae family. It causes upper and lower respiratory tract infections (RTIs), especially in young children and the elderly. Although the majority of HMPV infections are resolved on their own, some infected infants, children, and elderly patients need to be hospitalized. Patients with underlying immunodeficiency diseases, transplant recipients, and those with other co-morbidities, such as chronic diseases, are more likely to develop complications from HMPV infections, such as pneumonia. The symptoms of HMPV infections are similar to those of other viral RTIs caused by respiratory syncytial virus (RSV), influenza viruses, and coronaviruses. Differential diagnosis and identification of the etiological agents responsible for RTIs are crucial for improved patient care. Concerns of the next pandemic have been fueled by the discovery of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of the coronavirus disease-2019 (COVID-19) that caused the pandemic, and the recent advent of other viral diseases like mpox. In addition, the World Health Organization (WHO) has emphasized the importance of public health readiness, as many pandemics are expected to occur. In light of this and a recent increase in HMPV cases signifying its potential re-emergence, we tried to thoroughly examine and update information on origin, transmission, pathogenicity, clinical features, laboratory diagnosis, epidemiology, prevention, and treatment of HMPV.}, }
@article {pmid40612551, year = {2025}, author = {Thompson, M and Buttery, AK and Oh, SX and Chan, M and Lee, BH and Iino, T and Wang, YA and Clarke, C}, title = {Risk factors for severe COVID-19 outcomes in the Asia-Pacific region: a literature review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1562179}, pmid = {40612551}, issn = {2296-2565}, mesh = {Humans ; *COVID-19/epidemiology ; Risk Factors ; Asia/epidemiology ; Male ; SARS-CoV-2 ; Female ; Adult ; Middle Aged ; Pacific Islands/epidemiology ; }, abstract = {This comprehensive synthesis of severe COVID-19 risk factors specific to the Asia-Pacific (APAC) region addresses gaps in previous global studies, which often overlook regional demographic, epidemiological, and healthcare system variations. Three databases (PubMed, Ovid MedLine, Scopus) and two preprint platforms (BioRxiv, MedRxiv) were searched between December 1, 2019, and March 31, 2023. English-language publications from 11 APAC countries/regions (Australia, Hong Kong, Japan, Macau, New Zealand, Philippines, Singapore, South Korea, Taiwan, Thailand and Vietnam) reporting conditions associated with severe COVID-19 outcomes in adults (aged ≥16 years) were included. Of 295 publications screened, 123 met inclusion criteria, mostly from South Korea (n = 68) and Japan (n = 23). Common risk factors included older age, male sex, obesity, diabetes, heart failure, renal disease, and dementia. Less commonly hypertension, chronic obstructive pulmonary disease, cardio-and cerebrovascular disease, immunocompromise, autoimmune disorders, and mental illness were reported. To date, no prior region-specific synthesis of risk factors for severe COVID-19 outcomes across the APAC region has been identified. The findings support the development of tailored vaccination strategies and public health interventions at both national and regional levels, helping ensure high-risk populations are prioritized in ongoing COVID-19 prevention and management efforts.}, }
@article {pmid40612208, year = {2025}, author = {Abourjeili, J and Lattouf, C and Abou Mrad, A and Salameh, E and Zareef, R and Bitar, F and Arabi, M}, title = {Myocarditis Following COVID-19 Vaccine: What Did We Learn?.}, journal = {Sage open pediatrics}, volume = {12}, number = {}, pages = {30502225251336877}, pmid = {40612208}, issn = {3050-2225}, abstract = {The COVID-19 pandemic has had a profound global impact, with vaccination emerging as a key strategy for controlling the virus. However, concerns have arisen regarding potential cardiovascular side effects, particularly myocarditis following mRNA COVID-19 vaccination. This review examines the risk of post-vaccination myocarditis by analyzing over 40 studies. Findings indicate that myocarditis occurs most commonly within 2 to 4 days after the second dose, particularly in males aged 12 to 39 years. Proposed mechanisms include molecular mimicry and hypersensitivity reactions. Despite these concerns, most cases present with mild symptoms such as chest pain and dyspnea, resolving with supportive care. Importantly, the overall safety profile of COVID-19 vaccines remains high, with benefits significantly outweighing risks. Further multi-center studies are needed to fully understand the pathophysiology and mitigate potential adverse effects. No clinical trials were conducted for this review.}, }
@article {pmid40611647, year = {2025}, author = {Panzuti, G and Giancotti, G and Nava, S and Vega Pittao, ML}, title = {A clinicians' guide to non-invasive ventilation for exacerbated chronic obstructive pulmonary disease.}, journal = {Expert review of respiratory medicine}, volume = {19}, number = {12}, pages = {1193-1207}, doi = {10.1080/17476348.2025.2529540}, pmid = {40611647}, issn = {1747-6356}, mesh = {Humans ; *Noninvasive Ventilation/methods/adverse effects ; *Pulmonary Disease, Chronic Obstructive/therapy/physiopathology/diagnosis ; COVID-19 ; Patient Selection ; Disease Progression ; }, abstract = {INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD) is a debilitating condition marked by persistent airflow limitation, leading to increased morbidity and mortality. Acute exacerbations of COPD (AECOPD) can cause rapid deterioration, resulting in hypercapnic respiratory failure and respiratory acidosis. Non-invasive ventilation (NIV) is a key treatment for AECOPD, improving gas exchange, oxygenation, and reducing work of breathing while avoiding the risks of invasive mechanical ventilation (IMV).<br><br>AREAS COVERED: This review highlights NIV role as a first-line therapy in AECOPD management, discussing its mechanisms, indications, and clinical benefits. Proper patient selection, tailored settings, and careful monitoring are crucial for optimizing outcomes and minimizing complications.<br><br>EXPERT OPINION: The widespread use of NIV in AECOPD management raises concerns about staff expertise, as success depends on patient selection, ventilator settings, and monitoring. Identifying failure predictors is crucial to prevent delayed intubation and poor outcomes. Research should focus on training, reducing errors, and advancing technology, including Artificial Intelligence-driven automation to improve synchrony. Despite its increased use, especially during COVID-19, progress in staff education and technology remains limited. Enhancing clinician confidence and developing intelligent ventilator algorithms are key, but human expertise remains essential in ensuring effective and life-saving NIV application.}, }
@article {pmid40610704, year = {2025}, author = {Cahuapaza-Gutierrez, NL and Calderon-Hernandez, CC and Villavicencio-Escudero, TV}, title = {Kikuchi-Fujimoto in the light of the COVID-19: infection and vaccination. A systematic review.}, journal = {Clinical rheumatology}, volume = {44}, number = {8}, pages = {3153-3166}, pmid = {40610704}, issn = {1434-9949}, mesh = {Adult ; Female ; Humans ; Male ; *COVID-19/prevention &amp; control/complications ; *COVID-19 Vaccines/adverse effects ; *Histiocytic Necrotizing Lymphadenitis/etiology/epidemiology ; SARS-CoV-2 ; *Vaccination/adverse effects ; Child ; Adolescent ; Young Adult ; }, abstract = {BACKGROUND: The association between SARS-CoV-2 infection, COVID-19 vaccination, and the development of autoimmune diseases such as the Kikuchi-Fujimoto disease (KFD) is currently unknown.<br><br>AIMS: This study aims to review, synthesize, and analyze the current available evidence on the occurrence of KFD associated with both SARS-CoV-2 infection and COVID-19 vaccination.<br><br>METHODS: Case report, case series, and observational studies were included. Narrative review studies, systematic reviews, meta-analyses, etc., were excluded. A selective bibliographic search was performed in the following databases: PubMed, Scopus, EMBASE, and Web of Science until January 26, 2025. The Joanna Briggs Institute (JBI) tool was used to assess the risk of bias and quality of the studies. The SPSS Statistics tool (version 25.0; IBM Corp., Armonk, N. Y., USA) was used for statistical analysis.<br><br>RESULTS: A total of 52 patients were reported in the included studies. Of these, 16 developed new-onset KFD as a complication of SARS-CoV-2 infection, while 36 presented with the disease as an adverse effect of COVID-19 vaccination. Cases associated with infection had a mean age of 27.25&#x2009;&#xb1;&#x2009;16.87&#xa0;years, and the most frequent clinical manifestations were fever, fatigue, cough, and weight loss. On the other hand, cases related to vaccination had a mean age of 30.8&#x2009;&#xb1;&#x2009;12.63&#xa0;years, with a greater association to mRNA technology vaccines, particularly Pfizer-BioNTech (75%) and Moderna (11.1%). Most cases were related to the administration of the first dose (75%). There was a predominance of female sex and the presence of cervical lymphadenopathy in both groups. There were no cases of mortality or unfavorable evolution; on the contrary, almost all patients evolved favorably after timely diagnosis and adequate treatment.<br><br>CONCLUSIONS: SARS-CoV-2 infection could represent a new causative agent of KF disease. However, its occurrence as an adverse effect of COVID-19 vaccination is rare and infrequent, which may be attributed to limited case reporting and the relative novelty of the disease.<br><br>PROSPERO CRD42024522470.}, }
@article {pmid40610033, year = {2025}, author = {Cooper, N and Agius, S and Freeman, K and Church, H and Yoosoof, F and Frain, A and Frain, J and McConnell, R and Wilson, E and Leonardi-Bee, J}, title = {Impact of physician assistants on quality of care: rapid review.}, journal = {BMJ (Clinical research ed.)}, volume = {390}, number = {}, pages = {e086358}, pmid = {40610033}, issn = {1756-1833}, mesh = {*Physician Assistants/standards ; Humans ; *Quality of Health Care ; United Kingdom ; Physicians ; }, abstract = {OBJECTIVE: To determine the impact of physician assistants, compared with physicians, on quality of care in the context of an ongoing UK policy review.<br><br>DESIGN: Rapid systematic review.<br><br>SEARCH STRATEGY: Keyword search of three databases; search and citation tracking of previous systematic reviews.<br><br>ELIGIBILITY CRITERIA: Empirical studies that quantitatively compared care delivered by physician assistants with care delivered by physicians, including residents, in economically developed countries, published between January 2005 and January 2025.<br><br>MAIN OUTCOMES OF INTEREST: Measures of outcomes of care, as defined by the Institute of Medicine's definition of quality: safety, effectiveness, patient centredness, timeliness, efficiency, and equity.<br><br>METHODS: Eligible studies were categorised as primary care, secondary care, physician assistants versus residents in hospitals, diagnosis/performance, and cost effectiveness. Two reviewers independently extracted data on study design, samples, methods, and findings. Each study was assessed using a risk of bias tool. Owing to the heterogeneity of included studies, a narrative synthesis of the main findings was conducted. An assessment of confidence in the body of evidence for each outcome was based on the number and quality of relevant studies and the consistency of results between similar studies.<br><br>RESULTS: Of 3636 studies screened, 167 studies were eligible and 40 met the inclusion criteria. These consisted mainly of retrospective observational studies of weak quality. Most (31/40) were from the US, and no data from a post-covid-19 context were found. The greatest number of studies with the most consistent results were those that found that physician assistants practised safely and effectively when working under direct supervision and in post-diagnostic care. No difference was found in patient satisfaction between physician assistants and physicians. Although adding physician assistants to medical teams increases access to care, this may reflect the benefits of increased staffing rather than the unique contribution of the physician assistant role. Evidence on cost effectiveness is limited. Patients in the UK are more likely to see a physician assistant if they live in a socioeconomically deprived area.<br><br>CONCLUSION: The evidence found in this review is limited and does not support the safety or effectiveness of indirect supervision of physician assistants in undifferentiated (pre-diagnosis) settings. National guidance on the supervision and scope of practice for physician assistants can ensure that physician assistants practise safely and effectively.<br><br>STUDY REGISTRATION: PROSPERO CRD42024614992.}, }
@article {pmid40609996, year = {2025}, author = {Kazakova, AA and Leonova, EI and Sopova, JV and Chirinskaite, AV and Minskaya, ES and Kukushkin, IS and Ivanov, RA and Reshetnikov, VV}, title = {Progress in CRISPR/CAS13-Mediated Suppression of Influenza A and SARS-CoV-2 Virus Infection in in vitro and in vivo Models.}, journal = {Biochemistry. Biokhimiia}, volume = {90}, number = {6}, pages = {786-803}, doi = {10.1134/S0006297925601212}, pmid = {40609996}, issn = {1608-3040}, mesh = {*CRISPR-Cas Systems ; Animals ; *SARS-CoV-2/genetics ; Humans ; *COVID-19/therapy/virology ; *Influenza A virus/genetics ; *Influenza, Human/therapy/virology/genetics ; Disease Models, Animal ; RNA, Viral/genetics/metabolism ; Antiviral Agents ; }, abstract = {The worldwide number of deaths from complications caused by severe influenza and COVID-19 is about 1 million cases annually. Development of the effective antiviral therapy strategies for the disease treatment is one of the most important tasks. Use of the CRISPR/Cas13 system, which specifically degrades viral RNA and significantly reduces titer of the virus, could be a solution of this problem. Despite the fact that Cas13 nucleases have been discovered only recently, they already have shown high efficiency in suppressing viral transcripts in cell cultures. The recent advances in mRNA technology and improvements in non-viral delivery systems have made it possible to effectively use CRISPR/Cas13 in animal models as well. In this review, we analyzed experimental in vitro and in vivo studies on the use of CRISPR/Cas13 systems as an antiviral agent in cell cultures and animal models and discussed main directions for improving the CRISPR/Cas13 system. These data allow us to understand prospects and limitations of the further use of CRISPR/Cas13 in the treatment of viral diseases.}, }
@article {pmid40609955, year = {2025}, author = {Ghasemzadeh Rahbardar, M and Kesharwani, P and Sahebkar, A}, title = {Impact of resveratrol on neutrophil extracellular traps.}, journal = {Mutation research. Reviews in mutation research}, volume = {796}, number = {}, pages = {108550}, doi = {10.1016/j.mrrev.2025.108550}, pmid = {40609955}, issn = {1388-2139}, abstract = {Neutrophil extracellular traps (NETs) and the process of NETosis have emerged as critical participants in various pathological conditions. Resveratrol, a natural polyphenol found in several plants, has received significant attention due to its potential therapeutic properties. The purpose of this review is to investigate how resveratrol affects NETs and NETosis. The molecular mechanisms underlying NET formation and its role in disease pathogenesis are discussed, highlighting the involvement of various cellular and molecular factors. Moreover, the effects of resveratrol on NET formation, release, and stability are reported, focusing on its potential as a modulator of NET-associated diseases. Studies investigating the effect of resveratrol on NETosis in different disease models, including lung injury, COVID-19, cancer, and hepatic ischemia-reperfusion injury, are also summarized. Furthermore, the potential mechanisms through which resveratrol exerts its effects on NETosis, including anti-inflammatory, antioxidant, and immunomodulatory properties, are elucidated. The review also addresses the challenges and future perspectives in the field, emphasizing the need for further research to fully understand the therapeutic potential of resveratrol in targeting NET-associated disorders. Generally, this review provides a comprehensive analysis of the impact of resveratrol on NETs and NETosis, shedding light on its potential as a therapeutic intervention in various pathological conditions characterized by excessive NET formation. However, further research is essential to clarify the detailed mechanisms through which resveratrol exerts its effects on NETosis and to determine optimal dosages and treatment procedures.}, }
@article {pmid40609514, year = {2025}, author = {Drzymała, J}, title = {Environmental risk assessment of selective serotonin reuptake inhibitors (SSRIs) after COVID-19 pandemic: a systematic review.}, journal = {Chemosphere}, volume = {385}, number = {}, pages = {144545}, doi = {10.1016/j.chemosphere.2025.144545}, pmid = {40609514}, issn = {1879-1298}, mesh = {*Selective Serotonin Reuptake Inhibitors/analysis/toxicity ; *COVID-19/epidemiology ; *Water Pollutants, Chemical/analysis/toxicity ; Risk Assessment ; Humans ; SARS-CoV-2 ; Environmental Monitoring ; Wastewater ; Antidepressive Agents ; Animals ; }, abstract = {Nearly 4 % of people worldwide struggle with depression. This mental illness significantly affects daily functioning, and its treatment typically involves long-term pharmacotherapy combined with psychotherapy. Following the COVID-19 pandemic in 2019, the number of individuals suffering from depression increased substantially. One of the most commonly prescribed classes of antidepressants is selective serotonin reuptake inhibitors (SSRIs), such as citalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline. These compounds are detected in the environment, sometimes in considerable concentrations. For instance, fluvoxamine was found in surface waters at levels up to 1.92 μg L[-1], while fluoxetine was detected in drinking water at 0.0592 μg L[-1]. Their environmental presence is largely attributed to the limited efficiency of wastewater treatment plants, which allows these pharmaceuticals to enter aquatic ecosystems. This article presents a comprehensive analysis of recent data (2019-2025) concerning the environmental occurrence and ecological risks of SSRIs. Environmental risk assessments based on Risk Quotient (RQ) calculations, derived from measured environmental concentrations (MEC) and predicted no-effect concentrations (PNEC), using acute and chronic aquatic toxicity data, reveal a concerning picture. Citalopram was the only SSRI assessed to pose a moderate risk to algae (RQ = 0.50). All other SSRIs showed high environmental risks, particularly to algae (RQ range: 1.65-83.00). Fluoxetine was the only substance that exhibited a high risk to algae, crustaceans, and fish. Given the elevated risks, it is crucial to implement preventive measures to limit the environmental concentrations of SSRIs. These should include upgrades to wastewater treatment technologies and the introduction of systematic micropollutant monitoring programs.}, }
@article {pmid40609001, year = {2025}, author = {Bricklin, L and Snooks, KS and Mack, EH and Bell, R and Little, K and Behrens, DM}, title = {Firearm Injury Prevention From a Pediatric Critical Care Perspective.}, journal = {Pediatric annals}, volume = {54}, number = {7}, pages = {e238-e243}, doi = {10.3928/19382359-20250418-02}, pmid = {40609001}, issn = {1938-2359}, mesh = {Humans ; *Wounds, Gunshot/prevention &amp; control/epidemiology ; Child ; United States/epidemiology ; *Critical Care/methods ; COVID-19/epidemiology ; Firearms ; Adolescent ; }, abstract = {Firearm injury is a leading cause of morbidity and mortality in children and young adults in the United States. Inequities in this mechanism of injury related to race, gender, location, and economic status have increased during the coronavirus disease 2019 pandemic. Firearm injury is a public health crisis and requires a public health approach. By utilizing the Haddon matrix and injury equity framework, pediatric providers can systematically apply evidence-based medicine and strategies to combat this epidemic. It is imperative that acute care providers, including pediatric intensivists, pediatric hospitalists, and emergency medicine providers, unite with other subspecialists and primary care providers to reduce the burden of this preventable epidemic. [Pediatr Ann. 2025;54(7):e238-e243.].}, }
@article {pmid40608656, year = {2025}, author = {Freire, MP and Chioro, A and Tureck, F and Tofani, LFN and Silva, LGD and Bigal, AL and Vieira, ADCS and Louvison, MCP}, title = {Regulatory technology arrangements for hospital bed access during the COVID-19 pandemic: scope review.}, journal = {Cadernos de saude publica}, volume = {41}, number = {5}, pages = {e00044824}, pmid = {40608656}, issn = {1678-4464}, mesh = {Humans ; *COVID-19/epidemiology/therapy ; *Health Services Accessibility/legislation &amp; jurisprudence/organization &amp; administration ; Telemedicine/legislation &amp; jurisprudence ; SARS-CoV-2 ; Pandemics ; Brazil/epidemiology ; }, abstract = {The COVID-19 pandemic posed numerous challenges to health care systems, including hospital bed access. Analyzing the response provided and identifying regulatory technology arrangements that contributed to provide improved health care access can support the preparation of systems for future emergencies and also provide alternatives to current difficulties. The aim of this study is to mapping, summarize and categorize the regulatory technology arrangements used in hospital bed access during the COVID-19 pandemic using the scoping review method. The review used the recommendations of the Joanna Briggs Institute and the PRISMA-ScR report, and the PCC acronym (population [P]: of COVID-19 or non-COVID-19 patients; the concept [C]: of bed access regulation; and the context [C]: of the COVID-19 pandemic). The search was carried out in the PubMed, Scopus, Embase, Web of Science and LILACS databases between July and September 2022 and 45 articles were selected for review. We established three categories of analysis: Reorganization of services; Use of virtual tools and artificial intelligence; and Creation of alternative spaces, that assisted in the identification and analysis of the regulatory technology arrangements used. We note arrangements such as telehealth and telemedicine, the reconfiguration of existing spaces for expansion of health care capacity and modifications in the work process, including the adoption of specific protocols and the establishment of differentiated flows. The review showed the importance of regulatory technology arrangements in bed access and challenges such as regulation and financing, factors that may be essential for the use of regulatory technology arrangements.}, }
@article {pmid40608399, year = {2025}, author = {Bifarin, OO and Yelluru, VS and Simhadri, A and Fernández, FM}, title = {A Large Language Model-Powered Map of Metabolomics Research.}, journal = {Analytical chemistry}, volume = {97}, number = {27}, pages = {14088-14096}, pmid = {40608399}, issn = {1520-6882}, support = {R01 CA218664/CA/NCI NIH HHS/United States ; R01 DK132369/DK/NIDDK NIH HHS/United States ; R61 CA281667/CA/NCI NIH HHS/United States ; U01 DK134191/DK/NIDDK NIH HHS/United States ; }, mesh = {*Metabolomics ; Humans ; COVID-19/metabolism/diagnosis ; SARS-CoV-2/isolation &amp; purification ; Biomarkers/metabolism/analysis ; Large Language Models ; }, abstract = {We present a comprehensive map of the metabolomics research landscape, synthesizing insights from over 80,000 publications. Using PubMedBERT, we transformed abstracts into 768-dimensional embeddings that capture the nuanced thematic structure of the field. Dimensionality reduction with t-SNE revealed distinct clusters corresponding to key domains, such as analytical chemistry, plant biology, pharmacology, and clinical diagnostics. In addition, a neural topic modeling pipeline refined with GPT-4o mini reclassified the corpus into 20 distinct topics─ranging from "Plant Stress Response Mechanisms" and "NMR Spectroscopy Innovations" to "COVID-19 Metabolomic and Immune Responses." Temporal analyses further highlight trends including the rise of deep learning methods post-2015 and a continued focus on biomarker discovery. Integration of metadata such as publication statistics and sample sizes provides additional context to these evolving research dynamics. An interactive web application (https://metascape.streamlit.app/) enables the dynamic exploration of these insights. Overall, this study offers a robust framework for literature synthesis that empowers researchers, clinicians, and policymakers to identify emerging research trajectories and address critical challenges in metabolomics while also sharing our perspectives on key trends shaping the field.}, }
@article {pmid40608121, year = {2025}, author = {Ruzi, Z and Zha, W and Yuan, HY and Liu, J}, title = {RNA G-quadruplexes: emerging regulators of gene expression and therapeutic targets.}, journal = {Functional &amp; integrative genomics}, volume = {25}, number = {1}, pages = {143}, pmid = {40608121}, issn = {1438-7948}, support = {22262002//National Natural Science Foundation of China/ ; }, mesh = {*G-Quadruplexes ; Humans ; *Gene Expression Regulation ; *RNA/chemistry/genetics/metabolism ; Animals ; Neoplasms/genetics ; SARS-CoV-2 ; Neurodegenerative Diseases/genetics ; Alternative Splicing ; }, abstract = {RNA G-quadruplexes (rG4s) are non-canonical, four-stranded secondary structures formed by guanine-rich RNA sequences. These dynamic elements have garnered significant attention for their critical roles in regulating gene expression, including translation, alternative splicing, mRNA localization, and stability. This review synthesizes recent progress in understanding the structural determinants and formation dynamics of rG4s, highlighting the contributions of sequence motifs, ionic conditions, and RNA-binding proteins to their stability and function. Functional studies reveal that rG4s modulate key oncogenic transcripts (e.g., MYC, BCL2), contribute to splicing regulation, and influence intracellular RNA trafficking. In pathological contexts, rG4s have been implicated in the molecular etiology of cancers, neurodegenerative diseases such as amyotrophic lateral sclerosis and Fragile X syndrome, and viral replication mechanisms in pathogens including HIV and SARS-CoV-2. Advances in high-throughput techniques, such as G4-seq, rG4-seq, and live-cell imaging, have facilitated the global identification and characterization of rG4s in physiological and disease settings. Moreover, the therapeutic targeting of rG4s using small molecules holds promise for selective gene regulation and biomarker development. Comparative analyses across in vitro, in vivo, and clinical studies underscore the cell-type-specific and context-dependent roles of rG4s, especially in mediating stress responses and apoptosis. Despite methodological limitations and challenges in achieving targeted delivery, rG4s represent a compelling frontier for precision medicine. This review outlines current insights and future directions toward harnessing rG4 biology for therapeutic innovation.}, }
@article {pmid40607738, year = {2025}, author = {Debbag, R and Gallo, J and Ávila-Agüero, ML and Beltran, C and Brea-Del Castillo, J and Puentes, A and Enrique, S}, title = {Rebuilding vaccine confidence in Latin America and the Caribbean: strategies for the post-pandemic era.}, journal = {Expert review of vaccines}, volume = {24}, number = {1}, pages = {615-623}, doi = {10.1080/14760584.2025.2527327}, pmid = {40607738}, issn = {1744-8395}, mesh = {Humans ; Latin America/epidemiology ; *COVID-19 Vaccines/administration &amp; dosage ; *Vaccination Hesitancy/psychology/statistics &amp; numerical data ; Caribbean Region/epidemiology ; *COVID-19/prevention &amp; control/epidemiology ; *Vaccination/psychology ; Communication ; Pandemics/prevention &amp; control ; }, abstract = {INTRODUCTION: Vaccine hesitancy in Latin America and the Caribbean (LAC) has a complex nature. It is shaped by socio-political, cultural, economic factors, and an influence of the COVID-19 pandemic on increasing hesitancy patterns. While LAC has maintained high vaccination coverage, it has experienced a decline over the past 10-years, further exacerbated by declining vaccine confidence during the pandemic, driven by misinformation, political polarization, and conspiracy theories.<br><br>AREAS COVERED: We review the impact of vaccine hesitancy across various stakeholders in LAC, focusing on healthcare professionals, parents, and community leaders, including data from studies conducted in Argentina and Colombia highlighting regional variations in hesitancy patterns. It describes the role of pediatricians in recommending vaccines, particularly in COVID-19 vaccines. The study explores how the rapid spread of misinformation, particularly through social media, exacerbated mistrust, and offers an overview of vaccine hesitancy trends in LAC during/after the pandemic.<br><br>EXPERT OPINION: While vaccine acceptance remains high among certain populations, communication strategies are essential to address concerns about vaccine safety. It is imperative to strengthen the relationship between health-providers and the public to mitigate misinformation and improve vaccine uptake. We propose seven strategic approaches for a comprehensive communication aimed at changing the public behavior about vaccines.}, }
@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 = {P20 GM134973/GM/NIGMS NIH HHS/United States ; NFRFE-2023-00025//Government of Canada/ ; RGPIN-2022-03010//Natural Sciences and Engineering Research Council of Canada/ ; LT0017/2024-L//Human Frontier Science Program/ ; P20GM134973/NH/NIH HHS/United States ; //Edward Mallinckrodt, Jr. Foundation/ ; 5R21AI169548-02/NH/NIH HHS/United States ; R21 AI169548/AI/NIAID NIH HHS/United States ; RGP002/2023//Human Frontier Science Program/ ; R01 AI185127/AI/NIAID NIH HHS/United States ; R01AI185127/NH/NIH HHS/United States ; RAPID 2032157//National Science Foundation/ ; DBI 2515340//National Science Foundation/ ; }, 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.}, }
@article {pmid40607394, year = {2025}, author = {Panagiotidis, GD and Vasquez-Pacheco, E and Chu, X and Seeger, W and El Agha, E and Bellusci, S and Lingampally, A}, title = {Revisiting pulmonary fibrosis: inflammatory dynamics of the lipofibroblast-to-inflammatory lipofibroblast-to-activated myofibroblast reversible switch.}, journal = {Frontiers in immunology}, volume = {16}, number = {}, pages = {1609509}, pmid = {40607394}, issn = {1664-3224}, mesh = {Humans ; *Myofibroblasts/immunology/pathology/metabolism ; *Idiopathic Pulmonary Fibrosis/pathology/immunology/metabolism ; Animals ; Inflammation/immunology/pathology ; *Fibroblasts/immunology/pathology/metabolism ; Cell Differentiation ; SARS-CoV-2 ; COVID-19/immunology ; }, abstract = {Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease characterized by excessive extracellular matrix (ECM) deposition and irreversible lung damage. A key driver of disease progression is the phenotypic shift of lipofibroblasts (LIFs) into activated myofibroblasts (aMYFs), triggered by sustained epithelial injury, caused by inflammation, oxidative stress, viral infections (e.g., influenza, SARS-CoV-2), and metabolic dysfunction. Emerging evidence demonstrates that this transition is reversible, with pharmacological agents that promote aMYF-to-LIF reprogramming contributing to fibrosis resolution. The identification of inflammatory lipofibroblasts (iLIFs) highlights the importance of inflammation in fibrosis progression. Inflammation, mediated by IL-1β, IL-17A, and TGF- β, sustain aMYF activation, while immune cells shape fibrosis formation. This review combines current insights on the cellular and molecular pathways controlling fibroblast differentiation, highlighting key metabolic, immunologic, and oxidative stress-modulating targets for therapeutic intervention. Understanding and manipulating the LIF-iLIF-aMYF axis offers a promising strategy for reversing fibrosis and restoring pulmonary homeostasis in IPF.}, }
@article {pmid40607173, year = {2025}, author = {Halldorsdottir, T}, title = {Youth mental health crisis: A translational view of the COVID-19 pandemic.}, journal = {Neurobiology of stress}, volume = {37}, number = {}, pages = {100738}, pmid = {40607173}, issn = {2352-2895}, abstract = {Mental health problems among children and adolescents have increased over the past two decades, a trend that was further exacerbated by the COVID-19 pandemic. To improve prevention and treatment strategies, developmentally informed and data-driven multidisciplinary approaches are urgently needed to clarify the mechanisms underlying youth vulnerability and resilience. Stress and trauma exposure are among the strongest predictors of youth mental health problems; however, most children and adolescents remain resilient despite such exposures. The widespread and heterogeneous challenges posed by the COVID-19 pandemic offer a unique opportunity to examine, at scale, who develops mental health problems under stress and who remains resilient. Integrating emerging findings on pandemic-related risk and protective factors with evidence from animal models can illuminate sensitive developmental periods of heightened susceptibility to environmental influence and biological embedding. This approach can identify when, how, and through what pathways mental health problems emerge, including gene-environment interactions and epigenetic mechanisms. Such knowledge will inform both behavioral and pharmacological interventions, pinpointing not only specific treatment targets but also the optimal timing for intervention to be the most effective.}, }
@article {pmid40605295, year = {2025}, author = {Yang, YL and Zhang, T}, title = {[Recurrent COVID-19 in a patient with Good's syndrome: a case report and literature review].}, journal = {Zhonghua nei ke za zhi}, volume = {64}, number = {7}, pages = {680-684}, doi = {10.3760/cma.j.cn112138-20241022-00704}, pmid = {40605295}, issn = {0578-1426}, support = {XHZJ2412//Peking Union Medical Foundation/ ; }, mesh = {Humans ; Middle Aged ; *COVID-19/complications ; Female ; Recurrence ; SARS-CoV-2 ; Immunoglobulins, Intravenous/therapeutic use ; COVID-19 Drug Treatment ; }, abstract = {We herein report a case of recurrent coronavirus disease 2019 (COVID-19) in a 56-year-old female with Good's syndrome (GS) at Peking Union Medical College Hospital in April 2024. The patient was previously treated with thymectomy for thymoma and her immunoglobulin assays and lymphocyte subset analysis confirmed an immunocompromised state characterized predominantly by humoral immunodeficiency, consistent with a diagnosis of GS. Clinical symptoms improved following two courses of nirmatrelvir/ritonavir and four courses of molnupiravir, administered alongside adjunctive glucocorticoids and regular intravenous immunoglobulin (IVIG) supplementation. By the end of August 2024, a review of the literature identified 40 reported cases of COVID-19 in patients with GS worldwide. Among them, 25 met the diagnostic criteria for severe or critical illness, and 12 experienced persistent or relapsing infections. Antiviral therapy was administered in approximately half of the cases, most commonly for a 5-day course. However, four patients required prolonged or multi-target antiviral regimens due to persistent or relapsing infection, with the longest duration reported at 20 days. Convalescent plasma or monoclonal antibodies were used in 15 patients, and adjunctive glucocorticoids in 13. The vast majority received regular IVIG supplementation. Ten patients (25%) with GS and COVID-19 died. Patients with GS are susceptible to prolonged or recurrent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and are at increased risk of severe disease and mortality due to impaired antibody production. Upon diagnosis of GS, IVIG therapy should be initiated. In the context of COVID-19, potential treatment strategies include extended multi-agent antiviral therapy guided by viral load, use of convalescent plasma (where available), and glucocorticoids tailored to disease severity. Further research is needed to define the optimal duration and combination of antiviral and immunomodulatory therapies in this population.}, }
@article {pmid40604886, year = {2025}, author = {Katzmarzyk, D and Holle, D and Roes, M}, title = {Factors influencing the implementation of interventions for symptoms of posttraumatic stress disorder among hospital-based nurses and physicians during the COVID-19 pandemic: a scoping review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {885}, pmid = {40604886}, issn = {1472-6963}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Medical Staff, Hospital/psychology ; *Nursing Staff, Hospital/psychology ; Pandemics ; SARS-CoV-2 ; *Stress Disorders, Post-Traumatic/therapy/epidemiology ; }, abstract = {BACKGROUND: In the field of posttraumatic stress disorder (PTSD) among nurses and physicians working in an acute hospital setting, various investigations have been conducted on the prevalence of PTSD during the COVID-19 pandemic rather than on the implementation of PTSD-related interventions to improve the mental health of health care workers. It is known that implementation faces challenges, such as social restrictions or the dynamic of the pandemic itself. However, for successful implementation under these conditions, identifying barriers and facilitators is inevitable before using tailored implementation strategies. The following research question was addressed: What are the barriers/facilitators in the implementation of PTSD-related interventions for nurses and physicians working in an acute hospital setting during the COVID-19 pandemic?<br><br>METHODS: Using a scoping review approach, we conducted systematic literature searches from February to May 2023 in MEDLINE via PubMed and PsychINFO/CINAHL via EBSCO. We included primary studies (protocols), and concept articles focused on influencing factors in the implementation of PTSD-related interventions for nurses and physicians working in an acute hospital setting during the COVID-19 pandemic. We performed data analysis in MaxQDA via evaluative content analysis using the Consolidated Framework of Implementation Research (CFIR).<br><br>RESULTS: A total of 19 studies were included. Most of them used an empirical approach to evaluate the intervention during its development or adaptation process. The identified factors were mainly neutral factors that emerged from the inner setting and individuals as the intervention's target group. The management, the nurses, and the physicians as innovation recipients themselves, and the connection between the inner and outer settings could influence the implementation of PTSD-related interventions.<br><br>CONCLUSION: With these results, decision-makers in organizations in health care systems can be encouraged to implement interventions to improve PTSD among hospital-based nurses and physicians under pandemic conditions. Future research needs to focus on conducting implementation studies to evaluate influencing factors and investigate whether these factors enable or hinder the implementation of PTSD-related interventions.}, }
@article {pmid40604785, year = {2025}, author = {Domingos, ES}, title = {Rethinking malaria elimination: a perspective on challenges and solutions in Angola.}, journal = {Malaria journal}, volume = {24}, number = {1}, pages = {214}, pmid = {40604785}, issn = {1475-2875}, mesh = {Angola/epidemiology ; *Malaria/prevention &amp; control/epidemiology ; Humans ; *Disease Eradication/methods/organization &amp; administration ; COVID-19/epidemiology ; Antimalarials/therapeutic use ; }, abstract = {BACKGROUND: Multiple challenges hinder malaria control in Angola, including climatic variability, ineffective vector control, population displacement, socioeconomic inequalities, and increasing resistance to anti-malarial drugs and insecticides. These barriers have been further exacerbated by the COVID-19 pandemic, disrupting healthcare services and reversing prior gains. Despite a 36% reduction in malaria mortality since 2000, Angola remains off track to meet the Global Technical Strategy (GTS) targets for 2025, with no significant progress recorded in reducing malaria mortality between 2015 and 2023.<br><br>PERSPECTIVES: This paper analyses Angola's malaria landscape, emphasizing that persistent healthcare system weaknesses such as financial instability, workforce shortages, poor disease surveillance, and regional disparities in intervention coverage, necessitate urgent, tailored responses. Drawing from lessons learned in successful malaria elimination programmes in Cabo Verde, Algeria, China, and the recent WHO recommendations, the study recommends the implementation of three integrated strategies: (i) mass drug administration, to rapidly reduce transmission and help consolidate malaria control; (ii) intermittent preventive treatment for school-age children, to protect a high-risk yet often overlooked population; and (iii) post-hospitalization malaria prevention to decrease readmissions and mortality linked to severe malaria episodes.<br><br>CONCLUSION: Achieving malaria elimination or a substantial reduction in Angola's disease burden demands increased political commitment, sustainable financing, professional capacity building, and rigorous monitoring. A coordinated, evidence-based approach, aligned with WHO recommendations and tailored to Angola's epidemiological context, is essential to overcoming barriers and accelerating progress toward the 2030 malaria elimination goal.}, }
@article {pmid40604692, year = {2025}, author = {Aon, M and Oberconz, S and Brasholt, M}, title = {The association between health and prison overcrowding, a scoping review.}, journal = {BMC public health}, volume = {25}, number = {1}, pages = {2218}, pmid = {40604692}, issn = {1471-2458}, mesh = {Humans ; *Crowding/psychology ; *Prisons/statistics &amp; numerical data ; COVID-19/epidemiology ; *Prisoners/statistics &amp; numerical data/psychology ; *Health Status ; }, abstract = {It is estimated that the majority of prisons globally are overcrowded. There is consensus that overcrowding leads to negative health outcomes, however quantitative research of this association appears limited. This scoping review aimed to identify literature examining the association between prison overcrowding and health outcomes, and to summarize these associations. Two databases and a grey literature site were searched for quantitative studies where overcrowding was an independent variable, and the outcome was any physical or mental health issue. This yielded 34 records from 16 mostly high-income countries in addition to three multi-country studies. Studies applied a range of definitions of overcrowding with the most common being occupancy rates. Studies mostly concluded that overcrowding had a positive association on the outcome under study, i.e., as overcrowding increased so did the prevalence of the disease under study. When methodological limitations were taken into consideration, we found that in eighteen articles prison overcrowding was independently and positively associated with tuberculosis, COVID-19, self-harm, depression, overall prison mortality, and injuries due to violence respectively. Prison overcrowding was not found to be independently associated with suicide in four of the five studies where it featured.}, }
@article {pmid40603504, year = {2024}, author = {Madsen, HB and Durhuus, JA and Andersen, O and Straten, PT and Rahbech, A and Desler, C}, title = {Mitochondrial dysfunction in acute and post-acute phases of COVID-19 and risk of non-communicable diseases.}, journal = {npj metabolic health and disease}, volume = {2}, number = {1}, pages = {36}, pmid = {40603504}, issn = {2948-2828}, abstract = {The COVID-19 pandemic, caused by SARS-CoV-2, has resulted in widespread morbidity and mortality, with a significant portion of the affected population experiencing long-term health complications. This review explores the mechanisms of mitochondrial dysfunction in both the acute and post-acute phases of COVID-19, highlighting its impact on various organs and its potential role in the development of non-communicable diseases (NCDs). We discuss how SARS-CoV-2 directly affects mitochondrial function and the role of the virus-induced immune response in exacerbating mitochondrial impairment. This review highlights the critical role of mitochondria in COVID-19 pathogenesis and the importance of addressing mitochondrial health to mitigate acute and chronic effects of the disease.}, }
@article {pmid40603140, year = {2025}, author = {Amare, SN and Yee, KC and Leung, M and Naunton, M and Bushell, M}, title = {Impact of pharmacist-led interventions on COVID-19, herpes zoster, influenza, pneumococcal, and respiratory syncytial virus vaccines uptake in people aged 60 years and older: Systematic review and meta-analysis.}, journal = {Research in social &amp; administrative pharmacy : RSAP}, volume = {21}, number = {11}, pages = {857-871}, doi = {10.1016/j.sapharm.2025.06.110}, pmid = {40603140}, issn = {1934-8150}, mesh = {Aged ; Humans ; Middle Aged ; COVID-19 Vaccines/administration &amp; dosage ; Herpes Zoster Vaccine/administration &amp; dosage ; Influenza Vaccines/administration &amp; dosage ; *Pharmacists/organization &amp; administration ; Pneumococcal Vaccines/administration &amp; dosage ; Professional Role ; Respiratory Syncytial Virus Vaccines/administration &amp; dosage ; *Vaccination/statistics &amp; numerical data ; }, abstract = {BACKGROUND: While some review studies have assessed the role of pharmacists in vaccination services, none have comprehensively assessed their impact specifically on improving vaccination uptake among older adults across all major recommended vaccines. These include COVID-19, herpes zoster, influenza, pneumococcal disease, and respiratory syncytial virus. This systematic review aimed to generate evidence on the effectiveness of pharmacist-led interventions in promoting the uptake of these vaccines among individuals aged 60 years and older.<br><br>METHOD: Relevant publications up to June 2024 were comprehensively searched across six databases: Web of Science, PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, and Google Scholar. The pooled effect size was estimated using a random-effects model with a 95&#xa0;% confidence interval (CI). Subgroup analyses were used to evaluated differences in effect sizes according to pharmacist roles.<br><br>RESULT: A total of 10,998 studies were initially identified, of which 13 met the inclusion criteria. In eight pre-post studies, pharmacist involvement in immunisation services significantly increased vaccine uptake among older adults, yielding a pooled relative risk (RR) of 3.29 (95&#xa0;% CI: 2.01-5.39). Similarly, in five randomised studies, pharmacist-led interventions were significantly associated with increased vaccine uptake, with a pooled RR of 3.04 (95&#xa0;% CI: 1.46-6.34).<br><br>CONCLUSION: This review demonstrates the substantial impact of pharmacist-led interventions on vaccination uptake among older people. The findings suggest that the greatest improvements occur when pharmacists serve as educators, facilitators, immunisers, and advocators. Healthcare policymakers and organisations should prioritise and implement comprehensive pharmacist-led strategies to enhance vaccine uptake in this population.}, }
@article {pmid40603056, year = {2025}, author = {Ono, R and Iwahana, T and Aoki, K and Kato, H and Hattori, N and Oshima, T and Kouchi, Y and Hashimoto, R and Kishimoto, T and Ikeda, JI and Kobayashi, Y}, title = {Concurrent Fulminant Myocarditis and Severe Rhabdomyolysis in COVID-19-related Multisystem Inflammatory Syndrome in Adults: A Case Report and Review of the Literature.}, journal = {Internal medicine (Tokyo, Japan)}, volume = {64}, number = {13}, pages = {2007-2013}, pmid = {40603056}, issn = {1349-7235}, mesh = {Humans ; COVID-19 ; *Rhabdomyolysis/therapy/diagnosis/etiology ; *Myocarditis/therapy/diagnosis/etiology ; Middle Aged ; Female ; Extracorporeal Membrane Oxygenation/methods ; *Systemic Inflammatory Response Syndrome/therapy/complications/diagnosis ; SARS-CoV-2 ; *Coronavirus Infections/complications/therapy/diagnosis ; Pandemics ; *Pneumonia, Viral/complications/therapy/diagnosis ; *Betacoronavirus ; }, abstract = {This case report describes a 47-year-old woman with coronavirus disease 2019 (COVID-19)-related multisystem inflammatory syndrome in adults (MIS-A), who presented with fulminant myocarditis and severe rhabdomyolysis. Despite the absence of severe respiratory symptoms, the patient showed remarkable myocardial and leg edema with significant systemic inflammation and elevated creatine kinase levels after the COVID-19 infection. The patient required venoarterial extracorporeal membrane oxygenation (VA-ECMO) and Impella CP[®] for hemodynamic stabilization; however, she was successfully treated. We also reviewed reported cases of concurrent myocarditis and muscular involvement in patients with COVID-19, as well as cases of fulminant myocarditis and MIS-A requiring VA-ECMO.}, }
@article {pmid40602349, year = {2025}, author = {Ostrowsky, JT and Vestin, NC and Mehr, AJ and Ulrich, AK and Bigalke, L and Bresee, JS and Friede, MH and Gellin, BG and Klugman, KP and Nakakana, UN and Wang, TY and Weller, CL and Osterholm, MT and Lackritz, EM and Moore, KA and , }, title = {Accomplishments and challenges in developing improved influenza vaccines: An evaluation of three years of progress toward the milestones of the influenza vaccines research and development roadmap.}, journal = {Vaccine}, volume = {61}, number = {}, pages = {127431}, pmid = {40602349}, issn = {1873-2518}, support = {001/WHO_/World Health Organization/International ; }, mesh = {*Influenza Vaccines/immunology ; Humans ; *Influenza, Human/prevention &amp; control/immunology ; *Vaccine Development/methods ; Pandemics/prevention &amp; control ; Biomedical Research ; }, abstract = {Influenza vaccines that provide more effective immunity to seasonal influenza as well as protection against a broad range of emerging influenza viruses with pandemic potential are needed to reduce the public-health burden of influenza and enhance pandemic preparedness. The Influenza Vaccines Research and Development (R&amp;D) Roadmap (IVR) was published in 2021 to serve as a strategic planning tool to advance influenza vaccine R&amp;D. Following IVR publication, a 3-year monitoring, evaluation, and adjustment (ME&amp;A) program was implemented to assess progress in meeting the milestones outlined in the IVR. As of mid-May 2025, 16 (17%) of the 93 milestones had been accomplished or partially accomplished, with the majority (67; 72%) in various stages of progress. Of the 35 milestones designated high-priority, five (14%) had been accomplished or partially accomplished, 29 (83%) are in progress, and no progress was identified for one (3%). Key accomplishments include: establishing longitudinal cohort studies to characterize immune responses to influenza virus infection and vaccination by age over time and by vaccine product; creating a comprehensive landscape of innovative influenza vaccine technologies in preclinical and clinical development; advancing next-generation and broadly protective influenza vaccine candidates into clinical trials; identifying relevant lessons learned from accelerated SARS-CoV-2 vaccine development during the COVID-19 pandemic; and initiating development of a full value of improved influenza vaccine assessment (FVIVA) to inform investment and guide the eventual uptake of improved vaccines globally. Persistent challenges include clarifying immune mechanisms for generating durable and broadly protective immunity, enhancing understanding of immune imprinting and the role of mucosal immunity in preventing infection and transmission, identifying correlates of protection, and exploring regulatory options for broadly protective influenza vaccine licensure. The IVR ME&amp;A program provides a basis for ongoing critical review of progress in influenza vaccine R&amp;D to inform decision-making on research priorities and funding.}, }
@article {pmid40601925, year = {2025}, author = {Li, Q and Fang, F and Zhang, Y and Tu, J and Zhu, P and Xi, L}, title = {eHealth Literacy and Its Outcomes Among Postsecondary Students: Systematic Review.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e64489}, pmid = {40601925}, issn = {1438-8871}, mesh = {Humans ; *Telemedicine ; *Health Literacy ; *Students/psychology ; COVID-19 ; Cross-Sectional Studies ; }, abstract = {BACKGROUND: eHealth literacy is essential for postsecondary students; however, few studies have systematically reviewed its levels and related outcomes in this population.<br><br>OBJECTIVE: This study aims to systematically review the existing literature on eHealth literacy levels and the associated outcomes among postsecondary students.<br><br>METHODS: We systematically searched the PubMed, Web of Science, CINAHL, Embase, Cochrane Library, APA PsycInfo and APA PsycArticles, China National Knowledge Infrastructure, Wanfang Data, Base, and OpenGrey databases for studies published from 2006 to July 01, 2024, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were eligible if they were quantitative research papers, assessed eHealth literacy, described the relationship between eHealth literacy and other outcomes, and included postsecondary students. The risk of bias was assessed using the modified Appraisal Tool for Cross-Sectional Studies.<br><br>RESULTS: A total of 89 cross-sectional studies were included from among 45,168 eHealth literacy-related publications, with 68 rated as high quality and 21 as moderate quality. Various assessment tools were used across studies, with the eHealth Literacy Scale being the most commonly used (56/89, 63%). Reported eHealth literacy total scores ranged from 23.6&#x202f;(SD&#x202f;6.8) to 31.4&#x202f;(SD&#x202f;4.4), and mean item scores ranged from 3.42&#x202f;(SD&#x202f;0.61) to 4.10&#x202f;(SD&#x202f;0.56). Associated outcomes were grouped into cognitive, emotional, and behavioral domains. eHealth literacy was positively associated with cognitive outcomes, including health knowledge, self-efficacy, disease prevention behaviors, and health attitudes. Regarding emotional outcomes, eHealth literacy was linked to higher psychosocial well-being, more positive emotions, and lower negative emotions; however, its associations with overall well-being, depression, and COVID-19 fear were inconclusive. Regarding behavioral outcomes, eHealth literacy was associated with greater use of electronic information, disease prevention practices, volunteerism, and clinical decision-making. Its relationships with health care use, social media engagement, and healthy living were more complex and context-dependent.<br><br>CONCLUSIONS: eHealth literacy among postsecondary students ranges from moderate-low to moderate-high, with variations due to inconsistent assessment tools. It shows positive associations with cognitive, emotional, and behavioral outcomes, though links to healthy living, digital and health service engagement, and certain psychosocial aspects remain complex. Future research should standardize measurements and explore the mechanisms across disciplines and cultures to guide effective health promotion.<br><br>TRIAL REGISTRATION: PROSPERO CRD42024559587; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024559587.}, }
@article {pmid40601374, year = {2025}, author = {Zhang, P and Yang, M and He, S and Li, X and Lang, B and Zeng, L and Zhang, L}, title = {Evaluating the Impact of the COVID-19 Pandemic on Telepharmaceutical Service Effectiveness: Systematic Review and Meta-Analysis.}, journal = {Journal of medical Internet research}, volume = {27}, number = {}, pages = {e64073}, pmid = {40601374}, issn = {1438-8871}, mesh = {Humans ; *COVID-19/epidemiology ; Pandemics ; SARS-CoV-2 ; *Telemedicine ; }, abstract = {BACKGROUND: Telepharmaceutical services (TPS) led by pharmacists, an emerging telehealth service, improve access to medical services and enable patients to receive specialized services in areas with limited resources. With a lower risk of infection and no restriction of isolation measures, TPS showed great potential during the COVID-19 pandemic. However, whether the effectiveness of TPS changed before and after the outbreak of the COVID-19 pandemic remained unclear.<br><br>OBJECTIVE: This study aimed to evaluate the effectiveness of TPS, compare the effectiveness before and after the outbreak of the COVID-19 pandemic, and explore whether the effectiveness changed over time.<br><br>METHODS: We searched PubMed, Embase (Ovid), SinoMed, China National Knowledge Infrastructure, Wanfang, and VIP databases for randomized controlled trials that evaluated the effectiveness of TPS. The search covered studies published from inception to October 24, 2023. Eligible studies were conducted before May 5, 2023, when the World Health Organization (WHO) declared the end of the COVID-19 pandemic as a Public Health Emergency of International Concern. We used the random-effect model to pool the results and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the certainty of evidence. To explore whether the effectiveness of TPS changed over time, we applied subgroup analyses (studies conducted before December 31, 2019, and studies conducted after January 1, 2020). Using the independent-sample z test, we compared the effectiveness of TPS between the 2 subgroups. When a significant difference arose between them, we conducted a meta-regression analysis to further evaluate the trend of effectiveness over time.<br><br>RESULTS: In addition, 40 studies were finally included. Compared with no TPS or usual care (ie, face-to-face pharmaceutical services), TPS probably increased patient medication adherence (risk difference [RD] 0.15, 95% CI 0.09-0.20, moderate certainty), and may reduce the occurrence of adverse events (RD -0.10, 95% CI -0.18 to -0.02, low certainty) and improve the proportion of patients who were satisfied with medication (RD 0.16, 95% CI 0.05-0.26, low certainty). Moderate to high evidence indicated that patients accepting TPS probably achieved superior management of diabetes and hypertension. The effectiveness of TPS was not significantly different before and after the outbreak of the COVID-19 pandemic except for medication adherence (RD 0.12, 95% CI 0.03-0.21, P=.007), which also increased over time (coefficient=0.01, 95% CI 0.01-0.02, P<.001).<br><br>CONCLUSIONS: TPS probably improved patient medication adherence and may lead to better satisfaction and the incidence of adverse events. The effectiveness of TPS in general did not change after the outbreak of the COVID-19 pandemic.<br><br>TRIAL REGISTRATION: PROSPERO CRD42023487476; https://tinyurl.com/3s47enj6.}, }
@article {pmid40599824, year = {2025}, author = {Halma, M and Vottero, P and Thorp, J and Peers, T and Tuszynski, J and Marik, P}, title = {The Possible Mechanistic Basis of Individual Susceptibility to Spike Protein Injury.}, journal = {Advances in virology}, volume = {2025}, number = {}, pages = {7990876}, pmid = {40599824}, issn = {1687-8639}, abstract = {Injury from spike protein, whether induced by COVID-19 infection or vaccination, constitutes a significant health concern for numerous individuals. Considerable heterogeneity exists in individual responses to both COVID-19 infection and vaccination, despite the latter being principally more controlled and consistent than the wide variety of infection circumstances. This review explores the possible mechanisms by which the spike protein contributes to cellular and systemic damage, highlighting the importance of understanding these processes for developing effective diagnostics and treatments.}, }
@article {pmid40599434, year = {2024}, author = {Bargahi, N and Ghasemian, A and Hoseinpoor, R and Mahmoodi, S}, title = {A Concise Review of Major Challenges in the Vaccination, Diagnosis and Treatment of Novel Coronavirus Disease 2019.}, journal = {Archives of Razi Institute}, volume = {79}, number = {6}, pages = {1155-1164}, pmid = {40599434}, issn = {2008-9872}, mesh = {Humans ; *COVID-19/diagnosis/prevention &amp; control/therapy ; *COVID-19 Vaccines/administration &amp; dosage ; SARS-CoV-2 ; Antiviral Agents/therapeutic use ; COVID-19 Drug Treatment ; Vaccination ; }, abstract = {The rapid dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in the 2019 coronavirus (COVID-19) pandemic on a global scale. An efficacious strategy to control the ongoing pandemic of the novel coronavirus disease (2019-nCoV) includes the rapid recognition of infected patients and the implementation of vaccination programs utilizing accurate and reliable methods. A variety of diagnostic techniques, including computed tomography (CT) scans, serological assays, and molecular methods, have been employed for the diagnosis of coronavirus disease 2019 (COVID-19). Furthermore, a variety of vaccines, antiviral drugs, and immunotherapies have been employed to combat the virus. This is of particular importance for patients diagnosed with SARS-CoV-2 infection who are at high risk of developing serious complications. The prognosis, diagnosis, vaccination, and treatment of COIVD-19 present a number of challenges, including variability in disease severity, the emergence of new variants, individual factors and immune responses, co-infections and complications, a lack of long-term data, psychological and social factors, the availability and accessibility of tests, the sensitivity and specificity of tests, variability in symptoms, mild or asymptomatic cases, a limited number of specific antiviral options, clinical heterogeneity, the lack of a universal treatment protocol, overburdened healthcare systems, the management of severe cases, long-term effects and post-COIVD-19 syndrome, vaccine hesitancy, global cooperation, and vaccine production capacity. This article presents an overview of the most recent advancements in the field of Coronavirus Disease 2019 (Covid-19), encompassing prognosis, diagnosis, vaccination, and therapy. It is of the utmost importance to consult reliable sources such as national health authorities and the World Health Organization (WHO) in order to obtain the latest information on the vaccination of individuals against the novel coronavirus, including details on eligibility, availability, and recommended protocols in any specific region. The range of available treatment options and strategies is subject to ongoing evolution. Healthcare professionals and researchers are assiduously striving to surmount the challenges inherent to therapy and to enhance the outcomes for those affected by SARS-CoV-2 infection. It is imperative that randomized clinical studies be conducted with the objective of identifying the most appropriate and proven treatment in order to reduce the prevalence of SARS-CoV-2 infection and to prevent the occurrence of future pandemics.}, }
@article {pmid40599303, year = {2025}, author = {Lei, ZJ and Bai, MX and Li, MJ and Jin, P and Ding, YB}, title = {The Effectiveness and Influence of COVID-19 Vaccination on Perinatal Individuals and Their Newborns: An Updated Meta-Analysis.}, journal = {The Canadian journal of infectious diseases &amp; medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale}, volume = {2025}, number = {}, pages = {6115890}, pmid = {40599303}, issn = {1712-9532}, abstract = {Background: The COVID-19 pandemic has disproportionately affected pregnant individuals, increasing risks of severe illness and adverse outcomes. While vaccination is a key mitigation strategy, initial exclusion from clinical trials led to limited safety data. Despite evidence of vaccine effectiveness, hesitancy persists in this population. Objective and Sources: This meta-analysis aims to evaluate the efficacy and impact of COVID-19 vaccination in pregnant individuals, synthesizing evidence from 82 studies (3,676,654 participants) retrieved from PubMed, Embase, Cochrane Library, and Scopus (2019-2024). Study quality was assessed using the Newcastle-Ottawa scale (80/82 scored ≥ 7). Key Findings: Vaccination reduced maternal SARS-CoV-2 infection risk by 48% (odds ratio [OR] = 0.52), with mRNA vaccines showing higher efficacy (52% vs. 43% for inactivated). Maternal hospitalization risk decreased by 42% (OR = 0.58), and severe outcomes by 50% (OR = 0.50). Furthermore, neonatal outcomes improved, including reduced infection (OR = 0.69), preterm birth (OR = 0.87), stillbirth (OR = 0.64), and neonatal death (OR = 0.47). Protection against neonatal death was stronger in individuals without prior infection (OR = 0.43). Third-trimester vaccination may offer better protection against preterm birth. Conclusion: Overall, COVID-19 vaccination during pregnancy effectively mitigates infection and adverse maternal/neonatal outcomes, supporting its clinical recommendation.}, }
@article {pmid40598975, year = {2025}, author = {Jaafarzadeh, N and Ghanbari, M and Neisi, N and Kaydi, N and Jahedi, F and Hashempour, Y and Hasanvand, MS and Yonesian, M and Nadafi, K and Zahedi, A and Danyaei, A}, title = {Detection of SARS-CoV-2 in the Indoor Air of a Hospital and Comparison of Results With Other Studies Based on a Systematic Review.}, journal = {Scandinavian journal of caring sciences}, volume = {39}, number = {3}, pages = {e70061}, doi = {10.1111/scs.70061}, pmid = {40598975}, issn = {1471-6712}, support = {TRC-9916//Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences/ ; }, mesh = {Humans ; *SARS-CoV-2/isolation &amp; purification ; *Air Pollution, Indoor/analysis ; *COVID-19/transmission ; Iran/epidemiology ; *Air Microbiology ; *Hospitals ; }, abstract = {OBJECTIVE: The aim of this study was to investigate the presence or absence of the COVID-19 virus in the indoor air of Razi Specialized and Sub-specialized Educational and Medical Hospital in Ahvaz, one of the main centres for the hospitalization of COVID-19 patients in the southwestern region of Iran. The purpose was to enhance awareness regarding the potential airborne transmission of the virus in hospital environments and to support protective measures for healthcare personnel and the general public.<br><br>METHODS: A total of 48 air samples were collected during two different periods: 24 samples in the autumn and 24 in the spring. The samples were taken from the ICU4 ward and its adjacent corridor, where COVID-19 patients were being treated. Standard air sampling procedures were employed to detect the presence of SARS-CoV-2 in the indoor air. During the spring sampling period, two specific samples were emphasized as follows: one collected at a distance of 0.5&#x2009;m from a patient and another from the corridor leading to the positive section.<br><br>RESULTS: All 24 samples collected in autumn tested negative for the virus. However, during the spring sampling period, two of the 24 samples tested positive: one sample taken at a distance of 0.5&#x2009;m from a patient and another collected from the corridor leading to the COVID-19 positive section.<br><br>CONCLUSIONS: The findings suggest that the COVID-19 virus can be present in indoor air, particularly when central cooling systems (such as chillers) are in operation. The detection of the virus both near a patient and in a common area indicates a potential for airborne transmission. Further research is necessary to investigate the aerodynamic properties and particle weight of the virus, as well as the role of central air conditioning systems in its distribution within indoor spaces.}, }
@article {pmid40598558, year = {2025}, author = {Fujishima, S}, title = {Current corticosteroid therapeutic strategy for community-acquired pneumonia in adults: indications, dosage, and timing.}, journal = {Journal of intensive care}, volume = {13}, number = {1}, pages = {37}, pmid = {40598558}, issn = {2052-0492}, abstract = {Despite advances in treatment and the expansion of standard care, pneumonia remains a major cause of mortality. It frequently leads to complications such as septic shock and acute respiratory distress syndrome (ARDS), both of which carry high fatality rates. Although antimicrobial therapy is the cornerstone of treatment, additional supportive care and adjunctive therapies, such as corticosteroids, are often required, especially in severe community-acquired pneumonia (CAP).Recent updates to major guidelines on CAP, sepsis, ARDS, and critical illness-related corticosteroid insufficiency generally support corticosteroid use in severe CAP. However, the REMAP-CAP randomized controlled trial, published in 2025, failed to demonstrate significant benefit, potentially influencing future recommendations. Currently, corticosteroid therapy should be individualized based on CAP severity, particularly the degree of hypoxemia and respiratory failure. In eligible patients, early initiation and flexible duration of corticosteroid use based on clinical response may be appropriate. For nonbacterial pneumonia, strong evidence supporting corticosteroid use exists only for COVID-19 and Pneumocystis jirovecii pneumonia in HIV-infected individuals. Conversely, observational data do not support corticosteroid use for influenza or fungal infections. In CAP complicated by septic shock or ARDS, corticosteroid use is endorsed by recent guidelines; however, the recommended timing, dosage, and duration vary. Although combination therapy with hydrocortisone and fludrocortisone is a potential option, further direct evidence is needed. Biomarkers such as C-reactive protein and, in the near future, insights into corticosteroid-related immune repair mechanisms in COVID-19 may aid in identifying corticosteroid-responsive phenotypes.}, }
@article {pmid40598193, year = {2025}, author = {Elhosseiny, AA and Salama, M}, title = {Navigating the next surge: a perspective on Egypt's preparedness and prospects for another COVID-19 outbreak.}, journal = {Population health metrics}, volume = {23}, number = {1}, pages = {34}, pmid = {40598193}, issn = {1478-7954}, mesh = {Humans ; Egypt/epidemiology ; *COVID-19/epidemiology/prevention &amp; control ; SARS-CoV-2 ; *Pandemics/prevention &amp; control ; *Disease Outbreaks/prevention &amp; control ; Public Health ; }, abstract = {The global COVID-19 pandemic has presented healthcare systems and economies with unprecedented challenges. Like many other countries, Egypt has experienced the pandemic's multifaceted effects. As new variants continue to emerge, countries are enhancing their preparedness and response strategies in anticipation of possible future outbreaks. This review article focuses on Egypt and discusses the impact of the COVID-19 pandemic on the country's economy. It also examines the country's preparedness for a potential resurgence of COVID-19. Further, it explores Egypt's vaccination campaign, discussing the progress in achieving population immunity and the potential challenges encountered. It also extends to the public health communication strategies employed by the government, investigating their efficacy in disseminating accurate information and fostering public adherence to safety measures. While recognizing progress, the article also flags possible gaps and opportunities for improvement in Egypt's pandemic preparedness.}, }
@article {pmid40598071, year = {2025}, author = {Mehjabeen, D and Patel, K and Jindal, RM}, title = {Decolonizing global health: a scoping review.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {828}, pmid = {40598071}, issn = {1472-6963}, mesh = {*Global Health/education ; Humans ; COVID-19/epidemiology ; *Colonialism ; SARS-CoV-2 ; Curriculum ; }, abstract = {We summarize research on decolonizing global health and highlight existing gaps, including the lack of a formal definition and clear aims for the movement. We examine the decolonization of global health curricula and authorship in indexed journals, aiming to build a shared understanding among global health scholars. The review included studies from all global regions to ensure comprehensive geographical representation. Of the 155 identified records, most were published from 2021 onward and predominantly originated from the Global North. Studies focusing solely on racism were excluded. Additionally, non-English publications and studies prior to 2019 were excluded, which may have limited insights from other perspectives, such as those available in Spanish from Latin America. The included studies centered on topics such as curricula, the COVID-19 pandemic, and equity in authorship for Global South scholars. However, despite these discussions, voices from the Global South remain underrepresented in indexed journals, and there is limited focus on actionable strategies for shifting power dynamics to foster true decolonization in global health governance and funding. To address these issues, we recommend mentorship programs targeted at academics from the Global South, focusing on research capacity-building, grant writing, and leadership development. We call for broader structural reforms, including equitable funding allocation, the decolonization of research agendas, and the dismantling of hierarchical systems that privilege voices from the Global North over the Global South. The creation of collaborative networks focused on decolonization is critical in demonstrating a commitment to dismantling oppressive systems and fostering equity. While some progress has been made, further research is needed to explore how funding, knowledge systems and publishing can be more equitably distributed, supporting a truly decolonized global health agenda that advances social justice and health equity.}, }
@article {pmid40597822, year = {2025}, author = {Münte, C and Glattacker, M and Müller, S and Zülke, AE and Heinze, M and Riedel-Heller, SG and Pieper, D and Jacke, C and Deckert, S and Neumann, A}, title = {Long COVID in people with mental health disorders: a scoping review.}, journal = {BMC psychiatry}, volume = {25}, number = {1}, pages = {669}, pmid = {40597822}, issn = {1471-244X}, mesh = {Humans ; *COVID-19/complications/psychology ; *Mental Disorders/psychology/epidemiology/complications/therapy ; *Post-Acute COVID-19 Syndrome/complications/epidemiology/psychology ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Long COVID, Post COVID Syndrome or PASC (post-acute sequelae of COVID-19), according to the World Health Organization (WHO), is defined as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. The term Long COVID will be used throughout this review. Little is known about individuals with pre-existing mental health conditions experiencing Long COVID. This scoping review aims to provide an overview of these individuals, focusing on: 1) the course of mental disorders, 2) care needs, 3) utilization of healthcare services, and 4) psychosocial aspects, as outlined by the International Classification of Functioning (ICF).<br><br>METHODS: This review followed the JBI (Joanna Briggs Institute) methodology for scoping reviews and the PRISMA extension for scoping reviews. We included reports focusing on individuals with at least one pre-existing mental health diagnosis and Long COVID. Full-text reports in English or German were included, with no geographical limitations. Literature searches were conducted in PubMed, Embase, and PsycINFO on November 1, 2023, for records published between January 2020 and October 2023. Six reviewers participated in the screening process in pairs, independently conducting study selection and data extraction. Conflicts were resolved by consensus. Citation tracking was performed, and data were summarized narratively in tables.<br><br>RESULTS: From 4256 initial hits and citation tracking, 8 reports were included. The studies were heterogeneous, including chart reviews, case reports, cross-sectional, and longitudinal studies. Evidence on the impact of Long COVID on pre-existing mental health conditions was inconsistent. Most findings focused on the course of mental health disorders, ranging from symptom worsening to new symptoms of anxiety, depression, or insomnia. Evidence on mental health care needs, service utilization, and psychosocial aspects was limited.<br><br>CONCLUSION: Limited evidence suggests that individuals with pre-existing mental health disorders who experience Long COVID may be at an increased risk of worsening mental health. However, critical aspects such as care needs, service utilization, and psychosocial factors remain under-researched, highlighting the need for further studies on mental health care for Long COVID.<br><br>REVIEW REGISTRATION: Open Science Framework https://osf.io/tqexa .<br><br>CLINICAL TRIAL NUMBER: Not applicable.}, }
@article {pmid40597703, year = {2025}, author = {Ghafourian, K and Salehian, F and Shakeri, H and Saadati, A and Hatami, S and Goudarzi, M and Centis, R and D'Ambrosio, L and Sotgiu, G and Nasiri, MJ and Migliori, GB}, title = {Subacute thyroiditis as a post-COVID-19 complication: a systematic review.}, journal = {BMC infectious diseases}, volume = {25}, number = {1}, pages = {862}, pmid = {40597703}, issn = {1471-2334}, mesh = {Humans ; *COVID-19/complications ; *Thyroiditis, Subacute/etiology/drug therapy/diagnosis/virology ; SARS-CoV-2 ; Middle Aged ; Aged ; Adult ; Male ; Female ; Aged, 80 and over ; Adolescent ; Young Adult ; }, abstract = {INTRODUCTION: The emergence of Subacute Thyroiditis (SAT) in the wake of COVID-19 has presented a unique set of challenges for clinicians and researchers. This study delves into the intricate interplay between COVID-19 and SAT, examining a wealth of cases from observational studies.<br><br>METHODS: We conducted a comprehensive literature review utilizing PubMed/MEDLINE, EMBASE, and Scopus databases, encompassing studies available up to January 2, 2025. The search strategy incorporated a combination of keywords such as "Subacute Thyroiditis" and "COVID-19," complemented by synonyms and Mesh terms. Relevant studies, investigating COVID-19-associated SAT were included.<br><br>RESULTS: After a meticulous review of 964 papers, 46 records were included in the final analysis, consisting of 37 case reports and 9 case series. Our study, covered 75 individuals aged 18 to 85. Investigated patients presenting diverse symptoms, including anterior cervical pain and palpitations, displaying varying timelines from COVID-19 onset to SAT symptoms. Treatment approaches, involving prednisone and non-steroidal anti-inflammatory drugs (NSAIDs), led to recovery in many cases, but some individuals experienced a transition to hypothyroidism. The diagnostic and laboratory investigations across revealed diverse profiles, thyroid imaging findings, inflammatory markers, thyroid function tests, and the presence of anti-thyroid antibodies.<br><br>CONCLUSION: The complexity of SAT is emphasized, particularly in the context of COVID-19. The consistent trend toward recovery of thyroid function not only suggests potential treatment efficacy but also emphasizes the necessity for vigilant symptom monitoring, especially in individuals with a history of COVID-19. Future studies should further investigate the details of SAT post-COVID-19, improving approaches to diagnosis, treatment, and patient care.}, }
@article {pmid40597391, year = {2025}, author = {Maggio, MC and Castana, C and Caserta, M and Di Fiore, A and Siciliano, V and Corsello, G}, title = {MIS-C, inherited metabolic diseases and methylmalonic acidemia: a case report and review of the literature.}, journal = {Italian journal of pediatrics}, volume = {51}, number = {1}, pages = {202}, pmid = {40597391}, issn = {1824-7288}, mesh = {Humans ; *Amino Acid Metabolism, Inborn Errors/diagnosis/complications/therapy/genetics ; Male ; Child, Preschool ; *COVID-19/complications/diagnosis/therapy ; *Systemic Inflammatory Response Syndrome/diagnosis/therapy/etiology ; Methylmalonyl-CoA Mutase/genetics/deficiency ; }, abstract = {BACKGROUND: Methylmalonic acidemia (MMA) secondary to mutase deficiency, mut0, is an inborn error of metabolism causing complete enzyme defect, allowing a high risk of irreversible complications, secondary to metabolic decompensation, induced by infections and the hyperinflammatory state. Multisystem Inflammatory Syndrome in Children (MIS-C) is a hyperinflammatory syndrome that manifests 14-60 days after the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients aged < 21 years. Only a few cases of patients with inherited metabolic diseases (IMD) and MIS-C are described. However, to our knowledge, this is the first case of MMA with MIS-C.<br><br>CASE PRESENTATION: We describe a 2-year-old child with MMA secondary to mutase deficiency, carrying the homozygous mutation c.2179 C&#x2009;>&#x2009;T of MMUT gene, associated to mut0 phenotype. One month after SARS-CoV-2 infection, he presented fever, rash, significant increase of C-reactive protein (CRP), ferritin, triglycerides, interleukin (IL)-6, N-terminal fragment of the pro brain natriuretic peptide (NT-pro-BNP), compatible with the diagnosis of MIS-C. He was treated with intravenous immunoglobulins and methylprednisolone, with rapid clinical improvement. Ten days later, he showed the worsening of clinical and hematological parameters, associated with anemia, thrombocytopenia, metabolic acidosis, hyperlactatemia, increased urinary methylmalonic acid, leading to multiorgan failure (MOF). He was treated with high caloric intake nutrition by intravenous carbohydrates infusion; sodium bicarbonate, thiamine, carnitine, coenzyme Q, vitamin C, antibiotics, methylprednisolone and anakinra. Three days after the start of anakinra, a significant improvement in clinical and biochemical parameters occurred. Twenty days later, a sepsis from Methicillin-resistant Staphylococcus Aureus and Candida Albicans required the interruption of anakinra, with the decline of the clinical conditions and the exitus.<br><br>CONCLUSIONS: In patients with a severe form of MMA and MIS-C anakinra is a safe treatment. MOF and metabolic decompensation, secondary to the hyperinflammatory state typical of MIS-C, can be successfully treated with targeted therapy against proinflammatory cytokines. The description of these clinical cases is a precious lesson in managing IMD therapeutic emergencies. Paediatricians must provide a strict monitoring of metabolic compensation, to avoid irreversible complications.}, }
@article {pmid40597327, year = {2025}, author = {Ramadan, HK and Salah, AE and Mohamed, ZR and Ayoub, A and AboDief, AR and Badry, SH}, title = {False-positive reactivity of fourth-generation HIV enzyme immunoassay caused by COVID-19 and other infections.}, journal = {HIV medicine}, volume = {26}, number = {10}, pages = {1485-1492}, doi = {10.1111/hiv.70069}, pmid = {40597327}, issn = {1468-1293}, mesh = {Humans ; False Positive Reactions ; *HIV Infections/diagnosis/immunology ; *COVID-19/diagnosis/immunology ; Immunoenzyme Techniques/methods/standards ; SARS-CoV-2/immunology ; }, abstract = {BACKGROUND: Diagnosis of acute human immunodeficiency virus (HIV) infection and rapid initiation of antiretroviral therapy (ART) are the cornerstones in HIV elimination. Fourth- and fifth-generation HIV enzyme immunoassays (EIAs) can detect patients with acute infection. However, HIV false-positive results can occur, requiring confirmatory nucleic acid amplification testing, which is expensive and may not be available.<br><br>OBJECTIVES: This review highlights reports on various infections and vaccines causing false-positive reactivity in fourth-generation HIV immunoassays.<br><br>RESULTS: Despite the improvements in tests of HIV immunoassays, false-positive results may occur, which require continuous updates in testing algorithms to be used appropriately with newer assays. Many factors can result in false-positive HIV serological assays, such as COVID-19, several viral, bacterial or parasitic infections, and vaccines.<br><br>CONCLUSIONS: Physicians should be aware of the causes of false-positive HIV reactions and include them in the clinical assessment of suspected cases and consider confirmatory testing.}, }
@article {pmid40597250, year = {2025}, author = {SeyedAlinaghi, S and Mehraeen, E and Mirzapour, P and Yarmohammadi, S and Dehghani, S and Zare, S and Gholami, S and Attarian, N and Abiri, A and Farahani Rad, F and Tabari, A and Afroughi, F and Gholipour, A and Roozbahani, MM and Jahanfar, S}, title = {A systematic review on natural products with antimicrobial potential against WHO's priority pathogens.}, journal = {European journal of medical research}, volume = {30}, number = {1}, pages = {525}, pmid = {40597250}, issn = {2047-783X}, mesh = {*Biological Products/pharmacology/therapeutic use ; Humans ; World Health Organization ; *Anti-Bacterial Agents/pharmacology/therapeutic use ; Drug Resistance, Bacterial/drug effects ; *Bacteria/drug effects ; *Anti-Infective Agents/pharmacology ; COVID-19/epidemiology ; }, abstract = {BACKGROUND: Antimicrobial resistance (AMR) is a critical global issue, with bacteria increasingly resistant to traditional antibiotics, resulting in more treatment failures and higher mortality rates. Resistance can be defined microbiologically or clinically and arises through genetic mutations or acquired traits. In response to this growing threat, the World Health Organization (WHO) established a priority list of antibiotic-resistant bacteria in 2016 to guide the research and development of new antimicrobial agents. The COVID-19 pandemic has further exacerbated AMR, underscoring the urgent need for new antibiotics. Natural products continue to be a valuable source of antibacterial compounds and play a significant role in developing new antimicrobial treatments.<br><br>METHOD: This study employed a systematic review methodology, conducting comprehensive searches across PUBMED/MEDLINE, WEB OF SCIENCE, and SCOPUS databases, adhering to modified PRISMA-ScR reporting guidelines. A research librarian assisted in developing the search strategy, with searches executed on May 5, 2024, without restrictions on publication dates.<br><br>STUDY SELECTION PROCESS: Titles and abstracts were screened using Rayyan and Endnote. Inclusion criteria focused on original studies examining the antimicrobial effects of natural products against antibiotic-resistant pathogens, including risk estimates with 95% confidence intervals. The review identified significant effects of natural products on 12 families of antibiotic-resistant bacteria as reported by the World Health Organization (WHO). These findings underscore the potential of natural compounds as therapeutic agents in combating antimicrobial resistance.<br><br>RESULTS: A total of 4371 articles published between 2014 and 2024 were initially identified, from which 290 articles were selected for detailed review based on their relevance to the study period. All included studies were clinical trials. The analysis indicated that most of the research on dietary plants was conducted in countries within the Middle East, South America, and Africa. Among the pathogens investigated, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Salmonella typhi, and Staphylococcus aureus emerged as the most frequently studied due to their involvement in a wide range of infectious diseases. The findings revealed that alkaloids, flavonoids, phenols, saponins, tannins, and terpenoids were the principal classes of plant-derived compounds exhibiting antioxidant activity against bacterial strains. These bioactive compounds were extracted using a variety of solvents, including ethanol, methanol, aqueous solutions, benzoate, ethyl acetate, n-butanol, and methanolic preparations obtained from different plant parts such as leaves, bark, flowers, and roots. Notably, flavonoids represented 24.8% of the antioxidant product derivatives examined. The overall results underscore the significant therapeutic potential of regional medicinal plants in combating pathogens resistant to chemical drugs. Their antioxidant and cytotoxic properties may enhance the efficacy of existing antibiotic classes and contribute to reversing antimicrobial resistance.<br><br>CONCLUSION: Based on the findings of this review, the diverse effects and therapeutic efficacy of herbal compounds in managing antibiotic resistance were extensively examined. Consequently, in light of the demonstrated antimicrobial activities of these plant-derived compounds, further investigation into their potential as alternative agents to counteract antibiotic resistance has become increasingly essential.}, }
@article {pmid40597208, year = {2025}, author = {Yang, XF and Guo, JY and Peng, WS and Wang, BD and Qv, CR and Zhou, SJ and Sun, R and Liao, L and Zhang, WW and Liu, LY and Ren, LC and Zou, L and Xu, SH}, title = {Global perspectives on challenges, coping strategies, and future preparedness of nursing home staff during COVID-19: a systematic review and meta-synthesis.}, journal = {BMC health services research}, volume = {25}, number = {1}, pages = {872}, pmid = {40597208}, issn = {1472-6963}, support = {SYHL2022-N009//Shenzhen People's Meaning Nursing Fund for Young and middle-aged people/ ; A2024009//Medical Foundation of Guangdong Province/ ; YJYM2023009//Research Project on Nursing Innovation and Development of Guangdong Nursing Society in 2023/ ; }, mesh = {Humans ; *COVID-19/epidemiology ; *Adaptation, Psychological ; *Nursing Homes/organization &amp; administration ; SARS-CoV-2 ; Qualitative Research ; *Nursing Staff/psychology ; Coping Skills ; }, abstract = {BACKGROUND: The global public health crisis caused by COVID-19 in late 2019 was unprecedented. Due to their vulnerable population, nursing homes are a key epidemic response area. This study described the challenges and coping strategies of nursing home staff during COVID-19 and proposed recommendations for future public health crises in nursing homes.<br><br>METHOD: A meta-synthesis was performed to address the research question: What are the experiences of nursing home staff from the perspectives of COVID-19? From the beginning until August 31, 2024, searches were conducted in five international databases (CINAHL, PubMed, Web of Science, PsycINFO, and the Cochrane Library) and three Chinese databases (CNKI, VIP, and Wanfang). Two reviewers used the Joanna Briggs Institute's (JBI) qualitative research checklist to evaluate each manuscript. The findings were synthesized using pragmatic meta-aggregators.<br><br>RESULTS: The meta-synthesis included 22 qualitative studies and four mixed studies, which including 906 participants was analyzed to identify 268 findings that were organized into 15 categories and combined into three syntheses. Three synthesized findings were identified: Challenges (sub-findings: challenges implementing epidemic prevention and control, resource shortage, negative emotions, inadequate departmental communication and coordination, lack of support, physical strain); coping strategies (sub-findings: role adaptation and redefinition, innovative solutions and technology, work organisation and cooperation, positive psychological service, seeking community and organisational support, Improving infection prevention awareness), and suggestions for future preparedness (sub-findings: Enhancing communication and decision-making in response to COVID-19 changes, Optimizing material supply channels and physical space, and increasing medical related team and training).<br><br>CONCLUSION(S): This study focuses on the COVID-19 experiences and coping strategies of nursing home staff. Key coping strategies include role transition and redefinition, with staff taking on additional tasks to ensure ongoing diagnosis and treatment; innovative concepts and technologies, such as remote healthcare and digital tools, reduce the risk of infection; and strengthening collaboration and cooperation, improving efficiency, and decreasing employee workload. Mental health services and social support can alleviate stress and promote health. Maintaining optimism among staff members necessitates community and organisational support, resources, and effective communication. The findings of this study have implications for nursing home practices and policies. Sanatoriums require PPE, medical supplies, and trained personnel. Encourage system and organisational transformation. Emergency preparedness and flexible workforce initiatives enhance organisational adaptability. Increase infection prevention awareness: Sanatorium employees should get continual infection prevention training. Exploring nursing homes Layout: Relevant departments should establish criteria for the physical layout of current and prospective nursing facilities to prevent basic infectious diseases.}, }
@article {pmid40593310, year = {2025}, author = {Madhukalya, R and Yadav, U and Parray, HA and Raj, N and Lupitha, SS and Kumar, V and Saroj, A and Agarwal, V and Kumar, D and Das, S and Kumar, R}, title = {Nipah virus: pathogenesis, genome, diagnosis, and treatment.}, journal = {Applied microbiology and biotechnology}, volume = {109}, number = {1}, pages = {158}, pmid = {40593310}, issn = {1432-0614}, support = {LDIA-Proj# 10720//LifeArc/ ; }, mesh = {*Nipah Virus/genetics/pathogenicity ; *Henipavirus Infections/diagnosis/therapy/virology/transmission ; Humans ; Animals ; *Genome, Viral ; Chiroptera/virology ; Antiviral Agents/therapeutic use ; Zoonoses/virology ; }, abstract = {The highly infectious Nipah virus (NiV) is classified under the Paramyxoviridae family and is categorized under the genus Henipavirus. NiV spreads to humans through zoonotic transmission from reservoir host bats and other intermediate hosts. It is highly contagious and has a high case fatality rate (CFR) of ~ 40-80%. Only sporadic outbreaks have been reported so far, but like SARS-CoV2, NiV has a high pandemic potential and has been put on the World Health Organization (WHO) priority pathogen list. Currently, no clinically approved antivirals, immunotherapy, or vaccines are available to tackle NiV infection, thereby necessitating further research into its life cycle, transmission, and pathogenesis. This detailed review outlines the origin and spread of the Nipah virus, its modes of transmission, risk factors, its genome, key proteins, pathogenesis, and clinical features. We also discuss different diagnostic approaches and ongoing research to develop therapies ranging from antibodies to vaccines. KEY POINTS: •Pandemic preparedness for emerging and re-emerging viruses. •Novel approaches for diagnostics and therapeutics for Nipah viruse. •Global threat from biosafety level 4 pathogens. •Animal models for Nipah virus research.}, }
@article {pmid40592834, year = {2025}, author = {Himmels, JPW and Magnusson, K and Brurberg, KG}, title = {Systematic review of post-COVID condition in Nordic population-based registry studies.}, journal = {Nature communications}, volume = {16}, number = {1}, pages = {5717}, pmid = {40592834}, issn = {2041-1723}, mesh = {Humans ; *COVID-19/epidemiology/complications ; *Registries ; Scandinavian and Nordic Countries/epidemiology ; SARS-CoV-2 ; Incidence ; Fatigue/epidemiology ; }, abstract = {The long-term effects of COVID-19, known as post-COVID condition (PCC), are still not fully understood. This systematic review synthesizes findings from Nordic registry studies to highlight long-term outcomes after COVID-19 infection. Twenty-two studies, primarily reflecting the pre-omicron and early vaccination phases, reveal increased primary care use for respiratory issues and fatigue in the sub-acute and chronic phases, with PCC incidence estimated below 2% in the general population. Most individuals returned to work within three months post-infection, and the risk of new neurological or mental disorders did not exceed that in patients with other infections. The review demonstrates the value of high-quality Nordic health registries in capturing reliable, population-wide data, though generalizability may be limited to similar healthcare systems. Findings suggest the need for targeted follow-up in patients with severe COVID-19, particularly those requiring intensive care, to manage potential new-onset diseases and guide resource allocation in the pandemic's endemic phase.}, }
@article {pmid40592802, year = {2025}, author = {Jiang, X and Sun, Q and Huang, Y and Deng, Y and Li, C}, title = {Inactivated Mycobacterial Vaccine Nebulized Inhalation: A Effective Therapy for the Prevention and Treatment of Respiratory Diseases?.}, journal = {The clinical respiratory journal}, volume = {19}, number = {7}, pages = {e70101}, pmid = {40592802}, issn = {1752-699X}, support = {82360024//National Natural Science Foundation of China/ ; }, mesh = {Humans ; Administration, Inhalation ; *Nebulizers and Vaporizers ; Vaccines, Inactivated/administration &amp; dosage ; *Bacterial Vaccines/administration &amp; dosage ; Mycobacterium ; }, abstract = {Nebulized inhalation therapy is an important method in the prevention and treatment of respiratory diseases, and inactivated mycobacterial vaccine nebulized inhalation has received a wide attention recently, but the roles and mechanisms are still not fully understood. A literature search showed there is a strong scientific rationale and evidence that nebulized inhalation of inactivated mycobacterial vaccine is effective in the prevention and treatment of respiratory diseases. Clinically available mycobacterial vaccines include Mycobacterium phlei (M. phlei), BCG, and Mycobacterium vaccae (M. vaccae). Nebulized inhalation of inactivated mycobacterial vaccine, especially M. vaccae, has been used in the prevention and treatment of respiratory diseases, such as asthma, respiratory syncytial virus (RSV), coronavirus disease 2019 (COVID-19), and sepsis. It acts on the respiratory tract directly, thus stimulating the body to produce an immune response, enhance respiratory immunity, and achieve prevention and treatment effects. Nebulized inhalation of inactivated mycobacterial vaccine will be an effective therapy in the prevention and treatment of respiratory diseases.}, }
@article {pmid40592216, year = {2025}, author = {van der Drift, AR and Welling, A and Arntzen, V and Nagelkerke, E and van der Beek, RFHJ and de Roda Husman, AM}, title = {Wastewater surveillance studies on pathogens and their use in public health decision-making: a scoping review.}, journal = {The Science of the total environment}, volume = {993}, number = {}, pages = {179982}, doi = {10.1016/j.scitotenv.2025.179982}, pmid = {40592216}, issn = {1879-1026}, mesh = {*Wastewater/virology/microbiology ; *Public Health ; Humans ; *Decision Making ; *Environmental Monitoring/methods ; }, abstract = {This study provides a comprehensive overview of wastewater surveillance studies on pathogens, identifies key characteristics of studies that are associated with public health actions, and highlights the actions resulting from these studies. Many studies refer to the value of wastewater surveillance in public health decision-making, but it remains unclear how many studies support public health action and whether this is incorporated into study designs. Therefore, we conducted a scoping review following PRISMA guidelines and used the machine learning tool ASReview to identify wastewater surveillance studies monitoring pathogen circulation in human populations, followed by correlational analyses. A total of 974 studies were included, of which only 84 described public health action. Merely 28 of these incorporated strategies to facilitate action within their study designs. Studies leading to public health action primarily monitored viruses, e.g., SARS-CoV-2 and poliovirus, and since 2024 also influenza A and B virus, respiratory syncytial virus, hepatitis A virus and mpox virus. Furthermore, studies conducted by public health institutes or targeting non-standard locations are more likely to result in action, whereas those with larger population sizes or focusing on residential areas are less likely to result in action. The most common public health actions included informing health authorities and identifying cases. Our findings highlight the value of learning from existing use cases. While wastewater surveillance can support public health actions, evidence of its use is limited. Future studies should improve study designs by, e.g., incorporating strategies for public health actions to maximize their effectiveness and impact on decision-making.}, }
@article {pmid40591679, year = {2025}, author = {Masquelet, AC}, title = {Misconduct in science and medicine.}, journal = {EFORT open reviews}, volume = {10}, number = {7}, pages = {439-444}, pmid = {40591679}, issn = {2058-5241}, }
@article {pmid40591029, year = {2025}, author = {Mukherjee, A and Roy, D and Chakravarty, A}, title = {Uncommon Non-MS Demyelinating Disorders of the Central Nervous System.}, journal = {Current neurology and neuroscience reports}, volume = {25}, number = {1}, pages = {45}, pmid = {40591029}, issn = {1534-6293}, mesh = {Humans ; *Neuromyelitis Optica/diagnosis/immunology ; Multiple Sclerosis/diagnosis ; Diagnosis, Differential ; *Demyelinating Autoimmune Diseases, CNS/diagnosis ; Autoantibodies ; }, abstract = {PURPOSE OF REVIEW: Definitive diagnosis of multiple sclerosis (MS) requires exclusion of other central nervous system (CNS) disorders sharing similar clinical, pathological and radiological features. In this review we discuss some relatively uncommon disorders with special emphasis on their differentiation from MS clinically and radiologically. While most conditions have a demyelinating pathology, a few very important mimics may have a non-demyelinating pathology to merit some discussion.<br><br>RECENT FINDINGS: Two major areas of diagnostic advances have been made in recent times, the recognition of neuromyelitis optica spectrum disorder (NMOSD), and the myelin oligodendrocyte antibody mediated disorder (MOGAD). These two entities are mediated by completely different antibodies detectable in peripheral blood samples by enzyme-linked immunosorbent assay (ELISA) or cell-based assays and produce clinical disorders could be differentiated from MS by their clinical features, disease course, prognosis, and imaging features. NMOSD is a rare CNS autoimmune disease that predominantly targets the spinal cord, optic nerves and brainstem. In sixty to eighty% of cases of NMOSD, optic neuritis (ON) and/or longitudinally extensive transverse myelitis (LETM) result in blindness and paralysis. In NMOSD these are associated with a serological antibody to aquaporin-4 (AQP4). AQP4 is a water channel protein found in many organs, but in the CNS, AQP4 is expressed in a perivascular distribution on astrocytic foot processes around blood vessels and the glia limitans (glymphatic). Comparative studies of AQP4-seropositive and AQP4- seronegative NMOSD cohorts note that some of the seronegative NMOSD cases tend to differ from the seropositive cases in several aspects: bilateral optic neuritis, simultaneous optic neuritis and transverse myelitis, younger age at onset, and an apparently monophasic course. This prompted search for putative antibodies other than AQP4. MOG antibody disease is a CNS autoimmune disease associated with a serological antibody against myelin oligodendrocyte glycoprotein (MDG). MOG is a glycoprotein expressed on the outer membrane of myelin and solely found within the CNS, including the brain, optic nerves and spinal cord. Clinically, the disease resembles NMOSD in its predilection for relapses of optic neuritis and transverse myelitis. In addition, acute disseminated encephalomyelitis (ADEM) is a well-recognized phenotype of MOG antibody disease in children. About 42% of NMOSD patients who test seronegative for the AQP4 antibody test positive for MOG antibodies. MOG antibody disease has thus recently emerged as a distinct entity in a sizable portion of the patient population diagnosed with NMOSD or even MS. The second field where significant progress has been made is the recently modified McDonald criteria proposed at the ECTRIMS (European Committee (2024) for Treatment and Research in Multiple Sclerosis) which includes three new features - the central vein sign (CVS) and the paramagnetic ring lesions (PRL), along with CSF kappa free light chains (kFLC). The CVS refers to a blood vessel in the middle of MS lesions, visible on MRI. The PRL refers to rings of iron around the edges of active MS lesions, also detectable by MRI. Lastly, kFLC are molecules produced by white blood cells, now considered a diagnostic biomarker equivalent to CSF oligoclonal bands. This new criterion refines doing an MRI mandatory for making a diagnosis of MS. The list of non-MS demyelinating disorders of the CNS is vast. Most of the conditions are immunologically mediated. In the present review, diagnosis and management of NMOSD and MOGAD are discussed, along with a brief discussion on ADEM. Stress has been given also to some rarer conditions like antiphospholipid syndrome, Behcet disease, chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS), and Susac syndrome, which can mimic MS. The auto inflammatory syndromes, a newly described group of conditions, which are being increasingly recognized as conditions which can cause systemic as well as neurological disease, are briefly discussed. There is aberrant activation of the innate immune system, as against autoimmune diseases where the adaptive immune system is involved. Non-immune mediated conditions can also cause or mimic demyelination. The causes include drugs, toxins, infections, and neoplastic conditions. CNS lymphomas, both primary and secondary, may mimic MS plaques. Infections including bacterial, viral and parasitic, may also produce white matter signal abnormalities mimicking MS. COVID 19 related CNS lesions and PML are also discussed. The ready availability of genetic testing, including whole exome sequencing, have resulted in expansion of the phenotypic spectrum of leukodystrophies, and in some cases of atypical MS the diagnosis is being revised to some form of leukodystrophy. The types of leukodystrophy which can mimic MS have been discussed. Longitudinally extensive spinal cord lesions (LECL) can occur in demyelinating (LETM) as well as other conditions, and are extremely important to differentiate from each other, so that appropriate management can be provided. Lastly commonly encountered vascular lesions like lacunes resulting from lipohyalinosis may also mimic MS plaques and in this category more extensive lesion like in CADASIL, an autosomal dominant disorder with a specific genetic marker, needs differentiation.}, }
@article {pmid40590391, year = {2025}, author = {Dou, A and Xu, J and Zhou, C}, title = {The relationship between HERVs and exogenous viral infections: A focus on the value of HERVs in disease prediction and treatment.}, journal = {Virulence}, volume = {16}, number = {1}, pages = {2523888}, pmid = {40590391}, issn = {2150-5608}, mesh = {Humans ; *Virus Diseases/virology/therapy ; *Endogenous Retroviruses/genetics/physiology ; COVID-19/virology ; SARS-CoV-2 ; Multiple Sclerosis/virology ; Biomarkers ; }, abstract = {Human endogenous retroviruses (HERVs) are virus-related sequences that are a normal part of the human genome; they account for about 8% of the human genome. Reactivation of these ancestral proviral sequences can lead to the generation of functional products. Several reactivated HERVs are associated with cancer and autoimmune diseases. Emerging research suggests that reactivated HERVs may play a significant role in the development of viral diseases such as acquired immune deficiency syndrome (AIDS) and coronavirus disease 2019 (COVID-19), as well as in neuroinflammatory diseases possibly triggered by viral factors, such as multiple sclerosis (MS). Studies exploring the relationship between HERVs and exogenous viral infections have the potential to offer a fresh perspective on developing treatment and prevention strategies for exogenous viral infections. The mechanism of the transactivation of HERVs caused by exogenous viral infection, as well as the contribution of HERVs to viral diseases or diseases triggered by viral factors, deserve further research. Here, we review the relationship between exogenous viruses and HERVs in several common diseases caused or triggered by viral infections, with a focus on the value of HERVs as biomarkers for forecasting disease advancement or prognosis and as potential targets for therapeutic interventions.}, }
@article {pmid40590260, year = {2025}, author = {Sampson, AT and Hlaváč, M and Gillman, ACT and Douradinha, B and Gilbert, SC}, title = {Developing the next-generation of adenoviral vector vaccines.}, journal = {Human vaccines &amp; immunotherapeutics}, volume = {21}, number = {1}, pages = {2514356}, pmid = {40590260}, issn = {2164-554X}, mesh = {Humans ; *Genetic Vectors/immunology/genetics ; *COVID-19 Vaccines/immunology/genetics/adverse effects/administration &amp; dosage ; *COVID-19/prevention &amp; control/immunology ; *Adenoviridae/genetics/immunology ; *Vaccine Development/methods ; SARS-CoV-2/immunology ; Immunogenicity, Vaccine ; }, abstract = {The COVID-19 pandemic saw the first extensive use of adenoviral vector vaccines, with over 3 billion doses produced during the first year of the pandemic alone and an estimated 6 million lives saved. These vaccines were safe and effective, and could be produced at low cost in several continents allowing widespread use in low- and middle-income countries (LMICs). Despite their successful deployment against SARS-CoV-2, their impact has been overshadowed by relatively lower immunogenicity in contrast to mRNA vaccine technologies and very rare but serious adverse events such as vaccine-induced thrombotic thrombocytopaenia (VITT). The next-generation of adenoviral vector vaccines must address these challenges: here, we explore strategies to improve immunogenicity and safety by novel serotype selection, vector engineering, capsid modification and new delivery technologies, and discuss opportunities for next-generation adenoviral vectors against infectious disease and cancer.}, }
@article {pmid40590080, year = {2025}, author = {Goh, DY and Lam, WC and Zhong, LLD}, title = {Effect of interventions for the management of sleep disturbances in patients with long COVID: a systematic review and meta-analysis of randomized controlled trials.}, journal = {Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine}, volume = {21}, number = {11}, pages = {1993-2005}, pmid = {40590080}, issn = {1550-9397}, mesh = {Humans ; *COVID-19/complications ; *Sleep Wake Disorders/therapy/etiology ; Randomized Controlled Trials as Topic ; Quality of Life ; SARS-CoV-2 ; }, abstract = {STUDY OBJECTIVES: Long COVID presents with symptoms that persist for weeks or months postinfection, with sleep disturbances that significantly affect quality of life. The diverse approaches to managing sleep disturbances highlight the need for comparing treatment effectiveness to improve patient outcomes. This study systematically reviews and conducts a meta-analysis of randomized controlled trials to assess the effectiveness of current interventions for sleep disturbances in patients with long COVID and explores the underlying mechanisms and promising treatments.<br><br>METHODS: Relevant studies were identified through a comprehensive literature search across Embase, Web of Science, PubMed, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data databases. The included studies focused on interventions aimed at managing patients with long COVID with sleep disturbances. Data extraction and analysis were performed, followed by a meta-analysis of comparable studies. The quality of evidence was assessed using the Cochrane Risk of Bias Tool (RoB 2.0) and the Grading of Recommendations, Assessment, Development, and Evaluation system.<br><br>RESULTS: Out of 3,352 retrieved studies, 14 were included in the systematic review and 2 in the meta-analysis. Interventions were categorized as pharmacological and nonpharmacological. Whereas most studies indicated improved sleep quality measured by standardized scales, some did not demonstrate significant benefits. The quality of evidence varied from low to moderate.<br><br>CONCLUSIONS: The results suggest that sleep disturbances in patients with long COVID result from a complex interplay of physiological, psychological, and neurological factors. Both pharmacological and nonpharmacological interventions show potential in managing these disturbances, with nonpharmacological approaches showing particular promise. To establish more robust evidence, more high-quality, large-scale randomized controlled trials are necessary in future research.<br><br>CITATION: Goh DY, Lam WC, Zhong LLD. Effect of interventions for the management of sleep disturbances in patients with long COVID: a systematic review and meta-analysis of randomized controlled trials. J Clin Sleep Med. 2025;21(11):1993-2005.}, }
@article {pmid40589858, year = {2025}, author = {Saikarthik, J and Saraswathi, I and Padhi, BK and Shamim, MA and Alzerwi, N and Alarifi, A and Gandhi, AP}, title = {Structural and functional neuroimaging of hippocampus to study adult neurogenesis in long COVID-19 patients with neuropsychiatric symptoms: a scoping review.}, journal = {PeerJ}, volume = {13}, number = {}, pages = {e19575}, pmid = {40589858}, issn = {2167-8359}, mesh = {Humans ; *COVID-19/complications/diagnostic imaging/physiopathology ; *Hippocampus/diagnostic imaging/physiopathology/pathology ; *Neurogenesis/physiology ; SARS-CoV-2 ; Adult ; *Functional Neuroimaging ; *Mental Disorders/diagnostic imaging/physiopathology ; Neuroimaging ; Magnetic Resonance Imaging ; }, abstract = {BACKGROUND: Worsening of neuropsychiatric and neurodegenerative disorders occurs in COVID-19. Impaired adult neurogenesis is linked to most of the neuropsychiatric symptoms and disorders.<br><br>AIM: The current scoping review identified and mapped the available evidence on adult neurogenesis in long COVID-19, at a global level following the JBI methodology for scoping reviews and followed the framework by Arksey and O'Malley.<br><br>METHOD: Original studies focusing on structural and functional neuroimaging of the hippocampus to study adult neurogenesis in long COVID-19 were included in the review. Studies published in English language with no restriction on the time of publication were searched using the specified search strategy in PubMed, Web of Science, Embase, and SCOPUS. Articles obtained from the database search were collated and uploaded into the Nested Knowledge AutoLit semi-automated systematic review platform for data extraction.<br><br>RESULTS: The current review provides evidence of the potential alterations in adult neurogenesis in long COVID-19 and its potential link to neuropsychiatric sequelae of long COVID-19, with further research required to validate this assertion.<br><br>CONCLUSION: This review proposes conceptual and methodological approaches for future investigations to address existing limitations and elucidate the precise role of adult neurogenesis in the pathophysiology and treatment of long COVID-19.}, }
@article {pmid40589473, year = {2025}, author = {Amoako, K and Mokhammad, A and Malik, A and Yesudasan, S and Wheba, A and Olagunju, O and Gu, SX and Yarovinsky, T and Faustino, EVS and Nguyen, J and Hwa, J}, title = {Enhancing nucleic acid delivery by the integration of artificial intelligence into lipid nanoparticle formulation.}, journal = {Frontiers in medical technology}, volume = {7}, number = {}, pages = {1591119}, pmid = {40589473}, issn = {2673-3129}, abstract = {The advent of messenger RNA (mRNA) therapeutics has revolutionized medicine, with its potential underscored by rapid advancements during the COVID-19 pandemic. Despite its promise, nucleic acid delivery remains a formidable challenge due to enzymatic degradation, cellular uptake barriers, and endosomal trapping. Therapeutic lipid nanoparticles (LNPs), pioneered in the 1970s, have emerged as the gold standard for delivering mRNA and other nucleic acids, offering unparalleled advantages in stability, biocompatibility, and cellular targeting. This review explores the evolution and design of LNPs, focusing on their role in hematologic therapies and platelet transfection, where unique challenges arise due to platelets' anucleate nature. The paper systematically evaluates the composition of LNPs, highlighting the role of ionizable, cationic, and neutral lipids in optimizing delivery efficiency, stability, and immune response modulation. Strategies to overcome platelet transfection barriers, including tailored lipid compositions and particle engineering, are discussed alongside advances in artificial intelligence (AI) for predictive nanoparticle design. Furthermore, it examines various nucleic acid cargoes, including mRNA, siRNA, and miRNA, and their therapeutic potential in addressing platelet-related disorders and advancing personalized medicine. Finally, the review delves into emerging technologies and the integration of AI to overcome existing barriers in nucleic acid delivery. By fostering interdisciplinary collaboration, this work aims to catalyze discoveries in LNP-based therapeutics and transformative advancements in hematologic treatments.}, }
@article {pmid40589323, year = {2025}, author = {Preece, MV and Pathak, DV and Laffan, M and Arachchillage, DJ}, title = {Anti-PF4 disorders: Pathogenesis, diagnosis and treatment.}, journal = {British journal of haematology}, volume = {207}, number = {3}, pages = {709-722}, pmid = {40589323}, issn = {1365-2141}, support = {MR/Z505274/1//Medical Research Council UK/ ; }, mesh = {Humans ; *Platelet Factor 4/immunology ; Heparin/adverse effects ; SARS-CoV-2/immunology ; COVID-19/immunology/prevention &amp; control ; *Thrombosis/diagnosis/therapy/immunology/chemically induced/etiology ; *Thrombocytopenia/diagnosis/therapy/immunology/chemically induced/etiology ; COVID-19 Vaccines/adverse effects ; Immunoglobulin G/immunology ; *Autoantibodies/immunology/blood ; Platelet Activation ; }, abstract = {Platelet factor 4 (PF4) is a cationic protein, able to form complexes with negatively charged molecules upon its self-assembly into PF4 tetramers. The targeting of these PF4 complexes by immunoglobulin G (IgG) antibodies underlies anti-PF4 disorders such as heparin-induced thrombocytopenia (HIT) and Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT)/VITT-like disorders. The formation of IgG/PF4 immune complexes facilitates uncontrolled activation of platelets, neutrophils and monocytes, via IgG-mediated Fcγ receptor binding. This promotes the thrombocytopenia and thrombosis characteristic of anti-PF4 disorders. HIT is predominantly triggered by heparin exposure. VITT is a recently recognised anti-PF4 disorder, which developed following specific SARS-CoV-2 vaccinations. It is thought that hexon proteins, components of adenoviral vectors, may form complexes with PF4 to trigger anti-PF4 antibody production in VITT. A novel anti-PF4 disorder has been recognised causing platelet activation without the administration of heparin or SARS-CoV-2 vaccination and referred to as 'VITT-like disorder.' Clinical evaluation of HIT and VITT/VITT-like disorders is based on thrombotic events, platelet counts and D-dimer levels. Laboratory assays such as heparin/PF4-induced platelet activation assays can be used to distinguish between HIT and VITT. Treatment plans for HIT and VITT may differ across patient groups. In this review, we discuss the pathogenesis, diagnosis and management of anti-PF4 disorders.}, }
@article {pmid40589078, year = {2025}, author = {Persson, C}, title = {Well-Controlled Mucosal Exudation of Undiluted Plasma Proteins Serves Innate and Adaptive Immunity.}, journal = {Scandinavian journal of immunology}, volume = {102}, number = {1}, pages = {e70041}, pmid = {40589078}, issn = {1365-3083}, mesh = {Humans ; *Immunity, Innate/immunology ; *Adaptive Immunity/immunology ; *Respiratory Mucosa/immunology ; *COVID-19/immunology ; *Blood Proteins/immunology/metabolism ; *SARS-CoV-2/immunology ; Animals ; Immunity, Mucosal ; }, abstract = {Distinct from the pulmonary circulation, the human respiratory mucosa is supplied by highly responsive, superficial, systemic microcirculations. In the early symptomatic phase of mucosal infections, circulating peptides-proteins of all sizes are released just beneath the epithelium and will soon appear on the mucosal surface. The traditional view is that mucosal injury must be involved in this plasma exudation process. However, well-controlled human in vivo observations demonstrate that the inflammatory plasma exudation response reflects non-injurious physiologic microvascular-epithelial cooperation. Crucially, although plasma exudation brings unfiltered plasma solutes without size restriction to the mucosal surface this occurs without reducing the protective epithelial barrier against inhaled molecules. Plasma exudation starts early and increases until viral or bacterial infections resolve. Plasma exudation therefore has the potential to slow down, or even prevent, progression to pneumonia and beyond. Plasma exudation would boost efficacy of a mature adaptive immunity by delivering circulating pathogen-neutralising antibodies undiluted to infection spots in the upper airways. Early mucosal infections would thus be dampened and development of lower airway infections prevented. Inferentially, this explains how treatment with vaccines still allows upper airway infections but prevent severe respiratory disease with alveolar and pulmonary circulation injury. Plasma exudation may also contribute to real-life protection against severe influenza/Covid-19 in airway mucosal diseases that exhibit plasma exudation hyperresponsiveness. Such hyperresponsiveness is inducible indicating feasibility of finding future treatments that increase the mucosal innate and adaptive immunity. Altogether, the present synthesis of literature suggests that plasma exudation is an important component of human respiratory mucosal antimicrobial immunity.}, }
@article {pmid40588967, year = {2025}, author = {Olanrewaju, ZO and Faisal, M and Randell, R}, title = {Electronic Record Systems in Intensive Care Units During Covid-19: A Scoping Review.}, journal = {Studies in health technology and informatics}, volume = {328}, number = {}, pages = {459-463}, doi = {10.3233/SHTI250761}, pmid = {40588967}, issn = {1879-8365}, mesh = {*COVID-19/epidemiology/therapy ; *Intensive Care Units/organization &amp; administration ; Humans ; *Electronic Health Records/organization &amp; administration/statistics &amp; numerical data ; SARS-CoV-2 ; Pandemics ; }, abstract = {The Covid-19 pandemic underscored the critical function of advanced healthcare technologies, particularly Electronic Patient Records (EPRs), which were already embedded in numerous healthcare systems. This scoping review examines the role and impact of EPRs in Intensive Care Units (ICUs) during the pandemic. Following PRISMA guidelines, a comprehensive search of major databases was undertaken, complemented by stakeholder consultation to enhance rigour and relevance. The findings demonstrated that EPR adoption in ICUs contributed to improved patient safety, enhanced workflow efficiency, and more timely clinical decision-making. Nonetheless, several limitations were evident across the reviewed studies, including short implementation timelines, limited sample sizes, and persistent software integration challenges. To optimise the utility of EPRs in critical care, future research should prioritise longitudinal studies, broader cohort inclusion, and strengthened digital infrastructure.}, }
@article {pmid40588397, year = {2025}, author = {Wu, AW and Trigg, K and Zhang, A and Alexander, GC and Haut, ER and Rock, C and McDonald, K and Padula, W and Fisseha, S and Duncan, R and Black, J and Newman-Toker, DE and Papieva, I and Dhingra-Kumar, N and Wilson, RF}, title = {Interventions to improve patient safety during the COVID-19 pandemic: a systematic review.}, journal = {BMJ open quality}, volume = {14}, number = {2}, pages = {}, pmid = {40588397}, issn = {2399-6641}, support = {001/WHO_/World Health Organization/International ; }, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Patient Safety/standards ; Pandemics ; SARS-CoV-2 ; Cross Infection/prevention &amp; control ; Accidental Falls/prevention &amp; control ; }, abstract = {OBJECTIVE: To summarise the literature on healthcare interventions to reduce harm to patients caused by the COVID-19 pandemic across six domains: medication safety, diagnostic safety, surgical safety, healthcare-associated infections, pressure injuries and falls.<br><br>METHODS: We performed a mixed-methods systematic review, with the intention to present results narratively. We combined parallel searches and expert input across each domain of interest, identifying 13&#x2009;019 unique articles across the six domains. Of these, 590 full texts were assessed for eligibility. 7 were included for the medication safety domain; 7 for diagnostic safety; 32 for surgical safety; 11 for healthcare-associated infections; 5 for the pressure injuries and 2 for falls. Overall, a total of 61 unique articles were included-4 articles were represented across more than one domain.<br><br>FINDINGS: There were few rigorous evaluations of specific interventions to reduce patient harm caused by the pandemic. Adjustments in treatments, triage and procedures, and use of risk stratification tools reduced delays and permitted more elective surgery and diagnostic testing to proceed. These changes also led to improvements in medication safety practices and prevention of healthcare-associated infections.<br><br>CONCLUSION: There has been little research on interventions to reduce patient harm caused in healthcare settings during the COVID-19 pandemic. Interventions focused on preventing nosocomial transmission of COVID-19 and on permitting access to urgent surgical and diagnostic needs. A few studies tested strategies to reduce new risks imposed by the pandemic for medication safety, healthcare-associated infections, pressure injuries and falls. Development of high-reliability health systems and healthcare organisations to protect patients and health workers from harm will be essential to mitigating the impact of future pandemics within the objectives of the Global Patient Safety Action Plan 2021-2030.}, }
@article {pmid40588293, year = {2025}, author = {Chan, JCH and Rosa Duque, JS and Durrheim, DN and Tsang, T and Lau, YL}, title = {Achieving and sustaining measles elimination in Hong Kong, from 1967 to 2024: lessons to be learnt.}, journal = {BMJ global health}, volume = {10}, number = {6}, pages = {}, pmid = {40588293}, issn = {2059-7908}, mesh = {Humans ; *Measles/prevention &amp; control/epidemiology ; Hong Kong/epidemiology ; *Disease Eradication ; *Measles Vaccine/administration &amp; dosage ; COVID-19/epidemiology ; Vaccination Coverage ; Immunization Programs ; Incidence ; }, abstract = {Following the development and roll-out of the measles vaccine in 1954, measles incidence dropped to low levels in areas where measles vaccines with high coverage were introduced. The Measles and Rubella Strategic Framework 2021-2030 developed by the Measles &amp; Rubella Initiative aims to eliminate measles globally by 2030. However, there has been a resurgence of measles cases after the COVID-19 pandemic in many countries, including some in the Western Pacific Region. This review describes the journey from 1967, when Hong Kong introduced a single-dose regimen, to 2024 when Hong Kong had been experiencing an increase in imported measles cases despite being verified to have achieved measles elimination in 2016. Hong Kong's experience in maintaining high vaccination coverage and comprehensive surveillance may provide an exemplary framework for other countries in the Western Pacific Region.}, }
@article {pmid40588168, year = {2025}, author = {Porto Fuentes, &#xd3; and Muela Molinero, A and Alonso Ortiz, MB}, title = {Vaccination in chronic obstructive pulmonary disease (COPD): Scientific evidence and strategies to reduce risks.}, journal = {Revista clinica espanola}, volume = {225}, number = {7}, pages = {502330}, doi = {10.1016/j.rceng.2025.502330}, pmid = {40588168}, issn = {2254-8874}, mesh = {Humans ; *Pulmonary Disease, Chronic Obstructive/complications/immunology ; *Vaccination/methods ; Practice Guidelines as Topic ; COVID-19/prevention &amp; control ; Immunization Schedule ; COVID-19 Vaccines ; }, abstract = {Patients with chronic obstructive pulmonary disease (COPD) are more vulnerable to infections that may favor disease progression. Vaccination in COPD is an effective intervention that helps reduce infectious exacerbations, as well as associated morbidity and mortality. In recent years, the use of new vaccines has become widespread, not only targeting specific infections but also contributing to long-lasting immunity and slowing the process of immune aging (immunosenescence). Current clinical practice guidelines recommend the administration of six vaccines (against Streptococcus pneumoniae, influenza virus, SARS-CoV-2, respiratory syncytial virus, Bordetella pertussis, and varicella-zoster virus) for all COPD patients. However, vaccination rates in many countries still fall short of the established targets. Therefore, it is crucial to design a specific vaccination schedule tailored for COPD patients.}, }
@article {pmid40587997, year = {2025}, author = {Schwalbe, N and Lehtimaki, S and Hannon, E}, title = {The pandemic treaty: A forensic review of process and pitfalls.}, journal = {Global public health}, volume = {20}, number = {1}, pages = {2522916}, doi = {10.1080/17441692.2025.2522916}, pmid = {40587997}, issn = {1744-1706}, mesh = {Humans ; *COVID-19/epidemiology/prevention &amp; control ; *Global Health ; World Health Organization ; *Pandemics/prevention &amp; control ; *International Cooperation ; SARS-CoV-2 ; Politics ; }, abstract = {This article examines efforts to develop a pandemic treaty through World Health Organization member state agreement from 2021 to 2025, focusing on challenges during the process. The COVID-19 pandemic showed the critical need for strong global agreements to prepare for and respond to health crises, with relevance for policymakers and researchers. Drawing on observations as invited stakeholders, relevant literature, official documents, and reports from other stakeholders, we identify key patterns, themes, and challenges, particularly the competing priorities of countries and difficulties in reaching consensus. Barriers that slowed progress include uneven political commitment, lack of transparency, and exclusion of key stakeholders, which hindered agreements and limited the treaty's potential to address global health threats. Our analysis highlights practical steps for future negotiations, including stronger political engagement, better coordination, greater transparency, and ensuring a broader range of voices and stakeholders are included in the process. Learning from these lessons will be critical for improving global pandemic preparedness and addressing future health challenges.}, }
@article {pmid40587939, year = {2025}, author = {Ebo, TO and Olawade, DB and Ebo, DM and Egbon, E and Ayoola, FI}, title = {The lasting impact of COVID-19 on forensic mental health: A review of shifts in patient profiles, service delivery, and legal considerations.}, journal = {Journal of forensic and legal medicine}, volume = {114}, number = {}, pages = {102920}, doi = {10.1016/j.jflm.2025.102920}, pmid = {40587939}, issn = {1878-7487}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Forensic Psychiatry/legislation &amp; jurisprudence ; *Mental Health Services/legislation &amp; jurisprudence/organization &amp; administration ; *Mental Disorders/epidemiology/therapy ; Health Services Accessibility ; Pandemics ; Telemedicine ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic has had a profound and lasting impact on forensic mental health, reshaping patient profiles, disrupting service delivery, and introducing new legal and ethical challenges. This narrative review examines the long-term implications of the pandemic on forensic psychiatric populations, mental health service provision, and the justice system. Evidence suggests that rates of severe mental illness, including psychosis, depression, and anxiety, have increased among forensic patients, exacerbated by isolation, stress, and reduced access to care. Additionally, substance use disorders, and co-occurring psychiatric conditions have become more prevalent, complicating treatment and rehabilitation efforts. The pandemic also accelerated the adoption of telepsychiatry in forensic settings, improving accessibility but raising concerns about the reliability of remote assessments for competency evaluations and risk assessments. Inpatient and prison-based forensic psychiatric services experienced staff shortages, increased patient aggression, and limited access to therapeutic programs, further straining the system. Court closures and legal case backlogs delayed forensic evaluations, raising human rights concerns for detained individuals. Ethical dilemmas emerged regarding involuntary hospitalization, treatment prioritization, and resource allocation. As the forensic mental health field transitions into a post-pandemic landscape, key lessons include the need for hybrid forensic assessment models, strengthened forensic infrastructure, and better integration of legal and clinical perspectives. Future research should focus on developing resilient forensic mental health policies and ensuring equitable access to care while maintaining legal and ethical standards.}, }
@article {pmid40587679, year = {2025}, author = {Busili, A and Kumar, K and Kudrna, L and Rabbani, U}, title = {Examining the impact of the COVID-19 pandemic on mental health among adults with type 2 diabetes: A systematic review of pre and during pandemic insights.}, journal = {Medicine}, volume = {104}, number = {26}, pages = {e43112}, pmid = {40587679}, issn = {1536-5964}, mesh = {Humans ; *Diabetes Mellitus, Type 2/psychology/epidemiology ; *COVID-19/psychology/epidemiology ; Anxiety/epidemiology ; *Mental Health ; Sleep Initiation and Maintenance Disorders/epidemiology ; Depression/epidemiology ; Prevalence ; SARS-CoV-2 ; Pandemics ; Adult ; }, abstract = {BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has posed significant challenges to mental health, especially among individuals with preexisting conditions such as type 2 diabetes. The interplay between chronic physical conditions and mental health is well-documented, yet the pandemic's specific impact on the mental health of patients with type 2 diabetes remains underexplored. This study aimed to assess the prevalence of the most common mental health symptoms, including depression, anxiety, and insomnia, among type 2 diabetes patients before and during the COVID-19 pandemic to understand any potential changes in mental health outcomes.<br><br>METHODS: A systematic review of 42 observational studies published between 2010 and 2022 was conducted in accordance with PRISMA guidelines. Studies were identified through 5 electronic databases and included based on predefined eligibility criteria. Two reviewers independently screened and assessed the study quality. Due to limited directly comparable data, a narrative synthesis was performed.<br><br>RESULTS: The review included 42 studies, with 25 (60%) scoring 6 or less out of 9 in quality assessment. The prevalence of depression among type 2 diabetes patients ranged from 5.3% to 73.6% in prepandemic studies, compared with 5.6% to 30.4% during the pandemic. Anxiety prevalence was reported between 8.4% and 65.5% before the pandemic and remained at 8.4% during the pandemic. Insomnia was prevalent in 9.6% to 48.2% of patients' prepandemic, with one study reporting a 31.4% prevalence during the pandemic. Two studies directly compared depression prevalence before and during the pandemic in the same population; one reported a significant increase from 19.3% to 30.4%, while the other found no difference.<br><br>CONCLUSION: This study suggests that while the COVID-19 pandemic did not significantly exacerbate anxiety or insomnia in patients with type 2 diabetes, there may have been an increase in depression. The findings underscore the complexity of mental health outcomes during the pandemic and highlight the need for further research to fully understand the impact of COVID-19 on the mental health of individuals with type 2 diabetes. These results suggest the importance of ongoing mental health support for this vulnerable population.}, }
@article {pmid40587366, year = {2025}, author = {Croke, K}, title = {Politics, Political Science and the Pandemic.}, journal = {Health systems and reform}, volume = {11}, number = {1}, pages = {2521182}, doi = {10.1080/23288604.2025.2521182}, pmid = {40587366}, issn = {2328-8620}, mesh = {*Politics ; Humans ; *COVID-19/epidemiology ; *Pandemics ; SARS-CoV-2 ; *Delivery of Health Care/organization &amp; administration ; }, abstract = {Health systems research as a field has increased its attention to political factors that shape health system development. However, there has been a lack of consensus about which conceptual frameworks and models from the academic discipline of political science are most relevant to the study of health systems. The COVID-19 pandemic underlined the centrality of politics to health, but it also demonstrated the limitations of existing frameworks used to analyze the politics of health. This article reviews the political science literature on the politics of COVID-19, identifies several gaps in the theoretical frameworks used in this work, and draws some conclusions for future work on the politics of pandemics and the politics of health system development writ large.}, }
@article {pmid40587048, year = {2025}, author = {Asbaghi, Y and Goertzen, S and Houldsworth, A and Monnin, C and Choukou, MA}, title = {Immigrants' Experience of Navigating eHealthcare Tools in Canada: A Scoping Review.}, journal = {Journal of immigrant and minority health}, volume = {27}, number = {5}, pages = {809-819}, pmid = {40587048}, issn = {1557-1920}, mesh = {Humans ; *Emigrants and Immigrants/psychology/statistics &amp; numerical data ; Canada/epidemiology ; *Telemedicine/statistics &amp; numerical data ; *Health Services Accessibility ; COVID-19 ; Information Seeking Behavior ; Social Determinants of Health ; Mental Health/ethnology ; }, abstract = {Access to healthcare in Canada is evolving alongside eHealth tools. Despite a growing immigrant population, there's limited research on their usage of eHealthcare. Occupational therapists in Canada are increasingly involved in supporting and advocating for the accessibility of immigrants to the eHealthcare system.To provide an overview of services, barriers, and facilitators within the eHealth navigation experience by immigrants to Canada from the available published literature. A scoping review was conducted to gather academically published and grey literature, available between 2013 and 2024, that pertains to immigrants' use of eHealth in Canada. An initial search took place in 2023 and was updated in 2024, yielding 296 articles. Thirteen (13) manuscripts were included in the scoping review. Analysis of the results revealed three themes within the literature addressing immigrants' navigation of eHealth tools: the impact of COVID-19 on mental health, social determinants of eHealth, and online information-seeking behaviours. The analysis of the outcomes from the included studies revealed critical gaps in Canada's health system that challenge immigrants' access to eHealth services and recommendations to address these gaps. Collaboration among stakeholders is essential to develop tailored interventions and policies, with occupational therapists positioned to play a crucial role in helping to achieve equitable access to eHealth for immigrants in Canada. More research is needed to inform the creation and integration of culturally sensitive and linguistically accessible eHealth tools in Canada, tailored to meet the needs of immigrants in terms of their cultural background, context, and language.}, }
@article {pmid40586934, year = {2025}, author = {Pandey, A and Mishra, S}, title = {The multifaceted roles of nucleolin in viral entry, replication, and antiviral therapy.}, journal = {Molecular biology reports}, volume = {52}, number = {1}, pages = {655}, pmid = {40586934}, issn = {1573-4978}, support = {TAR/2023/000199//SERB (ANRF), Govt. of India/ ; }, mesh = {Nucleolin ; *RNA-Binding Proteins/metabolism/genetics/chemistry ; *Phosphoproteins/metabolism/genetics/chemistry ; Humans ; *Virus Internalization/drug effects ; *Virus Replication/drug effects ; *Antiviral Agents/pharmacology/therapeutic use ; Animals ; *Virus Diseases/drug therapy/virology ; }, abstract = {Nucleolin (NCL) is a multifunctional, highly conserved protein that shuttles between the nucleus, cytoplasm, and cell surface, playing pivotal roles in cellular homeostasis and disease. In recent years, NCL has emerged as a central host factor exploited by a wide array of viruses-including Herpesviridae, Flaviviridae, Pneumoviridae, Picornaviridae, Orthomyxoviridae, Coronaviridae, Caliciviridae, and Morbillivirus-to facilitate viral entry, replication, assembly, and immune evasion. This review provides a comprehensive, comparative synthesis of the mechanisms by which diverse viruses hijack distinct structural domains of nucleolin, highlighting both proviral and antiviral activities that are context- and compartment-dependent. We critically evaluated the strength and limitations of current evidence, discuss contradictory findings across virus families, and identify patterns in domain-specific and compartmentalized viral exploitation of NCL. Special emphasis is placed on recent advances in targeting nucleolin-virus interactions for therapeutic intervention, including aptamers, G-quadruplex stabilizers, and domain-specific inhibitors. While nucleolin's essential cellular functions present challenges for drug development, emerging strategies that exploit its unique roles in viral pathogenesis offer promising avenues for broad-spectrum and precision antivirals. By integrating mechanistic insights across virus families, this review positions nucleolin as a universal node in viral infection and a compelling target for next-generation antiviral therapies.}, }
@article {pmid40586328, year = {2025}, author = {Ailion, A and Helmstaedter, C and Vezzani, A and Koepp, MJ}, title = {The upside of epilepsy: Theories of an evolutionary paradox.}, journal = {Epilepsia open}, volume = {10}, number = {4}, pages = {987-998}, pmid = {40586328}, issn = {2470-9239}, mesh = {Humans ; *Epilepsy/physiopathology/immunology/genetics ; *Biological Evolution ; COVID-19 ; Neuronal Plasticity/physiology ; Brain/physiopathology ; Seizures/physiopathology ; Animals ; Immunity, Innate ; SARS-CoV-2 ; }, abstract = {The persistence of common, heritable conditions, like epilepsy, that are associated with reduced reproductive fitness is an evolutionary paradox. Endogenous analgesic, anti-depressant, and inflammatory mechanisms able to repair compromised functions can offer advantages in unexpected crises. Here, we challenge current thinking about the detrimental effects of seizures and epilepsy and suggest that (1) seizure-driven neuroplasticity might provide a protective mechanism, (2) seizure-induced neurotransmitter release not only helps to stop seizures but also increases resilience to pain, and (3) innate immune mechanisms triggered by recurrent seizures might neutralize novel viruses, like SARS-CoV-2, more rapidly, and so provided protection during the recent pandemic. PLAIN LANGUAGE SUMMARY: We explore the idea that epilepsy may activate the brain's natural repair systems, despite its risks. These include brain processes that help people recover from injury, infections, and reduce pain. Understanding these less frequently discussed aspects of seizures may help researchers develop novel questions and improve treatment.}, }
@article {pmid40585898, year = {2025}, author = {Teleanu, IC and Bejan, GC and Poiană, IR and Mîrșu-Păun, A and Dumitrescu, SI and Stănescu, AMA}, title = {Remote Monitoring of Patients with Heart Failure: Characteristics of Effective Programs and Implementation Strategies.}, journal = {Vascular health and risk management}, volume = {21}, number = {}, pages = {489-503}, pmid = {40585898}, issn = {1178-2048}, mesh = {Humans ; *COVID-19/epidemiology ; *Heart Failure/diagnosis/therapy/mortality/physiopathology ; Predictive Value of Tests ; *Remote Sensing Technology/instrumentation ; *Telemedicine/instrumentation ; }, abstract = {BACKGROUND AND OBJECTIVES: Although the effectiveness of remote monitoring (RM) has been extensively studied, a focus on the post-pandemic time period is needed given the social changes and technology advances since this global event occurred.<br><br>AIM: The present paper responds to this need by reviewing post-pandemic research, to determine if RM of patients with heart failure (HF) using non-implantable devices represents an effective strategy.<br><br>MATERIALS AND METHODS: A systematic literature review was conducted using PubMed and PMC, and the number of articles included was 19.<br><br>RESULTS: A total of 3,031 patients participated in the 19 studies in this review, who had HF (NYHA class I-IV). Most frequent outcomes of interest were: rates of hospitalization (13 studies), death (5 studies), adherence to medications / healthy behaviors (4 studies), associated costs (4 studies), symptom intensity or frequency (3 studies), etc. The studies included in this review unanimously presented significant findings in favor of RM.<br><br>CONCLUSION: The post-pandemic research targeting RM of patients with HF presents more homogenous results to support this type of intervention, as compared to the heterogeneity of the pre-pandemic research.}, }
@article {pmid40585709, year = {2025}, author = {Elechi, KW and Adeoye, AF and Olaniyi, AO and Akanbi, OO and Olumeko, I and Udensi, CG and Kolapo, TJ and Barrah, VU}, title = {Translational Success and Pharmacoeconomic Lessons of Pandemic-Driven Drug Repurposing.}, journal = {Cureus}, volume = {17}, number = {5}, pages = {e85033}, pmid = {40585709}, issn = {2168-8184}, abstract = {The COVID-19 pandemic spurred an unprecedented wave of drug repurposing as scientists and clinicians raced to find immediate treatment options for a novel disease. This narrative review examines how those crisis-driven repurposing efforts fared. It highlights key successes and failures in translating research into practice and assessing their pharmacoeconomic implications in high-income health systems. It also distills lessons to guide future pandemic preparedness and improve equitable global access to effective treatments. We performed a broad literature search across major databases (2020-2025) to identify studies and reports on repurposed COVID-19 therapies and health economic outcomes. While repurposing accelerated the delivery of treatments, results were mixed: a handful of existing drugs, such as the widely available steroid dexamethasone, that reduced mortality, emerged as life-saving interventions, but many other initially promising drugs ultimately showed limited or no efficacy. Agile translational research frameworks like large adaptive trials proved critical, separating truly effective therapies from many speculative candidates. From a pharmacoeconomic perspective, repurposed therapies yielded cost-effective breakthroughs and costly disappointments. High-income countries invested substantial resources in repurposed drugs. In some cases, this approach provided rapid access to evidence-based care but also led to significant spending on unproven interventions, underscoring the importance of timely evidence generation and prudent resource allocation. Disparities in access to effective therapies between wealthy and low-resource settings highlight a persistent global equity challenge. The collective experience of pandemic drug repurposing provides a pragmatic blueprint for balancing urgency with scientific rigor, economic prudence, and equity. This will ultimately guide how we might better pivot from crisis to cure in future global health emergencies.}, }
@article {pmid40584825, year = {2025}, author = {Brandt, T and Huppert, D}, title = {The mysterious sense of smell: evolution, historical perspectives, and neurological disorders.}, journal = {Frontiers in human neuroscience}, volume = {19}, number = {}, pages = {1588935}, pmid = {40584825}, issn = {1662-5161}, abstract = {Phylogenetically, the chemical sense of smell is the oldest of all sensory modalities in terrestrial and aquatic organisms. For most non-human species in the wild, it is essential like other senses for survival because it aids nutrition, detection of environmental threats, and mating. In contrast to other senses, olfaction holds some unique properties: vertebrates, humans, and other mammals can distinguish many thousands of different odors due to genetically determined specific odorant receptors which have a lifespan of about 1 month and then are continuously replaced by neuroneogenesis in the olfactory epithelium. From a historical perspective, fragrances and perfumes played a significant role in the most influential ancient cultures, Egypt, Greece, and China. Most important was the belief in the magic power of fragrances-which were classified as "pleasant" or "unpleasant"-for medical treatment, religious or funeral rituals, e.g., preparing the bodies of the deceased for the assumed life after death, purification and divine favor. Further perfumes were used to cover natural body odor, for personal grooming, or to offer a potential hedonic odor in sexual selection. In contemporary medicine, the potential diagnostic value of olfactory loss as a biological marker for an impending neurodegenerative disorder such as Mild Cognitive Impairment, Alzheimer's disease, Parkinson's disease, or estimating the inflammatory activity in Multiple Sclerosis is increasingly recognized. The regeneration of odorant receptors and inhibitory interneurons provide the basis for long-term recovery of loss of olfaction due to respiratory infections, for example in pandemics like COVID-19 or after a head trauma. Imaging disorders of olfaction disclosed clinically relevant structural changes of the brain network of olfaction and the intimate reciprocal interaction with other networks to subserve higher cortical functions such as an impressive specific odor memory, quality of life, emotion, cognition, selection of food, social interaction, stress, and depression. The latter higher olfactory functions often remain undetected by both patients and their doctors. A more intensive implementation of olfactory function and clinical testing should be considered in medical training.}, }
@article {pmid40584714, year = {2025}, author = {Liu, P and Luo, X and Wan, D and Li, Y and Su, B}, title = {Emerging trends and focus of Toll-like receptors in kidney diseases: a 20-year bibliometric analysis.}, journal = {Frontiers in medicine}, volume = {12}, number = {}, pages = {1599196}, pmid = {40584714}, issn = {2296-858X}, abstract = {BACKGROUND: An increasing number of studies have explored the role of Toll-like receptors (TLRs) in the pathogenesis of kidney diseases and their corresponding therapeutic potential. However, there is no comprehensive bibliometric analysis in this field. This study aims to investigate the hotspots and evolution of TLRs and kidney disease research over the past two decades.<br><br>METHODS: Publications from the Web of Science Core Collection database were searched and extracted on December 21, 2024 using the terms "Toll-like receptor" and "kidney disease" (and their synonyms in MeSH). CiteSpace was used to explore publications from January 1, 2000, to December 21, 2024, to visualize the contributions of countries, institutions, journals, and authors, and to detect the evolution of research focus and emerging trends in this field.<br><br>RESULTS: A total of 2,505 studies with 101,150 references were included in this study. The United States and China are the leading forces among all countries. The Egyptian Knowledge Bank is the leading institution, and Hans-Joachim Anders is considered the most influential expert in this field. PLOS One is the journal with the most publications, and Journal of Immunology is the most co-cited journal. According to the co-citation analysis, COVID-19 is the latest research hotspot. Additionally, both ischemia-reperfusion injury and diabetic nephropathy have been long-standing research hotspots and still hold significant values. Moreover, the use of TLR inhibitors as a therapeutic strategy for kidney diseases is increasingly emphasized.<br><br>CONCLUSION: Our study demonstrates a growing understanding of the crucial role of TLRs in kidney diseases over the past two decades. Future research should attach more importance to the identification of novel endogenous ligands for TLRs, which will be critical for developing TLR inhibitors as a viable therapeutic strategy.}, }
@article {pmid40584453, year = {2025}, author = {Han, SM and Hon, PS and Na, HY and Yong, TTH and Tambyah, PA and Wen, YT}, title = {Viral non-SARS-CoV-2 etiology of community-acquired pneumonia (CAP) in Southeast Asia: a review and pooled analysis.}, journal = {IJID regions}, volume = {15}, number = {}, pages = {100672}, pmid = {40584453}, issn = {2772-7076}, abstract = {Community-acquired pneumonia (CAP) remains a leading cause of morbidity and mortality worldwide, including in Southeast Asia (SEA). While bacterial causes are well studied, viral etiologies are less characterized. The COVID-19 pandemic has underscored the significance of viral pneumonia, alongside ongoing concerns from zoonotic influenza, human metapneumovirus, and other outbreaks. This review identified 16 studies from SEA, encompassing 8421 CAP patients (2012-2023), describing the viral etiology of CAP. Influenza virus (IV), respiratory syncytial virus (RSV), and human rhinovirus/enterovirus (hRV/EV) were the most frequently tested viral pathogens in 16, 13, and 12 studies, respectively. The pooled positivity rates were 9.02% (hRV/EV), 7.28% (IV), and 5.17% (RSV). While viral etiologies of CAP in SEA align with global trends, data remain limited. Enhancing microbiology capacity in SEA is essential to strengthen CAP surveillance, optimize treatment strategies, inform vaccination policies, and improve pandemic preparedness.}, }
@article {pmid40584180, year = {2025}, author = {Romanella, A and McCall, M and Corwin, R and Faruq, AA and Lingo, E and Bhambhani, S and Hammond, CJ and Balin, BJ}, title = {Infections with Chlamydia pneumoniae and SARS-CoV-2 and Alzheimer's disease pathogenesis.}, journal = {Frontiers in aging neuroscience}, volume = {17}, number = {}, pages = {1587782}, pmid = {40584180}, issn = {1663-4365}, abstract = {INTRODUCTION: Alzheimer's disease (AD) is the most prevalent neurodegenerative disease in the world, but our understanding of causation is still lacking. A current evidence-based hypothesis proposes that certain infectious agents initiate the neurodegeneration consistent with AD. Two infectious agents correlated to AD pathogenesis are Chlamydia pneumoniae (Cpn), a respiratory obligate intracellular bacterium, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus responsible for the COVID-19 pandemic. Both organisms may predispose susceptible populations to disease manifestations, such as AD.<br><br>METHODS: This review focused on peer-reviewed original research and review articles evaluating the potential association of Cpn and SARS-CoV-2 with AD. Our focus included: genetic risk with expression of APOE&#x3b5;4 and other biomarkers common to AD including interleukin-6 (IL-6), chemokine ligand 2 (CCL2), neuropilin-1 (NRP1), and structural/functional aspects of the infectious processes and resultant neuroinflammation.<br><br>RESULTS: Both Cpn and SARS-CoV-2 may infect the neuroepithelium of the olfactory system to enter the brain. Cpn binds to heparan sulfate proteoglycans for entry into mucosal cells. SARS-CoV-2 infects epithelia after binding to ACE2 receptors. Once inside the neuroepithelium, the pathogens may traffic to the olfactory bulbs. NRP1, an abundant receptor in AD, also potentiates SARS-CoV-2 infection. Furthermore, both pathogens may enter the systemic circulation for eventual entry through the blood brain barrier. The SARS-CoV-2 spike protein, in conjunction with CCL2, co-stimulates macrophages, resulting in IL-6 cytokine release. Likewise, Cpn infection leads to an increase of CCL2 and IL-6 cytokine release. The primary infection of either organism may lead to chronically elevated levels of IL-6 and secondary infection(s). Additionally, host APOE&#x3b5;4 expression appears to increase susceptibility to Cpn and SARS-CoV-2 infections.<br><br>DISCUSSION: Cpn and SARS-CoV-2 may enter the brain through olfactory neuroepithelial cells and/or through the blood brain barrier. SARS-CoV-2 utilizes specific receptors for infection, while Cpn utilizes binding of proteoglycans. Neuroinflammation may be an outcome of infection with one or both organisms as observed by increased levels of CCL2 and IL-6 leading to AD pathogenesis. Genetic risk is noted for infection with both organisms with expression of APOE&#x3b5;4. Ongoing and future studies will further dissect mechanisms of infection with SARS-CoV-2 and Cpn as they may inform on causation and diagnostic factors for AD.}, }
@article {pmid40584171, year = {2025}, author = {Ghosh, S and Kumar, S and Verma, R and Ansari, S and Chatterjee, S and Surjit, M}, title = {Emerging RNA-centric technologies to probe RNA-protein interactions: importance in decoding the life cycle of positive sense single strand RNA viruses and antiviral discovery.}, journal = {Frontiers in cellular and infection microbiology}, volume = {15}, number = {}, pages = {1580337}, pmid = {40584171}, issn = {2235-2988}, mesh = {Humans ; *RNA, Viral/metabolism/genetics ; *Antiviral Agents/pharmacology ; Drug Discovery/methods ; *Viral Proteins/metabolism/genetics ; *Positive-Strand RNA Viruses/drug effects/genetics/physiology/metabolism ; *RNA-Binding Proteins/metabolism ; SARS-CoV-2 ; Host-Pathogen Interactions ; }, abstract = {Positive sense single strand RNA (+ssRNA) viruses are one of the evolutionary successful organisms and many of them pose a significant threat to human health. Diseases caused by +ssRNA viruses such as COVID-19, Flu and acute viral hepatitis are major public health concern worldwide. Therefore, a lot of research is focused at decoding the life cycle of +ssRNA viruses and develop specific antiviral therapeutics against them. Interaction of the viral RNA with virus-encoded proteins and host proteins drives the lifecycle and pathogenesis of +ssRNA viruses. Recent developments in computational and high-throughput omics-based experimental technologies offer the sensitivity and specificity for molecular characterization of these RNA-protein complexes. These are promising tools to revolutionize the field of +ssRNA virus research and pave the way for antiviral discovery. This review summarizes the current scientific resources available to characterize the RNA-protein interactome of +ssRNA viruses and provides an overview of the drug discovery pipeline for developing antivirals against pathogenic +ssRNA viruses.}, }
@article {pmid40584095, year = {2025}, author = {Petakh, P and Kamyshna, I and Halabitska, I and Kamyshnyi, O}, title = {Effect of vitamin D supplementation on COVID-19 outcomes: an umbrella review of systematic reviews.}, journal = {Frontiers in nutrition}, volume = {12}, number = {}, pages = {1559471}, pmid = {40584095}, issn = {2296-861X}, abstract = {BACKGROUND: Vitamin D is suggested as a supportive therapy to reduce the severity of COVID-19 due to its immunomodulatory and anti-inflammatory effects. However, its effect on critical outcomes, such as ICU admissions and mortality, shows significant variation across randomized clinical trials and meta-analyses.<br><br>OBJECTIVES: To summarize the influence of vitamin D supplementation on ICU admissions and mortality among COVID-19 patients.<br><br>METHODS: Overall, 21 eligible studies were retrieved using a comprehensive search from Scopus, PubMed, and Web of Science. A citation matrix was developed, revealing a Corrected Covered Area (CCA) of 0.54, indicating moderate overlap. Fixed-effects models were applied to data with low heterogeneity (ICU admissions: Q&#x202f;=&#x202f;10.87, p&#x202f;=&#x202f;0.33), while random-effects models were used for mortality outcomes (Q&#x202f;=&#x202f;27.23, p&#x202f;=&#x202f;0.006). Pooled odds ratios (OR) with 95% confidence intervals (CI) quantified the overall effects.<br><br>RESULTS: Vitamin D supplementation was associated with a significant 38% reduction in ICU admissions (OR&#x202f;=&#x202f;0.62; 95% CI: 0.54-0.71) and a 33% reduction in mortality risk (OR&#x202f;=&#x202f;0.67; 95% CI: 0.56-0.79). The benefit was pronounced in vitamin D-deficient populations, although heterogeneity in mortality outcomes highlighted variability across studies.<br><br>CONCLUSION: While these findings suggest that vitamin D supplementation may help reduce ICU admissions and mortality among COVID-19 patients-particularly in those with vitamin D deficiency-the results should be interpreted with caution. The observed variability and potential confounding factors underscore the need for further large-scale, randomized controlled trials with standardized dosing protocols before definitive clinical recommendations can be made.}, }
@article {pmid40583757, year = {2025}, author = {Cornwell, WK and Levine, BD and Baptiste, D and Bhave, N and Desai, S and Dineen, E and Durstenfeld, M and Edward, J and Huang, M and Jacobsen, R and Kim, JH and Spatz, E and , }, title = {Exercise Intolerance and Response to Training in Patients With Postacute Sequelae of SARS-CoV2 (Long COVID): A Scientific Statement From the American Heart Association.}, journal = {Circulation}, volume = {152}, number = {5}, pages = {e50-e62}, doi = {10.1161/CIR.0000000000001348}, pmid = {40583757}, issn = {1524-4539}, mesh = {Humans ; *COVID-19/physiopathology/complications/therapy ; *Exercise Tolerance ; American Heart Association ; United States ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome ; *Exercise Therapy/methods ; Cardiovascular Deconditioning ; Quality of Life ; Exercise ; }, abstract = {The postacute sequelae of SARS-CoV-2, also known as Long COVID, may affect 10% to 25% of individuals diagnosed with SARS-CoV-2. More than 100 symptoms have been reported among patients with Long COVID, but almost all patients report severe fatigue, orthostatic intolerance, shortness of breath, and reductions in exercise tolerance. Emerging data suggest that cardiovascular deconditioning plays a major role in the development of this syndrome and that reductions in functional capacity among patients with Long COVID are comparable to reductions seen among individuals with cardiovascular deconditioning resulting from bed rest. Concern has been raised about the use of exercise training as part of the management strategy for patients with Long COVID. However, exercise training appropriately tailored to the patient with cardiovascular deconditioning may be an effective strategy to facilitate improvement in symptoms. This American Heart Association scientific statement provides a concise yet comprehensive overview of mechanisms contributing to development of Long COVID and methods by which exercise training may be applied to this unique patient population to alleviate symptoms and improve quality of life. In addition, methods of reintroducing exercise and return to play among athletes affected by COVID-19 are discussed.}, }
@article {pmid40582622, year = {2025}, author = {Xu, K and He, W and Yu, B and Wang, JJ and Wu, J and Wang, DW}, title = {Unveiling the silent threat: COVID-19 and myocardial injury.}, journal = {Pharmacology &amp; therapeutics}, volume = {273}, number = {}, pages = {108904}, doi = {10.1016/j.pharmthera.2025.108904}, pmid = {40582622}, issn = {1879-016X}, mesh = {Humans ; *COVID-19/complications ; *Myocarditis/etiology/virology/diagnosis ; COVID-19 Vaccines/adverse effects ; SARS-CoV-2 ; COVID-19 Drug Treatment ; }, abstract = {Since COVID-19 firstly appeared in 2019 December, it has been defined as an infectious disease mainly performing lung symptoms, which contracted more attention. However, more and more findings indicate myocardial injury appears in considerable proportion of COVID-19 patients (30 % - 50 %) not only but also major cause leading to the death in patients, many of whom may be even without severe respiratory symptoms. Meanwhile myocarditis after injecting vaccines has been paid more attention to globally which always performs uncontrollable inflammation and lead to death. Now myocardial injury has been a main complication in patients with long COVID-19, which is worthy of attention. Furthermore, myocardial injury or myocarditis is detectable and treatable. In order to abstract attention to myocardial injury associated with COVID-19 and provide more evidence and experience for patients who still suffer myocardial injury from COVID-19 vaccines or long COVID-19, the review comprehensively summarized previous researches from pathogenesis, clinical symptoms, diagnosis and treatment and emphasized the crucial role of RASS inhibitors especially ARBs.}, }
@article {pmid40582541, year = {2025}, author = {Hazique, M and Jafar, Z and Lohana, S and Reyaz, I and Burhan, M and Narayan, R and Alraies, MC}, title = {The Cusp Overlap Technique Reduces Pacemaker Implantation in TAVR: A Systematic Review and Meta-analysis.}, journal = {The American journal of cardiology}, volume = {254}, number = {}, pages = {75-84}, doi = {10.1016/j.amjcard.2025.06.024}, pmid = {40582541}, issn = {1879-1913}, mesh = {Humans ; *Aortic Valve Stenosis/surgery ; *Pacemaker, Artificial ; *Postoperative Complications ; *Transcatheter Aortic Valve Replacement/methods ; }, abstract = {Transcatheter aortic valve replacement (TAVR) has become the preferred treatment for symptomatic aortic stenosis, yet conduction disturbances leading to permanent pacemaker implantation (PPI) remain a significant complication, particularly with self-expanding valves (SEVs). The cusp overlap view (COV) technique has been introduced to achieve a higher, more controlled valve implantation compared to the conventional coplanar view (CPV). We performed a systematic review and meta-analysis (14 studies; 5,266 TAVR patients) comparing the COV to the CPV. Data were pooled using the DerSimonian-Laird random-effects model with I[2] for heterogeneity. The analysis demonstrated that the COV technique was associated with significantly lower PPI rates (11.2% vs 17.7%; OR = 0.63; p <0.0001). Additionally, patients in the COV group experienced a significantly shorter hospital stay (SMD = -0.56; p = 0.016) and a modestly lower mean transvalvular gradient (SMD = -0.10; p = 0.049). Although the depth measured from the non-coronary cusp did not differ significantly between groups, the arithmetic mean distance from the non-coronary and left coronary cusps was significantly lower in the COV group (SMD = -0.21; p <0.001), indicating a higher valve position. Our meta-analysis suggests that the cusp overlap technique significantly reduces PPI rates and improves procedural outcomes in TAVR with SEVs. In conclusion, these findings suggest that COV not only enhances patient outcomes by reducing conduction disturbances and shortening hospital stays but also optimizes healthcare resource utilization. Future randomized controlled trials are needed to confirm these benefits and further standardize TAVR protocols in clinical practice.}, }
@article {pmid40581875, year = {2025}, author = {Prentice, S and Dorstyn, DS and Massy-Westropp, N and Benson, J and Elliott, T}, title = {Burnout before and during COVID: A systematic review and meta-analysis of 48 698 trainees.}, journal = {Medical education}, volume = {59}, number = {11}, pages = {1156-1171}, pmid = {40581875}, issn = {1365-2923}, mesh = {Humans ; *Burnout, Professional/epidemiology/psychology ; *COVID-19/psychology/epidemiology ; Internship and Residency ; SARS-CoV-2 ; }, abstract = {PURPOSE: Postgraduate medical trainees exhibit elevated burnout levels. COVID-related workplace stressors created a further mental health challenge, potentially exacerbating this issue. This review compared literature on burnout levels in postgraduate medical trainees published before and after COVID, with consideration of group differences (e.g., specialty and country).<br><br>METHODS: This systematic review and meta-analysis was registered on PROSPERO (CRD42023404618) and followed the updated PRISMA statement. Embase, Ovid Medline, Ovid PsycInfo and the Cochrane Collaborative were searched until April 2025. These results were supplemented with pearling and citation searching of included articles and previous reviews. Studies that administered the Maslach Burnout Inventory - Human Services Survey (MBI) to postgraduate medical trainees were eligible. Where studies met eligibility criteria but did not provide required data (i.e., sample size, means and standard deviations), authors were contacted to supply these data. Methodological reporting quality (QualSyst tool) and publication bias were assessed (funnel plots, trim-and-fill method), and between-group heterogeneity explored (subgroup analyses, meta-regression). Differences in burnout levels pre- and intra-COVID (i.e., before and after March 2020, respectively) were quantified using Hedges' g.<br><br>RESULTS: Of 3 930 unique studies identified, 245 were included, comprising 48&#x2009;698 trainees. Impacts of the COVID-19 pandemic on burnout levels varied: although trainees' emotional exhaustion remained stable, reported levels of depersonalisation (from gw&#x2009;=&#x2009;0.611 to 0.430, p&#x2009;=&#x2009;0.045) and personal accomplishment fell (from gw&#x2009;=&#x2009;-0.348 to -0.626, p&#x2009;=&#x2009;0.009). Specialty and country variations were evident, with emergency medicine trainees trainees reporting worse burnout during COVID, whereas anethesiology, psychiatry and urology trainees felt less burnt out by their work.<br><br>CONCLUSIONS: Wellbeing supports should be prioritized for front-line specialty trainees, who were vulnerable to work-related stressors that emerged during COVID. Interventions should focus on fostering a sense of competence and mastery, both of which can enhance personal accomplishment.}, }
@article {pmid40581392, year = {2025}, author = {McBride, C and Loudermill, C and Wessel-Powell, C and McQuade, M}, title = {Bridging the gap across research and practice: The science of reading in contexts.}, journal = {Advances in child development and behavior}, volume = {68}, number = {}, pages = {1-23}, doi = {10.1016/bs.acdb.2024.10.004}, pmid = {40581392}, issn = {0065-2407}, mesh = {Humans ; *Reading ; *COVID-19 ; Child ; *Literacy ; Child, Preschool ; }, abstract = {In this chapter, we highlight research and practice considerations related to the science of reading. First, we provide a review of five cognitive-linguistic skills/constructs that are important for early literacy assessment and instruction across diverse contexts. These skills include pure copying, delayed copying, vocabulary knowledge, morphological awareness, and word reading. We discuss how research on assessment of these skills across languages and scripts facilitates early identification of children at-risk for reading and spelling difficulties and provides ideas and guidance for instruction. The second section of this chapter focuses on optimizing online literacy assessment and teaching while decreasing barriers to access (i.e., cost, accessibility) prompted by the COVID-19 pandemic. This pandemic brought with it new challenges and considerations for research and practice when the sudden pivot to an online modality was necessary. Finally, we highlight our shared interests and efforts related to the science of reading movement in the US. A brief overview of the science of reading movement in Indiana, our current context, is provided, in addition to observations of considerations that must be addressed when states move to implementing science of reading legislation. A shared excitement in and commitment to promoting research-aligned practices and informing legislation on assessment and instruction in science-based reading and writing from multiple disciplinary perspectives (i.e., developmental psychology, speech and hearing sciences, and education) fuels our efforts in advancing research and practice in the science of reading and writing.}, }
@article {pmid40581122, year = {2025}, author = {Gonal, BN and Dalbanjan, NP and Kadapure, AJ and Shubham, KR and Praveen Kumar, SK and Arakera, SB}, title = {Present and future prospects of vaccines: protecting humanity against emerging and re-emerging infectious diseases.}, journal = {Indian journal of medical microbiology}, volume = {56}, number = {}, pages = {100908}, doi = {10.1016/j.ijmmb.2025.100908}, pmid = {40581122}, issn = {1998-3646}, mesh = {Humans ; *Communicable Diseases, Emerging/prevention &amp; control ; *Vaccine Development/trends ; *COVID-19/prevention &amp; control ; SARS-CoV-2/immunology ; COVID-19 Vaccines/immunology ; *Vaccines/immunology ; Pandemics/prevention &amp; control ; }, abstract = {INTRODUCTION: Vaccines have proven to be one of the most effective tools for controlling infectious diseases worldwide, significantly lowering illness and death rates caused by various pathogens. However, the emergence of new and re-emerging infectious diseases highlights the critical need for advanced vaccine technologies that can respond to dynamic, evolving health threats.<br><br>DISCUSSION: This review examines recent advances in vaccine science, with a particular emphasis on the development of next-generation platforms such as mRNA and viral vector-based vaccines, as well as advancements in formulation and delivery systems. These advances have helped overcome immune escape mechanisms, which pathogens use to avoid immune detection and reduce vaccine efficacy. The review provides an historical perspective showing how each breakthrough has influenced current strategies, such as those used during the COVID-19 pandemic, and how cumulative progress has shaped today's rapid vaccine development and deployment capabilities.<br><br>CONCLUSION: Lessons from recent vaccine innovations, combined with historical perspectives, point to a bright future in which pathogen-specific vaccine designs, personalized immune responses, and global access will all play important roles in public health. Together, these findings lay the groundwork for future progress in pandemic preparedness and global health security.}, }
@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 &amp; numerical data ; *Vaccination Hesitancy/statistics &amp; numerical data/psychology ; *COVID-19 Vaccines/administration &amp; dosage ; Africa, Western/epidemiology ; *COVID-19/prevention &amp; control/epidemiology ; Cross-Sectional Studies ; SARS-CoV-2 ; Pandemics/prevention &amp; 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.<br><br>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.<br><br>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.<br><br>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.}, }
@article {pmid40580665, year = {2025}, author = {Affolter, KF and Tausendfreund, T and Eicher, N}, title = {Child protection during COVID-19: A systematic meta-synthesis of empirical studies exploring perspectives of young people and caregivers.}, journal = {Child abuse &amp; neglect}, volume = {167}, number = {}, pages = {107558}, doi = {10.1016/j.chiabu.2025.107558}, pmid = {40580665}, issn = {1873-7757}, mesh = {Humans ; *COVID-19/psychology/epidemiology ; *Caregivers/psychology ; Child ; Adolescent ; *Child Protective Services ; SARS-CoV-2 ; }, abstract = {BACKGROUND: The COVID-19 pandemic affected child protection services (CPS) and the lives of those involved in different ways. This review analyzes research methodologies and service users' perspectives on COVID-19's impact on CPS in literature, published between January 1st, 2020, and October 17th, 2023.<br><br>METHOD: First, a systematic literature search identified relevant studies, which were analyzed for data collection methods, participants, and main topics. Second, a meta-synthesis was conducted on studies featuring in-depth interviews with young people and/or caregivers.<br><br>RESULTS: Of the 240 articles pre-selected for study method analysis (&#x3ba;&#xa0;=&#xa0;0.84), the most common data collection methods were surveys (53.7&#xa0;%), interviews (21.3&#xa0;%), and mixed methods (13.9&#xa0;%). Surveys primarily targeted caregivers, while interview and mixed method studies mostly involved child protection professionals. Overall, service users were rarely asked about their perspectives on CPS. The meta-synthesis included 19 studies conducting in-depth interviews with service users, revealing that their experiences of COVID-19 were primarily crisis-stricken. COVID-19 and countermeasures were perceived as particularly challenging in areas of life where individuals lacked coping strategies, resources, and adequate support. A key challenge reported by service users was remote schooling, which disrupted daily routines, increased stress, and negatively affected overall well-being.<br><br>CONCLUSION: Research on CPS during COVID-19 often overlooked service users' perspectives, especially young people. Including these perspectives is essential for developing informed and responsive recommendations for CPS. Future research during health emergencies should therefore ensure that people's lived experiences and perspectives on CPS are researched with appropriate and diverse methods to identify newly emerging challenges and needs within CPS.}, }
@article {pmid40580492, year = {2025}, author = {Zhang, Y and Hou, R and Wei, Z and Yuan, J and Zu, S}, title = {Development of the coronavirus reverse genetic system: Core technology for pathogenesis mechanisms research and vaccine/drug development.}, journal = {Virulence}, volume = {16}, number = {1}, pages = {2525930}, pmid = {40580492}, issn = {2150-5608}, mesh = {*Reverse Genetics/methods ; Humans ; Animals ; *Vaccine Development ; Drug Development ; *Coronavirus/genetics/pathogenicity ; SARS-CoV-2/genetics/pathogenicity ; Viral Vaccines/immunology ; Antiviral Agents/pharmacology ; COVID-19 Vaccines ; }, abstract = {Coronaviruses (CoVs) are enveloped, single-stranded, positive-sense RNA viruses that cause respiratory, gastrointestinal, hepatic, and neurological diseases in humans and other animals. In recent years, frequent outbreaks of emerging and re-emerging CoVs have threatened animal and human health. However, an insufficient understanding of the mechanisms underlying CoV pathogenicity and cross-species transmission limits the development of drugs and vaccines against CoVs. Reverse genetic technology is a powerful tool for manipulating the genomes of CoVs and acquiring recombinant viruses, which allows researchers to better understand viral pathogenesis and develop genetically attenuated and marked vaccines and antiviral drugs. However, the large genomes of CoVs and the instability and toxicity of viral sequences in bacteria represent serious obstacles to the development of reverse genetic systems of CoVs. With the development of molecular biological methods, various new construction strategies have emerged. Accordingly, this review summarizes the construction strategies of CoV reverse genetics systems and their applications in studying pathogenesis, cross-species transmission, vaccine development, and drug screening, with the aim of providing an important reference for the prevention and control of CoVs.}, }
@article {pmid40579764, year = {2025}, author = {Visca, D and Centis, R and D'Ambrosio, L and Spanevello, A and Petrone, L and Migliori, GB and Goletti, D}, title = {Evaluating the impact of COVID-19 or SARS-CoV-2 vaccination on TB infection testing in the context of TB elimination.}, journal = {The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease}, volume = {29}, number = {7}, pages = {293-298}, doi = {10.5588/ijtld.25.0034}, pmid = {40579764}, issn = {1815-7920}, mesh = {Humans ; *COVID-19/prevention &amp; control/epidemiology ; *COVID-19 Vaccines/administration &amp; dosage ; *Interferon-gamma Release Tests ; *Tuberculosis/diagnosis/prevention &amp; control ; Vaccination ; }, abstract = {<sec><title>OBJECTIVES</title>The impact of COVID-19 and SARS-CoV-2-vaccination on interferon-gamma release assay (IGRA) indeterminate results is unclear. This mini-review aims to examine whether COVID-19 or SARS-CoV-2-vaccination affects the accuracy of IGRAs by increasing the indeterminate rate.</sec><sec><title>METHODS</title>Non-systematic literature review based on a PubMed search using specific keywords, including various combinations of 'TB', 'quantiferon', 'indeterminate or negative results' and 'covid' without any time limits.</sec><sec><title>RESULTS</title>A systematic review found an overall pooled effect size (equivalent to the indeterminate results) of 0.26 (95% confidence: 0.205-0.32) for QuantiFERON TB Plus (QFT-TB) with a mean true effect size of 0.26 (95% prediction interval: 0.11-0.5), and other studies confirmed the link with disease severity. SARS-CoV-2 vaccination does not affect IGRA interpretation.</sec><sec><title>CONCLUSIONS</title>The use of IGRAs is not significantly affected by the COVID-19 pandemic or vaccinations, except in a small number of severe cases observed during the pandemic's peak. IGRAs' reliability remains consistent with their pre-pandemic performance.</sec>.}, }
@article {pmid40579684, year = {2025}, author = {Jackson, D}, title = {Global Maternal Child Health Initiatives and Programs 1974 to 2023.}, journal = {Maternal and child health journal}, volume = {29}, number = {8}, pages = {1047-1060}, pmid = {40579684}, issn = {1573-6628}, support = {Takeda Chair in Global Child Health LSHTM//Takeda Foundation/ ; }, mesh = {Humans ; *Global Health ; Female ; Child ; COVID-19 ; *Maternal-Child Health Services/trends ; *Maternal Health/trends ; Child Health ; Primary Health Care ; }, abstract = {AIM: This review paper aims to review Global MCH initiatives and note trends across the last five decades (1974-2023).<br><br>METHODS: As an organizing framework, MCH initiatives and programs have been classified into five categories: Global Health Conferences, Declarations or Strategies; Global Health Surveys; Global MCH Programs; Global MCH related Data Initiatives or Working/Advisory Groups; and Global MCH Partnerships or Networks.<br><br>RESULTS: Over 50 Global MCH initiatives and programs have been implemented during this period. The first International Conference on Primary Health Care and the Alma Ata Declaration in 1978 initiated a new era of global public health. International conferences building on Alma Ata with a focus on population health and MCH, along with global surveys to measure the health status of populations across countries and global working groups to analyze these data, emerged over the next decades. Global MCH partnerships also emerged for advocacy and coordination of an increasing number of efforts to improve maternal, newborn, child and adolescent health and well-being-towards achieving the Millennium (2000-2015) and Sustainable (2016-2030) Development Goals.<br><br>CONCLUSION: Four trends were noted across these five decades: (1) MCH Mortality decreased but unacceptable inequities persist with COVID-19, ongoing conflicts and climate change threatening these gains. (2) Implementation of primary health care (PHC) as envisioned by Alma Ata in 1974 continues to see a debate about selective versus comprehensive programs. (3) As mortality declined (Survive), the field expanded focus to child well-being (Thrive) and across preconception through adolescents (Transform). (4) Global MCH issues are relevant across high-income (HIC) and low-middle income (LMIC) settings to achieve health and well-being of all women and children everywhere.}, }
@article {pmid40579573, year = {2025}, author = {Liu, J and Lyu, C and Kwan, C and Lan, X and Deng, J and Zhang, J}, title = {Understanding the effectiveness of psychosocial services for older adults' mental health in China: a systematic review and meta-analysis.}, journal = {Social psychiatry and psychiatric epidemiology}, volume = {}, number = {}, pages = {}, pmid = {40579573}, issn = {1433-9285}, abstract = {OBJECTIVE: Given the rapid development of psychosocial interventions for older adults in China and the significant mental health impacts of the COVID-19 pandemic, it is crucial to evaluate psychosocial interventions' effectiveness in promoting mental health of China's older population. To address this need, a systematic review and meta-analysis were conducted.<br><br>METHODS: We conducted a comprehensive search across nine electronic databases and Google Scholar for controlled trial studies published between 2018 and 2023. A meta-analytic approach with random-effects models was employed, and moderator analyses explored variability in effect size estimates.<br><br>RESULTS: Thirty-one studies with 5,941 participants were included. Guided by the WHO's framework, mental health indicators were categorized as positive or negative. Positive indicators reflect better mental health with higher values, while negative indicators show worse mental health. Significant effects were noted for negative (g&#x2009;=&#x2009;-1.21, 95% CI: -1.44, 0.99) and positive (g&#x2009;=&#x2009;0.68, 95% CI: 0.51, 0.84) mental health indicators, moderating by geographic region, intervention type, setting, and delivery modality.<br><br>CONCLUSIONS: Psychosocial services could significantly benefit Chinese older adults' mental health. The moderator and subgroup analysis suggests that the most effective interventions involve mental health professionals and utilize multifaceted approaches. Additionally, the results indicate that intervention duration is an important consideration, as shorter-term programs in Hong Kong exhibited relatively smaller effects.}, }
@article {pmid40577563, year = {2025}, author = {Eichenberg, C}, title = {[Not Available].}, journal = {Zeitschrift fur Psychosomatische Medizin und Psychotherapie}, volume = {71}, number = {2}, pages = {172-188}, doi = {10.13109/zptm.2025.71.2.172}, pmid = {40577563}, issn = {1438-3608}, mesh = {Humans ; *Internet Addiction Disorder/therapy/psychology/diagnosis/epidemiology ; *Social Media ; *COVID-19/psychology ; *Behavior, Addictive/psychology/therapy ; Comorbidity ; }, abstract = {UNLABELLED: Social media addiction: An overview of the current state of research Objectives: Social media addiction as a form of internet addiction is an increasing problem in psychotherapeutic practice, exacerbated by the COVID-19 pandemic. What is the current knowledge of psychopathology on social media addiction?<br><br>METHODS: Based on a literature search in PubMed, Researchgate, Connected Papers, and Springer Link (March/April 2024), the current state of research is summarised in the following areas: Definition, classification and diagnosis, prevalence, psychological comorbidities, personality traits, ethiopathogenetic factors (esp. attachment style and ability to mentalize), and treatment approaches.<br><br>RESULTS: The available knowledge is mainly based on studies from the last three years. Social media addiction has not yet been included in the current classification systems but can still be coded in a collective category (ICD-11: 'Disorders due to addictive behaviours, unspecified'), as studies have shown that social media addiction is a disorder in its own right. Treatment approaches investigated to date are based on various therapeutic schools and methods (i. a. cognitive behavioural therapy, art therapy, self-help).<br><br>CONCLUSIONS: Future therapy studies should include decidedly psychodynamic-based treatment methods, as latest studies have demonstrated the importance of attachment styles and mentalization ability as risk factors. Additionally, exploring the effectiveness of mentalization training in both treatment and prevention of digital addictions warrants further investigation.}, }
@article {pmid40576539, year = {2025}, author = {Leung, JG and Schmitt, CJ and Kuhn, AK}, title = {Clozapine and nirmatrelvir/ritonavir coadministration without apparent interaction in a patient with mild COVID-19 infection: A case with review of other clozapine-related CYP3A4 interactions.}, journal = {American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists}, volume = {82}, number = {22}, pages = {1228-1237}, doi = {10.1093/ajhp/zxaf156}, pmid = {40576539}, issn = {1535-2900}, mesh = {Humans ; *Clozapine/administration &amp; dosage/adverse effects/pharmacokinetics ; *Ritonavir/administration &amp; dosage ; Drug Interactions ; *Antipsychotic Agents/administration &amp; dosage/adverse effects/pharmacokinetics ; Cytochrome P-450 CYP3A/metabolism ; Female ; *Schizophrenia/drug therapy ; *COVID-19 Drug Treatment ; Aged ; COVID-19 ; Cytochrome P-450 CYP3A Inhibitors/administration &amp; dosage ; Drug Therapy, Combination ; Drug Monitoring/methods ; }, abstract = {PURPOSE: Clozapine is primarily metabolized by cytochrome P450 (CYP) 1A2 and to a lesser extent by CYP2C19, CYP2D6, and CYP3A4. The global pandemic of coronavirus disease 2019 (COVID-19) and use of nirmatrelvir/ritonavir brought forth new challenges for those caring for patients prescribed clozapine. Prescribing information describes a consideration for a clozapine dose reduction while monitoring for adverse reactions when clozapine is used with nirmatrelvir/ritonavir. Other drug information resources consider the combination a contraindication. A case is reported in which therapeutic drug monitoring demonstrated a lack of interaction between clozapine and nirmatrelvir/ritonavir. The complexities of infection-associated clozapine toxicity are discussed and a review is provided of CYP3A4 drug and gene interactions with clozapine.<br><br>SUMMARY: A 75-year-old woman with schizophrenia, prescribed clozapine 200&#x2005;mg by mouth at bedtime, was initiated on nirmatrelvir/ritonavir after developing a mild COVID-19 infection. Two days later, the patient was brought to the emergency department after an unwitnessed fall. Clozapine toxicity was included in the differential diagnosis, although no other signs or symptoms of elevated clozapine levels were present. Nirmatrelvir/ritonavir was discontinued. Clozapine was withheld for 1 day while a clozapine level was pending, but this measurement revealed no interaction when compared to a baseline level of clozapine.<br><br>CONCLUSION: Although there are hypothetical concerns when initiating a CYP3A4 inhibitor with concomitant clozapine, the information derived from this case does not clearly support an interaction with the addition of nirmatrelvir/ritonavir during mild COVID-19 infection. It is important to understand the risks of withholding clozapine, although fortunately no psychiatric concerns developed. In reviewing the literature, CYP3A4 inhibitors or genetic polymorphisms seem to have a minimal impact on clozapine levels, although clinical monitoring is warranted.}, }
@article {pmid40576111, year = {2025}, author = {Rizopoulos, T and Assimakopoulou, M}, title = {Angiotensin‑converting enzyme 2 expression in human tumors: Implications for prognosis and therapy (Review).}, journal = {Oncology reports}, volume = {54}, number = {3}, pages = {}, pmid = {40576111}, issn = {1791-2431}, mesh = {Humans ; *Neoplasms/genetics/therapy/pathology/enzymology/drug therapy ; *Angiotensin-Converting Enzyme 2/metabolism/genetics ; Prognosis ; COVID-19/virology/complications ; SARS-CoV-2 ; Gene Expression Regulation, Neoplastic ; Biomarkers, Tumor/metabolism/genetics ; }, abstract = {Angiotensin‑converting enzyme 2 (ACE2) is one of the components of the renin‑angiotensin system. The differential expression of ACE2 is associated with carcinogenesis. ACE2 expression is altered in certain types of tumor following severe acute respiratory syndrome coronavirus 2 infection. The present review aimed to summarize the role of ACE2 expression in the pathogenesis of tumors of the central nervous and endocrine system, respiratory tract, breast, gastrointestinal tract, genitourinary system, skin and bone, as well as hematological malignancies. ACE2 should be further evaluated in the pathogenesis of various types of human tumor to determine its diagnostic and prognostic value. Additionally, the present review summarizes the potential of ACE2 as a novel therapeutic target for cancer. However, the role of ACE2 expression as a novel chemotherapeutic tool for various human malignancies remains to be fully elucidated.}, }
@article {pmid40575972, year = {2025}, author = {Zhu, T and Li, X and Gao, S and Cui, R and Wang, J and Deng, Q}, title = {Successful salvage therapy of ruxolitinib on interstitial pneumonia after long COVID or post-COVID-19 syndrome with follicular lymphoma: two case reports and literature review.}, journal = {Chinese clinical oncology}, volume = {14}, number = {3}, pages = {35}, doi = {10.21037/cco-24-106}, pmid = {40575972}, issn = {2304-3873}, mesh = {Humans ; Nitriles ; *Pyrazoles/therapeutic use ; *COVID-19/complications ; Pyrimidines ; *Lymphoma, Follicular/complications/drug therapy ; *Salvage Therapy/methods ; Male ; SARS-CoV-2 ; Middle Aged ; Female ; *Lung Diseases, Interstitial/drug therapy/etiology ; COVID-19 Drug Treatment ; Aged ; Methylprednisolone/therapeutic use ; }, abstract = {BACKGROUND: Immunocompromised patients with B lymphocyte deficiency and hypogammaglobulinemia after anti-CD19 chimeric antigen receptor (CAR) T cell therapy for relapsed/refractory follicular lymphoma (FL) are at high risk of severe coronavirus disease 2019 (COVID-19) infection.<br><br>CASE DESCRIPTION: In our study, two patients with refractory FL had persistent COVID-19 infection after their anti-CD19 CAR T cell therapy. The patients were diagnosed with post-COVID-19 syndrome or COVID-19 with interstitial inflammation and persistent hypoxemia. The patients received molnupiravir and Paxlovid, along with methylprednisolone therapy when their interleukin (IL)-6 levels were high. No response was observed in interstitial inflammation, persistent hypoxemia, or persistent positive expression of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, the level of IL-6 decreased after these therapies. These two patients subsequently received low-dose ruxolitinib (5 mg, twice daily) as salvage therapy in combination with a gradually reduced dosage of methylprednisolone. After 1-2 months of ruxolitinib therapy, persistent hypoxemia was relieved, and interstitial inflammation was significantly absorbed. At the same time, the SARS-CoV-2 detection was found to be negative.<br><br>CONCLUSIONS: Ruxolitinib might be a safe and effective alternative salvage therapy for patients with COVID-19 having interstitial inflammation and persistent hypoxemia without high cytokine levels and no response to corticosteroids.}, }
@article {pmid40575740, year = {2025}, author = {Bahrampour Juybari, K and Shamsi Meymandi, M and Bashiri, H}, title = {Effects of colchicine, interferon β, IVIG, tocilizumab and corticosteroids on COVID-19 patient survival from all presently available published clinical trials: A narrative review.}, journal = {Caspian journal of internal medicine}, volume = {16}, number = {2}, pages = {198-214}, pmid = {40575740}, issn = {2008-6164}, abstract = {One of the deadliest diseases in the world, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing global pandemic known as COVID-19. COVID-19 symptoms range from undetectable to deadly, hyper-inflammatory response and the overproduction of pro-inflammatory cytokines or hypercytokinemia are key factors in the pathophysiology of severe COVID-19. However, no specific and effective treatment was available, anti-inflammatory drugs have been vastly used for treating patients. The goal of this narrative literature review (2020-2022) was to elucidate the connection between anti-inflammatory medications and COVID-19 outcomes, such as safety and survival rate. Overall, these studies are consistent in presenting that anti-inflammatory drug can be advised to target the host immune response in patients and have been beneficial in reducing the mortality rate. This is revealed in current recommendations from prominent global public health authorities, which support anti-inflammatory drug use for a decrease of cytokine storm during COVID-19.}, }
@article {pmid40575645, year = {2025}, author = {Sanyaolu, A and Okorie, C and Marinkovic, A and Prakash, S and Balendra, V and Lehachi, A and Abbasi, AF and Haider, N and Abioye, A and Orish, VN and Antonio, A and Badaru, O and Pandit, R and Izurieta, R}, title = {COVID-19 management in patients with comorbid conditions.}, journal = {World journal of virology}, volume = {14}, number = {2}, pages = {102674}, pmid = {40575645}, issn = {2220-3249}, abstract = {The novel coronavirus disease 2019 (COVID-19) causes serious respiratory illness and related disorders. Vulnerable populations, including those with chronic obstructive pulmonary disease, heart disease, diabetes, chronic kidney disease, obesity, and the elderly, face an increased risk of severe complications. As the pandemic evolves, various diagnostic techniques are available to detect severe acute respiratory distress syndrome (SARS-CoV-2), including clinical presentation, rapid antigen/antibody testing, molecular testing, supplemental laboratory analysis, and imaging. Based on peer-reviewed data, treatment options include convalescent plasma transfusion, corticosteroids, antivirals, and immunomodulatory medications. Convalescent plasma therapy, historically used in outbreaks like Middle East respiratory syndrome, Ebola, and SARS, is suggested by the World Health Organization for critically ill COVID-19 patients when vaccines or antiviral drugs are unavailable. Neutralizing antibodies in convalescent plasma help control viral load and improve patient outcomes, especially when administered early, though effectiveness varies. The United States Food and Drug Administration has authorized its emergency use for severe COVID-19 cases, but potential risks such as transfusion reactions and transfusion-related acute lung injury require further investigation to establish definitive efficacy. Antiviral agents like Remdesivir, an adenosine nucleotide analog, inhibit viral RNA polymerase and have shown efficacy in reducing COVID-19 severity, leading to its emergency use authorization for hospitalized patients. Other antivirals like ritonavir, lopinavir, and umifenovir disrupt viral replication and entry, but their effectiveness against SARS-CoV-2 remains under investigation. Dexamethasone, a corticosteroid, has been used in critically ill COVID-19 patients to reduce inflammation and prevent respiratory failure, as shown in the RECOVERY trial. Other immunosuppressants like ruxolitinib, baricitinib, and colchicine help modulate the immune response, reducing cytokine storms and inflammation-related complications. However, corticosteroids carry risks such as hyperglycemia, immunosuppression, and delayed viral clearance, requiring careful administration. Systematic reviews of clinical studies revealed that hydroxychloroquine with or without azithromycin did not decrease viral load nor reduce the severity of symptoms, but increased mortality among acutely hospitalized patients. There was no improvement in patients' clinical conditions after 15 days compared to standard treatment. The United States Food and Drug Administration has revoked the authorization for the use of hydroxychloroquine in COVID-19 patients due to the null benefit-risk balance. Monoclonal antibodies like itolizumab, gimsilumab, sarilumab, and tocilizumab are being studied for their ability to reduce the severe inflammatory response in COVID-19 patients, particularly cytokine release syndrome and acute respiratory distress syndrome. These antibodies target specific immune pathways to decrease pro-inflammatory cytokines, with some showing promising results in clinical trials, though their use remains under investigation. The Clustered Regularly Interspaced Short Palindromic Repeats/Cas13 family of enzymes, sequenced from many COVID-19-positive patients, can potentially inhibit SARS-CoV-2 replication, cleave the RNA genome, and aid in the amplification of the genome assay. Cas13 can also target emerging pathogens via an adeno-associated virus vector when delivered to the infected lungs. In addition to pharmacological agents, vaccines effectively prevent symptomatic infection, reduce hospitalizations, minimize mortality rates, and ultimately reduce the severity of the disease. This paper aims to explore the management of patients with underlying conditions who present with COVID-19 to lessen the burden on healthcare systems.}, }
@article {pmid40575145, year = {2025}, author = {Kammer, RL and Federici, R and Gormley, S}, title = {Topical Review: Clinical, Physiological, and Functional Benefits of Home-based Telerehabilitation with Occupational Therapists for Low Vision.}, journal = {International journal of telerehabilitation}, volume = {17}, number = {1}, pages = {6703}, pmid = {40575145}, issn = {1945-2020}, abstract = {For patients with low vision, rehabilitation enables the performance of daily activities and the acquisition of skills while enhancing quality of life, despite vision loss. Access to comprehensive low vision rehabilitation services, however, is often limited. The rise of telehealth during the COVID-19 pandemic has facilitated innovative delivery of healthcare, including telerehabilitation for low vision. This literature review was undertaken to evaluate the current evidence regarding telerehabilitation conducted by occupational therapists for patients with low vision. In this review, studies investigating the effects of new programs largely found significant improvements in outcomes. Results of a multicenter, randomized controlled trial found that reading ability significantly improved and results did not differ between therapies conducted through telerehabilitation or in-office. Additionally, studies surveying providers and patients regarding their sentiments about telehealth found that comfort level and overall satisfaction were similar between in-office visits and telerehabilitation.}, }
@article {pmid40575096, year = {2025}, author = {Kalulu, P and Fisher, A and Whitter, G and Sener, I and Doering, M and Carter, DB and Gabel, M and Ding, J and Esposito, M and McMurtry, CL and Sopory, P and Huffman, MD}, title = {Trust, trust repair, and public health: a scoping review.}, journal = {Frontiers in public health}, volume = {13}, number = {}, pages = {1560089}, pmid = {40575096}, issn = {2296-2565}, mesh = {*Trust/psychology ; Humans ; *Public Health ; *COVID-19/epidemiology ; }, abstract = {OBJECTIVE: This study investigates the scope of evidence on trust, trust repair, and public health.<br><br>METHODS: We identified quantitative studies that evaluated the relationship between trust or trust repair and public health from January 1990 to May 2023. Results were stratified evaluating trust as an exposure or outcome and reporting on trust repair. Data are reported on spatiotemporal trends in publications, level of trust (institutional trust, generalized trust, and interpersonal trust), types of trust measures used, objects and determinants of trust, and associations between trust and public health behaviors.<br><br>RESULTS: Among 194 included studies, most (86%, 166/194) were published after the COVID-19 pandemic and in high-income countries. Among 40 reports that evaluated trust as an outcome, most (52%) evaluated trust in government. Socioeconomic factors (n&#x202f;=&#x202f;18), perceived government performance (n&#x202f;=&#x202f;14), and media/information (n&#x202f;=&#x202f;8) were the most common determinants overall and for institutional trust. Three reports focused on trust repair (n&#x202f;=&#x202f;2) or maintenance (n&#x202f;=&#x202f;1).<br><br>CONCLUSION: This review provides a roadmap for future research on evaluating and improving trust and public health.}, }
@article {pmid40574520, year = {2025}, author = {Clark, N and Bright, R and Vasilev, K and Heimann, K and Mangoni, AA}, title = {Potential therapeutic effects of zinc and copper chlorophyllins in viral respiratory infections: recent developments and future directions.}, journal = {Critical reviews in food science and nutrition}, volume = {}, number = {}, pages = {1-22}, doi = {10.1080/10408398.2025.2524471}, pmid = {40574520}, issn = {1549-7852}, abstract = {Zinc and copper are essential trace elements that regulate immunity and inflammation, with antiviral effects that may help combat respiratory viruses like SARS-CoV-2, the virus responsible for COVID-19. These effects include reducing cytokine storms and acute respiratory distress syndrome (ARDS). However, zinc and copper uptake is limited by homeostasis mechanisms, reducing their effectiveness. Sodium copper chlorophyllin (SCC) and sodium zinc chlorophyllin (SZC), nontoxic chlorophyll derivatives, may overcome these limitations by delivering higher intracellular levels of these metals. Evidence suggests SCC and SZC exhibit antiviral activity against SARS-CoV-2 and other respiratory viruses by inhibiting viral entry, replication, and release from infected cells. Animal studies show that SCC can lower viral loads and reduce ARDS-like symptoms. Additionally, SCC and SZC may suppress proinflammatory cytokines, potentially preventing or reducing the severity of cytokine storms. This review highlights the antiviral and anti-inflammatory effects of zinc and copper, explores the therapeutic potential of SCC and SZC in viral respiratory infections, and discusses future research directions to optimize these treatments.}, }
@article {pmid40574110, year = {2025}, author = {Song, J and Su, D and Wu, H and Guo, J}, title = {Implications of Anaphylaxis Following mRNA-LNP Vaccines: It Is Urgent to Eliminate PEG and Find Alternatives.}, journal = {Pharmaceutics}, volume = {17}, number = {6}, pages = {}, pmid = {40574110}, issn = {1999-4923}, abstract = {The mRNA vaccine has protected humans from the Coronavirus disease 2019 (COVID-19) and has taken the lead in reversing the epidemic efficiently. However, the Centre of Disease Control (CDC) reported and raised the alarm of allergic or acute inflammatory adverse reactions after vaccination with mRNA-LNP vaccines. Meanwhile, the US Food and Drug Administration (FDA) has added four black-box warnings in the instructions for mRNA-LNP vaccines. Numerous studies have proven that the observance of side effects after vaccination is indeed positively correlated to the level of anti-PEG antibodies (IgM or IgG), which are enhanced by PEGylated preparations like LNP vaccine and environmental exposure. After literature research and review in the past two decades, it was found that the many clinical trial failures (BIND-014, RB006 fell in phase II) of PEG modified delivery system or PEGylated drug were related to the high expression of anti-PEG IgM and IgG. In the background of shooting multiple mRNA-LNP vaccines in billions of people around the world in the past three years, the level of anti-PEG antibodies in the population may have significantly increased, which brings potential risks for PEG-modified drug development and clinical safety. This review summarizes the experience of using mRNA-LNP vaccines from the mechanism of the anti-PEG antibodies generation, detection methods, clinical failure cases of PEG-containing products, harm analysis of abuse of PEGylation, and alternatives. In light of the increasing prevalence of anti-PEG antibodies in the population and the need to avoid secondary injuries, this review article holds greater significance by offering insights for drug developers. It suggests avoiding the use of PEG excipients when designing PEGylated drugs or PEG-modified nano-formulations and provides references for strategies such as utilizing PEG-free or alternative excipients.}, }
@article {pmid40573981, year = {2025}, author = {Petito, E and Gresele, P}, title = {VITT Pathophysiology: An Update.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573981}, issn = {2076-393X}, abstract = {Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare thrombotic disorder first identified in 2021 as a catastrophic syndrome associated with anti-SARS-CoV-2 adenoviral vector (AdV)-vaccine administration. It is characterized by the presence of oligo- or monoclonal anti-PF4 antibodies able to induce in vitro platelet activation in the presence of PF4. In addition to this immune-based pathomechanism, random splicing events of the Adv-vector DNA encoding for SARS-CoV-2 spike protein resulting in the secretion of soluble spike variants have been postulated as a possible pathophysiological mechanism. More recently, some novel clinical-pathological anti-PF4-associated entities also characterized by thrombosis, thrombocytopenia, and VITT-like antibodies but independent from heparin or AdV-vaccine administration have been identified. To date, these VITT-like disorders have been reported following the administration of vaccines different from anti-SARS-CoV-2 AdV-vaccines, like human papillomavirus (HPV) and mRNA-based COVID-19 vaccines, following a bacterial or viral respiratory infection, and in patients with a monoclonal gammopathy of undetermined significance. The purpose of this review is to provide an update on the knowledge on VITT pathogenesis, focusing on recent findings on anti-PF4 antibodies, on a possible genetic predisposition to VITT, on VITT-antibody intracellular activated pathways, on lipid metabolism alterations, and on new VITT-like disorders.}, }
@article {pmid40573968, year = {2025}, author = {Rezahosseini, O and Bazargan, A and Eiberg, MF and Korsgaard, AP and Niyati, R and Ekenberg, C and Nielsen, LN and Harboe, ZB}, title = {Safety and Immunogenicity of Co-Administration of Herpes Zoster Vaccines with Other Vaccines in Adults: A Systematic Review and Meta-Analysis.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573968}, issn = {2076-393X}, abstract = {Introduction: Herpes zoster (HZ), or shingles, is a vaccine-preventable disease with two approved vaccines: the live-attenuated vaccine (LZV) and the adjuvanted recombinant zoster vaccine (RZV). Evidence on the immunogenicity and adverse events (AEs) following co-administration with other vaccines in adults is limited. This systematic review and meta-analysis aims to evaluate the immunogenicity and safety of HZ vaccines when co-administered with other vaccines. Methods: We followed PRISMA 2020 guidelines and systematically searched multiple databases (January 1950 to February 2024) for studies on HZ vaccination with concomitant vaccines in adults (≥18 years). Observational studies, randomized controlled trials (RCTs), and non-randomized controlled trials were included, excluding reviews, case series, case reports, editorials, and non-English publications. Risk of bias was assessed using Cochrane tools (RoB 2 and ROBINS-I). A meta-analysis compared geometric mean concentration (GMC) ratios and vaccine response rates (VRRs) for RZV, applying the Hartung-Knapp adjustment. For LZV, meta-analysis was not feasible, and results were described narratively. AEs were analyzed using risk ratios and presented in forest plots. Results: Out of 369 search hits, ten RCTs were included. In six RCTs, RZV was co-administered with influenza, COVID-19, pneumococcal vaccines (PCV13, PPSV23), or Tdap. The pooled GMC mean difference was -0.04 (95% CI: -0.10 to 0.02, p = 0.19), and the pooled VRR was 1.00 (95% CI: 0.99 to 1.01, p = 0.59). Local and systemic AEs showed pooled relative risks of 0.99 (95% CI: 0.95 to 1.03, p = 0.73) and 1.01 (95% CI: 0.91 to 1.11, p = 0.90), respectively. LZV co-administration was investigated in four RCTs and was safe; however, co-administration with PPSV23 resulted in reduced immunogenicity. Conclusions: The co-administration of RZV with other vaccines was safe and immunogenic. However, limited evidence suggests that co-administration of LZV with PPSV23 reduced the immunogenicity of LZV through an unknown mechanism. Still, RZV co-administration could enhance vaccine uptake in vulnerable populations.}, }
@article {pmid40573967, year = {2025}, author = {Qiao, R and Li, J and Gong, J and Shao, Y and Yu, J and Chen, Y and Lu, Y and Yang, L and Lin, L and Hu, Z and Wang, P and Zhao, X and Zhang, W}, title = {Evolving SARS-CoV-2 Vaccines: From Current Solutions to Broad-Spectrum Protection.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573967}, issn = {2076-393X}, support = {2023YFC2605400, 2023YFC3404000//National Key Research and Development Program of China/ ; 32300121, 32270142//National Natural Science Foundation of China/ ; 92169212//Major Research Plan of the National Natural Science Foundation of China/ ; 23PJD007//Shanghai Pujiang Programme/ ; 22QA1408800//Shanghai Rising-Star Program/ ; 23410760500//the Program of Science and Technology Cooperation with Hong Kong, Macao and Taiwan/ ; SSIII-202416//Shanghai Sci-Tech Inno Center for Infection &amp; Immunity/ ; SKLGE-2304//Open Research Fund of State Key Laboratory of Genetic Engineering, Fudan University/ ; }, abstract = {The continuous evolution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the emergence of variants of concern (VOCs) underscore the critical role of vaccination in pandemic control. These mutations not only enhance viral infectivity but also facilitate immune evasion and diminish vaccine efficacy, necessitating ongoing surveillance and vaccine adaptation. Current SARS-CoV-2 vaccines, including inactivated, live-attenuated, viral vector, protein subunit, virus-like particle, and nucleic acid vaccines, face challenges due to the immune evasion strategies of emerging variants. Moreover, other sarbecoviruses, such as SARS-CoV-1 and SARS-related coronaviruses (SARSr-CoVs) pose a potential risk for future outbreaks. Thus, developing vaccines capable of countering emerging SARS-CoV-2 variants and providing broad protection against multiple sarbecoviruses is imperative. Several innovative vaccine platforms are being investigated to elicit broad-spectrum neutralizing antibody responses, offering protection against both current SARS-CoV-2 variants and other sarbecoviruses. This review presents an updated overview of the key target antigens and therapeutic strategies employed in current SARS-CoV-2 vaccines. Additionally, we summarize ongoing approaches for the development of vaccines targeting infectious sarbecoviruses.}, }
@article {pmid40573955, year = {2025}, author = {Zhang, E and Shang, S and Xing, Y and Cui, J and Pan, C and Seale, H and Fang, Q}, title = {Mapping Behavioral and Social Drivers of Influenza Vaccine Uptake in Older Adults: A Scoping Review.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573955}, issn = {2076-393X}, support = {RJKH(Y)-2025-015//Ruijin Hospital/ ; }, abstract = {Background/Objectives: Influenza vaccination plays a crucial role in reducing morbidity and mortality among older adults; however, uptake remains suboptimal, particularly in the post-COVID-19 pandemic. In many settings, countries have not recovered their influenza vaccine coverage rates to the same level as pre-COVID. Therefore, this scoping review systematically identified the behavioral and social drivers (BeSD) influencing influenza vaccination among older adults using the BeSD framework. Methods: A systematic search across five databases included quantitative, qualitative, and mixed-methods studies involving individuals aged 60 years and older. Data were charted across four BeSD domains: thinking and feeling, social processes, motivation, and practical issues. Results: Thirty-nine studies from 24 countries were included. Key barriers encompassed safety concerns, misinformation, financial burdens, logistical challenges, and cultural and language barriers. While motivation was positively associated with vaccination intentions, the transition from intention to behavior remains underexplored, and practical issues have received comparatively limited research attention. Conclusions: These findings underscore the need for multifaceted, behaviorally informed interventions and greater inclusion of under-resourced settings to support equitable influenza vaccination strategies for healthy aging.}, }
@article {pmid40573932, year = {2025}, author = {Oloruntimehin, S and Akinyi, F and Paul, M and Ariyo, O}, title = {mRNA Vaccine Technology Beyond COVID-19.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573932}, issn = {2076-393X}, abstract = {BACKGROUND/OBJECTIVES: Since their approval in early 2020, mRNA vaccines have gained significant attention since the COVID-19 pandemic as a potential therapeutic approach to tackle several infectious diseases. This article aims to review the current state of mRNA vaccine technology and its use against other diseases.<br><br>METHODS: To obtain accurate and reliable data, we carefully searched the clinicaltrial.gov and individual companies' websites for current ongoing clinical trials reports. Also, we accessed different NCBI databases for recent articles or reports of clinical trials, innovative design of mRNA vaccines, and reviews.<br><br>RESULTS: Significant progress has been made in the design and improvement of mRNA vaccine technology. Currently, there are hundreds of ongoing clinical trials on mRNA vaccines against different cancer types, infectious diseases, and genetic and rare diseases, which showcase the advancement in this technology and their potential therapeutic advantages over traditional vaccine platforms. Finally, we predict what could be a potential future direction in designing more effective mRNA vaccines, particularly against cancer.<br><br>CONCLUSIONS: The results of many of the ongoing clinical trials have shown significant positive outcomes, with many of the trials already at Phase III. Despite this outlook, however, some have been terminated or withdrawn for several reasons, some of which are not made available. This means that despite the advancement, there is a need for more research and critical evaluation of each innovation to better understand their immunological benefits and long-term effects.}, }
@article {pmid40573919, year = {2025}, author = {Eslami, M and Fadaee Dowlat, B and Yaghmayee, S and Habibian, A and Keshavarzi, S and Oksenych, V and Naderian, R}, title = {Next-Generation Vaccine Platforms: Integrating Synthetic Biology, Nanotechnology, and Systems Immunology for Improved Immunogenicity.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573919}, issn = {2076-393X}, abstract = {The emergence of complex and rapidly evolving pathogens necessitates innovative vaccine platforms that move beyond traditional methods. This review explores the transformative potential of next-generation vaccine technologies, focusing on the combined use of synthetic biology, nanotechnology, and systems immunology. Synthetic biology provides modular tools for designing antigenic components with improved immunogenicity, as seen in mRNA, DNA, and peptide-based platforms featuring codon optimization and self-amplifying constructs. At the same time, nanotechnology enables precise antigen delivery and controlled immune activation through engineered nanoparticles such as lipid-based carriers, virus-like particles, and polymeric systems to improve stability, targeting, and dose efficiency. Systems immunology aids these advancements by analyzing immune responses through multi-omics data and computational modeling, which assists in antigen selection, immune profiling, and adjuvant optimization. This approach enhances both humoral and cellular immunity, solving challenges like antigen presentation, response durability, and vaccine personalization. Case studies on SARS-CoV-2, Epstein-Barr virus, and Mycobacterium tuberculosis highlight the practical application of these platforms. Despite promising progress, challenges include scalability, safety evaluation, and ethical concerns with data-driven vaccine designs. Ongoing interdisciplinary collaboration is crucial to fully develop these technologies for strong, adaptable, globally accessible vaccines. This review emphasizes next-generation vaccines as foundational for future immunoprophylaxis, especially against emerging infectious diseases and cancer immunotherapy.}, }
@article {pmid40573888, year = {2025}, author = {Sanni, A and Ibrahim, N and Tilley, D and Bontha, S and McMorrow, A and Philip, RK}, title = {Maternal Vaccination as an Integral Part of Life-Course Immunization: A Scoping Review of Uptake, Barriers, Facilitators, and Vaccine Hesitancy for Antenatal Vaccination in Ireland.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573888}, issn = {2076-393X}, abstract = {Background: Maternal vaccination is a critical primary preventive approach and an integral part of life-course immunization strategy, influencing the infection-associated morbidity and mortality in pregnant women, foetuses, and young infants. Despite clear guidelines for the administration of vaccines against tetanus, diphtheria, pertussis (Tdap), influenza, and COVID-19 during pregnancy, maternal vaccination rates remain suboptimal in Ireland as per the National Immunisation Office of the Health Service Executive (HSE). Aim: This review explores the prevailing status, uptake factors, and maternal immunization-specific vaccine hesitancy in Ireland. Method: A scoping review was conducted, searching nine electronic databases, including the Irish health research repository Lenus. The search strategy utilised a Population-Concept-Context framework (pregnant women-vaccine uptake/hesitancy-Ireland). Key factors identified and categorised according to the 5A framework: access, affordability, awareness, acceptance, and activation. Results: Searches yielded 2457 articles, and 12 eligible studies were included for review. Influencing factors were identified in each of the 5A dimensions, with the majority relating to acceptance and awareness. Positively associated factors included healthcare provider (HCP) recommendation and knowledge of vaccine safety. Potential antenatal barriers were maternal lack of knowledge of vaccine-preventable illness severity, infection risks, and vaccine safety concerns. A pregnant woman's primary motivation for antenatal immunization was protection of her infant; however, the reluctance of HCPs to prescribe all recommended antenatal vaccines, inadequate immunization-specific discussion during antenatal consultations, and suboptimal knowledge of pregnancy-specific vaccine safety hampered potential positive influences. The Irish national immunization policy was a facilitator of affordability. Activation can be achieved through public health awareness campaigns and interdisciplinary promotion of maternal vaccination uptake. Conclusions: Maternal vaccination uptake in Ireland remains suboptimal, and a coordinated, targeted approach updating HCP recommendations, enhancing maternal awareness, and highlighting vaccine safety in pregnancy would be required to meet the life-course immunization goals recommended by WHO. By adopting a life-course immunization approach for healthy living, with maternal vaccination as the pivotal central point, vaccination programmes could close immunity gaps at various life stages.}, }
@article {pmid40573887, year = {2025}, author = {Sułek, M and Szuster-Ciesielska, A}, title = {The Bioengineering of Insect Cell Lines for Biotherapeutics and Vaccine Production: An Updated Review.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573887}, issn = {2076-393X}, support = {2019/35/B/NZ6/00472//National Science Centre (Poland) under project OPUS/ ; }, abstract = {Insect cell lines are a cornerstone of recombinant protein production, providing a versatile platform for biopharmaceutical and research applications. In the early 20th century, scientists first attempted to culture insect cells in vitro, developing continuous cell lines to produce the first insect cell-derived recombinant protein, IFN-β. Initial successes, along with advancements in the use of insect cells for recombinant protein manufacturing, primarily relied on baculovirus expression vector systems (BEVSs), which enable heterologous gene expression in infected cells. Today, growing attention is focused on baculovirus-free systems based on the transfection of insect cells with plasmid DNA. This approach simplifies the final product purification process and facilitates the development of stable monoclonal cell lines that produce recombinant proteins or protein complexes, particularly virus-like particles (VLPs). Thanks to advancements in genetic engineering and the application of adaptive laboratory evolution (ALE) methods, significant strides have been made in overcoming many limitations associated with insect cell BEVSs, ultimately enhancing the reliability, yield, and quality of the biomanufacturing process. Our manuscript discusses the history of developing insect cell lines, presents various recombinant protein production systems utilizing these cells, and summarizes modifications aimed at improving insect cell lines for recombinant protein biomanufacturing. Finally, we explore their implications in pharmaceutical production, particularly on Nuvaxovid[®]/Covovax, which is the latest approved vaccine developed using insect cell BEVSs for protection against SARS-CoV-2.}, }
@article {pmid40573885, year = {2025}, author = {Wełnicki, M and Mamcarz, A and Kuchar, E and Mitkowski, P and Jaroszewicz, J and Tomasiewicz, K and Gąsior, M and Leszek, P and Kamiński, KA and Wysocki, J}, title = {The Impact of COVID-19 and the Practical Importance of Vaccinations and Nirmatrelvir/Ritonavir for Patients with Cardiovascular Disease.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573885}, issn = {2076-393X}, abstract = {The COVID-19 pandemic posed a huge challenge to global health systems. In addition to searching for effective methods of treating and preventing infection with a new pathogen, we could once again observe that severe respiratory infection and its complications can be become a challenging problem for cardiac patients. Empirical observations are fully confirmed by the results of clinical trials. Patients with risk factors and already diagnosed with cardiovascular diseases are particularly exposed to the severe course of COVID-19, including death. That is why we consider it so important to promote vaccinations against COVID-19 as a safe and effective method of preventing serious infections in this special group of patients, in accordance with the updated recommendations of relevant experts. If an infection is detected, depending on its form and the risk of hospitalization, there are also several antiviral treatment strategies. Nirmatrelvir/ritonavir therapy is particularly effective in selected patient groups, but its use requires analysis of the cardiac pharmacotherapy regimen in the context of potentially significant drug interactions.}, }
@article {pmid40573879, year = {2025}, author = {Forchette, LT and Palma, L and Sanchez, C and Gibons, RM and Stephenson-Moe, CA and Behers, BJ}, title = {Cardiopulmonary Effects of COVID-19 Vaccination: A Comprehensive Narrative Review.}, journal = {Vaccines}, volume = {13}, number = {6}, pages = {}, pmid = {40573879}, issn = {2076-393X}, abstract = {Coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines have been associated with numerous side effects since their widespread release to the public. Cardiovascular complications include myocarditis and pericarditis, Takotsubo cardiomyopathy, postural orthostatic tachycardia syndrome (POTS), arrhythmias, sudden cardiac death, and cardiac tamponade. Pulmonary complications are pulmonary embolism (PE), interstitial lung disease (ILD), idiopathic pulmonary fibrosis (IPF), pneumonia, eosinophilic granulomatosis with polyangiitis, pneumonitis, and pulmonary hypertension. Despite these complications, the risk-benefit analysis still strongly favors vaccination, as these events occur more frequently with natural infection and confer a significantly worse prognosis. This study outlines the evidence surrounding each attributed effect, the clinical course including diagnosis and management, and the proposed pathophysiology. To our knowledge, this is the most comprehensive review of the cardiopulmonary effects of COVID-19 vaccination to date.}, }
@article {pmid40573609, year = {2025}, author = {Vicoveanu, D and Gherman, O and Șoldănescu, I and Lavric, A}, title = {Patient Health Record Smart Network Challenges and Trends for a Smarter World.}, journal = {Sensors (Basel, Switzerland)}, volume = {25}, number = {12}, pages = {}, pmid = {40573609}, issn = {1424-8220}, support = {Artificial intelligence-powered personalized health and genomics libraries for the analysis of long-term effects in COVID-19 patients (AI-PHGL-COVID)//Romania's National Recovery and Resilience Plan/ ; }, mesh = {Humans ; *Health Records, Personal ; Artificial Intelligence ; *Electronic Health Records ; Internet of Things ; Computer Security ; Wearable Electronic Devices ; Telemedicine ; }, abstract = {Personal health records (PHRs) are digital repositories that allow individuals to access, manage, and share their health information. By enabling patients to track their health over time and communicate effectively with healthcare providers, personal health records support more personalized care and improve the quality of healthcare. Their integration with emerging technologies, such as the Internet of Things (IoT), artificial intelligence (AI), and blockchain, enhances the utility and security of health data management, facilitating continuous health monitoring, automated decision support, and secure, decentralized data exchange. Despite their potential, PHR systems face significant challenges, including privacy concerns, security issues, and digital accessibility problems. This paper discusses the fundamental concepts, requirements, system architectures, and data sources that underpin modern PHR implementations, highlighting how they enable continuous health monitoring through the integration of wearable sensors; mobile health applications; and IoT-enabled medical devices that collect, process, and transmit data to support proactive care and personalized treatments. The benefits and limitations of PHR systems are also discussed in detail, with a focus on interoperability, adoption drivers, and the role of advanced technologies in supporting the development of secure and scalable health information systems for a smarter world.}, }
@article {pmid40573459, year = {2025}, author = {Negi, V and Miller, AS and Kuhn, RJ}, title = {Advances in Viroporin Function and Structure: A Comparative Analysis of Alphavirus 6K with Well-Characterized Viroporins.}, journal = {Viruses}, volume = {17}, number = {6}, pages = {}, pmid = {40573459}, issn = {1999-4915}, support = {5R01AI095366-10A1/NH/NIH HHS/United States ; U19 AI181960/AI/NIAID NIH HHS/United States ; R01 AI095366/AI/NIAID NIH HHS/United States ; }, mesh = {*Alphavirus/genetics/physiology/metabolism/chemistry ; Humans ; *Viroporin Proteins/chemistry/metabolism/genetics ; SARS-CoV-2 ; Animals ; Virus Release ; Antiviral Agents/pharmacology ; Hepacivirus ; HIV-1 ; Influenza A virus ; }, abstract = {Viruses encode ion channel proteins called viroporins to assist in infection and immune evasion. The alphavirus 6K protein is classified as a member of the viroporin family of proteins. Several studies have characterized the role of 6K in alphavirus budding and infection since its discovery in the late 1970s. In this review, we summarize 6K research and discuss some unanswered questions regarding 6K biology. We highlight the similarities and differences between 6K and viroporins of clinically relevant viruses-influenza A virus, HIV-1, hepatitis C virus, and SARS-CoV-2-and address their importance as therapeutic targets. The sensitivity of these viroporins to common inhibitors and their ability to functionally complement each other underscore their potential as targets for broad-spectrum antiviral therapies.}, }
@article {pmid40573442, year = {2025}, author = {Menis, AA and Gerovasileiou, E and Mantzarlis, K and Manoulakas, E and Deskata, K and Vazgiourakis, V and Makris, D and Dimopoulos, G}, title = {The Effect on Mortality of Bacterial Co-Infections on Critically Ill Patients with Community-Acquired COVID-19 and Influenza Pneumonia: A Systematic Review.}, journal = {Viruses}, volume = {17}, number = {6}, pages = {}, pmid = {40573442}, issn = {1999-4915}, mesh = {Humans ; *Bacterial Infections/mortality ; *Coinfection/mortality/microbiology ; *Community-Acquired Infections/mortality/microbiology ; *COVID-19/mortality/complications ; Critical Illness/mortality ; *Influenza, Human/mortality/complications/microbiology ; *Pneumonia, Viral/mortality ; Retrospective Studies ; SARS-CoV-2 ; }, abstract = {Background: Bacterial co-infections in patients with viral pneumonia might increase mortality. In this study we aimed to evaluate their effect on the mortality of critically ill patients with viral pneumonia. Methods: A systematic search was conducted in PubMed, Web of Science, Scopus and Cochrane from inception until 30 March 2025. We included studies comparing the effect on mortality of bacterial co-infections in critically ill patients with viral pneumonia. The risk of bias was assessed by the Newcastle-Ottawa Scale. Results: From 3643 studies, 10 were included in our study with a total of 2862 COVID-19 patients and 4573 influenza patients. Seven studies were retrospective and three prospective. In total, 359/2862 of the COVID-19 and 904/4573 of the influenza patients were co-infected. Co-infections increased mortality in five out of the six studies evaluating COVID-19 patients and in two out of the eight studies evaluating influenza patients. Conclusions: The majority of the included studies were retrospective, which may limit the accuracy of these results. The exclusion of non-English literature may have led to the omission of relevant data. Based on our results, the impact of bacterial co-infection may be more pronounced in patients with COVID-19 pneumonia admitted to the ICU than in patients with influenza pneumonia.}, }
@article {pmid40573357, year = {2025}, author = {Williams, R and Hales, J and Collier, W and Gould, P}, title = {Coronavirus Replication: Genomes, Subgenomic RNAs, and Defective Viral Genomes.}, journal = {Viruses}, volume = {17}, number = {6}, pages = {}, pmid = {40573357}, issn = {1999-4915}, support = {Internal University Grant (COVID-19 Studentship)//Coventry University/ ; Employer of some of the authors//OVO Biomanufacturing/ ; }, mesh = {*Virus Replication ; *Genome, Viral ; *RNA, Viral/genetics ; Humans ; *Coronavirus/genetics/physiology ; SARS-CoV-2/genetics/physiology ; *Defective Viruses/genetics/physiology ; COVID-19/virology ; Animals ; }, abstract = {With the emergence of the SARS-CoV-2 pandemic the process of coronavirus replication has been under increasing scrutiny. During the replication of their genomic RNA, coronaviruses produce a range of other RNAs in addition to the negative-sense replicative intermediates of the genome, which includes a set of subgenomic RNAs. These subgenomic RNAs are nested within the sequence of the complete genome and can be both replicated further and act as templates for protein production. Alongside these functional products of discontinuous replication, coronaviruses produce defective viral genomes that can potentially impact both the virus and infected host cells. These interactions can arise from the ability of these defective viral genomes to impact the production of new infectious virions, through either competition with the wild-type genome for replication or by stimulating an antiviral response. Examining the behaviour of defective viral genomes can also help to elucidate the functional elements of the genome involved in the processes of replication and packaging. This review covers the process of intracellular replication by coronaviruses describing the mechanisms by which the different RNA species are produced. Of particular focus are factors involved in discontinuous replication that produces defective viral genomes, and the behaviour of coronavirus defective viral genomes.}, }
@article {pmid40573356, year = {2025}, author = {Hellen, CUT}, title = {Viral Strategies and Cellular Countermeasures That Regulate mRNA Access to the Translation Apparatus.}, journal = {Viruses}, volume = {17}, number = {6}, pages = {}, pmid = {40573356}, issn = {1999-4915}, support = {R01 GM097014/GM/NIGMS NIH HHS/United States ; R21 AI166944/AI/NIAID NIH HHS/United States ; R21 AI188505/AI/NIAID NIH HHS/United States ; }, mesh = {*Protein Biosynthesis ; *RNA, Messenger/metabolism/genetics ; Humans ; *RNA, Viral/genetics/metabolism ; *Host-Pathogen Interactions ; *Viruses/genetics ; Animals ; Ribosomes/metabolism ; *Virus Diseases/virology ; }, abstract = {The papers introduced in the Commentary present new insights and review aspects of current knowledge concerning the competition between viruses and their hosts for the cellular translation apparatus. Viruses depend on this apparatus and utilize diverse mechanisms to usurp it for the translation of viral mRNAs and to suppress synthesis of cellular proteins. Virus-induced modification of translation factors, selective abrogation of mRNA binding to ribosomes and degradation of cellular mRNAs all impair elements of the innate immune response, thereby undermining host defenses against infection. Various cellular mechanisms prevent translation of viral mRNAs, by modifying components of the translation apparatus to effect a generalized shut-off of translation or by binding of host proteins to viral mRNAs to induce their degradation or to prevent their engagement with the translation apparatus. Viruses have in turn evolved countermeasures to evade these defenses, for example by encoding proteins that impair the activity of host factors or via alterations in the sequence and structure of viral mRNAs. Such changes enable viral mRNAs to avoid recognition by host factors or to support translation initiation by specialized mechanisms that involve only a subset of the factors that are required by cellular mRNAs.}, }
@article {pmid40573183, year = {2025}, author = {Chronopoulou, S and Tsochantaridis, I}, title = {Interferon Lambda: The Next Frontier in Antiviral Therapy?.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {18}, number = {6}, pages = {}, pmid = {40573183}, issn = {1424-8247}, abstract = {Type III interferons (IFN-λ) are the most recently identified members of the interferon family, distantly related to type I interferons and members of the interleukin-10 (IL-10). Unlike type I interferons, which have broadly distributed cellular receptors, IFN-λ signals through a heterodimeric receptor complex with primary expression on epithelial cells. This restricted receptor distribution makes IFN-λ a favorable candidate for therapeutic and antiviral applications with reduced side effects. In this review, we describe the molecular structure, signaling mechanisms, and the role of IFN-λ in the innate immunity of epithelial tissue, which are its primary sites of action. Moreover, this review will summarize and critically examine the antiviral potential of IFN-λ based on all published clinical trials conducted for the treatment of COVID-19, and hepatitis B, C and D virus. Furthermore, this review suggests IFN-λ as a promising therapeutic recombinant protein, with special emphasis on its potential for production using alternative expression and advanced drug delivery systems. To emphasize its potential as a therapeutic intervention, the design and engineering of recombinant IFN-λ will be presented, with a focus on its lower side-effect profile compared to Type I interferons.}, }
@article {pmid40572764, year = {2025}, author = {Sokou, R and Lianou, A and Lampridou, M and Panagiotounakou, P and Kafalidis, G and Paliatsiou, S and Volaki, P and Tsantes, AG and Boutsikou, T and Iliodromiti, Z and Iacovidou, N}, title = {Neonates at Risk: Understanding the Impact of High-Risk Pregnancies on Neonatal Health.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {6}, pages = {}, pmid = {40572764}, issn = {1648-9144}, mesh = {Humans ; Female ; Pregnancy ; Infant, Newborn ; *Pregnancy, High-Risk/physiology ; *Infant Health/standards ; Risk Factors ; Premature Birth/epidemiology ; }, abstract = {High-risk pregnancies (HRPs) constitute a significant global health issue due to their strong association with increased maternal and neonatal morbidity and mortality. Although pregnancy is generally characterized by positive expectations, the presence of maternal comorbidities, gestational complications, or adverse socioeconomic and environmental conditions can markedly elevate the probability of unfavorable outcomes. HRPs contribute disproportionately to complications such as preterm birth, fetal growth restriction, low birth weight, and congenital anomalies, which are key determinants of neonatal mortality and long-term developmental and health challenges. A broad spectrum of risk factors as well as insufficient prenatal care, underscores the complex nature of HRPs. These conditions necessitate a multidisciplinary management approach encompassing early risk identification, continuous monitoring, and individualized interventions. The neonatal prognosis in such contexts is strongly influenced by gestational age at delivery, birth weight, the standard of neonatal care, and the underlying etiological factors driving preterm or complicated deliveries. Preventive strategies including comprehensive prenatal screening, systematic antenatal follow-up, and timely referral to specialized perinatal care centers are essential for reducing the burden of HRPs. Furthermore, addressing social determinants of health-such as low socioeconomic status and limited access to healthcare-is critical for optimizing maternal and neonatal outcomes. This review consolidates current evidence on the epidemiology, etiological factors, and clinical implications of high-risk pregnancies, emphasizing the necessity of an integrative, preventive, and multidisciplinary framework to mitigate adverse neonatal outcomes and improve long-term health trajectories.}, }
@article {pmid40572743, year = {2025}, author = {Maritescu, A and Crisan, AF and Pescaru, CC and Oancea, C and Iacob, D}, title = {The Psychological and Physical Benefits of Progressive Muscle Relaxation in Chronic Respiratory Diseases: A Systematic Review.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {6}, pages = {}, pmid = {40572743}, issn = {1648-9144}, mesh = {Humans ; Anxiety/therapy/etiology ; *Autogenic Training/methods ; Chronic Disease ; *COVID-19/psychology/complications/therapy ; *Cystic Fibrosis/psychology/therapy/complications ; Depression/therapy/etiology ; Dyspnea/therapy ; Fatigue/therapy/etiology ; *Pulmonary Disease, Chronic Obstructive/psychology/therapy/complications ; Sleep Quality ; }, abstract = {Background and Objectives: Chronic respiratory diseases, such as COPD, cystic fibrosis, and post-COVID-19, are frequently accompanied by psychological distress and physical impairment. As a non-pharmacological intervention, progressive muscle relaxation (PMR) may benefit these patients psychologically and physiologically. This systematic review aimed to evaluate the effects of PMR on anxiety, depression, fatigue, sleep quality, dyspnea, and pulmonary function in patients with COPD, CF, and COVID-19. Materials and Methods: Following PRISMA guidelines, a comprehensive search was conducted across PubMed, Scopus, Web of Science, MEDLINE, Cochrane, SpringerLink, and ClinicalTrials.gov. Eligible studies assessed PMR in adult patients with COPD, CF, or COVID-19. Psychological and physical outcomes were extracted, and methodological quality and risk of bias were evaluated using standardized tools. Results: A total of 32 studies were included in the analysis. PMR was consistently associated with reductions in anxiety, depression, fatigue, and sleep-related distress, particularly in patients with COPD and COVID-19. Some also reported improvements in dyspnea and mild pulmonary function tests, but these were more variable. Only one study evaluated PMR in patients with cystic fibrosis, providing the first clinical data for this group. Interventions were predominantly short-term, with significant variation in design, duration, and methodology, and the risk of bias was often moderate or high. Conclusions: PMR is a helpful strategy in treating chronic respiratory diseases, particularly for reducing psychological distress and improving sleep. However, the evidence is limited by methodological variations and lack of long-term follow-up. Rigorous research is needed to support clinical application, particularly in cystic fibrosis.}, }
@article {pmid40572690, year = {2025}, author = {Storari, L and Piai, J and Zitti, M and Raffaele, G and Fiorentino, F and Paciotti, R and Garzonio, F and Ganassin, G and Dunning, J and Rossettini, G and Feller, D and Heick, JD and Mourad, F and Maselli, F}, title = {Standardized Definition of Red Flags in Musculoskeletal Care: A Comprehensive Review of Clinical Practice Guidelines.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {61}, number = {6}, pages = {}, pmid = {40572690}, issn = {1648-9144}, mesh = {Humans ; *COVID-19/epidemiology ; Diagnosis, Differential ; *Musculoskeletal Diseases/diagnosis/therapy ; *Practice Guidelines as Topic/standards ; SARS-CoV-2 ; }, abstract = {Background and Objectives: The aging population and the COVID-19 pandemic have led to a rise in severe conditions, including musculoskeletal (MSK) disorders. Although MSK conditions are often managed in primary care, they may sometimes mask serious illnesses requiring urgent diagnosis. The red flag (RF) concept is essential for identifying signs and symptoms of potentially severe disease. However, RF criteria vary across clinical guidelines and lack consistency. With the growing role of direct access to physiotherapy-bypassing physician referral-physiotherapists must develop strong differential diagnostic skills to identify serious pathologies that mimic MSK disorders. This review aims to systematically map how RFs are defined in MSK clinical practice guidelines (CPGs), supporting the move toward a standardized definition for clinical and research use. Materials and Methods: A comprehensive literature search was conducted in PubMed, Web of Science, Scopus, and Cochrane databases. Included studies were CPGs and systematic reviews (SRs) of CPGs addressing MSK disorders and incorporating the RF concept. Data extraction followed a rigorous process, and RF definitions were synthesized and compared in table format. Results: Out of thirteen-thousand three-hundred and ninety-three articles identified, fourteen met inclusion criteria (seven CPGs and seven SRs of CPGs), spanning both physiotherapy and medical fields. All definitions described RFs as signs or symptoms indicating possible serious pathology requiring further investigation or referral. Some definitions referred broadly to "patterns of signs or symptoms", while others offered more precise criteria. Conclusions: This review highlights the lack of a standardized RF definition in MSK care, leading to inconsistencies in clinical decision-making and diagnosis. To improve patient safety and guide clinicians-especially in direct-access contexts-a unified, internationally recognized definition of RFs is needed in future guidelines.}, }
@article {pmid40572277, year = {2025}, author = {Nichols, JH and Smith, AM and Jonsson, CB}, title = {The Intersection of SARS-CoV-2 and Diabetes.}, journal = {Microorganisms}, volume = {13}, number = {6}, pages = {}, pmid = {40572277}, issn = {2076-2607}, abstract = {The interplay between comorbidities and viral infections is a critical factor that influences disease severity and outcomes. Diabetes Mellitus (DM) is one such comorbidity that significantly elevates the risk of severe viral infection from coronaviruses, namely, SARS-CoV-2. DM is characterized by either a lack of insulin production (type 1 diabetes) or insulin resistance (type 2 diabetes), both of which contribute to a state of hyperglycemia, or high blood sugar. Hyperglycemia significantly promotes chronic inflammation, metabolic dysfunction, and immune dysregulation, which put diabetics at an elevated risk of critical health outcomes. Additionally, diabetes is hypothesized to amplify viral titers during infection by promoting the expression of the viral entry receptor ACE2 and providing a favorable cellular energy environment for viral replication. This review focuses on explaining the mechanisms that link diabetics with more severe COVID-19 disease and exploring some of the mechanisms that contribute to the phenomenon where COVID-19 can promote new-onset diabetes. By highlighting the interconnections between diabetes and COVID-19, this review aims to emphasize the implications that the SARS-CoV-2 outbreak has had on metabolic health.}, }
@article {pmid40572239, year = {2025}, author = {Duan, Q and Ai, T and Ma, Y and Li, R and Jin, H and Chen, X and Zhang, R and Bao, K and Chen, Q}, title = {Research Progress on the Application of Neutralizing Nanobodies in the Prevention and Treatment of Viral Infections.}, journal = {Microorganisms}, volume = {13}, number = {6}, pages = {}, pmid = {40572239}, issn = {2076-2607}, support = {20224BAB216058//Natural Science Foundation of Jiangxi Province/ ; xsq2023101081//Double-Thousand Plan of Jiangxi Province/ ; 32260623//National Natural Science Foundation of China/ ; }, abstract = {Public health crises triggered by viral infections pose severe threats to individual health and disrupt global socioeconomic systems. Against the backdrop of global pandemics caused by highly infectious diseases such as COVID-19 and Ebola virus disease (EVD), the development of innovative prevention and treatment strategies has become a strategic priority in the field of biomedicine. Neutralizing antibodies, as biological agents, are increasingly recognized for their potential in infectious disease control. Among these, nanobodies (Nbs) derived from camelid heavy-chain antibodies exhibit remarkable technical advantages due to their unique structural features. Compared to traditional neutralizing antibodies, nanobodies offer significant cost-effectiveness in production and enable versatile administration routes (e.g., subcutaneous injection, oral delivery, or aerosol inhalation), making them particularly suitable for respiratory infection control and resource-limited settings. Furthermore, engineered modification strategies-including multivalent constructs, multi-epitope recognition designs, and fragment crystallizable (Fc) domain fusion-effectively enhance their neutralizing activity and suppress viral immune escape mechanisms. Breakthroughs have been achieved in combating pathogens such as the Ebola virus and SARS-CoV-2, with mechanisms involving the blockade of virus-host interactions, induction of viral particle disintegration, and enhancement of immune responses. This review comprehensively discusses the structural characteristics, high-throughput screening technologies, and engineering strategies of nanobodies, providing theoretical foundations for the development of novel antiviral therapeutics. These advances hold strategic significance for addressing emerging and re-emerging infectious diseases.}, }
@article {pmid40572093, year = {2025}, author = {Welc, N and Frącz, W and Olejniczak, R and Żaba, R and Kavanagh, K}, title = {Analysis of the Effect of the COVID-19 Pandemic on Syphilis in Susceptible Populations: Men Who Have Sex with Men, People Living with HIV, and Patients with Gestational and Congenital Syphilis-A Narrative Review.}, journal = {Microorganisms}, volume = {13}, number = {6}, pages = {}, pmid = {40572093}, issn = {2076-2607}, abstract = {The COVID-19 pandemic triggered a public health crisis that significantly impacted sexually transmitted infections (STIs), particularly syphilis. However, data on syphilis incidence during the pandemic remains inconsistent globally. Key groups affected include women of reproductive age, pregnant women, individuals living with HIV, and men who have sex with men (MSM). This paper reviews available literature from databases such as PubMed, Scopus, and Google Scholar to analyse the pandemic's influence on congenital and gestational syphilis, focusing on high-risk populations. We discuss the pandemic's impact on the incidence of gestational and congenital syphilis, including changes in screening and treatment protocols. Additionally, we examine alterations in syphilis prevalence and testing among people living with HIV and MSM, including implications observed in blood donors. The findings underscore the consequences of impaired STI diagnostics for public health. We emphasise the need for uninterrupted access to diagnostics and treatment during public health crises. To prevent rising syphilis rates post-pandemic, it is crucial to implement robust education and accessible testing measures.}, }
@article {pmid40571256, year = {2025}, author = {Alford, BS and Hughes, CM and Gilpin, DF and McGrath, JW}, title = {Monitoring antimicrobial resistance in care homes through wastewater surveillance: a scoping review.}, journal = {The Journal of hospital infection}, volume = {164}, number = {}, pages = {8-17}, doi = {10.1016/j.jhin.2025.06.010}, pmid = {40571256}, issn = {1532-2939}, mesh = {Aged ; Humans ; *Anti-Bacterial Agents/pharmacology ; *Bacteria/drug effects/isolation &amp; purification ; COVID-19/epidemiology ; *Drug Resistance, Bacterial ; Homes for the Aged ; *Nursing Homes ; SARS-CoV-2 ; *Wastewater/microbiology ; *Wastewater-Based Epidemiological Monitoring ; }, abstract = {Antimicrobial resistance poses a growing threat, especially in care homes where older residents are particularly vulnerable due to frequent antibiotic use and comorbidities. Following the COVID-19 pandemic, there has been a growing focus on wastewater surveillance for detecting and monitoring pathogens in healthcare settings. This study followed the Joanna Briggs Institute scoping review framework to map the extent of available literature on wastewater-based epidemiological studies addressing antimicrobial resistance in care homes for older adults. Six electronic databases (Medline, Embase, Scopus, Web of Science, ProQuest, and Google Scholar) were searched from date of inception until August 26[th], 2024. The search strategy employed variations of the keywords: 'antimicrobial resistance', 'wastewater-based epidemiology', and 'care homes for older adults'. Studies were screened based on eligibility criteria, with data extracted by one researcher. Another researcher reviewed the charted data and resolved any queries. The search identified 83 studies, from which 11 studies, conducted between 2015 and 2024, were included. The studies used grab or composite sampling, combined with culture-based methods for bacterial identification, antimicrobial susceptibility testing, and molecular techniques such as polymerase chain reaction and whole-genome sequencing. Enterobacterales, including Escherichia coli and Klebsiella spp., were the most frequently detected, with high resistance rates, especially to some penicillins and cephalosporins. Despite the small sample sizes reported in this review, wastewater-based epidemiology shows promise in monitoring antibiotic-resistant bacteria in care home wastewaters, offering insights into trends and genetic diversity, with the potential to inform public health strategies and antibiotic stewardship programmes.}, }
@article {pmid40571116, year = {2025}, author = {Chapman, A and Barouch, DH and Lip, GYH and Pliakas, T and Polverino, E and Sourij, H and Abduljawad, S}, title = {Risk of severe outcomes from COVID-19 in comorbid populations in the Omicron era: A systematic review and meta-analysis.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {158}, number = {}, pages = {107958}, doi = {10.1016/j.ijid.2025.107958}, pmid = {40571116}, issn = {1878-3511}, mesh = {Humans ; *COVID-19/mortality/epidemiology ; Hospitalization/statistics &amp; numerical data ; Comorbidity ; SARS-CoV-2 ; Risk Factors ; Intensive Care Units/statistics &amp; numerical data ; }, abstract = {OBJECTIVES: This is the first meta-analysis assessing mortality and hospitalization risk from COVID-19 in individuals with comorbidities versus those without during the Omicron era.<br><br>METHODS: A systematic search (Embase, MEDLINE, PubMed, Europe PMC, Latin American and Caribbean Health Sciences Literature, Cochrane COVID-19 Study Register, WHO COVID-19 Database) identified studies published between January 2022 and March 2024. Studies included people with at least one of the following comorbidities: cardiovascular/cerebrovascular disease, chronic lung conditions, diabetes, and obesity. Studies were synthesized quantitatively using random-effect models. Evaluated outcomes were risk of death, hospitalization, intensive care unit (ICU) admission, and any combination of these outcomes.<br><br>RESULTS: Of 72 studies, 68 were meta-analyzed. Participant numbers per comorbidity ranged from 328,870 to 13,720,480. Risks of death, hospitalization, and the combined outcome were increased in individuals with cerebrovascular disease, chronic obstructive pulmonary disease, diabetes, respiratory diseases, heart disease, and heart failure (pooled relative risk [RR] range: 1.27 [heart disease, hospitalization; 95% CI: 1.17-1.38] to 1.78 [heart failure, death: 95% CI: 1.46-2.16]). Diabetes and obesity were associated with increased ICU admission risk (RR: 1.20, 95% CI: 1.04-1.38; RR: 1.32, 95% CI: 1.11-1.57, respectively).<br><br>CONCLUSION: During the Omicron era, individuals with comorbidities faced increased risks of severe outcomes from COVID-19.}, }
@article {pmid40571008, year = {2025}, author = {Lu, Y and Qian, C and Huang, Y and Ren, T and Xie, W and Xia, N and Li, S}, title = {Advancing mRNA vaccines: A comprehensive review of design, delivery, and efficacy in infectious diseases.}, journal = {International journal of biological macromolecules}, volume = {319}, number = {Pt 3}, pages = {145501}, doi = {10.1016/j.ijbiomac.2025.145501}, pmid = {40571008}, issn = {1879-0003}, mesh = {Humans ; *COVID-19/prevention &amp; control/immunology ; SARS-CoV-2/immunology ; *mRNA Vaccines/immunology ; *RNA, Messenger/immunology/genetics ; *COVID-19 Vaccines/immunology ; Vaccine Development ; Animals ; *Vaccines, Synthetic/immunology/genetics ; Drug Delivery Systems ; }, abstract = {The COVID-19 pandemic has highlighted the transformative potential of messenger RNA (mRNA) vaccines in biomedicine, thanks to their rapid design, scalable production, and strong immunogenicity. Nonetheless, their widespread adoption remains hindered by challenges related to sequence optimization, delivery efficiency, thermostability, and safety. This review systematically summarizes recent progress in mRNA vaccine development, including advances in molecular engineering, delivery platforms, adjuvant properties, and artificial intelligence (AI)-driven predictive modeling. It covers codon optimization, nucleoside modification, untranslated region (UTR) engineering, and novel structural formats such as self-amplifying and circular mRNAs. The review also compares various delivery systems-including lipid nanoparticles, cationic polymers, and virus-like particles-focusing on their physicochemical characteristics and translational applicability. Particular attention is given to the intrinsic adjuvant properties of mRNA molecules and their delivery vehicles, as well as strategies for incorporating exogenous adjuvants to modulate immune responses. Furthermore, the article provides a succinct overview of key preclinical and clinical advancements in mRNA vaccines targeting major infectious diseases (e.g., HIV, influenza, RSV, rabies) and tumor-associated antigens (e.g., HPV). This review is among the first to highlight breakthroughs in the application of AI for antigen screening, mRNA sequence optimization, lipid component selection, and vaccine stability prediction. Finally, the review addresses current platform limitations and proposes future directions for interdisciplinary collaboration, offering both theoretical insights and practical recommendations for the safe and effective implementation of next-generation mRNA vaccines.}, }
@article {pmid40570137, year = {2025}, author = {Nguyen, TQ and Vlasenko, D and Shetty, AN and Zhao, E and Reid, CM and Clothier, HJ and Buttery, JP}, title = {Systematic review and meta-analysis of respiratory viral triggers for acute myocardial infarction and stroke.}, journal = {Cardiovascular research}, volume = {121}, number = {9}, pages = {1330-1344}, pmid = {40570137}, issn = {1755-3245}, support = {//Australian Government Research Training Program/ ; //Murdoch Children's Research Institute/ ; }, mesh = {Humans ; *Myocardial Infarction/epidemiology/virology/diagnosis ; Risk Factors ; *Stroke/epidemiology/diagnosis/virology ; Risk Assessment ; *Influenza, Human/epidemiology/virology/diagnosis ; *Respiratory Tract Infections/epidemiology/virology/diagnosis ; Male ; Female ; Middle Aged ; Aged ; *Virus Diseases/epidemiology/diagnosis/virology ; }, abstract = {Respiratory viral infections may trigger acute cardiovascular events. However, relative pathogen-specific associations are poorly understood, limiting optimal preventive recommendations. The aim of this study was to systematically review the association between respiratory viruses with two primary outcomes, acute myocardial infarction (AMI) and stroke. We searched MEDLINE, PubMed, Embase, Cochrane, and Web of Science, from database inception to 26 August 2024. Analytical epidemiological studies of respiratory viruses identified by laboratory-confirmatory testing, involving human participants of any age in any country, were eligible for inclusion. Risk of bias was assessed using the Cochrane Collaboration approach. Data from studies of sufficient quality and homogeneity were pooled using a random-effects model. Certainty of the evidence was assessed for each identified viral trigger. Of 11 017 articles identified, we included a total of 48 studies published between 1978 and 2024. All were observational studies, of which 28 were suitable for quantitative synthesis. There was moderate-certainty evidence that influenza triggers AMI (incidence rate ratio, 5.37; 95% CI, 3.48-8.28; I2 = 69.4%). We found high-certainty evidence that influenza triggers stroke-influenza was associated with a 4.7-fold increased risk of stroke within the first 28 days following infection (incidence rate ratio, 4.72; 95% CI, 3.78-5.90; I2 = 0%). SARS-CoV-2 and cytomegalovirus may trigger stroke, while SARS-CoV-2, respiratory syncytial virus, and Coxsackie B were also identified as potential triggers for AMI. In this systematic review and meta-analysis, the findings suggest that common, often vaccine-preventable, respiratory viral infections are associated with an increased risk of acute cardiovascular events.}, }
@article {pmid40568792, year = {2025}, author = {Lenz, C and Song, M and Bandara, S and Kennedy Hendricks, A and Kramer, C and Sufrin, C and Fingerhood, M and Saloner, B}, title = {Implementation of Jail and Prison-Based Medication Treatment for Opioid Use Disorder Programs: A Narrative Synthesis.}, journal = {Medical care research and review : MCRR}, volume = {82}, number = {6}, pages = {439-453}, doi = {10.1177/10775587251345018}, pmid = {40568792}, issn = {1552-6801}, mesh = {Humans ; *Opioid-Related Disorders/drug therapy ; *Opiate Substitution Treatment/methods ; *Prisons/organization &amp; administration ; United States ; COVID-19/epidemiology ; *Jails/organization &amp; administration ; Female ; Pregnancy ; }, abstract = {Provision of medications for opioid use disorder (MOUD) programs in carceral settings is critical to reducing overdose during the high-risk period following release from incarceration. Efforts to expand carceral MOUD programs have increased in recent years. We conducted a narrative review to synthesize evidence on the implementation of MOUD in U.S. carceral facilities. We analyzed 36 studies from 2019 to 2023 using the Exploration, Preparation, Implementation, Sustainment framework. Findings highlight that MOUD in carceral settings requires significant resources, infrastructure, and staffing. MOUD diversion is a common concern, with program responses varying widely. Stigma against MOUD remains a challenge, particularly when treating pregnant people with OUD. Effective coordination between carceral and community stakeholders is critical for MOUD implementation and continuity of treatment postrelease. COVID